The setting

My pump station (with feline audience). That’s a rented Medela Lactina:

The galactagoges I am currently taking (domperidone, fenugreek, blessed thistle):

My apparata (27mm cone for left breast; SoftFit for right):

Well, cross that off the list, too

Even though it’s been more than four months of pumping, and even though my supply has not increased appreciably in over a month, I’m still trying to solve the problem of my low supply. My accommodating GP tested me for hypothyroid since I had the theory that maybe I had that (it’s common in women with PCOS) and that was messing with my supply. No dice.

I kind of hoped I had it so I could just take (yet another) pill and fix the problem once and for all. But it’s also kind of absurd to get upset about NOT having a malfunctioning thyroid. But at least I know for sure that’s not the issue.

My milk production seems to be topping out at 16ish ounces a day (from 8-10 pumps). I knew it could happen that I have an upper limit (I guess everybody does, theoretically, but since there’s the fact that people with normal endocrine systems seem able to make enough to feed multiples, I was still hoping I could make at least enough for just the one baby, at least eventually).

But I haven’t yet tried EVERYTHING to increase my supply, though I certainly have tried a lot of things (see below). The main thing left that I really ought to try is a PCOS-friendly low-carb diet, except that it should also include lots of oatmeal. And the oatmeal shouldn’t have brown sugar on it. So icky oatmeal, then.

The likelihood is that, as my LC originally opined, I just don’t have enough mammary tissue. In puberty and/or in pregnancy, my breasts just didn’t develop enough, thanks to PCOS, which I’ve had since early puberty. The domperidone has upped my prolactin and the frequent pumping has made the most of my low-storage-capacity breasts; so it’s possible I’m maximizing what I’ve got.

It’s also possible that in addition to PCOS-related problems, I just don’t respond well enough to the pump.

I’m not sure what to do next, besides work my diet. Pumping, though, has invaded all areas of my life (sleep, baby care, leisure time). I was hoping it would stay out of my main pleasure left: food. This thing with the food is related to the timing of my taking the domperidone. You’re supposed to take it 90 minutes after eating for maximum absorption but I don’t eat regularly enough, or with enough cognizance of the time, in order to follow this prescription. But I could try it, certainly. Yet another thing to keep track of.

At any rate, I have the pump for almost 3 more months, and since it’s a pre-paid rental and I hate to waste money, I’ll keep it up. But maybe I will have to give up on trying to increase. I may have reached the end of the road on that.

Things I’ve tried
Item	Results
Frequent pumping (every 1-3 hours during the day; at least once in the middle of the night)	Still doing it, not sure if it makes a difference, at least not anymore, but can’t hurt, right?
Compression and breast massage when pumping	Totally makes a difference. Do it every time I pump.
Fenugreek (3 capsules 3-4x a day)	Trying it for the second time right now, no obvious effect
Blessed thistle (3 capsules 3-4x a day)	Trying it for the first time right now, no obvious effect
Fennel (don’t remember dosage)	Tried it in the beginning, no obvious effect
Goat’s rue (as much as I could stand, never the max dose, 3-4x a day)	No obvious effect, other than the lingering taste of alcoholic bark in my mouth. Ick.
Domperidone (30 mg 3x a day before, now 40 mg 4x a day)	Been on it since week 3; holy hell yes, an effect, but still not a cure-all. Has at least (possibly tripled, hard to tell what the frequent pumping did) doubled my supply.
Metformin (850 mg 2x a day)	Went off this at 20 weeks pregnant, and back on at 1 week post-partum. Hard to tease out effect, but probably has helped. With more time on it does not seem to be keeping on making a difference (now that my supply increase no longer seems to be happening).
Plenty of water	Pumping makes me thirsty, and so I comply; effect unknown
Plenty of sleep	I actually sleep fairly well and have for most of this baby experience (in terms of overall hours of sleep)
Exercise	We take walks, and used to take more walks. Does not seem to be related to milk output.
Things I haven’t really tried (yet)
Eating well	Okay, not good at this. Eat a lot of candy, not a lot of protein. Am planning on trying a low-carb insulin resistance diet. Planning does not mean doing. But it’s one thing I haven’t tried and who knows? Especially with the PCOS it should at least be good for me.
Oatmeal	Haven’t tried this consistently; when I have had oatmeal, no obvious effect. Should try it in larger doses more often.
Skin-to-skin contact with baby	Basically I don’t do this. I find it too depressing because I can’t resist the urge to get baby to try to nurse. Of course, why would she want to nurse if my breasts are unfamiliar to her and don’t produce enough milk? Plus, to add injury to insult, I leak, wasting the little milk I do make.