Sharp pain and overall decreased supply

My son was born prematurely at 34 weeks and is now 5 weeks old and 1 day. I started pumping straight away in the hospital while he was transported to the NICU and my supply was great for a while. I also remained rather consistent initially. Nowadays I’m beyond drained to even wake up and most days I pump 3-5 times max… initially I pumped 8 times a day and it became an oversupply and it would absolutely hurt and the NICU didn’t have space for any more and gave me back 2 whole bags of many milk bottles at his discharge. My baby eats about 140mls nowadays and is well over 7lbs.

My supply has decreased as I was producing around 5-7 oz per pump (as I primarily pump and bottle feed) and now my average pump is about 3-5 oz. Some mornings when I am engorged (which is rare now) I will produce up to 9oz. Again… that’s most of the milk for the day.. followed by much smaller feeds.

I noticed I have been sleeping horribly, eating poorly, not enough water, and stressed. I would like to get more sleep but again, me and my husband take care of our son and he does night shift which is already a tremendous help. I eat as much as I can when I can. I’ve lost a ton of weight and although I’m not pre pregnancy weight (thank god) I was 125lbs and I’m 5’8… not healthy for me, but lean muscles. I’m about 20lbs lighter at 140lbs. Again, I’m happy. My core strength is slowly starting to come back although not cleared, I did move recently and helped as I could… again a lot of time consuming things that prevented me from pumping and I couldn’t breastfeed my son.

Because of the infrequent feeds, I’ve had pains here and there and I’ve noticed when they’re simply engorged or my nipples hurt… as of today my left breast (the slacker) has had very sharp shooting pains and I can’t tell if there are any red lumps but I do notice some spots hurt more than others. I can still express and it’s not a substantial difference but there’s always been a difference and sometimes they’re roughly the same.

Due to my financial position, we get as much food as we can but I don’t work anymore and we’re living off of what I’ve saved up as my husband is starting a career and investing in the long run, which is starting to pay off! I’m happy about it. We do have petty arguments here and there and I’m on lamictal since the very end of my pregnancy (days prior, surprisingly). I’m officially on 100mg as of this past week. It’s helped some, however I’ve noticed my brain fog remains and is still quite noticeable and impacts my everyday. I definitely don’t feel the same.

How can I increase my supply, get better quality of sleep, what nutrients can help without buying unnecessary supplements as I take postnatals already and am on a tight budget, and how can I relieve myself of this sharp breast pain and the spots that hurt?

I do not visibly see any clumping coming out. I don’t have a fever. I don’t feel great though. I have used vibration on my breast which I’ve done initially into my journey. Again due to him eating more, my supply needs to increase with his demand. He does sometimes have issues latching but that’s when he’s very upset and hungry. He doesn’t eat much and ends up spitting up a ton too which sucks. Makes me feel defeated.

I’m trying to pump every 2 hours now. Today has been better. I’ve remained rather consistent even despite losing track of time. I do have a reminder set.

Any helpful tips and tricks or advice or suggestions?

The pain is rough. It is occasional though, but isn’t stopping even with the pumping and massage and vibration to break anything up.

I wear size 24mm flanges and have been sized. I’m unsure if 22mm would be better (my nipples are 2 different sizes as both breasts had nipples piercing but in 2023 my slacker got infected and I took both out and it healed poorly and had drainage since. It stopped being an issue when I started pumping), I use a spectra s2 primarily. I did recently get the Zomee Mother Nature wearable pumps… not great and my quantity is quite pathetic with those. I have tried the 21mm insert and I have tried without. Not great. I like the medela hand pump. My nipples hurt and I use lanolin when they do.

I wanted to try the pitcher method too… we are unsure of the best collection methods and freezing and unfreezing a stash.