Mixed feeding formula and EBM

[Smerlin]

Hi there- this is my first post in the parenting rather than pregnancy forum 1 week after giving birth!

Due to various traumas around the birth I have ended up mixed feeding expressed breast milk and formula. Not at all what was planned but it seems to be working for us and is the best I can do at the moment.

I have a few areas of confusion I hope people can clear up though!

1- I am only managing to pump 3x a day at the moment while am recovering and as I also need to look after my baby! Get about 140ml each time but then between times I am leaking which frustrates me as it is a waste! Will my supply reduce so I don't leak so much? It's worse at night - shall I set an alarm to wake up and pump?!

2- how long should I pump for each session? I know frequency is more important and I hope to increase frequency when I am able to but at the moment I pump for half an hr till I have a good amount and the breasts are softened but the milk is still coming out a bit - I lean back and press down on my nipples to stop the flow. Should I keep going longer? Breasts never truly empty though do they.

3- how long can I expect my supply to last before it dries up if I don't manage to get back onto direct breast feeding?

4- I have heard of people exclusive pumping for 6mths. I know they pump more like 8x a day but how do their bodies know to produce more milk as the baby gets bigger? Do pumping sessions have to get longer and longer?!

Thanks for any advice given- I have been in such a tailspin since the birth that any help would be much appreciated.

[tiktok]

Hi, smerlin, welcome to this board :)

Sorry things are not working so well at the moment - if your plan was to fully bf, then it is much too soon to assume this choice is no longer available to you.

Here's some answers (I am an NCT bfc - call our helpline or any of the others to talk about your concerns, and a dialogue may help better than a talkboard):

1. Many women leak at first - it is part of early bf. You can put breast shells into your bra to collect the leakage if you like - it prevents waste :)

1. Pumping is a question of frequency as you say. Best yields happen when you 'switch pump' and watch the response of your breasts rather than the clock. When your squirts become trickles, switch sides, then back again, then back again.....each breast can be pumped twice or more. Most women find something between 20 and 40 mins is about right at this stage.

1. Your supply will last indefinitely if you express/feed frequently and effectively enough. 3 x in 24 hours will not work - you need to be expressing/feeding at least 8 x in 24 hours inc and especially at night. At the moment you have plenty of milk, because this is what happens after the birth, but if you continue only expressing 3 x it will disappear in a short time - individual experience is variable, but within a week or so would be usual

1. You don't need to produce more milk as the baby grows. Breastfed babies after about 3 months old have a stable volume intake - plenty of research on this. Formula fed babies increase their volume a little after this time, but not bf babies. Pumping sessions usually get a little shorter, in fact .

Hope this helps. Seems the main thing you can aim for is to see if you can get your baby bf direct, if there is any possibility of this.

[Smerlin]

Thanks for your quick reply tiktok- haven't decided on direct b/f yet as am still so incapacitated that DH js mostly looking after the baby and we're only just back from hospital so am not yet in the right headspace to start.

Baby was born Weds and my milk came in on Sat//sun- does that mean I have one week from birth or from milk arrival to get up to 8 pumps a day? Do they need to be evenly spaced to get an equal amount out each time or can I do a couple close together even if little comes out?

[tiktok]

Gosh, sounds a really rough start :(

While nothing is as knife-edge as 'one week from [insert time]' otherwise nothing will work, it's important to know that the whole physiology of it is no respecter of your headspace...that's just the way it is. You really have to get going as soon as you can - sorry to speak so directly! - and the longer you leave it, the harder it will be.

While it's true that people get their milk supplies back weeks after a bad start, or even after not starting at all, or after stopping very soon, they end up working very intensively over days and weeks to catch up....and the motivation has to be really sky-high to keep going. Babies don't always co-operate, either.

If you can tap out a message on a laptop/tablet, which presumably you're doing :), with help and support you can breastfeed....your baby can self-attach if you place him/her in a biological nurturing position, and enable him/her to get on that way (for ideas of comfortable positions, see www.biologicalnurturing.com/. At just a few days old, you have your baby's entire spectrum of instincts on your side to help you.

8 expressions a day don't have to be evenly spaced, but you cannot leave hours between expressions - that's what dries the milk up, the spaces between the times the breasts are 'used'. It's not very good expressing 6 times in 12 hours, then having a five hour gap, and then expressing twice more.

Hope this helps!

[littone]

You are doing so well to be doing this. My milk dried up after a haemorrhage when my son was 5 days old, I managed to restart it but took a few weeks and lots of feeding to get it back, I couldn't manage to express so you are doing far better on that front than I have ever been able to. I didnt feed at night for the next 5 nights either as too ill in hospital and my parents looked after him overnight. so i guess i wanted to offer my support, and echo TikTok that it is not too late if you want to kee it up. Good luck on whatever you decide is best for you and your family. Make sure you get plenty of rest and accept all offers of help. Xx

[Smerlin]

Thanks again- sadly while I was in hospital (major haemorrhage was one of my health issues) I had midwives shoving the baby at my breast while she was frantically trying to nurse very aggressively and yet not getting enough milk. I asked for help constantly and everyone said there was no problem with the latch etc despite my pain and the baby's hunger. Cue me left with very torn nipples to add to my health problems which are taking a while to heal (generous applications of Lansinoh are happening). If I decide to go back to direct b/f, it will have to be a very slow process with a lot of support, checking for tongue tie etc etc so pumping is all I can do while maintaining my own mental and physical health.

[Smerlin]

Have done an extra express in bed in between all these messages btw so haven't been wasting time

[tiktok]

Hope things work out for you, smerlin....the tale of rough handling in hospital is not unusual, sadly. When the dust settles, think about feeding this back to the unit. Hope you can find someone who knows what they are doing to support you getting a comfortable attachment.