feeding frequency vs expressing frequency

[amijee]

I am due to go back to work soon and I am wondering about my supply if I can't express as much as ds feeds. My ds is currently 15 weeks and will be around 19 weeks when I go back.

At the moment, ds feeds approx 2-3 hourly in the day ( with an occasional snack to help him nap)

I will be away from him all day (leaving the house just after 8am) but can express around 11-11.30am and also go home to feed him around 1-2pm. It will be quite hard for me to express after this and I won't be home until 6.30pm.

The questions I have are:

1. If ds feeds twice before I express in the morning, will I be able to match his intake in one expressing session done later in the morning?

1. Is it better to do lots of quick expressings rather than try to get a lot out of one session? (not sure how practical this will be)

1. If I can't keep up with his intake and start mixed feeding with formula - which would be the best feed to give him the formula? I know the obvious answer would be when I am not there but I was wondering about giving his midnight feed as formula so dh could give it and to see if it will make him last thru the night.

1. If I were to give him formula for all the feeds I am not there, what are the chances of milk supply drying up? I really would prefer to do this as it is the least exhausting route and I would happily continue with breast feeding for a longer time ( approx 1 year)

Sorry for the long post! BTW, I am limited to my expressing times at work as I am a GP and see approx 35 patients a day so can't really do it during consultation!!

[sallyrosie]

A few suggestions:

• try spacing his feeds more during the day - he can probably go for longer than 2 hours and it might encourage him to take fewer, bigger feeds (plus you won't be there for a 'snack'.

If you could get him to 2 morning feeds, 1 lunchtime feed, 1 mid afternoon feed and 1 evening feed then you'd only be missing the mid morning and mid afternoon ones

• book one less patient per afternoon and express - with a decent pump it should only take 10mins or so - I have an ameda lactaline which is very good and is a double pump so takes half the time

• start expressing now to build up a supply of spares for emergencies

[amijee]

bump

[amijee]

bump - again!

[FrannyandZucchini]

I don't know anything about expressing so can't help I am afraid. Sally seemed to have some good suggestions and it would have been nice to acknowledge her post before bumping again.

Why don't you ring LLL or the NCT breastfeeding support line if you feel you are not getting the advice you want here?

[auntymandy]

As a GP you should be able to find out the info you need!!
I would start expressing now. mixed feeding is ok and if you are expressing too your supply will stay good. pluss on weekends etc you can just b/f if you want to

[hunkermunker]

How many days are you working?

Start expressing now so you can stockpile some in the freezer. Freeze it in small quantities so it's easier to make feeds up from it and you won't waste as much as if you freeze it in "whole bottle" amounts.

[hunkermunker]

You too busy on your rant thread to answer?

[mamijacacalys]

Amijee- see my post on the other thread re going back to work (re weaning).

Agree with sallyrosie re spacing the feeds a bit if you can.

If you will be feeding him early in the morning, expressing mid-morning, feeding at lunchtime then again in the evening, imo your supply should be fine (though you're bound to feel "full" by the time the evening feed comes around!). With my DS, he was 4.5 months when I went back and I would feed approx 7-8am before work and then at approx 630-7pm at night with no expressing in between (plus 1 or 2 night-time feeds if he woke up). He was on solids by then though (see other post).

Even if you lay off introducing solids until 26 weeks on the dot, if he is 19 weeks when you go back, you will only have to manage the above for 7 weeks. Does he take a bottle of ebm OK? Otherwise you may have problems anyway trying to introduce formula. Neither of mine have had any truck with bottles so used cups (DD currently 4.5 months and started training her with a cup of water at mealtimes - she doesn't actually drink a lot it's just to get her used to it). Neither would take formula either.

I know there are strongly held views on MN on when best to wean, but at the end of the day, you have to do what you think will work best for your particular situation. Personally, I would rather wean a bit early if it means that the bf can continue OK, when ff has not been possible (as with both mine).

Sorry for long post, but HTH.

[lazycow]

Hi amijee

I didn't return to work quite so soon (9 months old) so ds was pretty much on solids by then and I went back PT (I assume you are back full time?).

I really had no opportunity to express at work so I gave a bottle of formula for the day (but ds never took more than 1-2oz of it so I stopped giving it quite soon after that.

If I were you I'd start weaning onto solids as soon as your ds hits 6 monthsso that the period of you needing to express is as short as possible. By 10/11 months he should be able to go the day without anything other than food and drinking (water/juice etc) though you can always leave formula just in case.

In the meantime I would express as much as you can at 11.30am and leave that along with some of those formula cartons (I used Aptamil but tbh I think they are much of a muchness) in case he wants more than you can express. I would also try and feed him at lunch time as often as you can even if it is only a few days a week until he is a bit older.

Also before going back try and build a stock of expressed milk in the freezer now so you have a reserve.

As to your specific questions

1 Don't really know - but I always had trouble expressing much at all, yet many women get masses. I think this depends on the individual mother and is a case of trial and error.

2 See answer to 1

4 If you give formula at all and you want to maintain a supply I'd only give one bottle of formula a day maximum - at least until he is a bit older and established on solids anyway. When he is nearer a year old, you may find that your supply is so established you can pretty much feed whenever it suits you or ds and not much will affect the supply.

4 My preference would be to give the formula for the day feed. This is because it will reduce the amount of expressing but this is really a decision for you.

Finally I think if you do give ALL his day feeds without you as formula at this age (i.e under 6 months) you might risk losing your supply. If you can express at 11/11.30am and also and feed at lunchtime for a few months more (say until he is nearer 9 months old) then your supply should be pretty solid by then and one bottle of formula a day along with bfeeds morning and evening/night and solids will probably be fine.

[mamama]

I was told that in order to maintain your supply you need to express when your ds would usually bf.

Sallyrosie had some excellent suggestions:

• try spacing his feeds now (as they get older they become more efficiant at breastfeeding so get more milk in each session and don;t need to nurse as frequently anyway)

• book one less patient per afternoon and pump then

• use a good pump (I found my manual Avent Isis better than the electric hospital grade Medela one I used)

• start expressing now to build up a supply in the freezer

[amijee]

thank you so much for your very detailed reples. it's been a great help - i am def gonna try spacing out the feeds.

unfortunately, i have been away from home for a long time for personal reasons so my freezer supply is slim. Will work on it when back as well as his feeds...and consider weaning a little earlier.

thanks again x

[jennster]

Hi Amijee. I went back to work when dd was 6 months. I was paranoid about losing my supply as managed to get meningitis a month before I went back and so had to re-establish it...long story. Anyway I pumped with an Ameda Lactaline. Much better than the Avent Isis (I found) because you do 2 breasts at once and got far better let down.

I pumped at 11.00, 14.00 and 17.00 as I too am out of the house long hours 8.00-19.00. I only managed to express enough for 2 feeds and because she would need a 3rd, I'm afraid I gave a small bottle of formula for the last feed. I figured as long as I was pumping the number of times I would have fed, then my supply would be OK. As I work Wed, Thur, Fri, I also have Sat-Tues to feed her to her hearts content.

DD is now 10 months and have dropped down to expressing at 11.00 and 15.00 only. Just recently noticed that the volume I express has massively decreased, but then also just discovered I am pregnant again so that MIGHT have something to do with it.

Hope this helps.

XXX

[mears]

No-one ever mentions hand expressing and it is the quickest way to express IMO with no faffing about with pumps.

When I went back to work I had milk stockpiled in the freezer. I expressed in batches of 2-4 oz whenever I had some spare time. Sometimes I expressed then DD would wake for a feed. That is not a problem as there is always milk there. I also expressed for a SCBU.
If you can express in the morning that should be fine as you will probably get a quite a lot of milk then. If you go home to feed at lunchtime i don't think you will necessarily need to express again in the afternoon. If you are full when you get home after 6pm, you could always feed from one breast and express off the other.
You will probably be amazed how it will all work out. Express extra milk when you are at home at the weekend. For me the secret to success is the stockpiling of milk before you go back to work. If you do that you will not need to give formula or wean early. HTH.

[mears]

hand expressing technique

[jennster]

I've bookmarked that link Mears and am goin to try it again. Know it wasn't meant for me but thanks any way.

[amijee]

interesting - i've never tried hand pumps. Will give it a go. I have a medela dual pump but only use one as I prefer massaging with the other hand to encourage flow.

My intention was to stock pile but unfortunately I've had to be abroad for 2 mths of my maternity leave as my father has just died. I will be home in a week so will have a few weeks to work at it.

Hopefully, it'll all work out!

[WriggleJiggle]

My dd was 6 weeks when I went back to work.

My day went something like this
6am-7am b/f
7.45am leave for work
10.30am express
1.30 express (hand pump worked best for me)
6.30 return home and b/f
Then cluster feeds till 10pm
b/f at 12am

Having along gap in the afternoon was fine (so long as I b/f as soon as I got home)

1. I found that I was expressing as much in 2 sessions as dd was having in 4 sessions of ebm.
   
   
2. People usually say little and often, but I found it more efficient just doing two larger ones. Besides which, as a teacher I was limited to certain times of day.
   
   

1. You will probably be able to keep up with his intake. I found dd just fed more in the evenings and early morning. Because you always work one day out of synch (unless you have stored some up as spares for that 1st day), I had one emergency carton of formula so I didn't have to worry about there not being enough milk. If you store some up first though that won't be a problem.

I'd go for co-sleeping - he'll soon learn to fill up at night rather than in the day.

I think you produce what you use (if you see what I mean), so you could still feed morning and night and your supply would adapt to that routine.

Sorry if long, hope it helps.

[mears]

amijee - my link is to show you how to express milk without using a pump at all, just your hand. It is so much fatser than using a pump once you have mastered the technique.

Sorry to hear about your dad

[amijee]

thanks mears. I noticed that the other day and tried it without much success but will try again. Think it may be a question of getting used to it.