My feed
Premium

Please
or
to access all these features

Get advice and support with infant feeding from other users here.

Infant feeding

Advice on expressing - last attempt at keeping up with BF

57 replies

Stefka · 10/11/2007 09:42

After sobbing my way through yet another feed last night I knew I couldn't stand to put him back on my left breast again. So I am going to try and express from that one and alternate a bottle with my less sore side to see if I can get this crack to heal. I am hoping my least sore side will hold up so that I can stand it.

I have a hand pump - it takes ages and I was up half the bloody night with it but I guess that is just what it is going to take. I only seem able to get about 30ml every time - how do I know if that is enough for him?

Aso how can I tell the difference between when he is hungry and just wanting comfort. I had fed him recently and he started crying and I was about to feed him again when he found his thumb and five minutes later he was asleep!

OP posts:
Report
paulaplumpbottom · 10/11/2007 09:45

I'm so sorry you are having such a rough time. I don't have any advice but you can have my sympathy

Report
Bienchen · 10/11/2007 09:48

Stefka, don't know how you feel about dummies but DD would take this happily for comfort and to go to sleep but would not take it if hungry.

Report
ib · 10/11/2007 09:51

Have you tried using a nipple shield? It might be easier than expressing.

Also lansinoh really helped me.

I thin Kellymom says on average you have to express 3 times to make a feed - most women can't pump as much as the baby can get out.

I'm sorry you are having such a bad time, how old is your ds?

Wrt sucking for comfort, I used to offer ds my finger before the breast, if he took it he wasn't hungry (he would suck much, much harder when he was hungry, then spit it out and demand the real thing!

Report
shreksmissus · 10/11/2007 09:56

Message withdrawn

Report
cazboldy · 10/11/2007 09:57

I always found expressing worked best if you are feeding on the other side or at least holding and/or looking at baby.
How old is your lo?
Does feeding in a different position help? such as tucked under your arm, or lying down, instead of tumy to mummy?

Report
ShowOfHands · 10/11/2007 09:59

Well done for trying so hard. I remember how painful it was in the beginning with bleeding, cracked nipples. Are you using Lansinoh or similar? I would also recommend getting some gel impregnated gauze to put in your bra to aid healing (several brands but the most known one begins with a 'J' [forgetful], your pharmacist will know). Other MNers swear by 'silverette' things to put over your nipples. Expensive but I hear very good things about them. I used to put on lots of Lansinoh before and after each feed, air my nipples for a long time after each feed and then put the gel-impregnated gauze in my bra to help healing. Took a couple of days to fix.

Are you seeing a breastfeeding counsellor? Is there a breastfeeding cafe near you? Do you now know that your latch is correct?

Nipple shields can be used for a short time but be aware of the disadvantages before using.

re comfort sucking. My dd used to suck a finger quite happily if she wasn't actually hungry, if she was hungry she would spit it out and demand food.

I find expressing easier after a bath or shower to stimulate the milk to flow. I also have an electric pump which is brilliant.

I wish you lots of luck. After a very painful rocky start I am still exclusively feeding a 26 week old. It did get better once it stopped hurting.

Report
throckenholt · 10/11/2007 09:59

expressing - only do it for 20 mins max - and then leave for at least 2 hours.

Massage before and during helps - and most of all - not stressing about how much you are getting - doing something else at the same time that distracts you helps - eg watching tv, reading a book, surfing the net, mumsnetting - whatever.

Try letting him suck your finger - if he settles then he just wanted to suck rather than hungry.

Report
cazboldy · 10/11/2007 09:59

Oh yes and make sure your nipples are dry before you put them back in your bra while they are sore. If you have no visitors fresh air helps!

Report
Pannacotta · 10/11/2007 10:06

Sorry you are having a hard time.
Have you tried expressing by hand in the bath or shower? I cant get much with a pump but find expressing in the shower (into a cup/glass) much easier.
Also look at www.kellymom.com/ for advice re sore nipples.

Report
juuule · 10/11/2007 13:07

Whenever this happened to me I would put a breast shell inside my bra which would keep everthing away from my nipple. I would also keep it moist with kamillosan or bm.
I never could express more than a few drops so if my breast got really full I would put baby on for just long enough to relieve the pressure. Even the deepest cracks were usually hugely improved or healed within 24-48 hours.
For me expressing was very painful with a pump and left me feeling bruised if I did it by hand.
Just use the uninjured side for the main feeds until the other side has improved enough to start small feeds on that side again.

Report
juuule · 10/11/2007 13:08

I never used a bottle either. Just feed from the less sore side.

Report
laura032004 · 10/11/2007 13:10

I would really recommend the silverettes. They worked absolute wonders for me. Expensive, but worth every penny IMO.

Report
StrawberryMartini · 10/11/2007 13:13

Hi, firstly get a different pump. Your nipples may take a week or so to heal and you will get repetitive strain injury from a hand pump.

I wrote a document on expressing to help other mums as I exclusively expressed for a year. Will cut an paste it here. If you need any more help let me know and I can email you.

Tips for Expressing & Milk Storage

Most of this information has been taken from other websites; some of it is my own opinion.

Pump

There are 4 basic types of pump: manual, single electric, double electric and two-phase electric pumps. Which one you get will depend on your budget and how often you plan to express. I can?t advise on hand pumps as I?ve never used one but they do seem like hard work!

§ Two-phase expression pumps mimic the way a baby sucks at the breast. Quick, light sucks at first to stimulate then slower, deeper pumping rhythm as the milk flows.

§ Single-phase pumps will apply the same pressure and technique throughout. Single electric pumps can be very noisy and obviously you can only express from one pump at a time.

§ Double pumps are very expensive and are best hired (around £30 a month). Pumps can be hired either through local pump hire agents or direct from Medela or Amber. Local pump agents can be contacted through the BF orgs or through Medela/Amber. It?s always worth looking them up because it might work out cheaper and could allow you to try before you buy. It?s only really worth buying one if you are planning to express long term.

Pump Care

It is not necessary to sterilise the pump every time you use it, if you are pumping more than once in 24 hours . In between pumps, the horns can be placed in the fridge without washing (in a bag if you prefer), and washed/sterilised every 24 hours. I stopped sterilising at 6 months but even then I don?t think it was necessary ? bm has anti-bacterial properties and theoretically any equipment doesn?t need any sterilisation, but you may want to for peace of mind.

I would NOT recommend the use of Lansinoh/Vaseline or similar products while pumping as these increase friction. Just a little olive oil rubbed in the horns will make for a less painful experience.

Hand Expression

Some mothers find hand expression to be a more effective way of expressing milk and there are many benefits to it e.g. no special equipment is necessary and the gentle massaging action may be quite relaxing .

Expressing Frequency

If you are breastfeeding frequently as well as expressing, you will not need to pump more than once a day as your nursing will maintain your supply, unless you are expressing at work or need to build a freezer stash. If you are exclusively expressing, you will need to pump every 2-3 hours during the day and at least once at night to maintain supply. After 12 weeks you can reduce this frequency slowly without too much damage to supply.

A good length of time for expressing is 15-20 minutes. It is advisable to continue pumping for 5 minutes after the milk has stopped flowing to trick your body into producing more milk.

Power pumping: in order to increase supply, after the 15 minutes expressing try stopping for 5 minutes then expressing for a further 5-10 minutes. I would often find that I got a second letdown during this second period.

You do not need to have the pump (electric ones) on full suction ? just have enough suction to feel comfortable. Do stop or reduce the pressure if it feels very uncomfortable or painful.

Time for Expressing

You will get most milk in the middle of the night unfortunately, as you are rested and your prolactin levels are at their highest. But practically, most women express first thing in the morning. Try to express at the same time as bf (I never managed this) as you?ll get a quicker letdown.

Milk Storage Guidelines

The UK has different guidelines for storing milk than the US. You can find the UK guidelines here:
www.breastfeedingnetwork.org.uk/pdfs/BFNExpressing&Storing.pdf
and also at the end of this document.

Personally, I have always adhered to the US guidelines which are more relaxed, and these are given at the end. I would say that the older the baby gets, the better his system can cope with milk that has been stored for a long time.

BM loses certain qualities the longer it is stored; therefore ideally it should be used at room temp as soon after pumping as possible. BM can be stored at room temp for up to 10 hours (less in hot weather).

Fridge Storage

It can be stored in a fridge for up to a week. In theory, warm bm should not be added to cooled bm in the fridge ? it should be cooled first ? but I did it on a number of occasions. The milk will separate in the fridge ? this is completely normal. It is also normal for milk to take on different colours depending on what you?ve eaten!

Freezer Storage

If you are planning to freeze your milk, freeze it in milk storage bags (Boots own brand are the cheapest) as soon after pumping as possible ? it can be put in the freezer while it?s still warm. I would not recommend freezing milk in ice-cube trays as it is harder to keep these sterile. Freeze milk in small amounts e.g. 4/5 oz and you will end up wasting less. In a normal freezer with drawers it can be kept for 3-4 months, and in a chest freezer for up to 6 months. Again, these are the US guidelines; I used milk that was older than this and it was fine.

The rule is that if the milk smells ok then it is ok. Your baby will refuse milk if it has gone off. Frozen milk does appear different when thawed ? it usually has a yellowish tinge and can smell more strongly than fresh bm.

Thawing/Warming Milk

Milk from the freezer can be thawed in two ways ? either in the fridge for 24hrs or if you are going to use it straight away ? in a bowl of hot water. Milk thawed in the fridge should be used within 24hrs of being thawed (although I went over this limit when my freezer defrosted by accident and the milk was fine).

BM should not be microwaved as it destroys 30% of the protective immunoproteins (antibodies). It should be warmed in a jug of hot water or in a bottle warmer, or even by holding it under a tap. Some babies will drink it at room temp and this is the best option if you can train your baby to do so! Don?t shake the milk as that breaks up some of the proteins ? just swirl the bottle. Unused bm can be kept for the next feed, preferably in the fridge or at room temperature if your baby will drink it .

How Much to Feed?

According to research, exclusively breastfed babies aged between 1 and 6 months take on average around 25oz a day, (with a typical range being between 19-30oz). Divide that amount by the number of feeds baby would normally take, for a guideline amount of what to leave for each feed . For example they will need 2oz every 2 hours or 3oz every 3 hours. They state that babies need less bm than formula. HOWEVER my son drank FAR more than this! At one stage he was drinking over 40oz a day. I don?t believe that bf babies can overfeed, and I kept offering milk until he left some in the bottle. These sites also suggest slow-flow teats to mimic bf but that didn?t work for me.

Bottles

As with the pump equipment, bottles do not necessarily need sterilising, and it?s up to you whether you do or not. It is not common practise in the US to sterilise equipment used for pumping / feeding of bm; they just wash them well in hot soapy water. I stopped at 6 months.

Mixing BM and Formula

It is fine to mix both bm and formula ? just mix up the formula first before adding to bm so you don?t have to shake the bm. However, it is not recommended to do this as you could easily waste bm as formula needs to be thrown away whereas warmed bm can be kept for the next feed (but not warmed again). I needed to do it to get my son used to the taste of his hypoallergenic formula. Remember if you had used formula, all bottles and teats should be sterilised.

Report
Stefka · 10/11/2007 13:27

Unfortunately I have thrush so I can't use creams etc - got to keep my nipples dry. I have the silverettes but I leak into them and I think the milk is a breeding ground for thrush so am guessing it isn't good for me to use them right now. Maybe someone knows differently though?

Someone leant me an electric pump but I can't get it to work.

I am also guessing that as I have thrush I should only use milk on a day by day basis to stop spreading the infection. Again I am not sure about this though.

Oddly someone sent me a dummy in the post today and even though I never planned to I have givenit to him. He's not feeling great because of the thrush and needs to comfort suck but I don't have time to express if he is at my boob all day.

OP posts:
Report
monkeybird · 10/11/2007 14:47

Hey again Stefka

Did you get any advice from the BF counsellor about whether to deal with the thrush or cracks as first priority?

I would definitely recommend a double electric pump (if you can't express much by hand) - I found it worked quite well. I bought one by mail order but you can often hire them from local NCT groups.

Jack Newman (who has a very useful website at www.drjacknewman.com argues that as the bug that causes thrush (Candida Albicans) is always all around us anyway, we shouldn't worry too much about it once thrush is present - most of us, including babies are colonised by it anyway - it is the overgrowth of it that causes the problem. He argues - but i don't know if this is current advice in the UK - that you can keep milk etc...

My three babies - including the current one - have all used dummies, and though with this one it has compromised the latch a little, it is not so bad it hurts. In your case, I think you need to do whatever you need to do to get you through these tough days - maybe try the dummy and if it isn't working out you can just get rid of it later

Are you taking fluconazole tablets or something else? Does the baby have some treatment also?

If you're using expressed milk just to feed your baby rather than to store for later, you could just express every couple of hours or so and give it to him straight away?

You've managed to get through another day feeding your baby yourself despite the agony so well done. and how many weeks is he now? It's at least a week since I first posted to you so you've done so well even though you thought you couldn't go on.

Once you find a way of getting those nipples healed and the thrush cleared, it WILL get better...

Report
monkeybird · 10/11/2007 14:52

PS on the question of how to tell when he's hungry, your baby will probably develop different cries for different things. Mine for example has a sort of coughing almost indignant cry when he starts of with hunger, then shifts to a wah wah wah wah over and over again... Rooting (opening mouth wide and wiggling head from side to side to find nipple) has never been a good sign of hunger with mine since he also does this when fed up. When he's tired and wants his dummy the cry is much more sad sounding and often he has real tears. He also turns his head away from everyone, into my armpit.

We find loud humming or putting the hoover on helps him soothe when he's tired so you could try this also in order to try and work out what he wants.

Good luck and keep asking for help - there are some very expert people on this board (Tiktok seems to be the most knowledgeable so you could also ask them direct)?

monkeybird

Report
Stefka · 10/11/2007 15:22

My good side is now painful. Honestly can I not just get a break somewhere in all this mess?

He will be three weeks tomorrow. I am just expressing between every feed basically so all I do is feed and express. It's pretty tiring. I may need to rest the other side too but I am not sure I can manage to express both sides. It's hard enough with one.

They told me to keep the nipples dry and get rid of the thrush. I am on those tablets which have taken the edge of the pains in my breast.

OP posts:
Report
moondog · 10/11/2007 17:33

What are you taking for the thrush.
Stefka, have experienced same agony as you. I know how it feels.You need a good whack of fluconazole. Sorted me out in a day or two after weeks of misery.Hang on...

Report
moondog · 10/11/2007 17:36

Breastfeeding Network

Report
throckenholt · 10/11/2007 17:38

you can express both sides in the same session.

Basically do 5 mins on 1 side then switch to the other 5 mins, then back to the first 3 mins, then back to the 2nd 3 mins, then the first side 2 mins, then the other 2 mins, then the first side 1 min, and the 2nd side 1 min - 20 mins in total.

Another thing that might be worth trying is to express at the same time as feeding - the letdown will be stronger because both sides are stimulated at the same time.

Also try and mimic the babies suck - soft and fast to begin with then as the milk starts to flow a bit harder and slower.

Air is supposed to help heal cracks - so lounge in bed with a bear top with the baby - lots of skin time - then express after that - hopefully it will stimulate the flow.

Good luck.

Report
Stefka · 10/11/2007 21:55

Those are the pills I am on - they have helped with that awful burning pain after feeds. The crack on my good side is starting to hurt more during feeds on my good side now. It was better when I had at least one side that was half working! I think I am a feed ahead of him now with milk though which is good.

OP posts:
Report
katiebirdie · 10/11/2007 22:10

Stefka,have you tried ditching the pump and trying hand expressing? When I was bf ds I wouldonly ever get 1/2ml with ANY pump but as son as I bf I would find a well and manange easy 7/8ml ml. Always worth a shot, think just some woman dont "fit" a breast pump well.

Good luck with the breastfeeding,you are a hell of a fighter to keep going through the pain ;

Report

Don’t want to miss threads like this?

Weekly

Sign up to our weekly round up and get all the best threads sent straight to your inbox!

Log in to update your newsletter preferences.

You've subscribed!

katiebirdie · 10/11/2007 22:12

When I say 1/2ml and 7/8 ml - I mean oz! sorry

Report
Stefka · 10/11/2007 22:51

I don't seem able to get the hang of hand expressing. I just end up with it all over my hands and none goes into the tub. I know it is meant to be better than using the pump so I should really try and figure it out.

OP posts:
Report
Stefka · 11/11/2007 10:45

How long do you guys think I can express from that side without messing it up completely and causing more probs for myself? I think it is going to take a while to heal. I really need to rest the other side too as it is getting very sore - almost as bad as the one I a resting and it just can't heal. I don't want to just give him bottles though. I really thought this would all be sorted by now

OP posts:
Report
Please create an account

To comment on this thread you need to create a Mumsnet account.