Expressing breast milk to top up feeds(23 Posts)
Hello, I'm looking for some reassurance and advice. Bit of a rambling post so thanks for reading.
Baby is 8 days old and at her 5 day weigh in had lost 8.5% of her birth weight. (She also had mild jaundice from day 2 but that is better) As per the midwife's advice, I fed her every 2 hours (breastfeeding). On day 7 she had only gained 10g. Apparently the expected weight gain should be 30g per day. So the midwife suggested I express after a feed and give that breast milk to my baby.
Now, she falls asleep and doesn't want to take the bottled breast milk straight after breastfeeding, so there ends up being a gap between the breastfeed and the "top up". Or, it takes me a while to pump the milk (I bought a hand pump as I don't want to get an electric one or rent one unless I know expressing is going to work out)). I have managed to save up small amounts but it takes me 2 or 3 sessions of expressing to get 20-30ml. Baby isn't so keen on the bottle but might get the hang of it.
Of course I want her to gain the weight but she seems content after her feeds albeit they can be frequent (and God, the cluster feeding) and she wees and poos. I also get dizzy after pumping and end up feeling a bit unwell after pumping especially if I have to continue topping up like this. My hands and thumbs are starting to ache from using the pump. Does that make sense- i would almost rather have her feed directly from the breast more frequently. But maybe she isn't getting the good hindmilk this way? And frequent pumping is supposed to encourage better supply even if I'm not expressing much?
I don't know if this post made any sense or if anyone has any advice. I was actually feeling confident until the day 7 weight check as I felt like I had more milk than with my first child. I guess what I'm saying is I can't see myself expressing like this long term. I'm not against the idea of formula but I know my own supply will eventually diminish (actually it went quite quickly with my first baby) and I was really hoping to breastfeed successfully this time but maybe not if it is making me feel this way.
Thanks in advance.
Also, if she is alert, continues to wee and poo, has her naps, takes feeds and has some weight gain, even if slower, is this a cause for concern or is the rate of weight gain everything at this stage? I just want the baby to be healthy.
Are you in the U.K.? Did they advise feeding every hours or at least every two hours? If you feel like you'd rather have your DD at the rear, then I'd do that and feed on demand. Maybe make sure you're offering at least every 2 hours.
8.5% isn't normally too much of a concern, unless there are other factors. They normally are concerned if it's more than 10%. And I've never heard of 30g weight gain a day but I'm no expert! Has she now regained her birth weight and put on 10g or just put on 10g?
And have they checked for tongue tie and checked her latch?
I was told it was absolutely normal for some babies (albeit not many but some!) to not have regained to their birthweight until 2 weeks old.
Do you feel like she's feeding well? Has she been assessed for a tongue tie? That can cause problems with milk transfer so could be feeding for a long time but not actually getting a lot.
What makes you think your supply will go? If feeding on demand there shouldn't be any reason for that to happen (unless any conditions etc!)
When my DD was small I gave a couple of formula top ups of around 30-40ml for a few days as she seemed to not settle and I was too exhausted to pump and she's 4 months now and EBF so if you're finding pumping exhausting there's nothing wrong at all with a bit of formula! Healthy mum and baby are the most important things!
I am also not sure why you're certain your supply will fail - is it down to a medical condition?
Otherwise I would probably just feed as frequently as you can manage and see how she does at the next weigh in.
Also, don't worry about foremilk/hindmilk, it's more complicated than its often described. If you're feeding frequently offering/swapping sides then she'll be getting what she needs.
Just read my first post - at the rear?? At the breast!
Thanks for all the messages.
I am UK based. I was aware of the 10% thing but as she only put on 10g in 2 days they felt she has not gained enough. She has not regained her birth weight yet.
I was advised to feed every 2 hours and I was managing to feed her every 2-3 as she was not always interested at the 2 hour mark! Similarly with the top ups she isn't always interested.
When the midwife suggested I express and use that as a top up, she suggested that I should fed every 3 hours.
What I have been doing is if DD wants a feed then I breastfeed her, even if she only has a five minute feed. I always offer both sides and often she takes a bit from both sides.
I think I am just worried that I won't have a decent supply which is what happened last time. That probably had more to do with the horrendous birth and fourth degree tear and depression that followed though!
She doesn't have a tongue tie thankfully and latch seems good but I can always ask for the midwife to check again when she is here tomorrow.
I'm sure she'll get there! Some babies are just slow to put the weight back on the wet and dirty nappies are great signs! A big thing is to make sure you're also eating and drinking plenty, being hydrated is really important
I had bought a £50 single electric pump from Amazon (it's called Little Martins) and found it so so much easier than a manual pump!
I could use it on one side as she fed on the other and got a lot more, it might be worth a try if you feel like expressing is something you'll continue with! A small price to pay for your sanity
Honestly, try not to put too much pressure on yourself. It sounds like you're doing absolutely everything you can to make breastfeeding work and for your little one to gain weight and with support I'm sure it'll happen! Are there any breastfeeding groups around near you you could get to?
I posted too quickly! With my first, he had jaundice and didn't put on enough weight but also wasn't feeding well in hindsight. By comparison I feel DD feeds better. When I introduced formula for my first child I would breastfeed first then give formula but he was waking frequently at night, my mum would do some bottle feeds (formula) for him and eventually I think he got hardly any breatmilk so the formula took over. But that had to be the case because I don't think I could have done any better at the time.
Are you still being seen by midwife to monitor the weight? My DS lost 8% and it took us 3weeks to get it back. He was slow to gain weight to start with but boy gas he made up for it now. It'll take time for your milk to stabilise and you little one needs to get the hang of feeding. So long as DD is making gains and you have the nappies try not to worry too much.
Yes, she is still visiting. LO did put on more weight so the midwife was happy. She will
come back to weigh on Monday and hopefully LO will be a k to her birth weight. She does wee and poo. She also spent near enough a day and night cluster feeding yesterday (11 days old). I was therefore unable to express milk between feeds as she was pretty much constantly attached to me when I wasn't having a shower/ eating/ going to the loo myself!
If she is feeding frequently though, then I assume my body is getting the message to keep producing milk even if the breasts feel softer when she is cluster feeding?
It's a supply and demand thing, so even during cluster feeding when your breasts feel softer you will keep producing milk. DS1 was slow to regain his birth weight, but he was gaining and came off after each feed content, and had plenty of wet nappies, so he got there in the end.
There's a website called Kellymom which is all about breastfeeding that I found to be an excellent source of information. I find it strange the MW said feed every 3 hours, when bf should be on demand. Maybe she meant don't go more than 3 hours, as I was told this with DS1. I don't get the point of advising too ups- if she's feeding well, had a good latch and no tongue tie she'll get enough and won't want top ups.
Breast feed can be really hard especially in the very early days. Express feeding can be incredibly hard. Both? I think that's madness. To me it sounds like you are following your instincts and you are doing amazing. Just keep doing that.
Yes, it is soft breasts that encourage milk production. "Full" breasts actually give a feedback signal that supply should reduce, as there is milk in your breasts that hasn't been taken if you see what I mean.
The 3 hour thing came from don't leave it longer than 3 hours to feed baby. I think the point of expressing was twofold; firstly to give LO a little more breast milk after she finished at my breast (turns out she falls asleep and isn't interested straight after coming off the breast) because between days 5-7 she only put on 10g and secondly to get me to produce more milk- this I learned from the Kellymom site.
However at the day 10 check she had gained 100g and had only accepted the odd top up from a bottle by still was breastfeeding so the midwife was content.
It doesn't sound like you need to express at the moment as baby is doing what the expressing would achieve. If you did try to express just imagine how full your breasts will be when baby isn't cluster feeding!
Thanks! You've all been very reassuring.
I did find myself expressing this morning (between breadtfeeds) because my breasts have felt fuller and I thought it would a)relieve me and b) continue to give my brain/body the message to keep producing milk. I have frozen some breast milk. Only expressed 20 ml-30ml max at a time though and I haven't as yet been able to face expressing at night since I'm too tired!
Silly question, if I don't express but feed roughly every 3 hours, will I still produce enough milk? Obviously LO might want to feed more frequently but I guess I'm just worried that my supply won't be enough.
It would be very unlikely that feeding at least every 3 hours would reduce your supply, as long as you're allowing your baby to feed as much as they want. Your supply should settle to match your baby. Then every so often your baby will want to feed more often than normal in order to increase your supply to match their needs as they grow.
Thanks. I'm a little clueless. I was advised the first fortnight is the worst but will it be 6 weeks or so before things settle?
I think it can be up to 6- I don't remember it being that long. I would think expressing at this point will unsettle your natural flow. You can't run out of milk but I know it feels that way. When baby needs more he'll suck more and your body responds
Thank you. It does feel slightly different from day to day; I'm grateful for every day I am able to breastfeed but it would be nice to know I can get to a point where I don't have to worry about it.
It'll happen- try not to worry too much, and if it doesn't you know your back up plan but for now in this moment it's working
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