Possible to switch from mixed to EBF at 9 weeks?

[Yika]

I started mixed breast feeding with my now 9-week-old DD (first child) right from day 3 or 4 because my milk didn't come in. I didn't intend it and always wanted to exclusively breastfeed.

Since then I have been continuously trying to get back to EBF but have struggled with low milk supply and wonder if I should accept that I will have to continue to supplement or if there is anything else I can do.

There is no nipple confusion or problem with latch (at this stage; I think the latch was poor for the first few weeks until I got some advice on how to correct it). The baby will take the breast before or after the bottle, no problem.

But at least once a day she is invariably unsatisfied after breast feeding and I have to supplement with a bottle, usually in the afternoon. I give 1-3 bottles per day, on demand, and the amount varies from as little as 60 to 200 ml a day.

I am now trying to express in the evening so that I can feed the expressed milk for the top up. But I can't express enough to meet the day's needs. By 'power-pumping' for the last week I've managed to increase the yield to as much as 95 ml on the best day.

Problems at the start were (a) anaemia after the birth (b) stress and depression due to relationship break-up at 8 months pregnant and (c) feeding on demand at too infrequent intervals (4-5 hours) until I was advised at 3 weeks that I should be feeding more often, since when I've increased the daytime frequency (but not at night as DD is a good sleeper for which I am very grateful!).

Is there anything else I can do to get my milk supply up or should I just accept that this is probably the way it will be from now on?

If you want to increase supply then you should express immediately after a feed. It doesn't matter if you don't get any milk out, but the stimulation will send the signal to your body that more milk is needed. You would need to do this after pretty much every feed.

The other thing you can do is switch feed, swap sides regularly throughout the feed. You may be doing this but you don't say. What happens if you just keep swapping sides when she seems unsatisfied initially after a feed?

I think you can absolutely get to a position of EBF, but not overnight and not without some effort but I highly recommend it simply because your life will be so much easier! :)

You have done fabulously well so far considering all the problems you had at the start :)

Hi Yika

I had a similar (but more extensive) problem and got back to EBY between weeks 10 and 15 using a supplemental nursing system like this: www.expressyourselfmums.co.uk/details1.asp/ProductID/292/sidMedela-Supplemental-Nursing-System

The good thing is that when you are topping them up they are still on the breast so stimulating your supply.

Where abouts are you Yika? If in London I could lend you mine and show you how to use it.

EBF not EBY whatever that is!

Thanks a lot both. Squiggley - I did use the supplemental nursing system in the hospital - if only I'd known you could buy them (I asked in the hospital but they said they weren't commercially available... perhaps Medela are not available here in Belgium). In any case, it's probably a bit too complicated for my needs in this case given that the baby is actually a good feeder and bottle feeding hasn't so far curbed her motivation to breast feed.

Alibaba - I will start expressing after each feed; how long would I have to do this for would you think? Another question: do I need to sterilise the pump each time I use it? I ask because one of my problems is that since I have no partner to help me I can't devote myself as single-mindedly to feeding as I otherwise might.

I currently try to feed every 2-3 hours throughout the day and even more frequently if the baby seems willing :) In the morning I have ample milk (should I express anyway?); in the afternoons it tends to dry up. I do switch feed and only resort to the bottle if I've been switching back and forth for at least half and hour and the baby is clearly unsatisfied (pulling off the breast, 'fighting' the breast, crying). A feed where the baby seems satisfied takes 15-20 minutes.

Another question on expressing post-feed, again relating to me being on my own and not having anyone to hand the baby to. Normally after a feed (especially in the afternoon when the baby is not so alert) I cuddle and soothe the baby to sleep. Should I feed-cuddle-express or would it be important to express immediately after the baby has come off the breast? in that case I think I may have to work out how to do it while holding the baby in the other arm :)

Many thanks!

I used to express on one side while I fed on the other as I found that easier than trying to express after. I also fed then put baby down and expressed say 10 mins later - that was fine.

I'd also say that the SNS is better than the bottle if you are trying to boost supply - all that expressed milk can go in there and then the baby is actually stimulating your supply when drinking the expressed milk because she is latched on. There's nothing like a latched on baby for stimulating supply - even more effective than expressing.

60ml-200ml isn't all that much though - I'm not an expert but surely it wouldn't take very long for your supply to catch up if you just ditched the bottles?

Yika I am hoping that Tiktok will come along to confirm, but I think that 10 mins or so is sufficient. Yes express anyway in the morning.

It isn't actually necessary to sterilise pumps/bottles or anything that breastmilk is being used with. A wash in hot soapy water is perfectly adequate.

I honestly don't know whether it makes a difference how soon after a feed you express. In your position I would be inclined to cuddle and then express, hopefully if anyone who reads this knows that this would be detrimental then they will say so!

Have you looked at the kellymom.com website? It is a mine of information, there are sections on increasing supply and everything else you can imagine to do with BFing.

Yika: at the BF clinic they were saying your pumping set-up should be good for 6 hours between sterilizing sessions, as breastmilk is good for 6 hours at room temp. They did suggest putting the whole set-up in the fridge for extra protection, however! (Can someone back me up on this? I only overheard this conversation...)

Or you could do what I did, and buy a 2nd set up. (Cost about £15 extra, well worth it for the extra sleep I got!)

Thanks for your replies! I started today but rather haphazardly and will probably continue in the same vein due to the logistics of being a single mum and trying to maintain a social life ... today I had friends over for tea and tomorrow will have others over for lunch! Couldn't be helped - they are visiting from abroad :( . Consequently I ended up giving several bottles today but one was the milk I managed to express this morning after reading your advice last night.

I am thus expressing as often as I can, whenever I have a free moment after or between feeds, for up to 10 minutes. I've only managed 3 times today but I'll keep going as often as I can and see if it helps.

Alibaba - I have read some of the sections on kellymom but will go back and have a more thorough look.

Good to know about the sterilising/cleaning etc. - that simplifies things (and yes I may buy a second set).