Support needed to continue to EBF - expressing not enough?

[Sleeplesssister]

My DD is 19 weeks and has been almost exclusively bf (the odd bottle of formula about once a fortnight). It's been a bit of a struggle since she will ill at 5 weeks and was nil by mouth for a week due to an operation, but have worked hard at it and have managed to stick with the bf-ing, which did not come naturally to me. However, i'm now concerned that my body is not making enough in the evening and am beating myself up about introducing formula (wanted to try and make it to 6 months).
For the last couple of months I have expressed last thing at night and given that to her at her 10pm feed. However, I'm worried that demand is now outstripping supply, I'm only able to express 120ml-140ml, and she takes 180ml now (have been using up my stash of frozen milk in the freezer). I really want to continue to do all feeds as bf's but am concerned that she is not getting enough from me from expressing. Does anyone know whether it is true that babies can get about an extra 1oz out of the breast after expressing (i.e. i could give her the expressed milk and then top her up)? Should I introduce a regular bottle of formula last thing at night which I feel guilty about, or is there a way i can somehow manage to up my milk supply? Sorry for the ramble, for various boring reasons have found bfing a bit stressful as have been worried that she is not getting enough - she is a good weight and on 50th centile line but still wakes up once a night for a feed (between 10pm and 7am).

Is there any reason you're not just breastfeeding her for the 10pm feed?

Sorry, not sure if that's a silly question! But if your dd is latchng and feeding fine then she will be much more efficient than a pump, and your breasts will naturally meet the demand. The more she feeds the more milk they produce.

I started giving her a bottle originally because of a friend's experience - her daughter suddenly started refusing a bottle and I wanted to make sure that DD continued to take one to allow me to leave her with DH, but maybe I should just go back to bf-in in the evening, she is now that bit older I suppose and is unlikely to now refuse? other reason was to make sure she took enough, she gets very sleepy at 10pm feed and would fall asleep after 10 mins or so when I bf, and then wake a couple of hours later. I should probably try and chill out a bit, that would help I guess...

Maybe you could breastfeed her then give some expressed milk as a top up after?

How many times do you have to express to get 120-140mls? If it's just the once (both sides) then you definitely don't have to worry about your supply. Conversely if it's more than once, then not a reason to worry, some mothers don't make as much milk for a pump as they do for baby, and it's quite common for mothers to have to pump 2-3 times for a single bottle feed.

Waking up once a night is very normal too, as would waking 2/3/4/.... times a night, some babies sleep thru early and some don't it really isn't a reflection of your supply just the temperament of your baby (and the developmental stage they are at - babies that sleep thru can start waking up with the advent of crawling etc)

I expressed full time for 3 months and always produced less in the evenings - makes sense, you are tired! I wouldn't worry too much about it.

Assuming you are BFing 'normally' most of the time, but if you want to up your supply then 4am always the most productive time to express for me. Used to produce literally twice as much (sometimes 180ml from each breast) than any other time of day. I was using a hospital grade pump though.

Waking only once between 10pm and 7am is pretty good going you know! My DS still doesn't do that very often. I am quite .

I know, don't get me wrong, I am quite happy to keep going with the one feed a night between 10pm and 7am - we have a 30 minute nap problem (which I'm going to post about separately) but I know I'm getting off pretty lightly at the moment. Thanks for the reassurance on the expressing front, I bf last night and we only had two wake-up's, only one I had to feed for, so am going to try and just chill out about the expressing and maybe just express every other day. I am getting 120ml at each pump (both sides) so thanks for the reassurance TruthSweet. Not sure I can manage expressing at 4am regularly but perhaps next time I can't sleep...

sleeplesssister, I think your right to relax about expressing...I used to give an expressed top up in the evening. I chose to do this as my DD went through a phase of feeding for hours and being really frustrated at my slow evening supply. We no longer bother, and to be honest, I think that expressing and topping up in the evening actually made my evening supply worse as the best way to increase supply is to ld your baby feed from you.

I would suggest that you always start by breastfeeding then topping up if this is still necessary. You'll soon find, like last night, that you don't actually have to use the top up as your DD will probably get more than enough from you.

1 feed per night is brilliant at 19 weeks. During the night feeds also stimulate your supply, so don't worry about sleep training or cutting out night feeds at this age.

I used to have alot of anxieties about my DD "getting enough". I think that most bf mums worry about this at some point. Be reassured by your DC's weight gain and be guided by her wet/dity nappies and alertness more than the percentile charts. My DD has followed the 50th percentile since she was 8 weeks old.

Agree with grumpla re: expressing during the night. When I was having a night out I used to always express during the night as I got loads too, but no way I would be doing this regularly, only in desperation!