A question about supply and expressing

[lookout]

Ds is 9 weeks old, ebf though we had some teeting troubles up until around the 5 week mark and he was mixed fed, formula and ebm as well as some bf. All good now though. If I was to go out for the morning and dh give him a bottle of ebm, would i then need to express when i got home to make sure my supply stayed the same for the next day? Or does a bottle here and there not affect supply?

TIA

As your DS is still so young and your milk supply is still adjusting to his needs I would either feed him 2-3 hourly or express at that time if you can't. Having said that, missing one feed every now and again is not going to suddenly make your milk supply dry up - particularly if what he's being fed is EBM rather than formula. The problem for your supply would be if you were regularly exchanging a BF for a FF.

Missing a single feed every now and again does not seem to affect my supply, but my boobs let me know all about it... they get super large and leak everywhere! If you can express while you're out, I would, but if not you may find there's enough to feed your child on your return from one side and pump the other to save for next time.

Yeah I agree at this age, depending how many hours, you may be super uncomfortable. You can always pump a bit of milk (hand express so you don't need equipment) and dump it if its not practical to bring it home.

Ok, thanks for your replies. So the consensus seems to be that i should express if possible but not to worry if i can't.

Can i ask another question? I've got into a routine of feeding at 1/2am then attempting (that's a whole different thread!) to put him down and expressing (i basically don't feed from 8pm til then, dh gives a bottle of ebm so i can sleep). If I don't express at that time my boobs are rock hard and leaky, but I am getting a little tired of being up at that time to express. How can i get it so that i can express at another time instead?

Hi lookout. I'm in a similar situation. DS is still finding it hard to feed on the boob so I give EBM by bottle at night and have to express to make up for the "lost" feed. I too am getting fed up with the middle of the night expressing and would love to know if there's a way around it that won't affect supply. Sadly, I read night expressing is pretty much essential until 12 weeks or so but I'm hoping someone may have creative ideas on here....I hope you don't mind me joining the thread to see if any answers come up. Thanks and good luck with the feeding. It's bloody tiring!

Well you need to remove milk from your breasts regularly to keep your supply up and yourself comfortable. Having a really long sleep is a nice idea, but it's not really practical if you plan to EBF. If you get into a good nighttime routine with your LO you shouldn't have to feed more than 2-3 times per night and he should only really wake you for two of those (i.e you feed at say 11pm, 3am and 6am). That sounds onerous, but it doesn't last forever (you'll probably be able to drop one of those feeds or push back the 6am to 7am before too long) and you should be able to just change, feed, burp and be back asleep within half an hour. I used to do it as a kind of sleepwalk! But no, I wouldn't be bothering to express in the middle of the night. Going a long stretch is too uncomfortable and it will compromise your supply if you do it all the time.

juneau, that sounds easy only ds doesn't settle to sleep after the night feeds. So I can't 'just change, feed, burp and be back asleep in half an hour'. And I am incapable of functioning without sleep. As in prone to depression if I don't take care of myself, so the long stretch (which is only 5 hours maximum and often less) is absolutely essential. I don't see why it can't fit in to an ebf routine. I just needed some ideas for ways through what I have decided to be the best thing to fit in with our lives rather than telling me what I'm doing is wrong. And surely there are plenty of 9 week old babies who go for a five hour stetch without feeding and their mother's supply presumably adjusts to meet needs??

MixedBerries, glad to have you on board! The night expressing is annoying, but I'd be awake anyway as ds doesn't sleep well after the night feeds atm. It's just a pain sterilising, pumping etc at 3am when I'd rather be at least resting! Good luck to you too.

mixedberries "Sadly, I read night expressing is pretty much essential until 12 weeks or so"

I don't understand. Why would night expressing be essential? In what circumstance?

lookout "And surely there are plenty of 9 week old babies who go for a five hour stetch without feeding and their mother's supply presumably adjusts to meet needs??" Not many :) It's rare for a 9 week old (no matter how fed) to go that long without being fed :) But yes, for those babies who do, mums boobs do adjust.

So let me see if I've got this right.

You go to bed at 8pm and DH has feeding control with EBM that you've expressed the day before. You wake to feed at 1 or 2am so you have 5-6 hours in a row, then express afterwards. Your breasts are hard and full even after the feed, before you express, at that 1 or 2am feed.

Your baby then doesn't settle well after this feed. What do you do then?

Is that right? Let me know and I'll try to think of some option for you.

I totally understand that especially as you're prone to depression it's really important to get that sleep. For many mums it's easier to just go with the flow as juneau suggested but I totally understand that you are looking at a more specific solution for your particular circumstance.

One other question - what is your bed set-up and what are you prepared to compromise on with that (if anything)?

occ, that's right exactly. After the 1/2am feed i put him in a swaddling blanket in his basket which is next to my bed. Dh is in the spare room atm as he can't stand ds's wriggling and grunting. This noisy sleep, which is very unsettled goes on for between 20 mins to an hour when he starts whinging and eventually crying. I then pick him up and pop him face down on my chest with me propped up with cushions, where he sleeps til the next feed. Then we do it all again after the next feed.

At the moment i feel like i'd do anything to get him to sleep, but bedsharing scares me a bit. I like the idea of it, but i equally am worried about never getting him out of the bed again! Also, so far when i've tried it he's not been any more settled in my bed than in the basket, unless i'm doing it wrong.

Thing is he sleeps well in the asket downstairs when dh has him from 8pm while i sleep, so i don't know what it is about night settling that bothers him.

I would appreciate any advice, thank you.

OK.

Are you in any way limiting the 1/2am feed in order to be able to express? Might the expressing machine be waking him or do you do that elsewhere? Anything at all that you can think of that's different to how you feed at 8pm and how you feed at 1/2am?

Regarding bedsharing, it's not the only answer :) although for some it works brilliantly. If you do choose to try it he WILL get out of your bed eventually - sometimes sooner, sometimes a little later, and you do have an influence on this as well! But if your DH struggles to sleep with him in bed then this may become a problem for you in the longer term. Or, he may get used to it. For me it was the other way round - I couldn't sleep with him in the bed whereas my DH can sleep through anything, and I quickly got used to it (but we had no option as DS wouldn't sleep unless cuddled by one of us).

If he's no more settled in the bed it may be that he's hungry rather than wanting cuddles, although the fact that he sleeps on your tummy implies that he DOES want the cuddles. He isn't cold in his basket, is he?

I'm thinking that as you're still very full after feeding him at 1/2ish, could this be because you're taking him off before he's ready in order to express? Or is that rubbish? :)

Hello again Organiccarrotcake! My comment about night expressing may not actually be that relevant to OP now I've read her circumstances with a clearer head! For me, as DS is not feeding very effectively, I have to express after feeds to make sure my boobs are drained (also to avoid mastitis which has been plaguing me) even in the day. I give him this in a bottle at the end of the feed as he's still hungry. I'm therefore effectively in a position of exclusively expressing despite DS having a bit of a go at the start of every feed. IYSWIM? And we feed only from the bottle at night as a boob feed takes 2 or even 3 hours. Anyway, I was told by the lactation specialist (and have read) that this is still early days in terms of establishing supply so I need to be feeding OR expressing at least once in the night. Ideally between 1 and 3. Does that make any sense at all?
What I was wondering though is that there are some babies who sleep through at 8 weeks and surely if the mum is EBF, her supply doesn't dry up just because she hasn't fed in the night. I'm a bit confused about that and am wondering therefore if the night expressing is really necessary.

And Lookout...your situation sounds very complicated too! I really hope you find a solution. I too have a history of depression (and came off my meds to BF so am determined to make it work) and completely understand the need to sleep and take care of yourself. Sounds like you're doing a great job for your LO so far. Keep it up!

mixed I see, that makes sense. The hormone which tells your body to make milk (prolactin) is higher at night so that's why it's important in your case to express overnight. You'll have reduced stimulation to make milk generally by pretty much exclusively pumping so that's why it's different to a mum whose baby is sleeping for long periods overnight. Any direct suckling that your boy can do will help keep up your milk (even if it's not actual feeding). Have you considered trying a suplimentary nursing system instead of bottles?

What help are you getting to encourage your LO to feed effectively? Have you been given any realistic ideas as to why he struggling?

TBH I have more of an oversupply problem as I express at least 100 ml from each boob at each go. From the night expression, I get about 350 ml in total which is nearly 3 bottle feeds worth so I have a massive stash in the freezer. I guess it's because my nipples are getting an awful lot of stimulation. I do try to boob feed whenever poss and go for as long as we can before he gets too tired or frustrated. So we do have several hours a day of feeding/suckling on the boob.
As for the reason..I'm not entirely sure why he's still not feeding brilliantly as in all other ways he's great- really alert and a healthy weight etc. His tongue tie was snipped about 2-3 weeks ago for the second time (first time wasn't done v well) so I'm told it takes a bit of time for him to get used to it. And the lactation woman said it will take time for his jaw and mouth muscles to build up and get the right technique. So I boob feed as much as is humanly possible but I'm still having to pump after every feed or I end up with mastitis and he ends up very hungry.
I haven't really thought about using a supplementing system tbh as they look like a lot of faff! At the moment I'm just hoping he'll get better at feeding in time but in the meantime anything that gets me more sleep is very welcome! And, of course, any way to help him feed more effectively. Compressions are going quite well but it's still nowhere near possible to feed by boob alone.

And sorry for the delay in replying- we made it out the house for lunch!

Bit more...I know everyone will hate me but I seem to have been blessed with a fantastic sleeper! He DOES sleep up to 7 hours at night on occasion but usually does 5 hour stint. If I were ebf, would that compromise supply? Surely not. Yet I don't see the difference between what I'm doing now and ebf in terms of maintaining supply.
And before you all really hate me, he hasn't always slept like that and I'm sure now I've mentioned it he's going to revert to being serial waker!

If you want to move to boob alone the SNS may be really helpful to help to encourage him. You don't need to use it all the time though.

How old is he now?

He's 8 weeks on Tuesday coming.

thanks for taking the time to reply, and i'm so sorry for slow reply, phone line has been down all day.

i don't limit feeds at all, but ds is so sleepy at that time that he feeds to sleep on one side and try as i might, i can't get him to take the other side. i guess that's the biggest difference. at 8pm he's fed on and off since 5pm so is well tanked up to go a longer stint whereas i can't fill him up properly at 1/2am.

he does settle on me in bed but not next to me so not sure how effective bed sharing is really. atm both he and i are so desperate for sleep that after the wriggling/grunting has woken him, i take him onto my chest and we sleep like that. so last night he slept from 9pm until 1am, had bottle with dh then wouldn't settle at all til 3 when he bf to sleep on one side, stayed asleep on me for a while, in basket in our room where he wriggled etc almost straight away, i expressed then went to bed for half an hour. ds then woke less than 2 hours after the last feed and fed on the other side before falling asleep again, i didn't even bother putting him back in basket and just let him sleep on me for the next hour when he woke for the day.

I wondered if he was cold too, the bedroom is cooler than the lounge where he sleeps from 8pm, even with the heating on overnight. I guess I could put an electric radiator in there, see if that makes a difference.

I express downstairs while he's in the bedroom with the monitor on which is how i know he's grunting and wriggling all the time. It's a manual pump anyway

I'd dearly love to be able to do what juneau suggests, feeding then settling then sleeping, without all the messing about with expressing then the unsettled sleep. just not sure how to achieve it. and i fear not having a block of sleep at some point, the depression loomed over me the first 7 weeks until we concocted this system and I don't want to succumb!

i would really appreciate any help.

mixed I'm really sorry but without actually seeing you I can't think of anything else that you could try other than the SNS. It is possible that the bottles are confusing him and making it harder for him to learn to breastfeed directly is what I'm thinking. On the other hand, at 8 weeks your milk supply will be getting itself nicely settled so it might be ok to stop the overnight expressing (certainly I wouldn't have said earlier than 8 weeks as that would have been too much of a risk). But even with a good milk supply it isn't a cut and dried "yes, it's ok" when you're mostly expressing as although you're getting lots now, it just isn't giving the same stimulation as a baby.

Hopefully Truthsweet is out there as she's got lots of experience of expressing..??

lookout Instead of putting a heater in his room, maybe consider adding an extra blanket, or a vest or something? I used to put mine in a lightweight hand knitted cardie on really cold nights but that might be too warm. Have you tried a baby sleeping bag?

If he's sleeping on you, though, it might not be food or being close to you that he wants but literally being ON you. I mean, I'm stating the obvious, but lying next to you he doesn't get your heartbeat, your breathing, your smell to comfort him. While he sleeps well like that, and given the especial importance to you of sleep, is it ok with you to go with that for now?

So if you were to drop the expressing overnight you'd feel better? Maybe he'd fall asleep on you after the 1/2am feed and you'd drift back off, too? Or is that not going to work because you're too full then and can't sleep?

Sorry to go backwards and forwards but I'm just trying to make sure I really understand.

Maybe if this is right you could try going with him sleeping on you (solves the wriggly problem) and express off one side will he feeds off the other? Is this helping anything at all?

Hi MixedBerries - I've got a few (ahem!) questions so don't know whether you would prefer to PM me or kept on this/another thread?

In general though a baby who is feeding ineffectively (not a judgement on you or baby btw) may well be less efficient than a pump especially if you have got lots of practice at pumping and have a good pumping technique.

You may well find that using a SNS/Lact-aid for a while, perhaps starting off with a larger gauge tube so that it is relatively easy for baby to feed at the breast before working up to a narrower gauge with a smaller top up.

If you have loads of excess milk I'm sure you would be able to find a recipient for it (either milk bank or Human Milk 4 Human Babies local chapter if you don't qualify for bank) or if the milk is stored in a deep freeze (kept at a consistent temp, not a self defrosting fridge/freezer) it may well keep up to 12m (more usually 6m).

(donating to a milk bank it needs to have been frozen for less then 6 months, and usually 3 months)

Thanks for popping in, TS.

Thanks for that OCC - I was thinking that if MB didn't want to donate/wasn't a suitable candidate/couldn't get a recipient then she might want to store it for return to work/starting solids/loads of nights out partying so long term storage might be appropriate in those circs.

Carrot- Thanks so much for the help. It's very much appreciated. I'll probably be doing the night expressing until 12 weeks just to be on the safe side as it's easier to wind it down it later rather than build up again from a measly supply. Plus I have a huge stash in the freezer for when I have to leave him for whatever reason.
Hi TruthSweet. Thanks for joining. I'll try a PM...
Lookout- sorry again for hijacking your thread- it wasn't my original intention! But thank you as I've had some good advice from it. I hope things remain positive for you and if you ever want a chat to a fellow mother of a young baby who has/had depression then do PM any time.

Absolutely, TS. Just wanted to clarify though as milk banks are so specific.

mixedberries sorry I wasn't much help :( But I'm glad TS came along - she's very experienced in expressing stuff and will be able to give you loads more info than me. Hope it helps. :)

lookout I'll be popping back in tomorrow, if not tonight.