Expressing breastmilk - when/how and how much does a baby need?

[Eglinton1]

My dd is 5 weeks old. I want to start expressing as she has bad reflux and I think the infant Gaviscon she's on will be more effective if given mixed in with a feed, rather than given after a feed with water - she usually vomits it straight back up again before it's touched the sides. So I wanted to try expressed milk with the Gaviscon mixed in for night feeds.
I have a pump, I have bottles, I have a steriliser - where/when do I start?
I've been pumping a little with every feed, just to test out the pump. But is that right? Do I do it before? Or after? I only feed from one breast per feed - it seems enough for her. So do I pump the other breast? Or have a go from both?
Can I do it throughout the day - a little after each feed? Or is it better to introduce a whole new 'feed' and pump separately from a real feed, and try to get a full breastful?
How much does a baby need for a feed?
And storage of it - if I only pump off a little with each feed, can I add each batch in to one bottle in the fridge? Or do I have to store each little expression separately? The bottle I used for the first expression was sterilised, obviously, and has been in the fridge - can I add to it? Once I open the lid, it's no longer sterile, right? So how do I get enough in one bottle for a feed?

I am not an expert, but I use to express from the other boob after each feed. I use to keep topping up one bottle of expressed milk per day, but a new bottle each day.
I hope someone else with more experience comes along and answers, otherwise phone your HV or MW.

When I first started expressing I used to pump about 30 mins after a feed. Lots of people find they get most in the morning and in the early days tat was the ase for me.

Nowadays I express between 90-120mls a day last thing at night before I go to sleep (eg I've just finished expressing for the evening.

My lactation consultant told me to express the first feeds of the day once you are both up. I feed from one boob per feed so I do two morning feeds if I can't get enough in one go.

Volume wise she said weight in kgs x 20 DS is 6.2kgs so we give him 130mls which is about the max he will take.

DS has reflux & I found gaviscon really difficult to administer. We switched in the end to ranitadine which we give 3times a day. Much easier & way more effective for us. I'm also dairy & soya free which has helped.

Sorry just to be clear, express after a feed rather than a fresh boob

Storage wise you can just add to it as you go along. No need for new bags/bottles every time. You can mix days together too, just date it the initial day you start then add if needs be. Storage guidelines here

I start with a sterilised bottle & then just pop that in the fridge in between expressing. Saves having to constantly be waging it up & waiting for it to dry.

If you concentrate on the morning feeds your body will get used to it & free you up for the rest of the day. Expressing can be a faff. I can get 150 mls now easily by 11am & then I'm done

If I pump, I do the first morning feed from one side of the breast and pump from the other, this morning I got 150ml and then ds went on there for a bit extra, I always have engorged breasts first thing though.

there is a good calculator on kellymom website on how much to give as it depends on how many feeds she has in 24 hours.

In respect to the reflux, you said she only takes one side. Do you think it could be oversupply at all. Also 50% of babies who have reflux are actually stative to dairy in you're diet and cutting this out could help with the reflux. Have a read on kellymom on the section about reflux and see if anything fits. There maybe another way to help with the sickness other then medication.

I second the opinions of expressing in the morning. My supply was always better then and could easily pump a small Medela bottle (around 150mls) before 10am. I would feed, wait an hour or so, then pump, then an hour or so later, DD would feed again. She was a right guzzler. Never had an issue with supply. In fact, I'm sure it helped my supply.

Although I did express in the afternoon/evenings, the supply was never quite as good. I would usually get about 1/3 - 1/2 less.

You'll be surprised how quick you can get at it and how easily it becomes a part of your daily routine. It won't be long before you have a goodly amount.

As Suckeddry says, you can add to the same bottle. Get good advice; practice good hygiene and you'll be fine. Not sure if it is worth mentioning, but if you and your pump don't get along, try another pump before giving up... I started out with a Medela "Swing" which was excellent, but I was much quicker (and quieter) with the Medela manual pump, "Harmony" (which you only need to change the hand pump part, not need a whole new machine). Expressing for the first couple of days is all an experiment as you find out what works for you.

Good luck and I hope the reflux settles down.

OH!! Forgot to say, make sure you eat and drink enough. Remember, you are pumping an extra feed.

As your DD is still quite young, and as I understand you're no longer planning to feed direct at night, you may want to do at least one expressing session overnight, as night feeds can be important for supply.