To pump or not to pump

[Thechick]

In short, I had my LO early 3 and a half weeks ago at 34 weeks. He's been bottle fed from birth and is doing really well. I want to exclusively breast feed and have been expressing from about day 5 of his life when my milk came in, initially every three hours. He's been home from the scbu for a week and I'm finding it impossible to express as often as I did but he is starting to do really well on the breast. I'm pretty sure that I'm not producing as much as he needs but also appreciate that that won't happen unless he is on the breast more or I'm expressing more. So my question is is it better to express and breastfeed knowing that he won't get as much when he's on the breast or just stop pumping and he can get it all.

I think this is something you need some good RL help with - someone who can help you taper down the bottles, and see how your ds is doing on the breast.

Are you bfing direct at every feed and then topping up atm ?

I would say that this is a tricky one to answer. I think you need to speak to the lactation consultant at the hospital or does the SCBU ds was in have an outreach nurse?

It is fab that he is doing so well at the breast and I have worked in SCBU in the past and seen many babies successfully breastfeed even once discharged. What I would say is spend a few days on the sofa, skin to skin with big blankets over both of you. Let him feed when we wants and pump every few hours as you have been. Don't try and do too much of everything else so limit visitor or only have people you feel comfortable around you so you can feed whenever.

Your ds is not even term yet so I would be wary of risking any weight loss just yet as a readmission would not be great for either of you.

Take some professional advice and keep up the good work.

When my LO wasn't drinking enough from the breast (he was small and jaundiced and just didn't seem to have the strength to drink) I was told to BF to keep him used to the breast then to express to make sure my supply didn't diminish as a result of him not drinking enough. I would then feed him some expressed milk to make sure he was getting enough. As he got stronger and I could quite clearly see that he was drinking plenty from me alone (the signs being his jaw moving at the ear, swallowing sounds, sleepy after a feed, gaining weight) I started to reduce the number of times I expressed. I did this gradually so my breasts wouldn't become engorged. When he first came home I was expressing in the night after his feeds, so needless to say these were the first pumping sessions to go! Not sure if i've actually answered your question but just thought I'd impart my experience.

This sounds like a question for our resident expert Tiktok, but from what I remember from a similar thread her advice was why express and top up when you can just feed your baby directly? Skin to skin and feed, feed, feed. Switch feeding is the best thing you can do - don't just stop after you've given the second side, put him back on the first again and keep on swapping sides until he won't take any more. That way he gets his 'top up' direct from the source and you get the best possible stimulation for your breasts to up your supply - a pump can't compete with a baby on that score.

ElphabaTheGreen......my sentiments exactly .

Thechick, good real life help from someone who can observe and assess the bf and compare it to your baby's needs....if he is feeding well, then you won't need to express, and expressing will not be any 'better' than an effectively feeding baby (and it's also a nuisance and a faff and time consuming - so not much going for it, really!).

It's a complex situation - for example, you'll need to bear in mind what his weight and health are like, and if he's gaining just fine, he can prob cope with a slightly lesser intake (if that's what happens) while you build up your supply without expressing. As I say, get someone you trust in RL who's knowledgeable.

37-38 weekers - like yours - are just on the edge of being able to let everyone relax so they can get on with it. A lot depends on whether he really is transferring milk effectively yet and he might be :)

Thanks all. Your advice has been very helpful. I'm going to get in touch with a lactation consultant tomo so they can check positioning and latch, but I think they are both fine and take it from there.