first time mum and confused with breast feeding and expressing

[carmen777]

Hi All

Can someone please offer me some advice on breast feeding and expressing? Currently, I have not been able to get my 6 week old girl to fully latch, hence, I am expressing and allowing her to drink from the bottle instead. However, I am only able to produce no more than 500ml per day irrespective if I express every 2 hours or every 4 hours. Hence, I am worried that I will not be able to sustain the amount she needs as she grows. Can you please advise on the following questions:

1. If one was to only express and not breastfeed, On average, what volume of milk is everyone able to achieve per expression on each breast?

2. If one was mix breast feeding and bottle feeding, what volume again is everyone able to achieve per expression on each breast?

From what I have been told, my milk production should increase if I breast feed but I have found that this is not the case and mix breast feeding followed by expressing still only gives me a maximum of 50ml per breast. ie. 20ml is taken directly by breastfeeding and 30ml is what I get straight after expressing. To add, when I mix breast feed with bottle, I am constantly getting mastitis as I am stopping and starting too often so its putting me off. Has anyone got any good suggestions on what I should do?

Finally, is anyone using the Advent bottle warmer to warm up the milk say 1 - 2 before their baby gets up? I have been told this is not advisable and that I should only warm up the breast milk 5 - 10 mins before feed. However, my girl cannot wait that long so I am finding it difficult to abide by that rule. I just hope I am not introducing any bacteria by warming it up for so long?

Thanks for reading. I look forward to hearing from you.
Carmen

If you are mixing breastfeeding and bottle feeding then it is worth investing in specialist bottles which prevent baby becoming lazy. Don't just go for a slow flow teat - they still drip milk. You need something like the Haberman teat so that your daughter has to put some effort into feeding.

Breastmilk doesn't do "bacteria" like other milks. It actually has special ingredients that prevent bacterial growth, so don't worry too much about that at this point. As long as you are not leaving it hanging around, or over heating it, the milk will be fine, and your daughter will not drink it if it is off.

Breastmilk is supply and demand, and nothing stimulates your milk demand quite like a suckling baby, especially those dreaded night feeds. There are also milk stimulants you can take, such as fenugreek tablets. They will make you and your milk smell slightly of curry - so be warned! Also, try not to clock watch too much. Put your baby to your breast frequently and express when you can, if you want to increase the amount of milk you are expressing. Drink plenty of fluids too, so that you don't become dehydrated.

Good luck - a local feeding support group will probably prove invaluable too. Plus wine and chocolate cake when it all gets too much!

Many thanks worldgocrazy for your quick response. The maximum time I ever leave the milk hanging in the bottle warmer is 2 hours as often, she appears to wake up and then falls back to sleep again, so its comforting to know that I am not doing anything wrong.

I heard about fenugreek so will give it ago. Just hope it does not interact with any of my medications that I am taking.

I'll persevere will the breast feeding with the nipple shields till she accepts the real thing. I suspect my girl is not latching on well as she was 32 weeks premature and was given the bottle straight off when she was in scubu.

Carmen - my dd was also prem & spent some time in SCBU & I remember the first few months of bfing being absolute hell, but rest assured it does get better & easier!

First of all, you NEED expert help on the latch. If you're in South Wales I can recommend a very good bf counsellor. A lot of mums find expressing milk difficult & don't get much out - that is not indicative of your milk supply, it's just (as a PP said) a breast pump is not as efficient as a suckling baby. That said, some pumps are better than others. I used the Medela Swing, which one have you got?

You need to get some professional help though - are there any bfing support groups near you?

carmen when she is not that hungry, put her to your breast without the nipple shields. Her saliva has chemical transmitters in which will tell your body what extra antibodies she may need.

Many thanks forgetfulmog for your advice too. I am based in London and has been attending my local bf group. They have showed me numerous bf positioning but my girl will only accept the cradle hold and has said that as she was premmie, it may take some time for her to latch so I will have to carry on trying. Nevertheless, I actually don't find expressing milk hard and I have the madela swing. Its just that when ever I do express, I don't appear to get anything above 500ml per day and she is now drinking above this. No doubt I may have to consider topping her up with formula....which I am trying desperately to avoid.

My health visitor suggested I drink fennel tea as my DD gets hiccups a lot. It didn't help with that but it did increase my milk supply a lot so it could be worth trying!

Yes it took 3 months for my dd to latch properly, but she was able to bf sufficiently to get milk during that time though.

Fenugreek & oats both help increase milk production.

Lots of skin to skin. Quiet room to ensure your dd isn't distracted by anything whilst bfeeding & put her to your boob every time she starts rooting. Nose to nipple & keep persevering. I know how hellish it can be - my dd took 2 hours to latch on in the early weeks.

All the above should help increase your milk supply, but the expressing may not be increased as some women have real problems getting enough milk expressed.

I do feel for you, but it does get easier, me & dd are living proof of that (stil bfeeding after nearly a year)

Carmen / is your dd fussy at the boob, crying a lot? Or is she just not able to latch? If its the latter, I'd keep persevering with the bfeeding, the former I'd get her checked for reflux

How do you know 20ml is taken directly by breastfeeding? Could she be getting a lot more than you think from you?

Instead of going by mls, I'd go by whether she is hungry as to whether she is getting enough.

I'm not sure if my girl is fussy at the boob but I know she fidgets a lot and do attempt to latch and suck but then falls a sleep straight after sucking twice. I have had the bf advisor watch me and we both tried to wake her up to encourage to suck more but not luck. Its as though she uses my nipple as a comforter as I do not give her the teat and prefers the bottle over it as its less work for them. I think I will give the Haberman teat ago and see how I get on.

You've probably tried this, but stripping her right down (cools her so wakes her up), blowing on her face, gently playing with her ear & tickling her feet are all ways to wake up a sleepy newborn (as well as changing her nappy).