talk to me about exclusively expressing

[omama]

DD (almost 3 weeks, born at 37+5) & I have struggled from the word go with breastfeeding & I am considering exclusively expressing & bottle feeding ebm.

I was advised by midwives/bf support workers/nicu staff to express at least every 3hrs in order to keep my supply going & also build up a stock of milk for future growth spurts. But I haven't yet managed to achieve this! Real life just seems to get in the way. Either DD wants feeding/changing, I have to do the school run, look after DS, cook tea, or something else which means I have to put off expressing. At night, by the time I've fed dd then tried (& often failed) to settle her, if I actually do get chance to express I've barely any time left to sleep before I have to get up & do it all again. Its feeling pretty impossible & I am ending up rather engorged & worrying that my supply will be affected.

How on earth do you keep it up???!!!

If you do this, how often do you express? Do you do it to a strict schedule or every time the baby feeds? How do you deal with everyday events getting in the way?

Please - any tips/pointers/advice extremely welcome. I feel a bit lost as to how its all supposed to work

Congratulations on the birth of your DD.

I exclusively expressed for 10.5 months - the first couple of weeks were a blur and hard work building up supply. First piece of advice is to rent a hospital grade double pump - it will save you so much time. I could pump in 15 mins with that compared to nearly 45 mins with a single bog standard pump.

I wstarted with every 3 hours then went to 5 times a day and nothing over night - used to wake up with massive boobs but couldn't bring myself to pump at 3am. For the first couple of weeks whilst supply was getting established I gave DS formula overnight then very quickly I had enough for day and night. I loved it and really felt it was worth it. I think you have to set yourself short term goals so my first one was to 6 weeks then it just increased.

I would say you have an older DS and DD to contend with and it is hard work to EE when you only have 1 so don't give yourself a hard time. Maybe try and express a bit for DD so she gets some BM but give formula the rest of the time? I am due with my next one and already dreading expressing with my DS demanding my attention!

I am nearly twelve weeks in to expressing for DS2, after getting sick and tired of interminable cluster feeds (record was 18 hours) and needing to pass some of the feeding burden to DH so I could rest. Feeds were, despite good latch, inefficient as he either fell asleep, struggled with the force of my let down, choked and screamed and never really took a good feed, so woke an hour later. Miserable. So I started pumping on day 19 and he has not had a drop of formula since then.

I had expressed as much as possible with DS1 but it was never exclusive as I didn't pump enough. However, interestingly this time it's been MUCH easier and quicker to get the milk out. Lactation consultant who suggested pumping said it is because my boobs have a sort of "memory" from lactating before. Did you breastfeed your other children - this may help if so? Do you have a DH/DP/family who can take care of your other kids/tasks while you are pumping?

Pumping in my view only works if it doesn't take too long to get a full day's feeds. I work on the basis of pumping 30-40oz a day and it takes about 1 to 1.5 hours spread over six sessions.

Tips (just my own personal experience, others may disagree)

1. Get some fenugreek from a health food shop and drink a ton of water over the course of the day. I do about 2.5 litres. Eat loads. I am on about 3000 cals a day. The pump is technically never going to be as effective as a baby at draining you so you want to make sure you have an abundant supply so the pump can get out enough. Food, water and a good galactagogue (google it) will help. Do breast compressions to really wring out every drop but don't cause pain or you could get blocked ducts or mastitis if you overpump/don't drain properly.

1. Check out kellymom.com for useful tips.

1. Yes, in the early weeks you need to get on the pump as much as possible. 8 times a day, every three hours. I reduced this to six times in week 6, so every four hours, but not rigidly. The more you drain both sides the more you will produce.

1. I now have a pumping station in the study so can mumsnet/facebook and pump so it's not so blooming boring and lonely. TV also good. Combine sessions with troughing a packet meal or sandwich to save time. Or set up in the kitchen and stand at the counter so you can perform simple tasks for the kids and bark orders so they get dressed or whatever you need them to do!!

1. Try to pump at some or all of the following

Before everyone gets up (10-15 mins and you want to be getting 4 to 5 oz)
When kids are having breakfast (or lunch or dinner)
When someone else is dealing with the children's needs
When baby goes down for a nap (mine does 3-4 naps so voila, 3-4 pumping sessions
At every opportunity when it's quiet
When kids are in bed
Just before you go to bed
If you get up for a wee in the night.

1. Nightime pumping sessions particularly important because that's when prolactin levels peak - especially in the early weeks. After that you might get away with cutting this out.

6b(just thought of this but can't be bothered to renumber!) try to build up a buffer of feeds - I've got about a day and half's worth in ready made up bottles in the fridge. So I'm not panicking about trying to get a feed out of me to be given immediately. Also, if he's gonna have a growth spurt, I'm ready for him and have time to put in a few more pumping sessions without the supply stash running out....

1. I am not brave enough to leave more than a six hour gap but of course if you were breastfeeding a baby who sleeps through the night it would be ok and you wouldn't lose supply. I just personally don't want to chance it.

1. No issue with letting baby cry for five mins while you express one boob (to the point when it's drained and no more coming out), go in, resettle, come out and do the other boob. If they cry, so be it, you won't be long. If during the day and crying gets more than you can stomach, put baby in bouncy chair and rock/playgym and talk to them while pumping so they don't feel on their own.

1. Don't do rigid times. Tipped me into PND the first time I think, getting anxious because I was due to pump but baby was awake! Just try to do every three hours. If you do 6am, 8am then 11am you can get a break until 3pm and you'll still get enough sessions in.

10. Get a back up pump as well as sod's law means it will break on Christmas Eve.....

11. Don't go nuts doing this. Many women are great at breastfeeding but can't express. A lot of this (my theory) is due to the pump not triggering their letdown (see tip1) - I was told that poor or slow let down might indicate a supply issue. Or your body may not respond to the pump. If you can't get a day's feed in pumping sessions totalling 2 hours, especially with two other children and a busy life, I don't think it will work for you and that's ok, don't pursue it bloodymindedly like I did first time round and end up in PND territory until my doctor ordered me to stop.

Hope helpful!

My advice would be:
-Get a double pump (I rent mine from the NCT)
-Get, or make, a pumping bra so you can be hands-free
-Before you fill your freezer with EBM, check that it freezes well. I'm speaking from bitter experience - I have a freezer full of milk that tastes so bad it makes me retch. Even tastes bad if I scald it before freezing, therefore it makes no sense for me to build up a stock.

In those early days, you probably need to be pumping 8x per day. They don't need to be evenly spaced, but I wouldn't leave more than 6 hours between pumps at night, and 4 hours during the day. I always did one pump overnight until about 10 weeks.

Around 6 weeks or so, you can start dropping pumps and see how it goes. My lactation consultant says that around 12 weeks, most women can go down to 4x a day without a drop in supply. However, as the poster above mentioned, the pumps get longer the fewer you do.

Good luck and don't feel bad if you have to stop. I am down to 3x per day now, which is almost enough to exclusively feed EBM, and not so much that I go crazy.