Help! Expressing at work, supply tailing off

[Tissy]

I hope someone can help- I've been back at work for two weeks following my mat. leave, daughter now 4 months old and at nursery full time. I've been expressing milk for her to have at nursery, and have noticed a definite reduction in the amount I'm able to express. I am now digging into my "stockpile" in order to give her enough to take at nursery each day. I've reluctantly started to send solid food in with her each day, as I'm worried that she won't have enough to keep her going. Does anyone have any tricks for keeping it going?

IMO, 4 mths is too young to start replacing milk with food. For the first few months of weaning, the baby is really just tasting rather than getting nourishment. She will be needing fluids to replace the milk as well. I think you will either have to express more often (ie 10 minutes each side every 2 hours)for the sake of stimulating milk production, or accept that she needs to have some formula for office hours feeds. I returned to work at 4 mths but was able to feed every morning and night till 15 mths. I used to make a point of giving night feeds whenever he wanted till 8 mths, as prolactin levels increase at night, and it helps maintain milk supply. However, this is exhausting when you are also working full time. He used to sleep in my bed and I would feed him lying down, half asleep. I also used to express whatever I could every lunchtime, but it was never as efficient as baby suckling, and so, yes I got gradually less and less, until I stopped expressing at 8 mths. A good way to stimulate milk production is all weekend stay at home, ideally in bed with her, with skin contact, and feed as much as possible. My stockpile soon vanished but I came to accept mixed feeding was better for us than giving up breastfeeding or leaving work. Good luck!

Try not to panic about it - you will have enough. Try expessing more frequently at work if you can. Also are you hand expressing as well to stimulate your breasts more? Pumps do not stimulate the breasts as well. Make sure you massage as well before expressing. I found sometimes I could only express small amounts then the amount would go up again.
A friend of mine was in the same situation as you, worried she wouldn't be able to keep up with working full time. She is still breastfeeding and her baby is now 18 months.

Two things I found helped me to express: propping up a photo of ds so that I could look at him while expressing, and Abba. Yes, I used to express to music. Almost anything fairly rhythmic would do, but I always had best results with Abba (weird, I know) .

Tissy, I managed to express for quite a few months after I came back to work and I think the key was feeling relaxed (& like wmf having photos of dd propped up in front of me) - so having somewhere quiet & private you can do it (I think this is a legal requirement on employers). I used an Avent hand pump and always got 5-7 oz, the most when it got to mid-afternoon before I remembered to express. I too have only just finished bfeeding dd - she's 23 mths.

Thanks- all these comments have been very helpful- I will certainly try massaging and music!

One thing that did occur to me was that when she comes home, we have been feeding her the milk she hasn't drunk at nursery, as it is heartbreaking for me to throw it away. I suppose that this is reducing the amount of time she spends on the nipple, and thus reducing the stimulation.

If I revert to breastfeeding her at all times when at home,should I send her in each morning with a little less milk (to preserve the stockpile), and ask them to give her water or formula if she finishes it all? Or should I just give her what I think she is going to need and accept that sometimes I will have to throw some away? Yesterday I sent in 12oz, and she only took 6oz all day (although she has taken 10 in the past), and I didn't have the heart to throw away a whole 6oz! I'm probably creating a vicious circle!

Tissy - does the nursery have a freezer somewhere? You could then send extra frozen only to be used if she needs it.

The other thing to do is send the milk that you have expressed the previous day at work with her. Then if that is not used, you can freeze it when she comes home, as long as it has been kept cold at the nursey.
I collected milk over the day - sometimes small amounts until I got a decent amount to freeze. That sometimes could take up to 48 hrs.Milk for your own baby will be fine kept for a longer period before freezing.
Definately bresatfeed her when she is with you. You sound as though you will have plenty of milk - it is just getting collection and storage sorted out.

Thanks mears- I hadn't even thought about asking if the nursery has a freezer- it must be the sleep deprivation!

I had thought of sending the previous day's milk, but had been told that breast milk only keeps for 24 hours in the fridge. If I express at work then keep it in the fridge overnight, some of the milk will already have done 24 hours before she drinks it. If I freeze what's left at the end of the day then it may have to go another 8 hours when defrosted- will that really be OK?

Tissy, I was thinking about you last night, and another thing I did was agree with the carer to limit the last bottle feed. Obviously, you have to be careful that the baby is not getting dehydrated and be a bit flexible if the carer says she has not drunk anything all morning. We agreed that the last bottle feed would be at 4 pm of 4 oz maximum. That way, as soon as I got home he was hungry and not asleep. He would fully empty the breasts and there would be enough new milk for another big feed by the time I went to bed, as well as 2 am and first thing in the morning. It takes a while to get used to seeing milk in bottles and judging what she needs, especially as she will need more as she grows. We used to keep detailed lists of exactly what he drank, and then over time you build up a picture of what is healthy for that individual baby. I found that breastmilk keeps well and it was very obvious one time when it went "off". I had no facilities to express and used to go to a public building near work that had an impeccably clean ladies loo! I used to store my milk in a thermos bag with 2 big freezer packs, hidden inside an enormous handbag. Another thing I wanted to say is take care of yourself Tissy. It is easy to try and be perfect at home and also at work, and get physically exhausted. Remember that breastfeeding a young baby can itself be regarded as a fulltime job. Try to eat well and rest and make a point of relaxing on your own occasionally. It sounds like you are doing really well so far.

I did it but the books will probably say otherwise. La Leche League advice is that your own milk for your own baby can be kept refridgerated for up to 5 days. This is because breastmilk is full of antibacterial agents, especially for organisms shared by you and your baby. You might want to do that instead. It is not OK to do that for donor milk for other babies. I donated breast milk to special care and I always froze it immediately. Breast milk can be defrosted immediately prior to use by running under hot water, so that would cut down the time delay between defrosting and use - if the nursery has a freezer. Can you tell I have been there and got the T-shirt

Thanks to you all for your comments- the nursery does not have a freezer I can use, but if I send in abottle of frozen milk in her coolbag, it has barely defrosted by the end of the day, so will be fine for the next day if not used. I'm still a little worried by the small volumes that dd seems to be taking at nursery, but I suspect that she is making up for it with the two night feeds, the little tinker! Any suggestions for getting her out of that habit?!

Tissy, my dd also started nursery at about 4 months, and similarly drank only a small amount of milk there, but then guzzled all evening when reunited with me. My theory was that she took just enough from her bottles of EBM to take the worst edge off her hunger, and saved her appetite for the pleasure of filling up with mummy-milk direct from the source when she got home (hard work for me, but I would have been sad if she hadn't preferred my tits to an Avent teat! )

This changed gradually as she settled into nursery and got used to the bottles - and perhaps was reassured that me and my breasts would always be there for her after nursery. My guess is that your daughter will do the same, but it might be a month or more before she takes reasonable amounts at nursery. So long as she fills up at night, you shouldn't worry.

Tissy, I think Zoya is right, and that it will take a couple more weeks for you both to settle down. It is hard with a young baby, because just as you feel you are getting some sort of routine, then it changes again. If you can cope with night feeds for the time being, I would say, forget about weaning for at least a month, as you have enough on your plate, but remember that in a few months, when she is eating 3 meals a day, then she will probably drop the midnight feed herself, as my baby did. I used to like to romanticise that this type of feeding pattern was very "natural" because in ancient times we were all subsistence farmers, and you would have been out in the fields working in the daytime, with your baby rocking in the treetop or on your back in a sling, and then you would end up doing most of the breastfeeding at night.

Thanks Cityfreak, I guess you could tell that I'm an older first-time Mum, and I need all the reassurance I can get! I wouldn't mind about the midnight feed if she would just drop the 4am one!!