Expressing breast milk

[BertrandRussell]

When has it become a "thing" for new mothers to be advised to express? There are so many themes at the moment from women with days old babies being told to express-one was told to express 10 times a day! It used to be advice to wait til at least 6 weeks until supply was properly established before expressing. I know there are sometimes health reasons while expressing is necessary, but surely for most people the best way to establish supply is to feed?

And I know people call it pumping now- but I can't bring myself to say that!

Who is telling them?

The only slight meander towards that I've had from the midwives with DC2 is them advising to hand express for engorgement in the early days.

I wonder if it's a misguided attempt to promote breastfeeding via a bottle rather than going straight to formula.

I think sometimes it’s to help establish supply. I had to express as lo was struggling to latch on and when they did with little reward! He also cane out by forceps so had a very sore jaw and head which I think makes it difficult to get the sucking action right.

Ali- yes that makes perfect sense. But there are loads of threads at the moment where women seem to be expressing as a matter of course with newborns. No medical issues at all.

I think it’s because they genuinely don’t know/aren’t trained on what breastfeeding looks like.

So if a baby is constantly feeding, crying, not gaining weight, or having any percieved problem at all, they feel the need to “fix” it.

Rather than reassure and encourage more breastfeeding- essentially not doing much, they start giving “advice” on how to improve supply- express. How to stop the baby crying or feeting constantly-top up with formula. A bottle means they can say that the baby is getting enough- it’s visual.

The ultimate aim of course being “get the baby into a routine”. Topping up after a feed so they go longer between feeds, waking babies 3/4 hourly- etc.

Breastfeeding is fairly alien to bottle feeders. No set feed times, no set amounts. Less convincing weight gain.

Solution, give formula then we know baby is getting enough.

think sometimes it’s to help establish supply

It doesn’t though. Not in the same way as actually feeding. It’s not just the amount you get out, ot’s the biofeedback of hormones as you look at your baby, the sucking action, the warmth and feel.

The quickest and easiest way to establish supply is to feed. Not express.

Inverted nipples. Latching was never going to happen. Did a year twice. Its a solution for women who can't get a baby to latch but still want to give breastmilk, and I think there's growing support for it.

I can absolutely see why you might mix feed or furnula feed. It's the expressing I don't understand. I can't remember anyone doing it early when I was bf. Once supply was established then build up a stash in the freezer, of course. But to establish supply then feeding is the key, surely?

Sorry, pessonaliry, missed your post. Obviously there are medical reasons. And a year, twice? You're a bloody hero!

I have no idea why you’d need to do it unless baby is incapable of feeding. That said I credit expressing with helping me to establish feeding. BUT I had a premie who simply couldn’t suck properly for about a week, so had to hand express colostrum, then moved onto hospital grade pump which worked really well. We were in hospital the whole time though and baby was cup fed, whilst we practised her latch and sucking for every feed. I think if I’d been told to express and bottle feed it wouldn’t have worked out as they were very adamant if she was given a bottle she’d never learn to b/f. I did have really good support and advice. I wonder if midwives like to advise it because they can record exactly how much the baby is having?

HV here, specialise in BF. We only advise expressing after six weeks once supply has settled. Advise hand expressing for engorgment / comfort. If baby has lost more than 10% of their birth weight we can advise to express also top-up.

Thank you, achanger. Sadly the message doesn’t seem to be getting through to some of your colleagues. . I wonder what we can do about it?

I meant express to top-up, bloody autocorrect. Is there any infant feeding specialist you can get in touch with?

I've had so many ladies express early on and have a massive over-supply. Really bugs me. A baby is no match for a pump.

The great thing about women who get an oversupply from expressing is that they are in a great position to help out others by donating to the milk bank, which is a real positive for those who are able.

My big baby lost 9% weight and I was advised to express to top up. Personally I think due to induction that his weight was a bit more inflated. --

I didn't have any actual time to do any expressing as my DS was on and off the boob all the time.

I felt it was pointless to express instead of just feeding them. I just didn't get why you would do that.
You are doing double work with the sterilising of the pumps and bottles. When your baby is sleeping on you you end up waking them up trying to pump.

I managed just one bottle expressed top up and failed to get anything other than a few drips on a quite few pumping attempts.

So i didn't do it and my DS was fine. He took a long time to gain weight , but the midwifes all said he was healthy, good colour and doing lots of nappies. So they just kept me on the books and I just breastfed and my supply increased gradually.

I do understand it's a risk of baby failing to thrive, but I think the top up culture finishes off breastfeeding for a lot of people. It takes staff to keep checking on people too.

My DS was fine and I continued to just breastfeed and he is still a big baby

I have exclusively expressed for 6 weeks now as my DS will not latch. Him not feeding ruined those first few days with him & I was distraught when the MW wanted to do a formula to up. He had syringes / cups for 2 days but by day 3 needed more, the MW were v honest with me that a bottle might mean he would never latch but as he wouldn't anyway, I had nothing to loose.

Expressing has saved my mental health, & helped me avoid PND. As long as it is an informed choice, I don't see expressing as a bad thing; baby gets breastmilk, partners can give a bottle to give mum a break & baby is likely to sleep longer between feeds. Is it really wrong for a mum to do what helps her own wellbeing (mental & physical) ?

@Cazinge I'm the same. DS is now fed expressed breast milk and it works really well for us. There is so much pressure on women at the moment, we can't get it right no matter what we do. I'm happy, baby is happy and is fed. Anyone else that has an opinion on how this happens is irrelevant!

Micah, I think if I hadn’t expressed I wouldn’t have ended up breastfeeding as long as I am or at all. Lo wouldn’t/couldn’t latch on and only cracked it after about 6 weeks and even then it was a struggle . I don’t know but I’d guess milk supply would have dried up by then?

Ideally more support on how to latch, newborns have tiny mouths and are easily tired. The midwives seems to just give the shove it in approach when baby opens his mouth. There are other ways to encourage latch and these should be taught in my opinion.

Hats off to anyone who can express and feed full time.

For me it would have been helpful if midwives were all singing from same hymn sheet. Lots of differing opinions which made it hard. I was in hospital for 3 days and every 8 hours a new MW came telling me to do something different and being shocked at what I’d been told before!