40 weeks pregnant and totally confused about expressing

[AluckyEllie]

Hello!

I’m 40 weeks pregnant on Wednesday and getting more and more confused about conflicting advice on expressing. I am aiming to breastfeed but wanted to express as well in order for my husband to be able to give the odd bottle so I could get a longer stretch of sleep or in case I had an appointment/ in case of emergency. Advice online and from friends was to start this early as sometimes babies won’t accept a bottle and it’s best to get them used to it early,

However, my NCT breastfeeding session seemed to be very anti-expressing. The woman said you will end up either not leaving enough for the baby to feed from or with over production (is over production a problem.) She also said you shouldn’t start expressing (unless medical need like babies in scbu) until breastfeeding is established, which would be around 4-6 weeks in. But is that not late to start? She also really advised against giving the odd formula feed (or formula before bed) as it would ‘disrupt the cycle.’

Basically- what has worked for you? When did you start expressing with a pump? I am hand expressing colostrum atm. Do you express whilst breast feeding on the other breast or between feeds? When did you give the first expressed feed in a bottle? Do you defrost and then warm the breast milk? Can you combine several different sessions expressings if you don’t get much in each one?

I don’t know if I’m making this more confusing than it needs to be but feeding seems to be such a large part of newborn life I just want to make sure I give it the best shot. Thanks!

I expressed from when my DS and me got home from hospital so I could have 1 feed a day that wasn't from me and so I knew he would comfortably take a bottle. I had over supply and it was a little painful but it evened out, I tended to express from the other breast while feeding or see what I could get out after feeding. It worked for us but everyone is different.

No idea.

But I just bought some ready made formula for Ds from about 2 weeks instead. covid meant I didn’t go anywhere anyway so we didn’t really try and he refused after a few weeks but hey

But basically I’m glad I didn’t bother expressing as that would have taken the same time as feeding again, so would rather have just used ready made formula as needed, so If dh was giving a bottle I could take a bath or something and not use that time expressing for the next day

Ds fed until 18 months in the end.

I used formula for the occasional bottle. It’s more important that they accept the teat than what’s in it.

The thing is, to be able to feed the baby expressed milk, you have to find time to express it. Expressing takes longer than direct feeding because the pump is usually less effective at getting milk out than your baby, and because of the time it takes to clean everything and then bottle feed the baby. So a lot of women find that it’s a crap way to try to get a slightly longer sleep because the milk isn’t there when you find 20minutes to express at some point during the day and then it is there at 11pm when you’d rather DH took over a feed. Often hearing your baby cry will set off a let down so you’ll be desperate to feed when you hear your baby cry for milk at 11pm.
It’s worth preserving if you need baby to take a bottle so you can go back to work early on, but it might not work that well as a way of getting a larger block or sleep.

I started giving expressed milk in a bottle at about 8 weeks and first left my baby for a day at work at 3.5 months.

I'm an 'oldie' who returned to work when my dd was 12 weeks old, so perhaps I can reassure you a little. I (and most of my friends who gave birth back then) were very pro bf but also realistic about the fact that as we'd be leaving our babies before weaning, they needed to be able to cope with more than just feeding directly from the breast.

I started expressing pretty much straight away, certainly within a fortnight of the birth, so that dd could get used to drinking from a bottle as well as the breast. This was with a manual pump so it was a bit of a faff tbh but nowadays there seem to be some excellent neat electric pumps. You can pump while baby is feeding from the other breast so it doesn't need to take up loads of extra time.

Your body adjusts to what the baby needs, so although there may be a few occasions when you feel a bit 'full', it's really not a big issue.

When I was back at work, dd had mostly expressed milk but I did start introducing a bottle of formula once a day as working and bf a 3 month old was a lot to manage and this made it a little easier. No problems with dd taking either kind of milk. She was brilliant at feeding from a bottle as well as breast, though from around 6 months she preferred a sippy cup or breast so the bottle got ditched.

IME there are some zealots about bf who scare monger that unless you are with your baby 24/7 to feed them directly from the breast at any given moment, they won't be able to bf effectively and it's all going to go tits up (pardon the pun!) Probably the same types who go on about the 'breast feeding journey' ... Honestly, I remember having some of the same concerns as you almost 30 years ago, but knowing I was returning to work quickly was actually really helpful in that I just got on with it, expressed milk, kept up bf after returning to work and dd thrived. I think it's also lovely for the baby's dad to be more involved in feeding too.

Started expressing a few weeks in using a medela. Like someone said it's finding the time. I did immediately after first morning feed. Didn't start right away until milk came in and all was well with supply so essentially established via prolactin.
She took a bottle in night from DF til 7 weeks when she began to sleep through then rejected it after dropping night feed. Think she was just so small, tired and hungry in night as a newborn she accepted it.

Now I pump just to relieve discomfort and have a frozen supply as we are only a month off potentially weaning so ill use the milk to add to food.

Don't get stressed about this just yet.

It's one of those things that really depends on baby.

I was never able to express much (and what you can express is no indication of supply. Baby is much better at getting milk out) but breastfed 2 kids.

I used a Haakaa style pump from day one with my daughter. They are great for helping with engorgement during those early weeks.

I'd agree with not trying to express a bottle so dad can 'help' in the early weeks. It's too much stress and faff and not really a help. He can help more by taking on all the household chores, keeping you fed and watered, holding baby while you shower or sleep.

Once things are established you might find a pattern emerges where it makes sense to give a bottle.

I combi fed one baby and EBF the other. I introduced bottles to both at the same time in the same way. My daughter hated the things, and dummies. I don't think I could have got her to take one even if I'd properly tried. She just didn't like them. My son didn't care and moved between both breast and bottle. If a baby is going to take a bottle, they'll take one. If not they won't.

Don't worry if they don't. At 6 months they can start having a sippy cup and can have milk in that or solid food if you need to be away.

The best advice I can give you is feed baby as soon as you can after birth, seek help often and soon, the first weeks are hard, but it passes and gets so much easier.

I expressed and gave baby a bottle once he was a week or so old and will do it even earlier when baby number 2 arrives this summer. I was told by my lactation consultant and pediatrician to give a bottle early so that baby will easily take a bottle and that worked for us. I was able to get a solid amount of sleep because my DH would take over a feed early in the morning using the expressed milk. Once baby was a few weeks old we also introduced one bottle of formula per day to allow me an even longer sleep in the early morning (I highly recommend HIPP formula, I spent a lot of time researching ingredients and manufacturing process and they came out on top).

Expressing milk is a nightmare, but I tried to make it efficient by getting a wearable pumping bra so I could pump hands free while getting ready in the morning. I also had an Elvie pump that I wore while doing housework and that helped to build up a supply.

I would say the best advice is to be kind to yourself. Hormones can make breastfeeding an emotional subject once baby is here. Maybe do some prep now, figure out how to use and clean your pump so you aren't overwhelmed once baby is here.

What the NCT said is what the official NHS advice is, and some of the reasons for it. Some mothers don't follow NHS advice and get on fine, but it is what is advised- expressing can cause issues for some women.

If you need/choose to feed expressed milk in the early days - look up paced feeding - and you don't need to use a bottle - a syringe, or even teaspoon may be better as baby only needs small amounts.

Kellymom is a good website for advice on expressing (has lots of info of as it's US based and there is more need for it due to less maternity leave there)

Like others personally I found expressing much harder than just feeding from the breast so there was no net gain of time saving/rest from doing it. In the early weeks I also had some sort of hormonal/instinctual connection to my baby that meant I felt I had to be near him and feed him -I couldn't sleep or rest without him near me (not everyone gets this feeling and there is nothing wrong with it if you don't though, but some mothers do - it calmed down after a few weeks). I'd see how you feel about it when the baby is here.

I planned to breastfeed but wanted similar to you in terms of bottles. Bought ones that mimic breastfeeding too ease confusion etc.

Unfortunately, numerous issues meant I couldn’t BF and so I ended up exclusively expressing from a few days in. Had to upgrade the hand pump to a hospital grade double pump and set alarms 3 hourly overnight (because expressing is less effective than a baby suckling so you can’t miss a feed). All whilst DH worked away 5.5 days a week.

No idea how but I managed to produce enough milk to last a year. It was hard work.

So if you can BF, get that sorted first and then work out what you want to do about expressing.

Perfect! Thank you so much for your replies. I shall not stress too much at first and I had considered a bottle of formula so I may start with that before starting to try to express. I have a second hand pump from a family member so I’ll get it out and have a look at it to get an idea but put most time and effort into the breastfeeding.

Thanks again, it’s one of those things you see other
Mums do and wonder- how do you know what you’re doing?!

I had no choice but to express from day 3 as baby wouldn't latch. (Hospital gave her formula but I wanted to offer breast milk). I pumped for all feeds for 6 months before I gave up night pumps and began to introduce formula. So I know a LOT about pumping

I would 100% recommend a Medela hospital grade pump which you hire easily from their website on a monthly basis and hand back when you're done. I tried all the latest pumps plus the hakka ones and the hospital grade one was so much easier and got so much more milk. After it got too much I "cheated" and stopped pumping at night so I could sleep. I was told this would stop my milk production but it didn't! So baby had formula at night abs breast milk during the day.

I never froze milk as I was only ever one or two feeds ahead in my pumping.

With formula I just used the ready made cartons 200ml poured at room temperature, no need to warm up, because life is too short for all that prep, and whilst they are marginally more expensive than powder if you can afford it then I wholeheartedly recommend this - anything that makes life easier.

Good luck!

@KeirStarmerisMarkDarcy

I had no choice but to express from day 3 as baby wouldn't latch. (Hospital gave her formula but I wanted to offer breast milk). I pumped for all feeds for 6 months before I gave up night pumps and began to introduce formula. So I know a LOT about pumping

I would 100% recommend a Medela hospital grade pump which you hire easily from their website on a monthly basis and hand back when you're done. I tried all the latest pumps plus the hakka ones and the hospital grade one was so much easier and got so much more milk. After it got too much I "cheated" and stopped pumping at night so I could sleep. I was told this would stop my milk production but it didn't! So baby had formula at night abs breast milk during the day.

I never froze milk as I was only ever one or two feeds ahead in my pumping.

With formula I just used the ready made cartons 200ml poured at room temperature, no need to warm up, because life is too short for all that prep, and whilst they are marginally more expensive than powder if you can afford it then I wholeheartedly recommend this - anything that makes life easier.

Good luck!

My milk didn’t stop completely for 18 months after stopping expressing!

My baby wouldn’t drink anything cold or at room/body temperature - it had to be warmer! Good job she was cute the work she caused me!

I'm confused about this too. 30 weeks pregnant and hoping to breastfeed but would also like to be able to offer a bottle in case I need to go out or whatever. It hadn't really occurred to me to use the odd bottle or formula as I keep hearing people say you have to EBF for at least 6 weeks or it'll interfere with your supply. But then if you leave it as long as 6 weeks are you running the risk of them refusing a bottle? It's really really confusing and overwhelming.

@jazzhands44 I was told that at NCT as well, don't give baby anything but breast. I think they said it was about baby getting use to sucking the breast not a teat as well as about establishing supply. Well this was when working mums went back to work after three or four months so no way was I prepared to leave it six weeks, half way through maternity leave, to see if my baby could take a bottle. I expressed from the get go alongside breast feeding and he drank from bottles fine, it didn't put him off the breast as I'd been led to believe it could

It may be NHS or NCT guidelines but honestly it's not set in stone. Lots of advantages to having a baby who will happily drink from a bottle of breast or indeed from a tiny spoon or syringe as someone else said

@sodastreamer thank you, can I ask when you introduced a bottle from? And did you just do one bottle a day to keep them used to it? I'm not overly keen on the idea of expressing so I wouldn't be adverse to combi feeding and using formula for the one bottle feed per day. But that will come down to supply I guess. I have a friend who had no choice but to express as she was producing too much and had to express for comfort.

@jazzhands44 I introduced the bottle when he was about 10 days old. NCT teacher had been quite unhelpful about it saying to fully establish bf we should give breast only for about 6 weeks and almost implying the baby might 'forget' how to bf if a bottle given earlier. Not helpful. Several of us in the class were working mums and back at a few months old in those days so it made sense to get the baby used to feeding from breast or bottle.

Sorry posted too soon, yes, one bottle a day to start with. I used expressed milk but many of my friends did mixed feeding from early on too.

DD3 is currently 4 weeks old and I also have a 1 and 3 year old who were both exclusively breastfed, so I’ll let you know what I did.

From about 2 weeks old I would pump each evening on both breasts just before I head to bed. I would then offer DD the milk in the bottle, so as not to miss a feed. Usually, I would express 60-90ml more than my daughter would drink so I would pop this in the freezer and every 3 days I would freeze it, meaning I was freezing about 3.5oz every 3 days.

Once the supply has established (for me around 6 weeks) I will start to pump on just one breast, offering her the other breast. I’d scrap the bedtime bottle and just freeze all the milk (usually about 3oz from one breast).

I quickly had quite a good supply going. In the early days I think DH shouldn’t really be doing feeds unless you’re also planning to pump at the same time. The first 2 weeks in particular are when you really want to be encouraging your milk supply to increase very quickly, and going too long without feeding won’t help x

Babies can decide to refuse a bottle anyway so introducing it early might not help

Both my 2 kids I breastfeed and introduced odd bottles of EBM from 2 weeks old. This was initially one bottle that first week, 2 bottles the next week, 3 bottles the third week etc. From 6 weeks with both I introduced some formula, I continued to express a bit but they both started drinking more in a bottle than I could pump easily and I couldn't be arsed to commit to pumping more so they had mixes of EBM and formula depending on how much I had pumped, but predominantly formula. My first I gradually weaned on to exclusively FF by 12 weeks as BF was still hideously painful and despite loads of support nobody had managed to fix it. My second is 4 months and still mostly BF, he has 3-4 bottles a week given by DH, 3 night feeds and an occasional extra day time one if I need or want to go somewhere for more than a couple of hours/around the time he wants a feed. I sacked off the regular pumping about a month ago. In the early days with both kids I would pump off one side as they fed off the other, usually for a bit in the evening where they were cluster feeding and I'd be stuck on the sofa for hours anyway, so it didn't feel like much of an extra job. However my son stopped the cluster feeding around the 12 week mark and he always is huge so I didn't find it comfortable to feed him in rugby hold anymore and couldn't find a comfy way to pump at the same time as feeding him then. And couldn't be arsed to add pumping as an extra job to my list. I only pump very occasionally now if like he's had a night where DH has given a bottle and he's not fed off one side since the evening before and he's not hungry for it when I wake up. Then I pump for like 10 mins or so just to relieve the engorgement. Otherwise he mostly has formula for his bottle feeds now. We just use pre-made as he only has a few a week so not worth it to buy tins.

I breastfed successfully for nearly a year and a half but could never express at all. Literally one drop after 45 mins of trying and lots of tears. There was literally nothing I could've done to have changed the outcome, my body simply didn't want to do it. I decided it wasnt for me and just stuck to breastfeeding. I really hope you are able to express if that's what u want op and I'm not trying to scare monger, just trying to raise awareness that sometimes these things are out of our hands to a degree. I wish someone had told me this when I was trying to express as it would've saved a lot of upset. Anyway as I said I hope it does work for you.

Colustrum expressing is a good idea, I wish I had for my first two who needed it for different reasons and I did for my third who also benefited from it when BF was difficult at first.

I didn't find expressing with my first so DH could feed worked too well, I'd still have to express around the time of the feed otherwise I was too full and uncomfortable!

You could use a Hakka on breast for each feed and collect the milk (it can be mixed to make one larger amount).

I've BF three babies, first 2 to 15 months, third is 7 months. If you are just looking to give a bottle a day so baby can happily take a bottle then I can't see an issue.

I ended up giving my 3rd a bottle after a BF as he wasn't gaining weight. He was on 6 a day at one point, now he is only BF so certainly having a bottle didn't affect his ability to BF! To do this I had to express after each BF so BF, bottle, express......repeat it's hard going!

As another poster said it may come down to how easy it is to express, I've always had plenty of milk so it was easy but it's not always the case.

Lots of babies are given bottles/syringes at the start to overcome various BF issues. Your NCT lady sounds quite extreme to be honest.

However, if all is going well I'm sure waiting till 4-6 weeks before trying a bottle will be fine.

Good luck, it's a learning process for you and your baby and every baby is different. my third was the hardest of all and it took a lot of determination to keep him BF and now when things are easy he's decided to bite...that's another story...