How much should I be able to pump?

[Chocolotandtea]

First time mum here looking for some advice.

I have an incredibly hungry 2 week old baby who often feeds (breast) for 6 hours per day and still need needs a 200ml bottle of formula at night.

I have been pumping a couple of times a day to help with how much he feeds - means his dad can take over whilst my nipples get a break. How much should I be able to pump in one session?

I get a decent amount of c.80-90ml in the morning but if I pump again in the evening it can be as little as 40ml. This seems like a lot of work for such a little amount of milk. I’m wondering if I just don’t produce that much and that’s why my baby is always starving.

Any insight would be so gratefully received x

It's so much hard work at the stage you're at, and it sounds like you're doing an amazing job. The first 6-8 weeks is just feed, feed, feed to build supply, and it feels never ending.

There's a great account on Instagram called Olivia Lactation Consultant. She has a recent post on this:
https://www.instagram.com/p/Cvl-QEit-oa/?igshid=NjIwNzIyMDk2Mg==

Basically, it's probably not that you're not producing enough - but some people do a have a smaller pump output. That's fine and normal! You may build it up a bit, but the amount you mention is normal.

Can you access some in-person breastfeeding support for more personalised advice?

When you say 6 hours a day, is that (for example) 12 x 30 mins? That's probably about right at 2 weeks, but I know that doesn't make it easier.

200 ml sounds big for a newborn's bottle, though - they'd normally just have a few ounces at a time. I know lots of people who've done one formula bottle a day from birth, though, it's really common. But still aim for 10-12 feeds if you can.

All the best to you.

Pumping is very difficult - you don’t produce nearly as much milk because you don’t get the same hormones stimulating it compared to feeding a baby.

I had no problems with supply breastfeeding but could barely produce anything pumping.

My DH gave the baby a bottle of formula every night so I could get some sleep, it was a lifesaver.

Please don't do what I did Op and keep trying to express when it doesn't work. It could take me half hour for something like 2oz. My baby was constantly hungry, would only sleep for 90 mins maximum all the time, but I had horrendous mum guilt as "breast is best". Now I look back and think you put yourself through all that for no reason at all, whereas I could have moved onto formula so much earlier and had much less stress and tears in my life.

Your baby is not starving. These early days is eating, drinking and feed feed feed. Your babies only job at the minute is to get your supply established.

Look at the size of a babies tummy and please don't overfeed with formula.

Some people can’t express. It’s a biological response and pumps just don’t trigger let down for some.

one word of warning- if you’re replacing night feeds with formula that is one thing that is most likely to affect your supply. Feeding in the night triggers a hormone response that increases supply- skip the night feeds and your supply will drop.

if you want to mix feed you may have a better shot long term replacing a day time feed and breastfeeding at night.

pumping is hard work and very time consuming. At this stage feeding, feeding and feeding more is the best approach until your supply is established. The amount you express has no relation to supply, and isn’t as effective at stimulating supply as well.

I’m not sure your baby is “incredibly hungry”- feeding for 6 hours sounds normal. :). I think mine fed every two hours for half an hour or so a time. It’s exhausting, but it will get better soon- usually around 12 weeks if you can hang in there. Bear in mind they have teeny stomachs to need to feed almost constantly in the early days.

I wouldn't bother pumping honestly.

It doesn't work for everyone, baby is much better at draining the breast.

That also might be why you aren't getting much when pumping.

If baby is feeding 6x a day then there's not going to be much left in between!

200ml is a huuuuge bottle for a 2 week old!

I successfully breastfed both of mine, but never managed to express more than a drop or two.it used to be that you shouldn't even try to express until
Bf was well established. I know it's different now, but it seems sensible to me to just feed and feed at this stage. You and the baby are still getting used to each other!

The only indicators of supply are nappy output and weight gain. Are you getting lots of wet and soiled nappies? Is the baby gaining weight? If the answer to both of these is yes, you're fine! I ebf 3 babies and they fed constantly and were chunky little things so I obviously produced enough milk, yet I could never get anything from pumping. At 6 weeks you absolutely should be feeding feeding feeding. As well as establishing supply, this is how the baby gets comfort, bonds, builds immunity and even gets pain relief. In my experience, if you're feeling like a 24/7 milk machine then it's going well! It will get easier. Good luck!

I used to only get 20ml per pump at times OP, but I am still breastfeeding an 11 month old now. Exclusively breastfed her for the first 6 months.

Babies are much better at extracting milk and a pump. I also found I did better with a hand pump than electric.

Babies of your little one's age do just want to feed round the clock, you're not doing anything wrong/not giving her enough. It does calm down eventually 😊

200ml is a HUGE bottle for a newborn. DS2 had some top up bottle feeds and they told us to aim for around 50-70ml. That did go up as he grew but I don't think he ever went to 200ml in one bottle (he stopped having the top ups around 4mo).

It's normal to be able to pump around 30ml total from both breasts per pumping session - it's common to be able to pump more in the early days, because your supply is still regulating so you'll produce more than you do later.

I will link some useful videos about establishing breastfeeding for you. Congratulations on your LO.

200ml is a huge amount for a tiny baby who is BFing all day.

Their tummies can get used to having so much in that they get hungrier, it's part of the "top up trap". Have there been any concerns about baby's weight? When you say "at night" do you mean middle of the night (ie after midnight) or late evening (ie 10pm) after baby has been on and off the boob all evening and still seems hungry?

Highly recommend you find a local support group and get some specialist face to face support. Adjusting your latch could mean that baby feeds more effectively and won't be as hungry.

Throw the pump away..
Fill a bowl with hot water and put on a table.. get a sterilised jug and lean your breasts over the bowl of water with the jug under and use your hands to gently " milk " your breasts into the jug. ( change water once it cools down.
You will get far more milk and much less painful.
The more you feed or express this way the more you will produce milk. If you can stop the formula and feed in night too .. this will help.. it's not the baby making your breasts sore.. it's the pump. I use to express this way into sterilised bottles the hospital gave me to help feed the incubator babies ( don't think they do it anymore.
If you are managing to breast feed at all.. there is no such thing as not having enough milk. Feed on demand.. yes it's a lot and time consuming.. but worth it.
A breasts fed baby doesn't need any kind of bottle.. if you feed on demand.
I worked for La Lechè.

Wow thank you all for your replies, I really appreciate it.

200 ml is massive yes. He had it over 2-3 feeds and he’s definitely hungry for it as giving all the hunger queues, hand in mouth etc.

6 hours is over the course of the day (minus a couple of hours sleep for me) but sometimes it’s hour sessions back to back which is just so intense.

Agree re just feeding directly would be best but 1. My nipples are so sore and 2. I need to be able to hand him over to DH for a couple of hours at night or I’ll go demented.

on a positive note he’s back to just above birth weight at 2 weeks and yes had one that if wet and soiled nappies until today when there’s been no dirty nappies at all (just wet). I have been v concerned but health visitor doesn’t seem to be.

from everyone’s responses it sounds like his level of feeding is normal but that I shouldn’t be pumping or giving him the formula at night. I really really really wanted to do this but it’s just so exhausting and I feel like I’m doing it all wrong

You're not doing it wrong at all. Feeding is tiring and stressful at this stage, and it's so hard to know what's right.

Ignore La Leche types who say no bottles at all. Almost everyone I know who successfully breastfed either pumps for one bottle a day or gives one formula bottle a day. It's fine! It's really up to you whether the pumping feels worth it, as it's so time consuming. Only you can say whether the balance is right there.

But I'd keep the bottle small if you want to exclusively breastfeed, like maybe 50-60ml. Sounds like you can pump that! Or, no shame in formula if you prefer.

But that "hungry" evening stage is totally normal, just sit in front of the TV for a few hours and lean into it, if at all possible. It does stop eventually.

All this said - please get some in person support. We can't possibly know how you and your baby are doing in real life. Please get some care and support for yourself at this very tough time. You are doing great, however you feed the baby.

Lansinoh nipple cream is very good. After every feed gently dry your nipples and apply it. I used to keep a tube in every room.

I used to breastfeed and then go to bed at 8pm. DH would keep the baby downstairs with a bottle of formula for the next feed, and then bring him up to me for the feed after that (about midnight).

It meant I was going into the night with 3 or 4 hours undisturbed sleep at least - psychologically better than starting the night wondering if you’re going to get any sleep at all!

Hour long stretches, and sore nipples, suggest something isn't right with your baby's latch.

Please find a local breastfeeding support group - preferably one run by an IBCLC - and get some face to face support. You may need to work on reducing the bottles but in the evening the constant hunger is completely normal - this is cluster feeding, they feed constantly, because at that point your prolactin levels are at their lowest.

When I pumped I had lots between 1am-6am (up to 150ml in an 15minute session), about 80ml in the morning/early aft, then only 40-50ml in the evening. I think that’s typical really. Try expressing in the middle of the night. It’s hard of course losing sleep but it’s normal to have smaller amounts in the evening.

Funnily enough I came to say the same thing as I am off to bed after pumping session (or I was until I locked eyes with a 7 week old that sharted herself awake).
I find I have to pump during the early hours now as I get uncomfortable but also like you I like husband to take the last feed and that's when I get a decent amount (good to keep this up if you want bottle feeding as an option so she learns to feed from both). Then I also pump a little just before I go to bed. If you know there are periods where your baby is going to be sleeping a while during th day you can do little top ups but I would prioritise sleeping then if you can as this will help your supply.

Hi OP

Congrats on your new baby!

My DD is 4 months old and we've combi fed from the beginning and I've primarily been expressing and bottle feeding for the last 2 months while we work on her latch.

It's so hard to know how much is normal to pump but I read that if you pump directly after a feed it's normal to get 0.5-2oz, and if you are pumping to replace a feed 2-5oz, so your output is well within that range! Sorry I can't find the link to share.

I've also found that the amount I pump reduces quite a bit during the day, it's to do with hormone levels apparently, so don't stress if you produce less in the evening. Also depends on how much you've eaten/hydration etc - make sure you eat and drink lots!

Do whatever works for you and don't ever feel guilty for replacing a feed with a bottle of formula - breastfeeding/expressing is exhausting! Although to echo the others 200ml is a lot for a baby so small - my 4 month old only ever has around 4-5oz max per feed. Make sure you pace feed the bottles so you can tell a bit easier if baby is getting full. Babies will suck anything so it might be that your little one is full but keeps sucking the bottle for comfort! People used to tell me my baby would unlatch from the bottle when she was full and that was total rubbish ha, she'd just suck all day if she could.

If you don't already, I'd really recommend following Lucy Webber feeding support on Instagram - she offers brilliant advice about all elements of feeding and has massively helped me.

Also I'm really aware that lots of advice in these early days can make you feel like everyone else has it nailed and sometimes that can make you feel worse! But don't forget everyone only has the advice from their experience with their own baby, and every baby is different. You're doing amazingly well!

Sorry OP - realised you said that the 200ml is given over 2-3 feeds so ignore my point on that! But still look into pace feeding if you haven't already.

As PPs said a lot of BF advice relating to bottles/pumping is very all or nothing - it's hard to find good balanced info about pumping or mixed feeding. It tends to either be very pro BF with mostly good BF info, but very anti bottle, or happy for bottles but then has unhelpful/counterproductive BF advice. Gah! Not very much about how to balance if you want to.

There is a book by Lucy Ruddle called Mixed Up which might be good.

You can give bottles whenever suits you best - we used to do the daily top up at bedtime so DH could give it and it would hopefully knock him out for a bit longer (nb this did not work).

What you want to avoid is falling into the top up trap which is where you top up when you think your milk supply is lower, which then lowers demand which leads to more fussy behaviour so you top up more and repeat. The best thing you can do for your milk supply is feed feed feed, keep the bottle feeds consistent and use direct breastfeeding for the variable, excess bits. I used to have some days where I'd literally put DS2 to the breast every hour (except overnight) to try and stimulate more milk supply, this always helped. I have never been responsive to a pump - I get about 10ml. This is disappointing but it hasn't mattered at all, I've fed all DC until over age 2 no issues. Pumping is not an indicator of overall supply.

There's a book called 'the sleeping baby routine' by Charmian Mead and it has lots of info about pumping and breastfeeding simultaneously - found it really useful.