Expressing milk talking it away from baby

[Pippinsdiary]

So I’ve been exclusively BF for just over 3 months and I think I have just enough milk, not an under supply but very little to spare. I was advised by a lactation consultant to pump after the morning feed as this is when prolactin is highest to encourage my supply and make sure my breasts are empty

I find once I’ve pumped in the morning, my breast just don’t seem to refill (I know they don’t ever fully empty but that’s how it feels) and when babies next feed comes, she just fusses and gets upset on the breast, so I end up giving her the expressed milk from the morning.

If I don’t pump after her morning feed and just let baby feed and not fully drain them, she feeds fine for the coming feeds. It makes me feel like pumping is taking the milk I need for her, but then I’m concerned my supply will dwindle

At 3 months PP, should my breast feel full after 2/3 hours when a feed is due?

Has anyone got any advice or experience with this?

By 3 months supply should be pretty well established and I think I've read that putting baby to the breast is the best way to encourage an increase in supply rather than pumping. Is there a reason you feel you need to increase your supply, is baby gaining weight, normal amount of wet/dirty nappies?

Thanks for replying! Baby was having slow weight gain, around 18g a day previously so I was advised to pump in the morning and then give that bottle of milk at some point during the day, whether it was all in one go or 20ml after each feed. We have got on top of it more now but she gets extremely fussy at the breast so although I know it’s better to put baby to the breast instead of a pump, it’s hard when she gets so fussy and then refuses to latch, which i think is frustration from not getting enough milk out.

Ahh that must have been really worrying for you! It sounds like she's doing great now but maybe see if you have a breastfeeding support group on your area that could help advise?

Putting the baby to the breast is the best way of stimulating supply. Skin to skin.

Have you tried doing breast compressions during the post-pump feed? It might not be a lack of supply so much as the flow being slower than she wants at that point.

I do breast compressions and they help slightly but not enough for her to have a good enough feed.

what would you suggest if she won’t be put to the breast? It’s like she gets so frustrated she just thinks there’s no point. We do lots of skin to skin and love a bath together

Her weight is fine but it takes a LOT of work to ensure she has enough to be satisfied and settle, I’m finding it so hard with a toddler in tow

That was actually my plan today but I’ve had a poorly toddler at home from nursery. I did phone the breastfeeding help line I’ve seen recommended on here but they were pretty unhelpful

I pumped after 2 months of EBF and saw my baby start to get fussy on the breast. Gradually she didn't want the breast anymore AT ALL and so I exclusively pumped for 1 month and it was draining! In month 3, I moved to formula and pumping and finally to only formula when she was 4 months.

I wish I hadn't introduced pumping as I didn't really have an issue with supply (wasn't under or over) or feeding.

If your baby needs more milk, she will go on the breast more and it will naturally increase for her.

I was in a similar situation to you. I would say that the pumping isn't actually stimulating your breast as much as the lactation consultant thought it would, so it it isn't actually making your breast make more. I presume the thought was

• breast makes X amount
• baby drinks less than that (Y)
• breast slows down production as it senses that X amount isn't needed
• you pump to mean that every feed is X amount even if baby only drinks Y amount
• breast makes extra/makes more quickly to always have X amount or even more
• Baby can drink up to X amount easily whenever she wants, encouraging her to drink more

Actually pumping isn't encouraging your breast to make more, so even if your baby only takes Y amount, pumping is just draining down to less than X amount at the next feed.

I'd stop pumping, and try a formula top up after each feed. If baby seems to take that, then continue with mixed feeding, if not maybe try feeding more often. Like give a top up between feeds off the breast and see if that will help you to produce more?

Try fenugreek, or a supplement like more milk, they're quite effective I found.

@YouFoundMe Pumping is exhausting! I bet it was a bit of a relief when you fully moved to formula.

The struggle I’m having is she barley seems to remove milk during her fussy period and it’s like she just settles and doesn’t attempt to, so I’m worried if I don’t pump during this time it’ll really affect my supply. I think I’ll stop pumping for a few days and see if she needs more efficiently

I had to read that a few times for my tired mum eyes to understand but yes I think you’re right. I was thinking of a formula top up and not pumping for a few days to see how I get on.

I'd wonder if baby has an issue with milk transfer (tongue tie?) It sounds like you have great supply but she struggles when the flow is slow, Woukd also explain the slow early weight gain.
Does she feed better if you switch breasts back and forth? Does she feed well for a few minutes but then either fuss or sleep or need to switch breasts? I'd be tempted to check in again with a lactation consultant.

I have some fenugreek actually I’m just not consistent in taking it. I was tempted to ask the doctor for domperidone but I have a heart condition so I doubt I’ll be prescribed it

Pretty confident no tongue tie as they was checked a few times in the early days. She definitely struggles when the flow is slow and just gives up, but I was also wondering if this could be bottle preference due to being recommended to add in top ups?

@TheDisillusionedAnarchist

Sorry didn’t answer your questions. If I swap back and forth she will latch very enthusiastic and then unlatch crying after a few sucks. The only time she feeds really well is in the morning, sometimes early afternoon, by 3pm she’s so frustrated and unsettled

It could be less of a supply issue and more of a let down one. Breasts are fuller in the morning and likely to let down quicker, I always found mine were slower in the afternoon and DS did get a bit frustrated at times.

Also, isn't 3 months a growth spurt age? Which would mean she's going to keep pushing for more and cluster feeding to get what she wants.

I would basically offer as often as she fussed and see what happens. Keep an eye on the number of wet nappies, if they start to decrease and baby is not settling then I'd try a top up

I would just feed her as usual. If she’s ok you don’t need to pump extra. It can be really hard to pump on top of feeding!

My daughter was fussy on the breast. It was due to silent reflux and food allergies.
It started when she was days old but wasn't until 17 weeks she was properly diagnosed/treated. At it's worst it took several attempts to feed her and she'd feed for seconds.

She does have reflux too actually but so far apart from being really sick in the early days she hasn’t had any severe symptoms. She is on medication for it, so it could be partly that. Today I didn’t express milk and she seems much happier feeding and my breast feel fuller. Usually by 3pm she’s fussy and won’t be put down but today she seems fine and is happy on her mat so I think I’ll lay off the pumping a bit

I wouldn't supplement with formula if you want her to get as much breast milk as possible.

Go with your instincts. Try feeding without pumping for a week and see how you go.

**Edited because errors! 😁

Just saw your update. 🙂

That’s the plan! Gonna do a week and get her weighed to see how we are getting on ☺️

My daughter had mild to moderate reflux and has severe silent reflux (still has it aged 4). It was under treated for over 2 months as the GP was only treating the reflux and didn't consider that there might be silent reflux too and for my daughter the silent reflux was so much worse. It was only when she was on the high dose of omperazole and removed dairy and soya that we saw the improvements in feeding.

Prior to that we went through slow and fast letdown assessments as they can both cause feeding issues. I did have a fast letdown and leaned back feeds helped but didn't remove the feeding issues. You might have a slow letdown and after you've expressed it might then be slower. It might be worth knocking off the expressing or switching the timing to after a feed to see if that helps

That’s interesting about the silent reflux, did you have to push for a diagnosis? Was she a fussy feeder?

we have had a really successful day feeding so I think you all might be right about her not being happy with the flow and let down. I really thought all the BF issues would be long gone by 3 months

Thankfully and I truly mean this she had a reaction to her 4 month jabs and screamed inconsolably for 3 days resulting in 3 GP appointments over 8h then a trip to paeds. We saw a different GP and they asked about her general health. At the time she cried for 16-20h a day, barely fed during the day but fed all night. He upped her omperazole and when we saw the paediatrician that evening he said she should have been on that dose weeks ago. She also had developmental delays and didn't respond to sounds and didn't smile. She scored in the concerning range across the board in her 4 month assessment. The paediatrician said it was unlikely to be food allergies but at this point it's worth trialling me going dairy and soya free. Within a week of the high dose omperazole plus gaviscon ( the original GP told us it was one or the other and we couldn't give both) and the dietary changes she started having days when she didn't scream all day and she started smiling and turning to sounds. When the HV came 3 weeks later she was perfectly average on the 5 month assessment.

Unfortunately her reflux has gone in and out of control since then and she's not outgrowing it. It took until she was 18 months to identify all of her allergies so it hasn't been a straightforward journey but that vaccine reaction catalysed the end of an awful beginning. Turned out she's just a bit sensitive to the menB and it makes her feel a little more unwell than in most babies but there wasn't anything inherently wrong with the vaccine she just had a strong reaction to it.