Transition from expressing while LO in SCBU to BF now she is home

[thomsonf]

Hi

To start with my good news ? I have just got my daughter home from SCBU this evening after a long month following her birth at 33 weeks. During this time, I have been expressing every 3-4 hours round the clock as until very recently she was tube fed and could not feed from me and then have introduced direct breast feeding in the last 10 days. Now she is home, I plan on BF completely apart from one bottle of EBM which my husband will give. I have a massive supply of EBM in the fridge and freezer so don?t need to express any more for that purpose.

However, as my daughter is so tiny, she only feeds from one side for 20-25 minutes at most, and about every 3-4 hours so if I only fed her, and did not express, there could be 8 hours between feeding from each side. I roomed in last night and this pattern is so much less frequent than my expressing of both sides every 3-4 hours that I am already starting to feel engorged again.

What should I do about expressing (or not?) to make sure I keep my supply up but don?t end up with too much milk, or having to still express round the clock ? there just isn?t time what with a baby and a toddler to look after! If I stop expressing, will my supply just go down in the short term but then go up as her needs increase over time? If I do stop, do I do it gradually or just stop completely?

Please can someone give me some guidance as I have not been able to figure it out and the nursing staff at the hospital were not sure what to recommend either.

Thanks

Fiona

I'm no expert - you need Tiktok or another BF counsellor from the helplines - but could you not just feed from each side as necessary and express from the other side at the same time perhaps? If you've already a large store, you could donate the milk to the SCBU?

Or perhaps, given you will be feeding at all every 3-4 hours, be able to manage with just her feeds - and perhaps she will gradually build up her needs.

But I think you probably need specialist advice so you should ring the NCT/BFN/LLL I reckon - good luck.

Thomson, the fact that you have a massive supply in the freezer suggests to me that you were pumping more than your dd needed. I would suggest pumping from one side while your dd feeds from the other and maybe gradually decreasing the amount you pump. She will demand more milk anyway as she gets bigger so this phase shouldn't last too long. And if you can't be bothered with sterilising you could just pump and dump but I personally hate dumping liquid gold so couldn't do it myself!

Could you keep pumping donate any of your fantastic haul to the neonatal unit at the hospital? There is a national BM bank I think.

Otherwise, and unless she goes for very long gaps, your supply should even out in time and keep step with her demand. You might find that you get engorged for a while though, as you transition from expressing vast amounts to her drinking rather less of it.

Oh, and many congratulations on getting your little daughter home btw. Exciting!

Congratulations for your DD and having her home now. Well done for keeping expressing for so long. I had DD1 in SCBU for 2 weeks and we managed to fully BF after that, till after she turned 2. Good luck and many congratulations again. (Sorry, can't help with the technicalities as DD1 never fed for more than 5 minutes at a time and i wasn't over-producing either.)

For a start I again am not a huge expert but I would say the following:

1. Pumping is supposed to be less efficient at removing milk from hte breast than a babies delicate lips. So she could be getting as much from one side in 20mins as you did from both sides in 20min with a lump of plastic.

1. She is taking what she needs. Your body needs to make what she needs - so it will do no harm if your supply goes down a bit. Just feed her and pump the amount you need for the bottle in a 24hr period. You don't need more. You supply will adjust. Your supply needs to adjust. It will adjust again as she gets bigger and starts telling your body that she needs more.

bf is a natural process. Let it be a natural process and don't over complicate it by trying to maintain your supply at what it has been it sounds as though it is too much.

how lovely, congratulations and must be wonderful to have her home.

i do agree with wilf, specialist advice needed. wonder whether 3-4 hours is often enough? am utterly ignorant as to how tube feeding works and how much she would be having already. better check out before taking action which would result in your supply dropping needlessly.

My ds3 was a 32 weeker and by the time we left hospital 2 weeks later he was on 4 hourly feeds. I wrecked this lovely routine by feeding on demand when we got home. But that's how bfing works. I had gotten conflicting advice from the hospital staff: I'm in Ireland and the Irish nurses told me to "top up" with bottles of EBM when we got home, the Asian paediatrician and nurse told me to bfeed on demand. As Ireland has the worst bfing rate in Europe (and maybe the world) I listened to the Asian staff`
Just to be clear thomsonf, the only reason I would suggest expression is to relieve engorgement rather than maintain a supply which appears to be too much for your LO.

Also think about contacting Bliss.

I boggle when I see questions like this, we weren't allowed home until we were comfortable together and had all those issues ironed out. I hear women running down the hospital I was at, but stories like yours make me grateful.

Was in exactly the same situation when I brought ds home from SCBU. I just stopped expressing. I got hugely and painfully engorged for 2 days, finally gave in and expressed once again (maybe a more gradual approach would have been more sensible..) and was fine from then on. Ds now nearly 2 and still bf so it worked for us. Don't think you should have a supply problem as long as you are exclusively bf as you should adjust to your baby's needs.

Congratulations!

Just be careful about getting too engorged, you can get blocked ducts/mastitis which is NOT pleasant.