Advice on starting expressing with engorgement/recurrent mastisis

[Strifelight]

I've been exclusively breastfeeding my first born son (9 weeks old) and would like to start expressing and introducing a bottle. I had intended on starting at 4 weeks based on advice, but at that point I started having issues with fast letdown and engorgement. Despite DS emptying the breast well, I've already had 4 bouts of suspected mastisis (most recent this week) which I managed without antibiotics using ice and ibuprofen. I get the feeling I am just one of those people who is prone to this.

I don't want to keep waiting for the engorgement to go away as he is already 9 weeks and I'm afraid of him rejecting the bottle. However I'm also afraid of making my engorgement worse. I have a haakaa ladybug to catch excess but the amounts I get are quite variable and I would like to get into more of a routine. Any advice would be appreciated!

Be careful with the haaka as it does have a bit of suction and it will increase supply if you're using it and making oversupply worse.

I don't think the Ladybug does have suction. -I think it juts catches what drips out naturally. Unless it has a suction option, but I think for Haakaa that's the Shell?

OP, I've had a couple of bouts of inflammatory mastitis, and am still reguarly engorged with a fast let down. My son's first bottle was with what was caught in my catch cups, then after that I used my pump to replace a feed he had. I was doing both breasts, but when I didn't that I was getting about 9oz, when he was only drinking 2-4oz, so next time I pump, I'll just do one breast. I've switched to one breast per feed now anyway. My baby is 8 weeks and we have zero routine at the moment though, and he mostly doesn't fully settle after a bottle and wants a breastfeed after. We use a Lansing bottle and run it under the hot tap for a little while before giving it. It's not warm, but it takes the edge off the fridge cold and he's not fussy about that. If you just pump to replace what he drinks you shouldn't make your engorgement worse.

Side note - I'd love to her what you think of the Haakaa Ladybugs? I got the Medela ones because they're cheaper, but they leak a lot when I bend over/ Does the plug on the Ladybugs work well enough to stop leaks and do they stay in place well? I'll probably stick with the Medela this time, but if I have a second

Thanks, I've been using it with the bare minimum suction to hold it in place, and I don't think it's made it worse...

Thanks for the detailed response, I'm glad you're managing to pump without problems. Funnily enough the engorgement has improved since I made this post, but then DS has been feeding more regularly (including through the night 🙃).

When you say you use a bottle to replace a feed, do you mean you express and then immediately give it to baby? I'm assuming you don't wait until they're hungry as they will undoubtedly kick off by the time you're done! What time of day do you tend to express? I'm also seeing conflicting advice out there, with some people pumping immediately after a feed from the breast they've just fed baby from, whereas it sounds like you do it at another time.

R.e. the haakaa ladybug, it does the job it's intended for! I don't find it very comfortable (tends to make my skin itch if I use it more than a couple of times a day) but I do have sensitive skin. You can really control how much suction it has as you just press it into place - some people might prefer more suction, some very little. I've collected a decent amount of milk from it in the past.

When I said I pump to replace a feed, that assumes I have a feed on hand. My baby would be raging if he had to wait for me to pump a bottle! I often have a couple of feeds worth of milk in the fridge collected from what passively drips from letdown, and I’m either my husband uses then to feed the baby, or they go into the freezer. When my baby has a bottle it’s always the between 4-8am feed. I should technically wake up when the baby has the bottle, but my supply is pretty good so I pump when I wake up, usually about 8-9am so I can catch up on sleep before getting the pump out. I find that at that time of the morning, my supply is really good and I can pump quite a lot. I don’t pump when he hasn’t had a bottle that day though.

I think that if you want to build a freezer stash of pumped milk then pumping in the morning from the opposite side is the best time to do it, as well as pumping to replace a feed to tell your body the demand is there. But if you are in a place where you have enough milk on hand for your baby and you’re happy with that then you don’t need to do extra pumping sessions when your baby hasn’t had a bottle, you just pump before/during/after a bottle so your body maintains the supply and so you have another bottle on had for the baby.