Mastitis at 20w pp - am I going overboard with nursing, pumping and hand expressing alongside formula?

[jodieeleanor]

Right now I’m trying to up my supply as my baby has developed bottle preference to fall asleep. She still nurses happily upon waking, dream feeding and while awake, and nurses exclusively through the night. On top of this, for the last few weeks I have upped my regime to try to replace all formula feeds with breastmilk:
• pump every time she takes a bottle
• pump whenever she’s asleep for a while
• pump whenever she has only had a short nurse
• pump once she falls asleep for the night and occasionally when I can find it in me I get up in the middle of her 5-hour sleep stretch on a night
• hand express everything I can get both before and after every letdown

ive gotten good with the pump now, I can usually get 3 letdowns each time. I notice my letdowns seem forceful but very short, never longer than a couple of minutes - I’ve read this can be to do with overstimulation or too much pressure causing my ducts to slow down. Through the day I rarely go longer than 1.5 hours without a feed/pump session.

I’ve not been able to get to the gp about my mastitis, not too worried yet - this is my second time with it and I’ve not had a fever (last time had a very high fever and abscess when she was a few weeks old, before I was doing any of this). I’ve ordered sunflower lecithin to try to help thin my milk as I’ve read this helps mastitis pass.

Can anyone shed light on why I might have mastitis again, if my regime is too much, and has anyone got any suggestions for what I should change or do? I’d really appreciate help, my goal is to eliminate formula or reduce it as much as possible - I’ve already seen improvements here but want to see more! Thank you! I’d also love to hear any success anyone’s had with boosting supply at this stage!

So yes, in short I'd say you're doing too much. Pumping is quite forceful on your boob but not as effective as a baby at getting milk out. If it's just to go to sleep I would stop pumping and I would rely on your baby to up your supply - it will only take a couple of days to get that extra milk although it's probably already fine. It's not like you're going from hardly feeding at all to everything. Sounds like you're on it, but at the first sign of fever call for OOH antibiotics - I got antibiotics quickly and still ended up in hospital on IV antibiotics due to sepsis concerns.

You don't need to pump to increase your supply - your baby is far more effective at removing milk that a pump, and if you drop the formula feeds, your body will adjust to the babies demands. You're likely to create an oversupply and it's really no wonder that you have ended up with mastitis.

@Shallanathanks for your reply! I understand in theory babies remove milk more effectively, however mine rarely settles into a feed, and quickly gets agitated - even hand expression right afterwards gets out a notable amount, showing n practice she isn’t draining me as effectively as a baby theoretically would. Also, my supply is now about a quarter of her intake, and her weight gain was consistently a bit below normal range before upping her supplements - if I were to drop bottle feeds she would certainly starve at least for some time and I can’t do that! On a more positive note my mastitis has healed now :) how would you advise to help get her back onto the breast more?