Exclusive Expressing Breast Milk - any tips?

[EyeoftheStorm]

DS2 born at 30+5 and after 7 weeks in NICU, it looks like he will be home soon. Hooray!

I breastfed DS1 and DD1 and assumed I would do same with DS2 despite his prematurity. But he is a VERY sleepy baby and we are struggling to latch at all.

I just want him home and as he improves, feeding is becoming the sticking point. Have now decided to bottle feed with EBM, just to get rid of feeding tube he needs now. When he is home, I will try breastfeeding again in more relaxed environment, but I want to be ready if it still doesn't work.

Has anybody bottle fed exclusively with EBM? What tips do you have? How much work is it? I can express 130-150 mls in 10 - 15 mins. Am I naive to think I can do this with 3 children?

Am at hospital for next couple of days so hope to return to lots of advice.

I never did exclusive bf but for a while did express for every 2nd feed. Do you already know to alternate breasts regualrly (decereasing the time each time) when expressing - unlike when breastfeeding "direct".

Make the most of the "good" times to express: morning is usually when prolactin levels are highest. Can you get someone to help look after the other kids then so that you can concentrate on expressing?

Ds was very bad at latching on when he was young - used to take me up to half an hour to goet a good latch. I also got very good at techniques to wake him up: stripping him off, tickling his feet, wiping his feet and/or face with damp cotton wool - and when really desparate, dripping water into his ears

Oh - and congratualtions on your ds coming home soon!

I expressed for first 4 weeks. Found it difficult on days I was alone with DS ( almost 3 ) and DD ( baby). However after four weeks gradually re-introduced direct BF and still BF now at 14 week ( fingers crossed and wood touched).
Was much better when had help around. Found expressing at night after having prepared and given bottle of milk to DD very tiring.

I express full time & have done for 3 months so it can be done but I am now starting to introducing formula as well. The main problem is that unlike breastfeeding you can't hook yourself up to a milking machine in public! To keep up with feeding I was pumping every three hours at one point - which obviously has a bit of an impact on your social life / sanity.

Using one formula feed every 24 hours I am now able to pump every 4 to 5 hours in the day, with one night time session when he wakes up for a feed at about 5am. That is the longest session (takes about 30-40 mins) and most productive - I usually get at least 250mls, sometimes a lot more.

I would definitely invest in a decent pump. I use an Ameda Lactaline, you can do both sides at once.

Good luck!

Hi,

I had my ds at 31+3 and had similar problems to yourself. I got home but only using nipple shields. After a few days, my milk was noticeably drying up and his nappies were bone dry . When the midwife came and he'd lost weight, I decided to give him bottles of EBM. I managed to exclusively express for 6 months, then introduced a little bit (like 1oz) of a carton of readymix formula in each feed, gradually increased until he was having no EBM at all by 7 months.

I found this (US) forum invaluable for tips. Kellymom has lots of resources (a whole page of links on exclusive expressing). I also used this site an awful lot as they have some brilliant products. I really am a fan of the Ameda Lactaline - you do need a pump like this designed for heavy use if you are going to succeed. Also, I strongly recommend the easy expressions bustier or halterneck (sold on the above website among others). It looks expensive, but I struggled when I didn't have this (to the point that I was willing to stick it on its own into the dryer and hang around waiting to express when it was dry).

I did still have a good social life - I would go out (on public transport) to places and express in breastfeeding rooms. Just used a hand pump for those times and brought spare bottles and a packet of Medela wipes (invaluable for expressing when out and about).

Oh, and double pumping is a must if you are serious about this - expressing every 3 hours and leaving no more than 1 6 hour gap in every 24 hours (could be overnight, but often your supply is best at night, or could be in the day while you are out).

Hope this helps you decide if it's for you or not. I intend to do it again with my next baby (pg again now) if I need to. Also this time I will try hard but if it's all that's keeping them from going home i will be happy to give bottles of EBM (ds was in hospital for an extra 2 weeks because I refused bottles and carried on trying to breastfeed).

I did this with ds1. Exclusively ebm until he was 6 months old then after we had started to introduce solids I mixed ebm with formula at 7 mos and continued that until he was a little over a year.

Main tips

1. A very good double electric pump

2. Stay well hydrated

3. Stay on schedule and make sure to pump every 3 to 4 hours

4. Use breast compression to get more bm and make sure you are getting plenty of hindmilk.

HTH

This thread from a while back has some very good advice.

Hi there, have not read through all the thread but wanted to congratulate you and say that it is fantastic that you want to do this for him!

I exclusively ebm for 3 months for every feed when dd went on strike at 3 months so not sure if I can advise on your situation in introducing the breast after bottle feeding but I will share that having done what I did, it is not easy at all - it was my first child and I had all the time in the world - I became a slave to the pump and I could barely leave the house without planning my next expressing session.

I am so pleased that I did it and would like to encourage you to do your best at it as I feel very rewarded for doing it but I don't think I would do it again for dd 2 - fortunately she seems to love the breast (maybe too much even lol).

Hope you get some good advice here x

DD was prem and didn't get the hang of latching - like you I ended up giving her EBM via bottle just so we could go home.
That was when she was 3 weeks old - it was another 6 weeks before she eventually got the hang of it.
I think with her after the first few weeks the main problem was nipple confusion rather then being sleepy etc - and it was using nipple shields that got me from exclusive EBM to exclusive BF in 24hrs.
These are the ones I used - and there are other helpful links on that site.
DD was my PFB though so can't advise on how to manage when there are other children in the picture - just wanted to let you know that it might be possible to establish bf even after a couple of months.

Good luck with it bet you can't wait to be home

I think what you are doing is amazing!!

I exclusively bf dd1 (in fact, all my kids, but it is dd1 who is the issue here) - but I had a plan to go on holiday with my Gran (arranged before I got pg) when dd1 was 5 months old. I was away for 8 days. I look back on it, now my Gran is dead, and am so glad I did it with her.

I decided when I was pg that dd1 would only have ebm while I was away. SO - I fed her exclusively to 4 months (as was the advice 9 years ago) and also expressed 12oz breastmilk morning and evening and about 6oz at lunchtime, from when she was just a few weeks old. When I left for the trip, there was close to 3/4 of a gallon in the freezer! (totally freaked out MIL, who was helping dh look after dd1 then!)

I don't know a lot about electric pumps - I hated the one I borrowed and went back to the avent hand pump that I loved!

It is possible to express as much as you need. Dd1 had 8 days of exclusive bottle fed ebm and in fact my milk was used for cereal etc as well as back then weaning at 4 months was the norm) and there was actually some left! But you do need to be pretty commited to the expressing - it was weird for me when I went away to have to continue to express (i went on to feed her until I got pg with ds when she was just over 1) and throw away - especially as I had been expressing and bf.

Hope you can make this work. Its so cool you are getting him home at last - well done. I am sure the home environment will make the whole thing easier!

the book 'exclusively pumping' is worth investing in. it is written by a mum who expressed for a year.

also learn to hand express and combine it with the use of a double pump. it gets out more milk. a friend of mine had a son born at the same age and established exclusive bfing at home.

I knew I would get good advice and some much-needed cheerleading (thanks lecohen)on mumsnet.

I am determined to do it. Strikeuptheband - like you I feel my attachment to breastfeeding is delaying DS2 coming home. Exclusive EBM seems the best way to satisfy me, DS2 and the NICU.

Wuglet and Wobbly Pig - good to hear that mums have gone from exclusive EBM to breastfeeding and I will be returning for more advice when he is home. It is also good to know that mums have continued to do it for months, Jabberwocky and Grumpla. My social life is pretty circumscribed at the moment - school gate, nursery, friends who live nearby - so feel confident I can do enough pumping if I have to.

Prettybird - I have been draining one breast then the other. Can you explain more about alternate breasts with decreasing time please? Does this increase volume or quality of milk?

Feeling much more relaxed. Thank you all.

Thanks weegiemum and foxytocin. I had seen that book on her website and will get it. The more information I have the easier this will be.

I had to express for my baby who couldn't breastfeed for medical reasons. This was my experience, but not sure if it is representative.
Lots of good advice on here so far.
Second the drinking loads yourself, and the double pumping (to cut down on the time taken as well as improving supply).
I found that in early days I had to be disciplined in pumping every 3-4 hours, but could stretch that a bit as the months passed (hopefully your DS will breastfeeding by then)
If I had a wobble about supply I would take fenugreek and eat oats for a few days. Not sure if it had any effect other than placebo, but a good excuse to make flapjacks .
Someone told me that hormone levels are higher in the small hours, so I did have a 20 minute expressing session at 2 / 3 am if I was up around then (and even a couple of times set my alarm for it), but by no means every day.
Managed to get 3/4 bottles in the fridge and the odd bag in the freezer. Husband or mum would give bottle while I expressed sometimes, to save time.
Don't remember going out very much in the first weeks, but this was probably the shell-shock of being a parent for the first time as much as the expressing regime.
All this was for a first child, so can't say how it will fit in with your other children. Good luck, and congratulations on your baby coming home!

I only found out about it 'cos when ds was just over 2 weeks old, I ended up back in the maternity hosptial with a nasty infection.

I had already started expressing 'cos of ds' lack of weight gain, so started using the pumps in the "expressing room" in the hopsital. It's there particualrly for mums of premmies - and also for any members of staff who wanted to express.

(it was great 'cos I didn't need to sterilise or anything - auxilliaries came in and did it for me! I also got a great supply of wee bottles for storage!)

Anyway, on the wall was posters exapling the most efficient way to express - and stating that it wasn't like feeding a baby. It may have explianed why, but I can't remember.

Depending on how much time you have, you do 8 minutes on one boob, then swap over and do 8 minutes on the other, then swap back to the first and do 5, then 3, then 2 minutes. It's also a function of your boobs and how much you are getting out of them, but by keeping on swapping over, you manage to get the maximum out.

I tihnk I got into the routine of "as soon as the flow started to slow", I would swap over.

Obviously, this doesn't apply if you are double pumping.

One other bit of advice, if you don't manage to get him back on to the breeast, is whenver he does drop a feed, keep expressing at that time to maintain your supply.

Like weegiemum, I went on to feed ds for over 12 months (weaning at 4 - our kids are similar ages ), which included going back to work f/t when he was 4.5 months old and going away skiing when he was 6 months old and leaving sufficient supplies in the freezer for the whole 9 days we were away.

However, I was able to bring back what I had expressed (in the middle of the foot and mouth crisis - but if stopped, would have been able to "vouch personally for eavety drop"! ), which stood me in good stead over the follwoing months, particualrly towards the end, when I found that my expressing started to diminish.

Again like weegiemum, I got on best with my trsuty avent hand pump. I expressed in all sorts of places: airports (travelling on business), cusomters' offices, Heathrow Express, army boot camp (work team building exercise), ski slopes - and once, when stymied by bad weather, even in a mountain restaurant - but no-one would have guessed as it was hidden by a combination of dh, my ski jacket and the table

Thanks Prettybird I will try that. You have an impressive list of expressing situations. There's no room for lack of confidence when it comes to feeding your baby, is there?

One upside to expressing is that I can control my supply. Had mastitis several times with DS1 and DD1 but all this hand and pump expressing has taught me a lot about my milk and hopefully will avoid it with DS2.

Sorry for all the typos - but you will have got the gist!

BTW - I weaned (as in, introduced ds to solid foods) ds when he was 4 months old, not 4!