Milk supply when exclusively pumping

[blackcat86]

My LO is now 2.5 weeks old and is being bottle fed a mix of expressed breast milk, topped up with formula. This is done all as one bottle as she seems to take it better without a break to switch bottles and we also find that if there is a bit of breast milk in the bottle she gets less reflux.

I had a c-section due to numerous health issues for me and LO, and she was quickly admitted to SCBU where she spent 8 days. She is now back home and absolutely thriving, putting on lots of weight and doing well. I was keen to exclusively breast feed but whilst she was latching on in hospital, she didn't have the energy for more than a 5-10 suckles and clearly wasn't getting what she needed. I expressed what I could and as soon as she had a bottle she started to improve. Now she is demanding more and more feed which is great, but also heart breaking that her diet is increasingly formula. I seem to be able to express around 30ml (combined) with an electric pump but no more. I was advised by SCBU to do 15mins every 3hrs which is what I've continued.

Although I don't feel like I could put her back on the breast, I would love to increase my supply and wondered if there were any tips to do this? Also, is it better to put what I've expressed all in one bottle or break it up into other feeds? Sometimes she wants to feed every 90mins, sometimes 4hourly so it can be difficult to match her feed for feed. She is doing so well on the bottle now and I am terrified of back peddling and her ending up being re-admitted but I also know the benefits of breast milk. Thoughts and advice would be much appreciated.

I should add that baby weighed 5lb 1oz at birth (now 5lb 2) and doesn't always take a whole bottle hence the dilemma as to how to split the breast milk. Sometimes she'll chug 90ml, other times she might want 40ml and then another 40ml an hour later.

Hi, why don't you want to put the baby on the breast? It's benificial even if she doesn't get much as it helps stimulate milk, also the milk creates antibodies to combat germs in saliva. I'm a new mum with an early 2 month old baby, heavier than yours but due to jaundice I was mixed feeding but am now exclusively breast. I had a weeks hospital stay and lots of breastfeeding support, from professionals and family. The midwifes recommended to put baby on my breast at the beginning of every feed then move to the bottle after a few minutes on each side. I was recommended to express after feeding or washing. Now my milk supply is well established,( I get about 60 ml when I express in the mornings if my boobs are sore) she's refusing the bottle which is a bit fraustrating as was nice to have a break once in a while.

Also, have you tried hand expressing or maybe lifestyle changes to help endorfens. Eg I find I have full breasts after a walk.

Drink plenty of fluid. This really made an impact on how much I expressed.

I exclusively expressed as my baby was premature and unable to breast feed. I struggled to get her to breastfeed when she was older as shhe was used to the bottle.

I used an electric double pump and kept pumping for longer and more frequently. The milk comes on demand so the more you pump, the more milk gets produced.

I think being stressed doesn't help. So try to relax and pump in a relaxing environment.

I would feed on demand. Others seemed to insist on exact amounts every 4 hours but I preferred my way. I would freeze any excess but can store in fridge too.

I pumped exclusively. Luckily for me I was a milk truck but I few friends of mine gave me some special cookies that helped with lactation. I also find being in the bath, as hot as you can handle it, used to set my boobs off and I’d have a little bowl to catch it all in

It’s hard work though, so well done you!

The best way to increase supply would be to put her back on the breast. A baby is more effective at getting milk and stimulating supply than a pump. She will be able to tell your body to make more milk which is difficult (possible, but harder) to do with a pump.

Plus she will get the benefits from feeding directly that you can’t get from expressed breast milk.

I understand the reluctance to put her back on the breast. You’ve overcome one massive hurdle, turned a corner and she’s thriving and you don’t want to go back to that place where you’re struggling again. I say that from experience as I had a week long stay in hospital with a very jaundiced newborn who was to tired to breastfeed and was losing weight. Bottles of mainly breastmilk but a bit of formula we’re key to getting weight on and DS waking up enough to want to feed himself.
Once we got there, exhausted but proud of our efforts, getting a 2 week old bottle fed baby to breastfeed felt like a mountain that I was too tired to climb!

If you would like to be ebf I would recommend offering the breast at every feed, nipple shields if latch is difficult to make you a bit more bottle like. It worked for us, eventually. I also pumped after each feed, even if we only managed a few sucks and then had a store of expressed milk, I got a lot more first thing in the morning so did more then. Offered a bottle of expressed after I fed him and the amount he took gradually got less and less until he was ebf.

Also, make sure you’re drinking loads and loads of water, nothing affected my pumping more than dehydration.

That's absolutely my reluctance. We've come from her literally being on deaths door (blood sugar of 0.5, hypothermia and low platelets) to thriving, alert and gaining weight. If I put her back on the breast and it goes well then great but if it affects her bottle feeding then I would feel awful and fear it could go very wrong very fast. I appreciate it's possibly more fear than anything.

I'm also still physically recovering from the experience. I was left on a ward with women and their newborns so by day 3 I'd only had 2hours sleep the whole time and was always down at baby's cot, by day 5 my skin was going a weird grey colour, by day 8 the sides of my nails had started to come away and I actually collapsed in the unit. It sounds like my health could be affecting supply. I'm slowly recovering fortunately and hubby has another week off work.

I probably do need to be more conscious of my fluid intake. I generally drink a lot of water but its easy to let these things slip with a newborn. I also like the idea of using heat. Both sound very doable.

Oh I can torally understand your journey. My LO was born 7 weeks prematurely with a weight of 2lb8 and it was paramount he had to gain a certain amount every week! He was in hospital for 5 weeks where I expressed exclusively and at home had to start to top up with formula too.

There are lots of things to increase milk, what helped me was drink water and eat loads of oats and oat milk. There are also herbal tablets you can take, but not sure if they really work.

I agree with others though, the most milk I got was after latching my son on. It was extremely hard to get him to drink enough from the breast at first. So i topped up wvery breastfeed until I knew he was more efficient. My only way of keeping it up though was that I trusted him to cry if he was still hungry, as I knew he was a great feeder at the bottle. And I weighed him weekly to get confirmation. Good luck!

If I put her back on the breast and it goes well then great but if it affects her bottle feeding then I would feel awful and fear it could go very wrong very fast.
I understand why you are worried, it’s awful having had a sick baby and can take a long time for the fear to leave you.

It’s only likely to affect her bottle feeding if she’s taking breastmilk from you which is what you are aiming for. You would probably have to do it gradually anyway so it’s unlikely to go ‘very wrong very fast’.

You can watch for her swallowing to reassure yourself she is taking milk and obviously keep an eye on her nappies/skin/softspot to check she’s not getting dehydrated.

Would you consider some real life support, like NCT group or a lactation consultant just to reassure you she is latched and feeding well.

Obviously you’re decision entirely but expressing and bottle feeding can be incredibly hard work, even for those who can express easily. If you are struggling to express and/or struggling with supply it can be much harder.

If you were able to transfer her onto the breast it would probably be much easier for you in the long run, plus obviously very beneficial for your DD. If you do decide you want to give it a go there are lots of things you can do to make it easy as possible.

I empathise with your ward experience as mine was similar, not skin and nails but I did collapse after my first wash and was angry as I knew I was anemic, but it took 4 days to give me a blood test and what was to check for infection. My breasts leaked over my pjs in reaction to other babies crying when mine was asleep. I second the recommendation to get breastfeeding support if you always wanted to breastfeed. There's lots of clinics in my area.

Thanks for all the info. I had heard about oats being good for breast milk but hadn't considered oat milk. I'll also have a look at local support.

Don't ever feel pressured to put him back on the breast if you don't want to, if you have made an informed decision, it's your baby, your body.
So, My advice would be, drink as much fluid as possible and make sure you are eating plenty. Expressing is exhausting but once you find your routine it will come easier, always have your drink set up ready at each expressing and express every couple of hours for about 15 to 20 mins. It will come easier and good luck.

Another way to help boost supply is to have lots of skin-to-skin time. You could try taking your top off, stripping the baby down to a nappy and snuggling (without offering your breast). Also, I had to express at times and found I produced significantly more milk if I was looking at and touching my baby (which you may well be doing already). You are doing amazingly. Goodluck!

Try some Fenugreek capsules and Brewers yeast. Also take some multi vitamins... I take loads of bloody tablets every day I should rattle. i Think I have iron and vitamin C and a vitamin D tablet plus a well woman one. Good luck xx

I'm currently taking the pregnacare breast feeding supplements which looked like the standard follow on from their pregnancy range. It looked good for breast feeding but also for replenishing my nutrient stores although I have no idea if it is actually the best thing to be taking. Does anyone have other recommendations?