Breast feeding & expressing

[Friedseasalt]

I really hope to breast feed & also pump to allow bottle feeding. Won’t have too long on mat leave so it is really important that baby is comfortable with taking a bottle. Can I please get all your tips for this? And what will I need?

Well, firstly, hope is the right word because not everyone can express or pump very much, for some people the baby always gets enough milk themselves but pumping isn’t easy. Others find it fine, but to some extent you’ll have to wait and see. Buy the best pump you can afford.

I wouldn't buy anything expensive ahead of time.
Introduce a bottle early, we started using a bottle around 2-3 weeks, friends that waited until 6 weeks never got the to accept a bottle.
We started small and as I had a fast letdown and plenty of supply a haakaa style silicone pump which was enough to get a few Oz from my other side whilst feeding her to test her with the bottle.
For our needs this was great for the first few months but reflux and allergies gave her intermittent bottle aversions once we got her over them I was fairly confident that for my expressing needs a basic manual pump did the job untill we moved to formula at 10 months.
If you are returning to work and will need to pump quite a bit the question will possibly be whether you go for a good hands free pump, whether you need a hospital grade pump or whether you actually hate pumping completely and deciding that actually for you combination feeding is right and you breastfeeding when you can, pump a little and top up the rest with formula. You might find that breastfeeding doesn't work for you at all and you go quite quickly to formula. Don't stress too much about the ideal scenario but do you research on the different options and then once baby is here and you figure out what feeding will look like for you you can then put one of your plans into place

I'm not in the UK. Here we don't have long maternity so most women pump. That means lactation consultants offer pump consults where they'll bring all the different pumps for you to try, check the fit and make sure you're doing it right. If you can find someone in the uk who does that, it will save you spending hundreds on something not quite right, which could potentially cause a lot of pain in the long run. Buying a pump really isn't a simple as buying the most expensive. I'm taking a longer leave so didn't want to spend a lot of money. I've got an old medela freestyle for €35, but I had to buy flange adaptors because medela parts don't go small enough for me. It works fine, but if I was going back at 12 weeks, I'd need something better fitting and hands free.

Similar to others, we started a bottle early - tried within a few weeks rather than the recommended 6 weeks, it wasn’t consistent but it did give me comfort that she could take a bottle.

I only started pumping from about 6 months old. I ended up giving 1 formula feed a a day, and I would then pump that feed to build up a stash. I wanted only 1 formula feed per day, until after 12 months so if I ever had to leave baby then the day feeds could be breast milk from the freezer. This ended up working out really well for us.

I think also manage your expectation with whether pumping will work for you or not. A had friends who could easily pump 180ml per boob each pump session, for me I would only get 30ml sometimes!

Flange size is incredibly important, you want to get that right.

Use nipple balm when pumping, game changer as well.

I wouldn't try to pump until 4-5 weeks, give yourself time to get the hang of breastfeeding first.

Philips Avent bottles worked really well for us although everyone else who breastfeeds and pumps seems to prefer MAM.

And I second seeing a lactation consultant, best money I have ever spent. No exaggeration.

I couldn't express at all, but definitely made enough milk. They don't necessarily correlate! Baby had a bottle of formula per day until 4 months, when we increased the amount formula in the day (out of choice). We also did formula top ups when the baby had jaundice (not on advice, again my own choice) until baby made their back birth weight.

We did formula from day 2; for a long time my baby would only take formula from my partner and not from me, which I hear is common for combination fed babies/pumped BM. To begin with the baby only needed 5-10ml formula, they take so little to begin with because they have tiny stomachs. We were using the pre-made bottles with sterile teats; my baby couldn't take the Tommee Tippee bottle until about 3 weeks (mouth too small maybe). I combination fed until 8 months, so we had time to see my baby adapt and change. If you do combination fed with formula or pumped milk, don't fall into a trap worrying your baby isn't getting enough milk because of what you can or can't pump, or because of the duration of breastfeeding sessions. If the baby is peeing, pooing, growing/gaining weight, they are getting enough from you.

The health visitor told me they don't advise giving a bottle until 4-6 weeks, but that in her experience, babies often take it more readily if it's introduced earlier. So make of that what you will!

Don't feel obliged to pump if you find you like breastfeeding, all my middle class friends pump and I was put under a lot of pressure to pump rather than give formula once a day by my GP and I just didn't want to. Equally, if you want to exclusively pump or combination feed or formula feed, those are all good options too.

Try and make sure baby has a bottle a day/ every other day. As they can be fine on a bottle at 4-5 weeks, then forget. I.e. they need to practice the skill regularly.

I agree, it's all about getting the right flange size, you can buy inserts relatively cheaply. Hand pumps are a great place to start to see if pumping and feeding expressed milk works for you.

Be careful not to get carried away and over pump, i.e. try to quickly build a big freezer stash, over supply can lead to mastitis!

Interesting about the advice against bottles before 6 weeks. We were encouraged to give a bottle per day from 3-4 weeks to make sure he didn't forget (I didn't follow this). He was getting bottles of pumped and formula in his first week to make up weight, then after that just breast milk. He gets 1-2 bottles per week now at 9 weeks and shows no sign of forgetting. I only managed to get the right size flange at 6 weeks, so he wasn't getting any until then. Most babies go to day care at 10-12 weeks here so there is much more pressure to get pumping to work (and a lot of parents switch to formula)

The problem with giving a bottle early on @Paaseitjes is they can easily develop a bottle preference as it's much much easier than breastfeeding directly when they are so little. Women in the UK get 12 months mat leave so it would be a nightmare to have to stick with pumping full time if you don't have to go to work as breastfeeding directly is a million times easier (I say this as someone who has had to do both).

I think it's a balancing act not giving the bottle too early to avoid a preference for the bottle over the breast but equally waiting can mean a preference for the breast over the bottle. From my very limited experience those that waited until 6 weeks never got them to accept bottles, those that gave it before 2 weeks mostly ended up switching to formula. The trap of "knowing how much they have had" had as much of an influence as the breast aversion. I always suggest something in the middle and working with the baby you have not the text book to friends!

The midwives were encouraging me to give a bottle from about 10-14 days for my mental health it took a few days to decide then a few days to research and sort bottles out. The midwife witnessed a few feeds and said it was clear that she had got the hang of breastfeeding and the occasional bottle a few times a week would be unlikely to change that. We had a love hate relationship with breastfeeding and bottles for various reasons and ended up being a rockier journey than those first few weeks!
I'm expecting number 2 and I think we will test a bottle around 3 weeks again.

Something I forgot to put in my first reply was you might find that baby doesn't like expressed milk. I think I had high lipase and my daughter only accepted the fresh expressed milk so I was never able to build a stash as such. Expressing for me was for a feed no more than 12h later.

Oh and I didn't give a bottle until around 9 or 10 weeks. Zero issues with bottle aversion. In real life, no one I know has a baby with a complete bottle aversion. It's common, I'm sure, and you see it here all the time, but most people are fine. I wouldn't make my first couple of weeks with a newborn more stressful by pumping and introducing a bottle.

Thank you all. I formula fed DS so this is all new to me. Trying to understand as much as I can, however not putting any extreme pressure on myself.

I've breastfed two and despite having an oversupply with my first pumping was painful and unproductive even with a hospital grade pump. Neither of mine took a bottle, with my first we (husband, childminder and I) tried everything from 6 weeks to 9 months and every bottle or cup and my milk and formula and they would only take milk from me and water from a cup. I do know someone who exclusively pumped but it looked like triple the work of either breastfeeding or formula feeding. If you are having a very short maternity leave you might be better looking at breastfeeding forums in the US as a short mat leave is fairly typical there.