QuoteReplyTopic: Express feeding Posted: 25 January 2009 at 8:19pm
Hi all, just have a few questions, perhaps for anyone who has express fed their babies before...
My little girl has been fed mostly on the breast up until now. I have a (what seems to be natural) over supply of milk, and an extremely fast/strong let-down. My baby can't manage it, she chokes and struggles while on the breast, and it results in her screaming and coming off the breast and still being hungry but she is usually too frustrated and upset at that point to go back on. It has been making feeding very difficult and stressful.
To give you an idea of how much milk I have, if I express I can usually get 150mls off ONE side and up to 180mls in the morning off one side. That is far more than my baby is needing. I also worry about the fact she may be getting more of the thinner milk than the hind milk, because she just won't take all of that milk.
Anyway, I've decided to full-time express, I've been considering it for a while but it has been difficult making the decision to give up feeding her AT the breast...since the few times that it has gone well, it has been awesome. However, her need to get a proper feed is more important than me wanting (needing?) her to feed naturally from me rather than a bottle. So express feeding it is.
I am first aiming for the 6 month mark, and ideally I would like to get to 1 year, but I am just concentrating on getting to 6 months first.
Now, I have an Avent Isis manual, which is great...it's relatively easy and is efficient.
Questions...
-If you expressed full time, did you create a routine around it? Like say, express every 2 hours both sides or whatever?
-How do you manage to increase your milk when baby is going through a growth spurt and is upping the amount of milk they drink? Just express more often in that time period, whenever they feed to mimic what they're wanting?
-How do/did you manage expressing when you have to go out somewhere? As far as I'm aware breast-milk has to be kept cold until it's about to be used, so heating up is/could be an issue.
Finally, is it worth getting an electric pump, rather than a manual? Considering getting the Avent Isis IQ, but is it really that much better than the Avent manual (which I'm very impressed with...but it requires a bit of time and both hands)?
Thanks, sorry there are a few questions there, I just want to ensure I know as much as possible and arrange things so this is as painless and easy for me as possible. It has been difficult to get my girl into a routine or good sleeping pattern because of the feeding difficulties.
I don't feed expressed very often but I hear you on the fast let down and gagging bubba! I find lying down is often the only way she will feed sometimes, especially in the morning.
Anyway, to answer a little bit, I used the manual pump for a while but after using an electric one there is no going back! It's just so much easier to just hold it on my breast and read a book for a bit.
If I was to feed EBM full time I would express as often as bubba feeds now. Maybe express just before she is due to wake or if she goes to sleep after a feed, express then.
Oh, I used the avent manual and the meleda (or something like that) electric which is fine. It's kinda loud though, I don't know if they're all like that?
Also, I have found that suddenly this week my supply has dropped right off. I can still easily get 200ml off one side in the morning and the milk is always there, I'm just not so super full anymore which apparently happens at about 3 months, you only produce as much as bubs needs.
Firstly, I have not expressed full time, but I have had a bubs who has struggled at the breast for a variety of reasons, so know what it is like to have to make the decision you are making. We've only just gone to bottle feeding and I am struggling big time with the loss of the closeness I felt with my son when breastfeeding.
I considered full time expressing, and did it for a short while, but it is hard work and can be time consuming. It is also difficult to keep up your supply. We chose in the end to go with formula as my boy has not been gaining weight.
Lots of ladies have managed it and I am sure they will have some really good tips for you. You might want to consider seeing a Lactation Consultant for advice too. If you have more than she needs right now, you can keep adding to the freezer for when you need it later.
I just wanted to say that I have an Avent IQ electric pump and found it really, really good. Having one hand free is hugely useful, I used my spare hand a lot of the time to do breast compression.
If you're doing it full time, long term, I'd definitely go electric. I did it full time for about 4 days with a manual Avent, and it was OK, but electric would have been best.
I'm going to be expressing when I start work - there is a fridge there to store it, but I've also bought a freezer-bag lunchbox thing (sorry, makes no sense - I mean insulated lunchbox) and some small gel pads that can be frozen, so when I'm out and about, I can put the milk in there and it should be OK. That's the plan (and it's a good excuse to buy a new handbag to fit the lunchbox in!)
Hi, I can see what you are saying about having too much milk, but expressing all the time is a real mission, and as the nurses at the hospital told me, it is not something that you can really do long term.
If you are getting too much milk, could you not express say 60 or so ml off and then let baby feed off the breast?
Sorry, just my 2c, but I know how hard it was having to express for three months for the twins when they were in NICU. It's very tiring and time consuming!!!
I don't know the answers to your questions but - if you don't mind me saying so - don't give up on bf just yet! If you really want to keep it going, just offer her only one side per feed and that should help settle your milk. Also because of your baby's age, your milk will start settling down (in terms of supply) quite soon and the gagging will stop very soon.
Not that I would judge you if you really wanted to express full-time but that is really hard work and it seems like you are so close to everything settling down of it's own accord!
Sorry to completely ignore your question, but just to echo busymum, your supply is likely to settle down really soon! I had exactly the same problem and once I did a bit of reading up on kellymom's page about oversupply problems (which I'm constantly recommending, sorry to be a broken record again) I did a few things - including feeding on one side only - that helped settle it down, and the gagging and spilling passed after only a few days.
Mind you, I absolutely HATE expressing so I'm totally biased!
I hope, either way, feeding your bubba is a joy again soon
PS if you do keep going with the bf, when my supply naturally slowed at around 3 months and JJ got all frustrated with me I panicked thinking I was starting to dry up which meant I got all tense and letdown took a while - so just be aware that may happen too!
I expressed full time with both my babies - for 6 months with Gina and for 7 months with Emma.
Questions...
-If you expressed full time, did you create a routine around it? Like say, express every 2 hours both sides or whatever? I expressed roughly every 4 hourly including during the night, once bub was fed (which was 4 hourly) and asleep, I expressed
-How do you manage to increase your milk when baby is going through a growth spurt and is upping the amount of milk they drink? It's advisable (can't remember where I read this) to express about 10-15% more than your baby consumes and freeze it so you have milk for periods of increased demand like growth spurts
-How do/did you manage expressing when you have to go out somewhere? As far as I'm aware breast-milk has to be kept cold until it's about to be used, so heating up is/could be an issue. - I think going out is though regardless. I'd either try to go out between expressing ie leave as soon as finished and be back to express again or I'd take the pump & my Medela cooler bag with me. Heating is easy enough, once bub is ready to be fed, you just need a container with hot water to pop the bottle in until it's warm
Finally, is it worth getting an electric pump, rather than a manual? Considering getting the Avent Isis IQ, but is it really that much better than the Avent manual (which I'm very impressed with...but it requires a bit of time and both hands)? I had a Medela Pump in Style - so double electric. Yes a double electic was def great investment for us, does all the work for you. I also invested in a "hands free kit" - had to get it from the USA but was worth it's weight in gold! It enabled me to attach the pump and have both my hands free to do anything - have a cuppa, read a magazine or browse the net (that's what I used to do all the time )
Just to explain, I have done expressing before, with my first for a few months. I was hoping that if I did it again, I would be able to do it more long term than that...
But I am definitely aware of the time it takes and how much of a pain in the butt it can be lol.
I am already only feeding off the one side...have never fed off both sides, my baby has never needed to go on both sides.
I've tried expressing only 50ml or so before giving her a feed, but she doesn't like to wait and gets upset and again, won't go on the breast.
It just seems that feeding is getting harder, rather than easier. Baby is struggling more now than she was for the first 3-4 weeks. She literally only stays on the breast for a minute, maybe 2 or 3 if she manages better than usual. Her weight gains are not great and she is rarely sleeping longer than an hour or so...if she sleeps at all, we have had several days of hours and hours of awake...and screaming.
I admit, this is majorly stressing me out. And there are other factors, such as my hubby has gone away and will be gone for the next 3 months. My 3 year old has Autism, and he stresses and gets a bit funny out when I am feeding (or trying to), which is just adding to the stressful situation.
Mostly I'm just worried about my little girl not getting enough to eat...
Lactation consultants...I have been seeing them, they were very helpful when I was having trouble getting her to latch. I have tried a few suggestions since, such as not expressing AT ALL to help it settle down, that managed to score me the beginnings of a breast infection because my breast just wasn't being emptied. I have also been told I am lucky to have so much milk, because some women have very little...as though none of this is a problem at all.
I would like to breast-feed 'normally', but what can I do when she won't stay on the breast longer than a minute or two? I can't let her go hungry... The whole thing is overwhelming.
I haven't read all the replies yet but feel compelled to reply first anyway...
Oversupply at 6 weeks (roughly, right?) is very common. As is a strong let down. IMHO the best thing you can do is to express the first wee bit - anywhere from 20 mls to 60 from what you say - then put her on that side. The expressing off the first bit will help get the first - and strongest - let-down out of the way, and also ensures she's getting enough of the hindmilk. If you do this, try to err on the side of expressing less than more - if you do too much your supply won't drop at all and you'll still have the problem.
From my knowledge, milk supply settles down around the 3 month mark - by this time, it should more or less match your baby's needs (bar growth spurt or unexpected sleep through, etc) so what you're experiencing now is very much a temporary problem - though I KNOW it doesn't seem like it from your point of view!
Another thing I've heard reccommended especially for strong let-downs is to feed on a recline.... like with you lying back somewhat (not flat, but like in a recliner, or against a slope of pillows) as this means the milk has to travel uphill (so to speak) and thus slows the initial burst. Haven't tried it myself, but know people whom it's worked well for.
Finally, to expressing...
I exclusively pumped for 10 weeks because DD2 wouldn't latch - at all. In the end she figured things out and latched at 10 weeks old ( ) but it was HARD going. You DO need a routine for pumping, but it needs to be 24 hours - so everytime you feed bubs, you need to make sure that you're pumping at least that much, preferably more. This means when baby feeds at 11pm, 3am, 6am, etc, you need to be awake and pumping then too.
If you do exclusively (or even largely) pump, an electric pump really is a MUST. I started out using a single Avent Isis IQ, and it was good... I was getting 300mls (both sides total) in about 45 minutes. After about 8 weeks of it I bit the bullet and gathered the money (all $800) for an Avent Isis IQ Duo and it was TOTALLY worth it - I could then get that same 300mls in 10 minutes. Of course, you don't have an active toddler to deal with but you still have better things to do with your time!
Pumping - even with a hospital grade double pump - simply does not stimulate milk supply the same way as bubs feeding at the breast (it's a hormonal thing). Therefore, very very few exclusive pumpers manage to last to a year - most don't make 6 months without prescription augmentation for the supply. At 6 weeks it seems pretty easy.... by 12 weeks, especially once your supply settles down, it will be hard yakka. Especially having to fully wash and sterilise EVERYTHING each time you pump.
Lastly - the one positive here breastmilk can rest at cool room temperature (under 20 C) for up to 6 hours before it's "off". This is what I did - I pumped 300mls worth, and fed from the same bottle for the next 2 or so feeds, until either 6 hours had passed since pumping, or she'd drunk it all. This is ONLY true for milk that has NOT been chilled and reheated at all... once it's heated breastmilk has a lifespan of no more than 1 hour. But my bubs at least had no issues drinking room temp EBM so we were fine in that regard
Hope this helps in some way - I would definitely encourage you to PLEASE seek help for breastfeeding ON the breast, it's best (in many ways) for both you and bubsy, and is FAR easier in the long run! Contact LLL, your MW, or Plunket if you need more help with working the BF out so both you AND your little one are happy and comfortable with it.... expressing is definitely better than formula, but it's a distant second to the way nature intended.
yummymummy, thanks! It's good to know that it IS possible to make it to at least 6 months. I think it relieves me somewhat, knowing that I do have this option to turn to, and that it can be done.
Thank you for the answers too, you have been very helpful.
Thanks to everyone who has responded.
Tonight I am using some of the expressed milk that I have in the freezer. To be perfectly honest, I feel like I need the break or I'm going to be tempted to give up entirely, which I do not want to do.
It's frustrating, I had trouble with latching for the first few weeks and got help with that...it was so tempting then to give up breast-feeding but I went through that 'NO, I am going to do it!' kind of thing...resolved the problem, and am now faced with another one.
Perhaps I will try again, I'll just see what happens. Tomorrow is another day, eh?
* Gag, choke, strangle, gulp, gasp, cough while nursing as though the milk is coming too fast
* Pull off the breast often while nursing
* Clamp down on the nipple at let-down to slow the flow of milk
* Make a clicking sound when nursing
* Spit up very often and/or tend to be very gassy
* Periodically refuse to nurse
* Dislike comfort nursing in general
Got this from the kellymom site (thank you weegee), my baby does ALL of these things. So no doubt about what the issue is I guess. Am still reading that info, and the links...I like that it shows better ways of feeding...I have difficulty with trying new positions and seeing the better ways (rather than just reading what you're 'supposed' to do, ya know?) is helpful.
It sounds like you are going through exactly what I was going through!
I pretty much could have written answers identical to yummymummy, except I used an Avent Isis IQ which was great.
I tried everything too, positional feeding, LC's, expressing before feeds, reflux meds, etc. and nothing seemed to help and Chloe's feeding just got worse. So in the end I was expressing almost fulltime (most days doing 1-2 BF's) and we made it to 3 and a half months. I would have kept it up but Chloe got tonsilitis and wouldn't feed, and it was too hard to keep expressing while looking after a sick screaming baby - that's when I packed it in.
Anyway, just wanted to let you know that I know exactly how you feel and how frustrating it is. Keep trying and if expressing is the only way you feel you can keep BF for as long as possible, then go for it.
I'm giving breast-feeding another chance, the first two times I tried she absolutely refused to even go on the breast (I'm putting this down to the fact she has been having bottles and now has them as her preference), but the last two feeds have gone reasonably well. I had to give her a small 30ml top up with expressed milk because she stopped feeding before she was quite full, but that's OK. The last feed she managed to stay on for an entire feed. She still struggled and came on and off a bit, and the feed took almost 40 minutes all up with all the stopping and starting, but she managed to get her fill from the breast only.
I've found something that seems to help a little, when she starts to struggle and come off the breast crying, I pop a dummy into her mouth and continue to hold her in the position that I feed her in...then when she is calm, I take out the dummy and try to get her back to the breast. It's successful about 50% of the time...and that's an improvement, so I'm happy. I'm also expressing out about 40ml before putting her on the breast.
I've also tried feeding her in front of a fan, since I do believe the heat is contributing to the problem.
Am trying the breast before giving her any expressed milk, I'm just making sure that I have a bottle of expressed milk in the fridge in case it doesn't work...makes me feel better knowing there is a feed there in case it goes badly.
Thanks for the help everyone. I'm not sure how this is going to work out, but I may as well try for a bit longer.
I did a lot of expressing with my first and it is very time consuming and exhausting but if you are going to do it I would definately go electric and would recommend medela. Even if you don' t express full time it is handy to have a pump.
I don't know if it is true but I have been told that you can not maintain your supply by expressing alone.
Have you tried expressing off the initial let down and bf from there?
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However, her need to get a proper feed is more important than me wanting (needing?) her to feed naturally from me rather than a bottle. So express feeding it is.
)
but you still have better things to do with your time!
