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Where’s the Beef (on Pumping)?

Jul08

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Advice Smackdown ArchivesHi Amy,
I’m working up to being a first time mom in September and have thrown some questions at you in the past. I live abroad and have noticed some cultural differences in how Germans (where I am now) approach things like breastfeeding and I’m trying to overcome an info gap here. I want to breastfeed and hope to manage six months (maybe longer). I do want to be able to work some freedom into the feeding schedule and also give my husband a chance to take part. You’ve discussed breastfeeding, supply issues, and bottle supplement feeding before, and quite well.

There are just some things I don’t get: when can you start pumping and giving the baby breastmilk from a bottle? Does this really work in tandem with breastfeeding (can my husband take a few night feedings)? And what’s the deal with preventing nipple confusion or using restricted flow nipples?
I have a feeling this isn’t laid out well in the books I’m reading because I’m apparently the only one who doesn’t know. But I don’t! Help?

(Also feel free to recommend any books in this, I haven’t found them on my own so far.)
Thanks,
Megan
 

This is actually a deceptively tricky topic, so don’t beat yourself up too badly over being kinda confused about it. Because it sadly, DEPENDS. Depends on your boobs, your supply, your baby…and even what “expert” you’re talking to or reading at the time.

If everything is going according to “plan” for you in regards to breastfeeding, it’s best to put off pumping until your supply is fully established. Extra pumping (on top of your baby’s on-demand feedings) can lead to oversupply. This happened to me with Ezra, and it’s distinctly not fun — think rock-hard boobs and a FURIOUS let-down of milk that chokes and gags your baby, which leads to stuff like gas and vomiting and other digestive distress. On the flip side, REPLACING actual feedings with pumping — or skipping feedings entirely while your husband gives the baby a bottle of pumped milk — can cause undersupply.

Basically, for the first month (or even up to six weeks), you ideally want to let your baby handle most-to-all of the milk removal business. IN A PERFECT WORLD, ANYWAY. If you have supply issues or your baby comes early or spends time in the NICU or won’t latch right at first or any one of a million other hypotheticals, you very well might end up pumping during that first month. Or not! DEPENDS, ARGH.

I pumped AFTER every feeding with both Noah and Ezra to boost my supply. I did not pump INSTEAD of nursing, and only with Ezra did I actually pump enough milk to store and use in bottles. If I was home and available, I nursed, even at night. “Your baby is best at emptying your breast,” was the stupid rhyme my LC singsonged at me. The bottles were for the babysitter or for Jason if I had to leave the house for a few hours.

This time, with Ike, I didn’t bother with the post-feeding pumping, as my supply established itself just fine without it. We have gone out (sans baby) about once a week so far  — usually for all of three hours or so — and the first time I left a bottle and formula behind. (He’d had both at the hospital, and I refuse to be all neurotic about it.) Then I came back and prepared to pump…but Ike woke up and demanded to eat anyway. The second time, he stayed asleep upon our return and I was able to pump a few ounces to stockpile, and I’ve OCCASIONALLY pumped in the evening when Ike surprises us with a longer-than-usual stretch of sleep.

Now, at five weeks postpartum, I pump because 1) Ike is sleeping and my boobs start feeling uncomfortable, and 2) I want to start really building up a stash of frozen milk for nights out (and my upcoming two-night trip to Blogher) and just sort of…do it in between feedings when I have free time. (HAAAAA.)  I still don’t hand off nighttime feedings, though — I don’t want to be reckless with my supply just because it *seems* perfectly established, and honestly, I’d have to wake up and pump anyway, because OW. And pumping at 3 am is really not an equal trade off. Nursing at 3 am is seriously the better option for getting more sleep.

So. Three babies, three COMPLETELY different experiences with pumping. Noah was never really exclusively breastfed and the pump didn’t really help my supply issues — if anything, replacing feedings with the pump once I went back to work is ultimately what killed nursing for us completely. With Ezra, pumping was a regimented-from-day-one attack on the supply issues, until I hit oversupply levels and had to dial it way back because the pump was SO effective. With Ike, I’ve pumped all of…three times, I think. I have a couple bags of milk in the fridge and will be trying to find more time to pump this month before I have to fly to San Diego, but again — if he gets a bottle of formula or two, I’m not going to go berserk over it. He’s getting buckets of breastmilk and we’re doing just fine without agonizing over the pump.

My husband is used to not really being “part” of the feeding process by this point, at least early on. He handles other things — like the late-night diaper change, or bath time, or wearing Ike in a sling during the pre-bedtime fussy hour. He doesn’t feel “excluded” or anything because we don’t give Ike bottles regularly, honest. He’s super pro-breastfeeding and supportive and finds other ways to be hands on with a newborn. And before we know it, Ike will be on solids and probably getting bottles more often (I will have to go get mah hair did, at some point, and he’ll be on solo-dad duty next month during Blogher), so…yeah. Don’t feel like you’re leaving your husband out in the cold by not pumping from the get-go in order to pass off the 2 am feeding. Trust me, you’ll be awake through the whole thing anyway. Thanks, biology!

As for your last question about nipple confusion — I suppose it happens. I have no personal experience with it. All three of my babies were introduced to the bottle in the first days of life and all three of them went back and forth between bottle and pacifier and boob no problem. (Noah and I definitely had a ton of difficulties, but “nipple confusion” really wasn’t one of them.) I’m…actually kind of in favor of introducing the bottle earlier, since it SEEMS like most of the babies who reject bottles altogether are the ones who follow the “no bottles until six weeks old and breastfeeding is established!” rule. I really think you can do both, though that’s where the low-flow (“preemie flow”) nipples come in. You want the baby to learn to suck from something besides your boob, but you also want to make sure they do have to really SUCK and work at it a little bit. The nipples they gave Ike in the hospital were not preemie-flow and seriously, you tipped the bottle just slightly and the formula just gushed the hell out into his mouth. Ever since, I’ve had a preemie nipple in the bottle so he really needs to suck and not get all lazy and develop a bottle preference. One bottle a week and a mass of rejected pacifiers later, he definitely has not lost interest in nursing.

As for books and resources, I love kellymom.com. Books…eh. Granted, I read a couple while struggling early on with Noah and got so angry at every one of them because they were totally not realistic or honest about how difficult things can get. “If it isn’t going well, it’s just that you’re just doing something WRONG” was the message my overly sensitive postpartum self received, even if that wasn’t at all their intention. But a lot of them don’t really address pumping or how to balance wanting a break or some freedom while still being committed to breastfeeding — in fact, it’s often the opposite. Nurse no matter what, all the time, it’s glorious and bonding and you love it anyway and if you think otherwise UR DOIN IT WRONG.

(I just recently read a breastfeeding article that was SUPPOSED to be about introducing the pump but went on and on about letting your baby use YOU as a pacifier as much as they want early on — with no mention of how much that can freaking HURT, like KNIVES, when your nipples aren’t toughened up yet and scabbed and raw. Mine were, even with Ike, for two full weeks. Everything changed at three weeks, but I sure as HELL offered him pacifiers or my fingers for the comfort sucking instead of my boobs. And if you told me not to do that and to only let him suck on me in spite of all that pain…well, if he was my first baby I probably would have quit. Anyway. Not sure why I’m bringing that up except to say that it’s okay to not do things according to the books. Nobody knows everything about breastfeeding, because nobody else will know what it’s like to breastfeed your particular baby. And that’s the real wild card here, because I’ve done this three times and am still making it up as I go along.)

Anyway. You’ll figure it out! You will do great. And if you have other specific questions once you get started, well, you know where to find me and my run-on sentences.

Amazon Mom

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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30 Responses to “Where’s the Beef (on Pumping)?”

  1. camille Jul 08 at 12:58 pm Reply Reply

    Be aware that the guidelines are to not introduce a bottle until baby is 6 weeks of age. However, if breastfeeding is going well, Harvey Karp (pediatrician and author of Happiest Baby on the Block) advises introducing a bottle earlier (at 3-4 weeks I believe) because if you wait even a few weeks longer, they may not accept it. My daughter never took a bottle, which caused a lot of stress and anxiety as I work outside the home (yes, she would basically scream her head off for 8 hours). With my son, we introduced one much earlier and he takes it like a champ. They’re very different children so it may have not been an issue even if we waited, but something to think about.

  2. karen Jul 08 at 1:11 pm Reply Reply

    Also try La Leche League’s international websites for resources or groups that meet in Germany. Depending on your general nursing support network, this could come in handy. I found this link: http://www.lalecheliga.de/index.php?option=com_content&view=article&id=428&Itemid=168.

    And for what it’s worth, I wish I had pumped less when my daughter was a newborn. I tried to make a big deal out of giving myself a break and letting my husband help feed but it was much more trouble that if I had been more relaxed and just pumped when I had a chance. Amalah is right, let your boobs do their job and your husband will help out in other ways. Not giving his child a bottle during the first few weeks will not cause your baby to reject him as a father or make him seem negligent. Interesting how the perspective on this changes after the first child comes through
    .

  3. Dawn K Jul 08 at 1:27 pm Reply Reply

    I went back to work full time at 11 weeks, and made it 6 weeks before I had to give up the pump, and ultimately nursing. “if anything, replacing feedings with the pump once I went back to work is ultimately what killed nursing for us completely” pretty much sums up my experience with the pump. There is no way that I was able to manufacture the same amount of milk Ella would consume by nursing. I actually got very poor support from the resources I sought out at all stages. However, I’m proud that I made it 4 1/2 months nursing. DAMN PROUD. A few tips if ou really want to try your hardest:

    -Formula is not the devil. Yest, breast is best, but healthy, alive baby is actually what is best, however you get there. Be mentally prepared to supplement with formula.

    -Find as many recources as possible. The hospital clinic I used didn’t actually staff any LCs, and my LLL experience ended up being pretty disappointing. Don’t hesitate to search for doulas or other community members to help guide you.

    Good luck!

  4. AJU5's Mom Jul 08 at 1:47 pm Reply Reply

    As for when to introduce the bottle – that part is funny. My daughter got a bottle before I even got to hold her 9NICU/c-section deal), and by 2 months she refused it because we went a week or two without giving her one just because there was no need. My son didn’t get one until he was a lot older (6 months I think), and he had NO problem. Both took pacifiers though with no problem. I normally pump 1-2 times a week just to have some in the freezer “just in case.” It isn’t enough to affect my supply really, so it works fine for us.

  5. IrishCream Jul 08 at 1:47 pm Reply Reply

    I had to pump starting at three days postpartum, as my daughter wasn’t great at latching on. It didn’t seem to affect my supply one way or the other. It may have dropped a little until we were able to stop supplementing with formula when she regained her birthweight at four weeks, but it bounced back to meet her needs within a day or two. That means, of course, that my daughter was drinking from a bottle from three days old as well. She did not have nipple confusion so much as nipple preference. She did prefer the bottle at first, which made establishing nursing tough, but we stuck with it and by one month, she loooooved the boob.

    All that is to say that things will work out for you and your baby. There will no doubt be some trial and error involved, which will seem like a huge deal when you’re exhausted and hormonal, but you will figure it out and come up with a system that works for you. Do your best to keep your perspective and go easy on yourself when there are hiccups. Good luck!

  6. Stephanie Jul 08 at 1:53 pm Reply Reply

    Amy – you give such great, no nonsense, guiltfree advice! 

    I wanted to add that my coworker just back to work (after baby number 3’s maternity leave) and her baby WILL NOT take a bottle.  He waits ALL DAY for her to come home to nurse.  She has to rush home during lunch and breaks and feed him. How awful!

    I completely agree that if you’re planning on going back to work, introduce that bottle sooner rather than later. 

  7. the grumbles Jul 08 at 2:35 pm Reply Reply

    So much of this will depend on your individual baby. Me? I went back to work at 8 weeks and introduced the bottle/pump at 6 to start practicing. Our son HATED taking a bottle, it was a huge battle at first much like Stephanie’s story above. In retrospect I wish I had tried a little earlier so it wasn’t such a huge shock from awesome boobs all the time to WTF is this plastic thingy. But I was so worried about my supply that I refused to EVER miss a feeding. I was maybe a little too crazy about it but on the other hand my supply flourished so… eh. I went on to pump at work for 15 more months so clearly the pumping thing worked out ok (for us).

  8. Kate Jul 08 at 2:49 pm Reply Reply

    I introduced a bottle (one per day) at 3 weeks on the nose. Introduced one daily pumping session – morning – at about 2.5 weeks, about 10 minutes or so. Have a bit of an oversupply (now back at work, 13w) but am making enough money during the day at work for twins. Will try to dial back (also have way more milk than I need in a freezer for daycare/babysitting) once I’ve been back for a few weeks, but I don’t think its been too bad on the weekends. I will still have to pump once per day (even on the weekends) but it hasn’t been too bad. 

  9. Kate Jul 08 at 2:50 pm Reply Reply

    I introduced a bottle (one per day) at 3 weeks on the nose. Introduced one daily pumping session – morning – at about 2.5 weeks, about 10 minutes or so. Have a bit of an oversupply (now back at work, 13w) but am making enough money during the day at work for twins. Will try to dial back (also have way more milk than I need in a freezer for daycare/babysitting) once I’ve been back for a few weeks, but I don’t think its been too bad on the weekends. I will still have to pump once per day (even on the weekends) but it hasn’t been too bad. 

    Ah, and he’s also had one bottle (now more than one) every day since the three week mark.

  10. Olivia Jul 08 at 2:57 pm Reply Reply

    My experience: 

    Introduced the bottle at less than a week because of latching problems. No nipple confusion. 

    Always nursed when I was with my baby, even at night, to make sure that relationship was never sabotaged.

    Went back to work when she was 3 weeks old, so I pump 3 x a day there. At around 4 months my supply WHEN PUMPING dipped. I had plenty for my daughter, the pump just didn’t empty the breast as well. So, we gave her 1 bottle of formula on work days and I continued to pump what I could and nursed on demand when I was with her. I think it’s important to remember breastfeeding doesn’t have to be all or nothing. If you can’t pump, or pump enough, your boobs and supply will adjust to just what your baby actually nurses given you’ve had at least several weeks to establish nursing well AND you keep nursing on demand when you are together.

  11. Kari Jul 08 at 3:39 pm Reply Reply

    Because I would be going back to work, we were advised to introduce a bottle at three weeks. The little guy is six months old now, and happily switches from bottle to nursing (and pacifier). I started pumping in the first week, just to relieve some of the pressure of my very full boobs. I have an excellent lactation consultant, and she said that sort of thing (a couple of ounces) was okay, just not to pump an extreme amount. Now I have a whole freezer full of milk (money in the bank, I like to call it). I will say that, despite me not wanting to believe it, I do have to pump four times for his three daily bottles. I pump three times at work, once in the morning, and even once at night to keep things high. But it doesn’t sound like you are planning on working, just wondering how to get some money in the bank. Don’t worry if you can’t get a whole bottle at one pumping, though.
    I agree with Amy that the nighttime feeding thing is tricky. After the baby starts sleeping more, you will have time (morning and night) to pump some extra milk. But I tend to think that generally it’s too much of a hassle to have my husband prepare a bottle when I can just lie in bed and feed the baby and get it over with quickly, letting all of us sleep more. But we have done it on nights I am super tired.
    (And we introduced a pacifier before the end of the first week because I needed him to STOP SUCKING ON ME OW OW OW.)
    To sum up, try to find some people you can trust who can help you answer questions. As you can surely tell from these answers, it varies!

  12. Bethany Jul 08 at 4:57 pm Reply Reply

    My son wouldn’t latch and I didn’t have a lot of resources because I live in a small town. Our nursing sessions were lasting more than an hour and then he continued to scream because he was hungry. I nursed for about 2 weeks and supplemented when I couldn’t handle the screaming anymore. I started pumping shortly after that and ended up pumping and exclusively feeding my son breastmilk from a bottle for a year. To complicates matters further, he had no problems with a bottle, but WOULD NOT take formula after those first few weeks. Luckily, I was also able to stockpile plenty of milk in the freezer. The worst part for me was having to throw out bags of frozen milk when we discovered food allergies and realized that I had been eating all of that stuff so it would be in the frozen milk. That saying, “Don’t cry over spilled milk?” That DOES NOT apply when talking about liquid gold! The best advice I can give you is to make sure you are eating and drinking A LOT of water. The rest will work itself out since so much of it depends on your baby. Good luck!

  13. EW Jul 08 at 5:22 pm Reply Reply

    With both of my kids (now 26 months and 8 weeks), we introduced a bottle around 3 weeks because breastfeeding was going well.  My husband always gave them the bottle, and we never saw any issues with nipple confusion.  

    My oldest did go on a bottle strike anyway, from 8 weeks until I went back to work full time when she was five months, but once I was gone long enough, she started taking bottles very well again.  

    With my oldest I would pump at the end of the day (typically getting very little) or to replace a bottle feeding.  Currently we have a quart of the stuff in the freezer, so am dropping the end of the day session for now!

  14. Hi, I'm Natalie. Jul 08 at 10:07 pm Reply Reply

    If you’re able to sleep through the night as a nursing mom… you will be my HERO. The first time my daughter slept through the night, I was extremely uncomfortable & was awake trying to express SOMETHING (my letdown was AMAZING with a baby and EXTREMELY crappy with a pump). I second the suggestion that midnight diaper-changes are dad’s best bet for being involved overnight.

    Also, I hope you have better luck with introducing the bottle – Even Amy couldn’t help me with that one! (http://alphamom.com/parenting/baby/bottle-strike/)

    Good luck!

  15. Katie Jul 09 at 9:32 am Reply Reply

    I had exactly the same questions before my daughter was born last summer! I think it’s nice to have a pump on hand when baby arrives in case you need to relieve some pressure (latching problems, oversupply, whatever the cause). But I found that all my concerns about getting a break and letting my husband be involved were a little off the mark. For the first few months, when I was not working, it was way easier for me to just be with the baby and nurse her – pumping was more hassle than nursing, and less pleasant once we got over the ouch-my-nipples phase*. I didn’t have a problem starting pumping and bottles when I went back to work about 5.5 months in. And like others have said, my husband got lots of involvement changing diapers (babe had her first smile on her change table!), ergo-ing around the block to calm her down, swinging her to sleep.

    *the most effective advice I got: for the first few days/weeks, express a few drops of breast milk with your fingers and rub them into your nipples after every feeding. Let air dry, coat with Lansinoh. This saved me – still a little sore, but no cracking or bleeding. 

  16. Michele Jul 09 at 12:30 pm Reply Reply

    My girls were using bottle/pacifier at 3 weeks, and take it like champs.

    I also pumped every chance I got between feedings , because with twins, I wanted to make sure my supply was enough for both of them. For awhile, I was only getting an oz or two at a time, but that improved. I did end up with oversupply at times, but found that if I pumped for 5 minutes before the babies latched, I was able to alleviate that (and build up a pretty decent freezer supply).

    I got a little lazy with pumping after 9 months or so, and I’m regretting it now. I stopped pumping in the evenings before I went to bed, and now it’s a lot harder for me to get anything useful out of the pump. My 11 month olds are still getting plenty while BF, but my bottle supply has dropped considerably.

    However it works for you, know that you are doing your best, and that’s all that counts!

  17. Megan Jul 09 at 10:52 pm Reply Reply

    I introduced a bottle when my daughter was just 4 days old. she took a bottle until she was maybe 3 weeks old and then completely refused any brand, style, nipple, anything! So it was ALL boobs, ALL the time! She would just scream at a bottle, no matter how long she had to wait for the boobs. I finally just accepted it, tried bottles and sippies randomly, and finallly weaned her at 14 months. She wouldn’t drink more than an ounce a day from a bottle for a week then I guess she forgot about breastmilk and moved on to cow’s milk. Also, I had no supply problems and never felt a letdown reflex. I was never nervous or anxious about pumping but I was never able to produce anything with a pump. It was a really draining year but she never once had a cold, fever, diarrea,nothing! Ahh, the joys of breastfeeding 8 times a night for months on end, I won’t miss you!

  18. Shannon Jul 10 at 1:10 pm Reply Reply

    My daughter is eight months old and I’ve been breastfeeding the entire time. I went back to work at 12 weeks. The one thing (other than a baby who has been a champion eater who doesn’t care where the food comes from as long as it KEEPS COMING) that has been most helpful to my continued success is a daycare that is about a half mile from work. I feed the baby before work, then I go on my lunch break and feed her again, then we nurse on demand all evening. Keeping up my supply with pumping has been a challenge, so the ability to limit the number of feedings that I must supply by being able to feed her during the day has been very important. A side benefit has been that it was a good way to help me adjust to being away from her during the day, which I was very anxious about at the beginning.

    I started pumping at around six weeks. I pumped for 10 minutes after some of her feedings. Most of the time, I got less than an ounce per pumping session. I froze a bag anytime I managed to get 4 oz together, and I also started leaving the house for more than 20 minutes, leaving a bottle behind in case the baby couldn’t wait for me to get back. By the time I started back to work, I had a small cache of frozen milk, which I’ve dipped into anytime there were supply issues.

    The rhythm that’s working for me is that I pump after the first feeding in the morning, once mid-morning, once mid-afternoon, and after the last feeding at night (that also helps me not wake up with rock boobs). Most days, this ends up supplying almost exactly what my baby eats during the day at daycare. Anytime I get 4 – 7 oz. extra stored up, I freeze it. Sometimes I have less milk (for example, right now, I’m struggling because I have a cold and an ear infection), and I can dip into the frozen milk to make up. Other times, I have more milk, or the baby isn’t as hungry one day and I can freeze the extra.

    Other things that I think have been helpful:
    1) fenugreek – I take it in capsule form, about 8 capsules per day.
    2) drinking tons (TONS) of water
    3) low flow nipples – even after we switched to larger bottles, I kept using the low flow nipples from the little bottles.
    4) lanolin – I didn’t have too many problems with cracking or pain, but the lanolin worked like a charm when I did. Bonus: we use it for all kinds of stuff now, so that one tube I got at the beginning didn’t go to waste. Baby’s got a dry spot on her face? Lanolin! Cracked lips on mama? Lanolin!
    5) An understanding employer. I scheduled my pumping sessions like meetings, and no one asks me to skip them. I leave at lunch every day, and no one asks me to skip (usually – there have been a couple of exceptional circumstances, but they’ve really been great about working with me on this).

    What my partner has been able to do to help is to change diapers in the morning at at bedtime (or during the night, when we were still doing nighttime feedings), make sure that I have time to pump at night, handle all the bottle feedings when those were necessary, basically any little chores that helped free me up to be the Provider of Milk.

    Sorry this is so long, I know how anxious I was about this before my daughter was born! Good luck!

  19. Liz Jul 10 at 3:02 pm Reply Reply

    You won’t know ahead of time whether your baby is one of the ones who will refuse the breast once they’ve had a bottle. I had a mom call me just a few months ago with just that problem. It took several days of hard work to get her back on the breast again, even though she’d nursed really well before that. There’s a good reason why most of the people in the lactation field are recommending not introducing a bottle before 4-6 weeks.

    That said, one trick for getting a baby to take the bottle for the first time is to have someone other than mom offer it. If the mom is even in the room frequently babies will refuse to have anything to do with the bottle. I knew a mom once whose doctor insisted babies be switched to formula at 3 months (this was obviously over 30 years ago). Her little girl went over 24 hours without eating anything because she didn’t want to take the bottle that her mom was offering. I suspect the dad might have had a better shot at it.

    And by the way, if you have cracked nipples there’s something wrong with the way the baby is nursing. Nipples may sometimes be somewhat tender initially, but anything that turns into a scab is an indication of poor positioning, no matter how great the latch looks. Keep moving the baby around until it feels more comfortable. The other thing that can irritate nipples is some pumps. Frequent nursing in the early days shouldn’t be uncomfortable, sometimes the problem is that moms aren’t nursing frequently enough so they get overly full and the baby has a hard time getting a big enough mouthful because the areola is too taut from being so full.

    But you’re right, every nursing dyad is different. They fit together differently for one thing, and each baby has their own particular approach to nursing.

  20. Amy J Jul 11 at 9:16 am Reply Reply

    I second http://www.kellymom.com I go there when I have a question. I started pumping in the hospital and have not stopped since. I have HORRIBLE supply and it was the only way to keep up enough initially and now I am back to work so pumping it is. I introduced the pacifier and the bottle on day 3 and have not had “nipple confusion”. You just need to remember that, like adults, all babies are different and what worked for me or any of the other commenters, may not work for you. Just keep trying and formula is not the end of the world if you need it. I am just greatful that when I need food for my child that I cannot produce I can get it.

  21. Jenny Jul 11 at 12:34 pm Reply Reply

    My baby had a bottle before she was a week old because my milk took five days to come in and I figured bottle > starving baby (it only lasted two days). I did one bottle a day for most of my maternity leave, but when I went back to work, she began majorly prefering the boob. She will no longer take a botlte from me or anyone else if she knows I’m within 5 miles. She’s starting to even dislike bottles at daycare. I also can’t pump worth a darn while at work and supplementing with formula induced major gagging and diva behavior from the babe (husband calls her the boob snob). Sigh. I’m hoping the situation improves soon, or at least stops getting worse.

  22. Hannah Jul 11 at 1:05 pm Reply Reply

    My little girl had to have a bottle her first day out (NICU, poor latch, etc.) and because it wasn’t a preemie nipple, after that, she wouldn’t nurse. Hated it. Spit out the boob and howled. So I pumped and bottle fed her, which she loved. LOVED.

    I went back to work at 6 weeks, and pumped for 7 months. I was able to supply her 6-8 bottles a day (I pumped, I think, 6 times a day – I clearly had no supply issues with the pump). So, YMMV – your kid might like the boob, like the bottle, hate the boob, hate the bottle – no way to know. The best advice? Whatever happens, don’t stress out about it. Stress will just make you crazier (and post-partum hormones are NO JOKE at the best of times), and crazy mama is not a recipe for a happy mama or a happy baby. Think zen, go with what works, and your baby will be healthy, happy, and eating solids before you know it.

  23. tasterspoon Jul 11 at 3:36 pm Reply Reply

    My baby started out with high bilirubin, so lots of formula via free flowing nips + UV lights for 5 days, anything to get the goop out of her system. I had a bed at the hospital, was on call round the clock every 3 hours: she’d nurse, THEN I’d pump to squeeze out the DROPS of colostrom and give her those via syringe, THEN she’d get a bottle of formula. And oh my goodness, the pain, the pain when she nursed! I could hear the new mother in the room next to me screaming obscenities every time her twin babies nursed and I was right there with her, man.

    One of my lactation consultants was all like, nurse through the pain, it’s the only way you’ll toughen up. Actually, the better advice was that it’s OK to take a break from nursing for 24-48 hours at a stretch so you can heal up. So I’d alternate, a day of nursing (oww!) with a day of pumping (ahhh). That was the ticket for getting through the first four weeks. (We also got one of those expensive widemouth bottles with the natural looking nip – preferred she practice on that than on me.) We gave the pump back after a month (though nursing wasn’t totally comfortable till 3 months). Let’s hear it for pumping: it is the only reason I am still nursing today at 8 months. (And I do prefer nursing – so portable, no worries about refrigeration…)
    After the first month she went 100% boob until we had a date night in month 4 (with daycare pending) and she shocked us by refusing the bottle. We just assumed since she had so much early bottle experience we were golden. She did come around, though, and to the frozen milk, too, so don’t psyche yourself out in advance. I’m not saying bottle wars aren’t real, but your own level of confidence and conviction (or that of your caregiver) does matter.

    Agree with Amy re sharing nighttime duty; I did all nighttime feedings, but now that we’ve instituted a no-nighttime feeds policy, my husband is the cuddle back to sleep guy. So your partner will get their chance/burden. And oh Mama, when you get six hours of sleep strung together, you will feel like a million Euros!

    Another tip not mentioned: the flanges come in different diameters. Get ones that fit.
    Other pumping tips? It is bo-ring. Get a pumping bra or find hands-free/one handed activities: weights to hold your book open or an eReader, one-handed snacks, etc. In the beginning I Tivoed a bunch of dumb movies my husband didn’t want to see that I watched in 20 minute installments to sweeten the prospect of pumping in the middle of the night.

  24. Margie Jul 11 at 7:29 pm Reply Reply

    Yes on the hands-free bra! Once I had my pumping routine down I watched hulu in my office while pumping and it was great.

    As you can see, everyone has a different experience, and normal is a huge range. My kiddo breastfed well with the help of a visit from our friendly lactation consultant and a phone call here and there (which is something you could keep in your back pocket. Even with the time change you could call a great LC over here for personalized help. Can I mention my specific one? Is that okay? She’s online if you Google Nurturing Mothers LLC.)

    I went back to work at eight weeks. I first pumped around 6 weeks and my husband gave her the bottle and it went okay. I only pumped when I had to until I went back (like maybe three more times?), and then pumped three times per day at work. I had three sets of accessories so I wouldn’t have to wash parts at work. I never got much stockpiled but always pumped one day what she would be fed the next. Except for hating to be away from her, it all went very smoothly.

  25. Megan Jul 12 at 3:29 am Reply Reply

    Amy and everyone who has commented so far: THANK YOU! This was the kind of explanation I was hoping for. I don’t know why this has been so hard to find over here, but it’s been difficult to get a ‘real’ honest answer. I really appreciate all the details and personal experiences. Of course every child is different, but this is information I can work with. Big thanks!

  26. Kathy Jul 13 at 5:42 pm Reply Reply

    With both of my children I started pumping while I was still in the hospital. My daughter was great at nursing and I still pumped several times a day just to stay comfortable. She nursed for a year. My son was too lazy to nurse and at 8 months refused to nurse at all. I still pumped several times a day until he was a year old. You just don’t know what your body or your baby will do. With my daughter I could have fed triplets. With my son I produced enough for him and a nice stock pile.

    Seek out resources, help from nurses, friends etc. Without the nurses at the hospital where I delivered I would have quit in not time.

  27. Shanon Jul 16 at 4:23 pm Reply Reply

    As for books on breastfeeding, i totally agree with you. My first had jaundice right off amd my book basicly told me I had failed. I later read The Breastfeeding Cafe and feel the book really got me pumped about the hard work that was ahead of me. I am a Doula and that is tje only BF book I rec. I also tell them that breast feeding is as difficult and ambigous as labor. Love your blog, just found it!

  28. Momma Fergie Jul 19 at 10:42 am Reply Reply

    Wait a minute.. You mean to say if I pump, then I should be able to hand of these night-time feedings to my husband??? (speaking to husband) You’ve had it easy for 5 months now… but not tonight I tell you… Not tonight :P lol…

    I’ve been pumping exclusively since week 2. My daughter had jaundice and had to have formula the first week to get the bilirubin out of her system. After have the bottle she refused to latch :( I have a Medela pump and LOVE IT! It’s the best investment I’ve ever made :) I started out pumping every 3 hours and got about and ounce out of each breast each time (it varies). Now at 5 months my doc says I’m a super producer. I only pump twice a day (morning and night.. once at work 9am and once at home 9 pm). I get about 14 ounces in each session. I owe it all to a good pump and also cupping techniques to increase output. Don’t be afraid to try things out and do whatever works best for you. I am also a first time mom and knew NOTHING about pumping/breastfeeding. I’m sure you’ll do just fine :) Good luck!

  29. April Jul 22 at 2:34 pm Reply Reply

    Just wanted to add my 2 cents that I started pumping at 5 days and it caused major oversupply issues. It was no fun to try to feed my baby and have her gag and choke – and my boobs were uncomfortable around the clock.  I completely agree with Amalah – wait a month before pumping (if at all possible).

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