re: Boobies 101 - for mommas who intend to nurse

CAN'T I JUST PUMP & BOTTLE-FEED?

Sure, you can...but there are plenty of reasons not to go that way & you ought to understand them before making that choice.

Pumping does not work as well as nursing for most moms. This works in 2 ways - firstly some moms NEVER have good pump output, no matter how much they try & secondly - some moms respond really well to the pump initially, but long term, even those moms tend to loose supply if they are doing no nursing.

Like I said in a prior post - the compression of the baby's jaw actually aids in prolactin levels - so a pump is a very different input for info - it really only does milk removal. Milk removal is one signal to make more milk, but not the only signal. The other thing moms do - when they respond well to the pump, they often don't do what you are "supposed to do" with pumping, which is pump in the same pattern a nursing baby often eats which means 8-12 times per day - day and night. So babies are born with tiny tummies, after a week or so they often will do about 1-2 ounces per feed. But mom is early on & she is still in her engorgement phase, so she may find she makes 4 oz per session. So she skips a pumping - because she pumped "2 feeds" in one session. Some moms wait until they are super engorged to even pump, because then they get more milk for their efforts & the flow is faster, so they get done faster. So mom might pump every 2 hrs & get 2 oz per session, then skip one & pump at 4 hrs & notice she got 4 oz. So logically she thinks, why go through the hassle & set up for pumping every 2 if I get 4 if I wait...but the problem is, over a short bit, the milk supply WILL drop - because the body receives different messages than what is happening. If baby eats every 2, mom should pump every 2. The ONLY way to properly regulate supply is to pump in accordance to baby's feeding patterns. It is why I chuckle in my head when people say a mom should "just pump" when she goes in public...well then Einstein, what happens when she is engorged, baby is crying to eat, her milk is letting down because he r body knows it is time to eat & then she pulls out a bottle. She she also pull out a pump to alleviate her engorgement & to maintain supply or does public pumping bother you too? LOL

So yes - if you must pump, you can. I wouldn't recommend it as a lifestyle choice because it is all the work of nursing and all the work of formula feeding and then some. It's work with a capitol W. I would do it for work (and I did) I would do it if my baby needed me to (like baby was ill or preemie & unable to feed) . I would NOT do it ":just because" - it is just a lot more work than nursing is.

If you find yourself struggling with latch issues & such, do NOT revert to pumping if you can help it. You may not get baby back to breast & you will be stuck with a FAR harder way to feed baby in the long run. If you do plan to exclusively pump OR if you are in a situation where you have to do so, join an online support group It is not easy to maintain supply AND it's a ton of work, so you will really benefit from the advice & experience of BTDT mommas! My hats off to anyone who can do that & make it a year. I thought it was hard enough doing it for work...for real.

Quoting justanothamotha:" HOW MILK SUPPLY WORKS When a baby nurses they have a specific jaw movement they do that is kind of like ... [snip!] ... after to get back on track. :/ It will not always be so touchy as it is early on, but those first few weeks are tough."

I was also going to mention that the body naturally produces the most prolactin between 1-2am. This would be a critical time to stimulate the breasts, especially in someone having "supply issues". This is often the time when many women want to suppliment to get more sleep, but it is the worst time possible to do so for ones supply. I discourage supplimentation at this time more so then any other time.

Quoting nursemaya -mommy to 2:" I was also going to mention that the body naturally produces the most prolactin between 1-2am. This ... [snip!] ... it is the worst time possible to do so for ones supply. I discourage supplimentation at this time more so then any other time."

ABSOLUTELY.

Here is a study too that was done (it's small) that showed that bedsharing infants took in much more milk at night than non bedsharing infants. http://pediatrics.aappublications.org/content/100/2/214.abstract

I bedshared because we needed more sleep (I had an all night nurser) and because I worked at 6 weeks & knew that it helped to promote & protect milk supply. EVERY momma must make her OWN determination about where everyone should sleep AND understand what constitues a safe bedsharing environment & what hazards you MUST address before putting an infant in your bed.

Quoting justanothamotha:" ABSOLUTELY. Here is a study too that was done (it's small) that showed that bedsharing infants took ... [snip!] ... what constitues a safe bedsharing environment & what hazards you MUST address before putting an infant in your bed."

That's something that I could never do - at least not at night. I am far to paranoid that baby would fall. For me it worked best to nurse in the chair in the nursery. This is just proof that there are many ways to cope with night feedings and one must find what works best for them.  

Quoting nursemaya -mommy to 2:" That's something that I could never do - at least not at night. I am far to paranoid that baby would ... [snip!] ... nursery. This is just proof that there are many ways to cope with night feedings and one must find what works best for them.  "

I started that way & started falling sleep holding him. I researched it & if you are in a "safe sleep' bed, it is safer than sleeping in a chair holding an infant - or rather falling asleep while holding them (I wasn't trying to sleep there). That is when I had enough...I was scared to death I'd let him slip into a bad spot because I couldn't stay awake. He was averaging waking every 45-90 mins & I had to work...there was no choice in that & at 6 weeks when I went back I was lucky if I got 1 2 hr stretch in w whole night. :S Not good.  

And yes - there are LOTS of different ways to do it & none is "right" except what is best in that particular situation.

Quoting justanothamotha:" I started that way & started falling sleep holding him. I researched it & if you are in a "safe ... [snip!] ...   And yes - there are LOTS of different ways to do it & none is "right" except what is best in that particular situation."

I can never sleep in chairs - especailly our horrid rocking chair. That thing was the most uncomfortable beast ever lol

Quoting nursemaya -mommy to 2:" I can never sleep in chairs - especailly our horrid rocking chair. That thing was the most uncomfortable beast ever lol"

I once fell asleep holding him upright between my breasts as a tiny newborn (he would cry & cry when I put him down) & I drooled on his head & his soft spot caved in & collected the drool like a bowl.   When I woke up (I was probably only out a few minutes - because I am a drooler when I am overtired & the drool woke me) I flipped out & called the L&D nurses hysterical & bawling about how I brain damaged him. They assured me he was fine, to put him down & go to sleep. I think he is fine - he is 5 now & very bright, thank heaven. I can't fall asleep setting up either at any other time - but he seriously just never slept & it got so I couldn't even talk straight & would fall asleep anywhere at any time & say random nonsensical things that sounded like I was a stroke victim, literally.   I once told my MIL that his farts were really expensive & we still laugh about it now because I have no idea what I was trying to say - it wasn't supposed to be about farts OR money though - I can promise you that. I followed it up to explain myself by telling her that "soy grows on peanuts"...and then I handed her my baby & went to bed.  

THE FIRST FEW DAYS:
If possible tell your birth staff of your intention to breastfeeding & let them know you'd like to nurse ASAP. Ideally you will breastfeed within the 1st hour after birth. Babies have a very strong reflex to latch right away & are normally very alert & calm in that 1st hour. Here is some great info on what to expect when nursing right after birth: http://www.askdrsears.com/topics/breastfeeding/rightstart-techniques/tips-breastfeeding-immediately-after-birth

Now over the next few days HOPEFULLY latching goes well. Some babies will nurse very very frequently, others may need a little encouragement if they are drowsy. On day one in particular there may be a lot of sleeping. After day 1 try to make sure to put baby to breast at least 8 times every 24 hrs and aim for closer to 12, even if baby isn't seeming to cue. You want to attempt to offer about every 2-3 hrs, even with sleepy babies, in order to get your milk established. Most likely this won't be an issue as most babies will cue to eat often enough on their own, not all do though.

If you experience any significant pain or soreness enough to make you want to avoid nursing, get help. Latch is not something you grin & bear it. If it is not right, it won't magically become better. You will continue to see pain increase. About day 3 or so many babies "perk up" and your previously docile baby will start to nurse more often, wake more at night,e tc. this is COMMON, not a sign that anything is "wrong".

On day 1 baby needs at least 1 wet diaper. Day 2 baby needs 2 & about day 4-5 this will change over to about 4-6 every day from then on. "Wet" is about 45ml of fluid. You can put 3 tablespoons of water into a dry diaper if you want to feel what that feels like. By day 4 the poop should change over from tarry & sticky to looser & yellowish with some curds in it. Early on babies often poop with every feed. For the 1st month baby MUST poop daily. After 4 weeks ANY stooling pattern is normal...5 times a day all the way out to not pooping for 7-10 days...no joke. This has to do with the maturing of baby's intestines & the high digestibility of breastmilk. But in that 1st 28 days (the neonate period) pooping daily is what should be expected from a breastfed baby & if baby is not pooping daily, then a trip to a lactation consultant is in order.

Weight loss - this seems to be of large concern to many....so bookmark stuff to help you remember this. If you get IV fluids before birth, your baby is likely to experience MORE weight loss. Ask your staff to do your baby's baseline weight 24 hrs AFTER delivery. When baby carrie sextra water weight from the IV's, it spends the 1st 24hrs doing diuresis....or excessive urination in order to rid the body of excess fluids. By 24 hrs your baby has likely gotten rid of all the extra fluids & is now at it's baseline weight. If the weight is taken before this point, you can get alarmist reactions from staff that your baby has "lost too much weight" when in fact your baby is doing just fine. You can find the info to back that up here: http://www.internationalbreastfeedingjournal.com/content/6/1/9
I actually printed stuff out like that & took it with me. Many of you ladies are so handy with your laptops you can likely link right from your room at the hospital.  

JAUNDICE:
PLEASE read info on jaundice before delivery. It impacts 50-70% of all babies & therefore IS something you want to be aware of beforehand so you can know what it means, what to expect & what to do (and not do).

Here is EXCELLENT INFO on it from Dr. Jack Newman: http://www.nbci.ca/index.php?option=com_content&view=article&id=79:breastfeeding-and-jaundice&catid=5:information&Itemid=17 (can't get it to let me imbed the link for some reason).

Basically this article explains why supplements are normally never necessary or desirable. If you have a jaundiced babies, it is common to be pressured into using supplements. If you have proper info on your side you *can* avoid this. I did not have proper info the 1st time. They easily talked me into supplementing because I was overly fearful & not at all informed about the real protocol, what the real "dangers" were & weren't, etc. With #2 I came equipped with a much better understanding & he was never supplemented & his levels were higher than #1's were & came down faster. Go figure. :/ You live & learn.

I am wanting to build a stock pile of my milk asap. Is it ok to start pumping after she gets here once my milk comes in or will that up my supply too much too early??

Quoting Tattooed Mommy to Be:" I am wanting to build a stock pile of my milk asap. Is it ok to start pumping after she gets here once my milk comes in or will that up my supply too much too early??"

It depends on the momma as to whether it will create over supply. Generally speaking it is a good idea to pump 1st thing in the morning for best output & you want to establish pumping at the same time of day for best response from your supply. Your body not only set overall milk production based on patterns of feeding & pumping, but also times of day. So if your body gets used to pumping in the morning on top of feeding, then your body will be more likely to cooperate with giving you a decent output. So if you want to pump more than that, pick general times & do it at the same times every day for best response.

It is not necessary to stockpile a lot. If you are returning to work soon, you will generally want to feed baby the freshest milk and use your stock pile for emergencies or if you happen to have trouble with pump output. Otherwise, you normally pump Monday what baby eats Tuesday, so try not to stress over it. I tried really hard to get a stockpile with #1 & it really wasn't needed for reasons I already explained. I never bothered with #2 at all, but I also was home. I pumped when I wanted to & only for things like relieving engorgement & I never an into a situation where I didn't have milk for him when I needed it.

Quoting Tattooed Mommy to Be:" I am wanting to build a stock pile of my milk asap. Is it ok to start pumping after she gets here once my milk comes in or will that up my supply too much too early??"

If you want an excess of milk (I did) pumping after feedings will create an additional supply for you. I pumped after each feeding with my first and had HUGE amounts of milk. It probably could have been termed over supply, but it did not negativly impact the baby so I was happy with the situation. It all depends on what you want for your life style. The decision should not be made without taking into account your personal situation as well. Are there things that might impact your supply already (breast surgeries, history of thyroid issues, PCOS, gestational diabetes) all these things might make it wise to generally increase stimulation anyway. There are also homone imbalances that can cause one to alreay produce excess amounts of milk. You may want to figure out if you have any of these issues before decideing to do additional stimulation

Question!

I both nurse and pump. I pump because two days a week I am away from my baby from 9am- 9pm and he drinks 4ounces every 2-3 hours.

First question: Is 4ounces of breastmilk too much every 2-3 hours?
Second question: because I pump I have an oversupply, particularly on one boob (because I manually pump that boob while he eats from the otherside at night). my DS chokes on that boob everytime he eats -- what should I do?

Thank you for your assistance!

<blockquote><b>Quoting nursemaya -mommy to 2:</b>" If you want an excess of milk (I did) pumping after feedings will create an additional supply for you. ... [snip!] ... amounts of milk. You may want to figure out if you have any of these issues before decideing to do additional stimulation"</blockquote>

I do have gestational diabetes. That decreases your supply? The reasons why I am wanting to pump a stock pile is so I'm certain she has enough and so that after the first few months my fiance can help with the feedings. I won't be going back to work for at least the first 6 months. I should (hopefully) have a good supply going by then.

Quoting Tattooed Mommy to Be:" <blockquote><b>Quoting nursemaya -mommy to 2:</b>" If you want an excess of milk ... [snip!] ... feedings. I won't be going back to work for at least the first 6 months. I should (hopefully) have a good supply going by then."

It doesn't inherently decrease supply, but can. I have thyroid stuff, but it has never been a hindrance & my niece had thyroid cancer & had her thyroid & parathyroid removed and have an almost 12 lb baby & never supplemented. Knowing issues that *may* be hindrances* helps you to make sure you are stellar in what you do early on to ensure you avoid issues. Moms who "break the rules" and get away with it (skip feeds & such) are likely moms who don't have ANY issue that may predispose them to supply sensitivities.

Quoting Tattooed Mommy to Be:" <blockquote><b>Quoting nursemaya -mommy to 2:</b>" If you want an excess of milk ... [snip!] ... feedings. I won't be going back to work for at least the first 6 months. I should (hopefully) have a good supply going by then."

with GD we see a delay in the milk coming in - where a GD woman's milk will come in on day 5-7, one without will have it come in at 3-5. There is also potential that the supply will limited, especially without frequent stimulation. I too was GD in addition to having PCOS and a whole crap ton of other health problems and I had no issues with supply, but I did pump after each feeding.