Breast feeding advice

[Cybercere]

First, please DO NOT respond to this post if you are going to criticize me. I am suffering from severe depression during this pregnancy as I did with my last so believe me, I'm hard enough on my self already :-)

Here is my question:

My daughter is due in late December. I have to return back to work, at least part-time, very shortly after my daughter will be born (probably 3 weeks or so). Unfortunately, I am a doctor working in public health care so taking longer off isn't really an option. Yes, this sucks. I do want to breast feed, but I'm considering exclusive pumping. With my son, who is now 8, I was unable to breast feed due to several factors (including his lactose intolerance and severe post partum depression). So, I didn't have a great experience the first time around. I do, however, realize the importance.

So, my question - exclusive pumping? who's done it? Advantages? Disadvantages? My midwife suggested I attempted to start baby on breast anyway, and my concern is that 1) it won't work and 2) I'll be so exhausted I'll not be able to go back to work when I need to. On top of all this, my husband is deploying three weeks before baby is due, so I'm concerned that I'll need my rest to be single mom to two.

Suggestions?

C.

[KristyDi]

You sure are dealing with a lot right now.

I've not pumped exclusively and really haven't pumped all that often so take my thoughts for what they're worth.

I agree with your midwife that you should start the baby on the breast. IMO feeding at the breast is easier than pumping. Once you get the hang of it you can nurse side lying and even doze through nursings. Rather than dealing with pump parts and bottles and keeping your babe happy while you pump you can just lift your shirt and latch that baby on.

If it doesn't work you haven't lost anything. You can still switch to pumping.

I'd suggest you find a good international board certified lactation consultant before the baby's birth so you have someone to call right away if there are problems. Also I'd suggest you connect with your local LLL group before the baby is born. It can be so helpful to talk to women who are or have been where you are.

Lastly, I have a feeling you've explored this already but thought I'd mention it just in case. A good friend of mine suffered pretty badly with PPD (post partum depression) with her first and it made BFing her first very difficult. With her 2nd she started Zoloft (can't remember if she started it before the birth or just after) and has had a MUCH easier time. There are meds you can take even while you BF.

Oh and thank you and your family for your husband's service. I have great respect not only for soldiers, but for their families.

[PatioGardener]

Oh Mama, that's a hard situation.

I can tell you that there is some evidence that shows PPD is less of a risk in women who breastfeed. If you did have good LC and midwife support for the first few weeks and it did work, then breastfeeding at night and bottle feeding during the day may really help with sleep, PPD, etc. So I can understand your midwife's thoguhts.

I can completely understand your fears though. I hope you get some good information here that will help you balance risks and benefits in the way that works best for you.

Best wishes for the birth!

[paxye]

I agree with your midwife. I would breastfeed and then switch to a mix of breastfeeding and pumping... using pumped milk only when you are not with baby...

I believe that there is often a direct correlation between PPD and the lack of breastfeeding. Though pumping is not as harsh as formula feeling in that aspect, pumping does not stimulate the same hormones as breastfeeding does.

Also, if your baby is in daycare, he/she will pick up a lot of illnesses... though pumping may transmit your antibodies, if you are not breastfeeding you will not have the benefit of creating antibodies for what the baby has been exposed to.

Breastfeeding can be tricky at times to start but it is not a lot of work IMO compared to pumping, sterilizing, filling, and reheating bottles...

I think a good plan of action may be to breastfeed exclusively until after the 3 week growth spurt or even until after the 6 week growth spurt then to start pumping while breastfeeding to start a freezer stash... I wouldn't worry about getting baby to take a bottle before starting daycare... it is harder for a baby to take a bottle when the breast is right there so it might just cause more confusion and frustration then needed... just trust that baby will take a bottle when hungry when mom is not there... when you go back to work you can breastfeed before leaving, when you get home and at night... it is a great way to bond after a long day...

Also, if you are co-sleeping, breastfeeding at night means that you hardly have to wake up and you will most likely feel a lot more rested for the next day..

eta: I thought you were returning after 8 weeks... misread the 3... sorry...
For pumping advice then I would start only after week 2 to start a stash... there is a change in the milk around that time and you will have had at least 2 weeks to start your supply with baby only...

[bodhitree]

Originally Posted by paxye

Also, if you are co-sleeping, breastfeeding at night means that you hardly have to wake up and you will most likely feel a lot more rested for the next day..

:

Your babe will need to be fed at night one way or the other. If you are exclusively pumping, you'll need to wake up to pump in the middle of the night, and then you'll also need to bottle feed the little one. Both of those involve waking up fully and getting out of bed. On the other hand, if you cosleep and breastfeed, you can just roll over, get the baby latched on, and go back to sleep. I think it's a good idea to think about how to minimize your sleep deprivation, especially if you're going to be a solo parent for a while. I just think exclusively pumping (for many women who try it, anyway) is more time-consuming than pumping part-time and will result in less rest for you. Also, some women find it challenging to keep up a good milk supply if they're exclusively pumping. Putting baby to breast makes it much easier for your supply to regulate itself.

And regarding your other concern, there's no reason why breastfeeding can't work if you have good support from a good lactation consultant when you need it (barring a few very rare situations). It may be hard for the first few weeks, but if you keep on going and get help when you need it, it WILL get easier.

I also wanted to say I'm so sorry you're experiencing severe depression while you're having to deal with so many other challenging things. I know that is so hard. Please don't hesitate to come back here and ask for help if you need it!

[Carlin]

I exclusively pumped for 2 days, and I have to say it was far, far more exhausting than breast feeding. I have a ton of respect for anyone who has exclusively pumped for a long amount of time, but it seems to me it is a much harder route to take. You may also find that this baby is totally different from your last one and may have a great breast feeding experience.

[Rivka5]

I'm also a working mom, and I have a postpartum anxiety disorder. I too was unable to nurse my first baby despite REALLY REALLY trying, and so I know firsthand the nightmare spiral that breastfeeding problems can be, and how scary it is to think of going through that again.

First, I would suggest that you see what kind of nurser your new baby is. I totally get that you can't handle another situation like trying to nurse your first. But for me, my second baby was completely different. He "got" nursing right away and gained weight beautifully and never had any problems, and nursing him wasn't stressful at all. So you might want to think in terms of making a plan for what you think you can tolerate and what you think would be grounds for stopping, instead of deciding from the outset not to do it.

Second: in my opinion, pumping is pretty stressful. I always feel a little worried about keeping up (and when I first went back to work I was VERY worried) and the logistics can be difficult. Pumping at home when you are the only one who is available to take care of the baby is very difficult indeed. I am concerned that by planning to pump exclusively you are setting a bar for yourself that is much too high, and is going to cause you a lot of stress and worry.

Honestly, if I were in your situation - going back to work at 3 weeks, husband leaving, severe depression - I would keep firmly in mind the fact that every drop of breastmilk is beneficial. It's not an all-or-nothing thing. I would nurse my baby when I could, and when I couldn't, I would use formula. I am a huge proponent of nursing, but I just don't see how your situation is going to permit it. It really is okay to use formula when you have to.

Finally, I hope that you have good care providers who are being aggressive about treating your depression. There are safe medications for both pregnant and (if you decide to go this route) nursing mothers.

[_betsy_]

You have so much on your plate right now.

Try not to stress about what happened last time. It's in the past and you can't change it, but you can try to have a positive, optimistic attitude about the future, you know?

Pumping is a lot of time and work, and if you can feed directly from the breast while you're together, it'll be a lot easier on you.

Do try to get as much help and support as possible. LLL is a great place to start!

Good luck!

[MeepyCat]

I like Rivka5's advice, and will add my experience to it:

I nursed at home and pumped at work and school for nearly a year. It was not always easy - some days it was damn near impossible. The people who kept me nursing were not the gung-ho Breast is Best folks (although those folks mean well), but the gentler ones, the ones who told me that if I wanted to stop, it was okay. By gently assuring that I was still a good mother no matter what my son ate, they kept me from being too hard on myself and helped us build a breastfeeding relationship that we could sustain.

I feel like sustainability is going to be a big factor in your situation. With two kids, a demanding work schedule, and your husband deployed, I think you need to do what you can, when you can. You only have so much energy and so much time, and you need to meet your own needs in order to be able to care for your children. Get as much help as you can, and if some of that help is cans of formula, then that's the way it is.

[petra_william]

i agree that for the first couple of weeks to get your milk supply established and to make things easier for you all round breastfeeding would be the best option. after two weeks start pumping (you can also do this while nursing on teh other side which often works easier and allows you to get more milk) to build up a stash in the freezer. i also agree that it will be so much easier for you if you could breastfeed when you are wiht the baby and let her be fed by bottle (expressed or formula or both) by the daycare provider. that way you are not having to get up in the middle of teh night to pump or warm up bottles and can just roll over and nurse your baby right then and tehre without really having to wake up which will be a huge benefit as you need to be alert for work too.

i know i couldnt go back to work so soon and i feel for you that you've got so much on your plate. i hope things work out ok for you and you can build a happy nursing and pumping relationship with your baby

[Cybercere]

Thanks all!

Thank you all so much for the supportive and practical advice. I am going to meet with the lactation consultant at the birth center where I plan to have her. We also made a good decision over the weekend - one of our best friends who is a part-time single dad and police officer who works alternating shifts will be moving into our house for the next 18 months. He needs help when he has his kids and lord knows, I'm going to need help so we decided to co-parent for a year. He can't breast feed but he loves babies and kids and is trained to go with little sleep :-). And best of all, because I have a flexible schedule, my daughter will stay with him when I'm at work so she won't have to go to a day care (not that I am against them, just haven't found one I really like for someone so young!) I'll keep you all posted and thanks again for the support - it really helped.