Breastfeeding Schedule Confusion

[Darryen]

A friend of mine wrote this for me but I'm kinda confused. Can you help explain?

Here is what you need to do.

Nurse the baby AT LEAST every 2 hours (day and night). If he wants to nurse more then let him, but it needs to be at least every 2 hours.

Next you let him nurse until he pulls of. I mean the kind of pull of where they and they don't want it anymore. Some babies in the beginning have a hard time staying latched so if they pull of after a few minutes then you need to put them back on. At this age it should take 20ish minutes a side.

After you nurse one side. Burp him, change him, get him good awake and offer the other side. Once they are finished with that side then pump for 10 minutes. Repeat the process in 2 hours (from the time you started NOT the time you finished).

You HAVE to do this day and night! Its extremely important to nurse at night during the first 6-8 weeks b/c it helps establish your supply. Not nursing at night will likely cause your supply to drop.

My response was:

So essentially, nurse for 40mins or so, pump for 10 mins per side, then wait an hour and start all over? How long is the schedule like that? He is 1 month old now and 8lbs if that matters. I don't mean to sound critical. I have read similar things so I know you are right but I am seriously confused... How do you have time to do anything with a schedule like that? Do you just not pump while out grocery shopping or something? When do you find time for cleaning and laundry? I could take a shower during one of those hours I am not feeding or pumping but I def. can't cook, clean, or shop within an hour's time. Do mom's just sit at home and not do those things for the first couple of months? That just doesn't seem plausible. I REALLY want to breastfeed exclusively and if this is the way then I'll make it work but I'm really confused on the logistics of the schedule.

[treegardner]

Pumping isn't necessary, unless you are trying to build a stash. There isn't a lot of time for other things in the beginning but it gets better. DS nursed almost every hour as a newborn.

[AnnR33]

Oh my, first just take a deep breath and try to relax. If your babe is 1 month you must already be nursing right? Or or you trying to re-lactate?

The great thing about nursing is you DO NOT need a schedule! No offense to your friend, but that rigorous schedule is not the norm. Baby will nurse when hungry and that may be every 2 hrs or 3 hrs or even a little longer at night. The "rule" is that babies should nurse 8-12 times in a 24 hr period. Some nurse more often in the early weeks too.

You don't need to offer both sides at each feeding unless you think baby is still hungry. I would nurse until they are done actively nursing/suckling and they will typically pull off but sometime fall asleep still latched. 5-20min is normal for a feeding per side.

You do not need to pump at all. This will only increase your supply unnecessarily. By feeding on demand your supply will regulate itself.

Your friend may have had some issues that she needed to do those things but those things are not needed for everyone.

Good luck and feel free to keep asking ?s

www.kellymom.com is a good resource too

[stormborn]

Were you having problems with supply or baby gaining weight?
Unless there's some special circumstance you don't have to watch the clock or pump. That's not to say that baby won't have to eat that often....but he'll let you know...no need to time it or wake him up.

[HoosierDiaperinMama]

Nurse on demand, mama! IMO, there is no schedule when to feed your baby. I would thank your friend for her advice, but I don't think you should follow a schedule and do all that pumping unless, like a pp said, you are needing to have milk to put away. I wouldn't limit time at the breast either. Baby will let you know when he is done.

[MeepyCat]

What AnnR33 said.

This kind of scheduling advice is why women think breastfeeding is too hard. Forget "how would you grocery shop?" - when would you sleep? At some point, the effects of stress and exhaustion do begin to counteract the effects of all this pumping and nursing. I know that there are circumstances in which this kind of demanding schedule is necessary, but for most moms and babies, these recommendations are exhausting overkill. You need to establish supply sufficient for the babe or babies you have, not for a refugee camp full of orphans.

[Darryen]

Long story short - he was early (3 weeks) by c-section and I was on magnesium so he didn't eat without being forced awake for the first 2 weeks of life or so. He has been supplemented with formula up until now. For his 3rd week of life he was awake enough and big enough to suck at the breast but only screamed when I put him to it because it was too hard to get the milk out compared to the bottle (we have pretty much narrowed it down to that since it isn't a food allergy or anything else that was suggested might be wrong). Then in the last week or so I have gotten him able to suck a few sucks but then he is done and wants his bottle. We bought a SNS to start out on the fastest feeding speed and gradually slow the formula (or expressed milk when I have enough - he is eating about 25-30oz a day now) until he will get back on the breast alone. My mom is also going to ship me some of those Breastflow bottles in case DH needs to feed him or I for some reason can't use the SNS and he needs to eat so he doesn't get confused. This whole thing was all started wrong. I was afraid my breasts wouldn't work because I had a reduction but they do... only now he doesn't want them. Hrm that wasn't really short but comparatively it was.

Even with only sporadic pumping (I've been really bad about that since its so depressing) and no breast feeding my supply is still good. I have let down (I think) but I don't "feel" it. Whenever any baby cries or I think of my baby my breasts ache and leak which I have read is let down but I also read that I should feel it which I don't. That may be because of the surgery though since I don't have too much feeling in my breasts.

Ok, so here is my next question/problem. I am thinking the SNS will fix this but if not... When he is hungry he will only take the bottle. He only fights my breast and screams if I offer it (even when he very first becomes hungry). If the SNS doesn't work, should I offer an oz or so of bottle then the breast when he shows signs of hunger? Which btw has been constant this week. He has been napping for an hour or so and when he wakes he is starving (he thinks ). I'm not really sure how to transition him back onto the breast but I really think its best and I am pretty sure it can be done. /sigh I hate that all this happened. I just want to get past it and back to how it was supposed to be to begin with.

[MamaPhD]

First of all, great job so far!
I think baby is preferring bottle because it is easier to suck. In that case, you can pump for a few minutes, have your bm flowing well, and then latch him. That will be easier on him. As far as pumping, I would continue with it more regularly to give bm in bottle since it sounds like he will drink from bottle for a while. One of my friends actually pumped 4 times a day and fed bm in bottles only (not from boob) because her baby preferred the bottle but she was able to do this for at least 9-10 months (I think maybe until 1 yo?), so that maybe another option for you.
But I would say keep trying the boob. Good luck!

[MamaJenese]

You are dpoing a wonderful Job! I just wanted to let you know not all women feel a let down. I have never had any breast surgery and have nursed 2 babies for a combined 4.5 years and have never felt a let down.

[zjandosmom]

My 1st was a preemie (8 wks early). For me...I had to cut all bottles. It was hard but it was the only way to get him to the breast. I would pump to get the milk flowing and then latch him on. He was like your son and did not want any part of it at first. I was determined to do this one thing right. I did not allow any bottles and would rec you do the same until your nursing relationship is firmly estabished. It's too confusing to baby to offer both. HTH

[rachelsmama]

It sounds like you are well informed enough to recognise what's going on, and that's half the battle right there. Two little ideas that might help a little at some point: breast compressions to speed up the milk flow, and cup feeding instead of bottles if you're giving an appetiser. Also, if you spend time topless with your little guy snuggled against your boobs in a sling it might help him make friends with them. I rarely ever feel letdowns either, and my boobs are un-reduced.

[AnnR33]

You're doing great-keep it up!

The other advice I'd offer about the bottles, when you have to use them get the really slow flow nipples. Yes, he prefers the bottle because it's easier for him. So to change his association from "Bottle=easy and fast flow" to "bottle=work" I don't know of any brand names, but I know they are out there.

Take things day by day, keep taking baby steps. It will be hard work but sooo worth it for both of you! Support is so important so try to find a support group or LaLeche League group.

As far as pumping, I would still offer the breast at each feeding but if he does not nurse then I would pump. Even though you think your supply is OK, it can change quickly so you want to be consistent with either the nursing or pumping just so your body gets into the cycle of producing milk when he eats.

You go girl

[HoosierDiaperinMama]

Originally Posted by AnnR33

The other advice I'd offer about the bottles, when you have to use them get the really slow flow nipples. Yes, he prefers the bottle because it's easier for him. So to change his association from "Bottle=easy and fast flow" to "bottle=work" I don't know of any brand names, but I know they are out there.

We've found the best bottles to offer when I have to be gone for a few hours are Avent with the slow flow nipples. They are $10 for the 9 oz. size, but they are well made and worth the extra $$. We just have one b/c I am not away from DS much.

Keep up the great work!!

[Darryen]

My mom is searching for a bottle called the Breastflow bottle by First Years. It mimics the breast nipple by making baby suck and compress to get the milk out. Here is a link to it. Breastflow Bottle

When I tried to cold turkey the bottles he refused to eat. I went several feedings and nearly half a day of him not eating before I gave his bottle back. I don't think I could go an entire day without him eating... I am hoping this SNS will work. I have it all set up and we are going to try it today to see what he thinks of it.

Thanks so much for the encouragement. This has been such a struggle. I am making an appointment on Monday to talk to someone about it all and the birth. My depression is getting out of my control so it's time. I'll keep you all updated.

[Juvysen]

Yeah, it's gonna be kind of a lot of work for the first few weeks until the baby figures out the nursing thing. No, that's not how it'll stay, so take heart Once you have a baby that's used to the bottle, though, it can be a problem getting them to the breast. Luckily things can go fast once he figures it out

I can see suggesting pumping *only* if you're not sure about your supply, or for use as supplementing. An SNS would probably be helpful in getting your baby to switch over, but the pumping a bit first, like others mentioned, can help... gets the milk flowing and also makes your nipple more elongated (sorta more like a bottle... might feel more familiar to him).

[Ruthla]

OK, with the extra information you gave in later posts, the suggestions of your friend make a LOT more sense.

I don't quite agree with pumping after every single feeding (which IS appropriate if you're building up your supply or relactating) but offering the breast every 2 hours makes a whole lot of sense in your current situation. You said the baby won't accept the breast when he's super hungry. So, you want to offer the breast BEFORE he gets super hungry, so he'll accept it. I'd suggest keeping him in your bed at night to make it easier to nurse him frequently at night- but it really IS ok if he has 1 longer stretch of sleep (4-5 hours) each night, so you both get more rest.

Ideally, you'll be able to get him off bottles completely very soon. In the meantime, keep the bottles small- no more than an ounce- so that he'll want to nurse after finishing the bottle. It would be even better to offer any supplemental milk (preferably your own pumped milk, not formula, which will keep him full longer) in something other than a bottle, such as a syringe or a cup. It's best if he gets all his sucking at the breast- but if he's too hungry and frazzled to nurse, then you need to get milk into him. Try the syringe when he gets like that, or give him a bottle with as little ebm as it takes to calm him down and get him onto the breast.

I would definitely cut back on the pumping when he's recently had a good feeding. If you find yourself pumping a few minutes before he wants to nurse again, that could make your milk flow more slowly, making him want a bottle, and the whole cycle repeats itself. You have no need to pump at all once he's off the bottles and nursing exclusively. When you're out and about with the baby, simply nurse the baby wherever you are.

[Darryen]

Originally Posted by Ruthla

You have no need to pump at all once he's off the bottles and nursing exclusively. When you're out and about with the baby, simply nurse the baby wherever you are.

That's what I'm hoping to get to.

[Megan73]

I'm glad to hear you have the SNS and that you'll be seeing someone about feeling depressed. It will all seem much more manageable when you're feeling better.
I think you could also really benefit from seeing a lactation consultant if that's possible.
I don't think your friend's advice is off base.
You can't just stop the bottles if your baby isn't nursing well. Babies can't learn to breastfeed if they're too hungry. And if baby isn't nursing you do need to pump at least 8 times a day to build your supply.
It IS hard to fit in all the pumping and attempts at feeding. I nursed then pumped every three hours and I couldn't have shopped, cooked or cleaned - my mom and husband did all that while I sat on the couch and nursed or pumped around-the-clock.
I hope you can find the help you need to make this work, mama.

[SeekingJoy]

Your friend's advice makes a lot of sense given the additional information you posted.

If you feel your breasts ache, you are feeling letdown. What oher sensations do you think you would feel.

You are doing a great job in trying to get your baby to nurse. Hopefully in a few weeks, he will be a nursing champ!

[Darryen]

We tried the SNS tonight and it didn't go well. After 2 hours of him screaming I finally put him down to rest. He only ate 1/2 an ounce. I want to do what's right and get him to the breast but its so depressing every time we try and now he is starving himself because we won't let him eat from the bottle. I had it at the fastest flow and was squeezing it in his mouth so all he had to do was swallow. I just want him to associate the breast with food right now and not worry about it being hard to suck but he still screamed. Its gut wrenching.

Unfortunately DH can't help much. He supports me and makes the bottle up for the SNS but he can't do any chores due to his surgery. It'll be 6 months before he can lift more than 2lbs with his left arm. He did put a load of laundry in for me today but I know it was extremely difficult for him to do so. He has to go back to work tomorrow too. My parents were here but only for a week and they really didn't help much. They got the nursery sorta in shape because they were staying in there on our spare bed and they cooked some meals but those left overs are gone already. It's all me now. I wish we could afford to hire someone to help but the cost of living in AK is too much for us to afford paid help. We'll manage though. There are moms out there without a husband/friend for even emotional support so I count my blessings anyways. I guess maybe the best thing to do would be to make a list of things that need to be done in a day and then when I have time btw feedings/pumping I can pick something on the list and try to get them all done.

I'm starting to think maybe I should stick to my original plan to pump exclusively and bottle feed him my bm. I had decided to give bfing a try once he was big enough and awake enough to suck but for the life of me I can't remember why I wanted to do that... maybe because it would cut out the whole setting up the pump and cleaning it steps? I don't remember now. /sigh Pregnancy brain + Depressed brain = really bad memory. I just don't know how many more hours or days I can listen to him scream at my breast and watch him starve himself. I'm putting him to breast WAY before he is super hungry too... the moment he squeaks or begins to root. He wakes up, sees that he's on the breast and all hell breaks loose.