Baby drinking all I can pump--how to persuade caregiver not to use freezer stash?

[blake201]

Here's my dilemma: even though I have oversupply, baby is drinking so much pumped milk each day when I'm at work (over 20 oz) that I'm having trouble keeping up. But if my mother doesn't give her bottles whenever she's hungry, she'll cry and feel like no one is responding to her cues. So what to do?

I've asked my mother (who cares for her during the day at my apartment) NOT to use the freezer stash except in case of emergency, since if she starts using a little of the stash each day my milk supply will plummet. ( see http://www.workandpump.com/freezerstash.htm) And I've also asked if she could try to keep the baby from eating for at least an hour before I get home.

But my mom keeps saying "how can you expect me to withhold milk from a baby who is crying with hunger?" and I don't know what to say in return! If I were home I would never let my baby cry for even a second--I'd nurse her! ... but if my mom uses that freezer stash, I'll lose my supply and then baby will REALLY be crying all the time!

So not only does my mom occasionally use a few ounces from the freezer stash, baby is often just fed when I get home at 6:45pm, painfully engorged.

I don't really know anything about bottlefeeding and wish I didn't have to--I personally nurse my baby on cue when she shows signs of hunger, so what should I tell my mom? Are there ways of pacing out a feed or making it last longer?

I want to breastfeed exclusively until baby is 6 months old (when we might introduce a little bit of solids or we might wait) and to continue nursing until baby is at least 2 years old. And I don't ever want baby to have a drop of formula if I can avoid it (she's dairy and soy allergic).

Anyway, here are the details:

• Baby is 3 1/2 months old
• I'm away from baby 10 hours per day including the commute, so I pump 3 times per day for 10-15 minutes per side using a Symphony rental (my Pump in Style hurt too much).
• I generally get about 5-8 ounces per session, or 18-21 oz total. The first week I was back at work she only drank 8-14 ounces per day, so I'd always be able to put the extra in the freezer. But now she drinks all 20 oz!
• I nurse her at least twice in the morning before work, at least 2 or 3 times when I get home, and at least once in the middle of the night.
• On days I'm not working, I nurse her on cue--which could be every half hour--or as far apart as three hours--when she's awake.

I mean... 20 oz. is enough for 10 hours, right, especially since I nurse her usually seven times in addition to that?

Baby girl is over 15 lbs. already and very healthy, but I've heard babies drink more from a bottle than they would from the breast. When a lactation consultant weighed her for me before and after a feed, she took 3 1/2 ounces.

[Annie Mac]

It seems to me that when the baby is hungry, you feed her. If you can't keep up with her demand via pumping, I think it's time to look into other options that will work for you both. Is it possible to come home at lunch and nurse her? How about a milk bank? Do you have access to one to augment your own supply? Other than that, it seems like you will either have to pump more until your supply meets the demand, or supplement with formula. I'm curious, how do you know your 3 1/2 month old is dairy and soy allergic? Has she been tested? Has she actually had these things and had a reaction?

[Mosaic]

Have you calculated how much she's drinking? How does her eating schedule compare on a work day versus a weekend? Is it possible that your mom is overfeeding her or assuming that she is hungry every time she fusses? My MIL always insisted DD was starving and went through 4-5 4oz bottles in 9 hours; but whenever my mom or friend watched her, magically she needed only 3-4 bottles during the day and seemed a lot less fussy to boot.

It could be a growth spurt, if this is a recent development. Otherwise, I'd double-check the nipples on your bottles and make sure your mom has everything she needs to discern hunger from other needs (paci or teether, a diaper changing routine, toys, stroller, etc. in case your mom just doesn't know what else to do with her).

[blake201]

I work too far away to nurse her during lunch--it's a 45 minute each direction commute, and I live in Brooklyn and work in NYC, so my mom would have to bring her to me on the subway, something she can only do occasionally.

I've read that bottlefeeding is different than breastfeeding--that it's very easy to overfeed with a bottle, whereas you can't overfeed by nursing. And all the advice I saw on work and pump and kellymom leads me to believe I'm leaving MORE than enough milk, and she should be able to

I forgot to add that pumping is EXCRUCIATINGLY painful for me (I have thrush and other issues), and it's already hard to get three 20 minute breaks to do it in.

I know she's dairy and soy allergic because I did an elimination diet--until I stopped eating dairy and soy she was having bloody stools and colic-like symptoms which vanished magically with the elimination of dairy and soy. And even if she weren't allergic, I feel like it makes no sense that even with my oversupply she is drinking more than I can pump.

[Juvysen]

Does she have a pacifier? I'd encourage your mom to find other ways of dealing with baby's fussiness... that is, try other things to calm her before trying food (and really *try*). Seems like maybe it's just an easy fix. Also, can you look for slower-flow nipples? maybe that would help baby get the nursing/milk comfort for longer without going through as much milk?

[jeminijad]

Originally Posted by Annie Mac

It seems to me that when the baby is hungry, you feed her. If you can't keep up with her demand via pumping, I think it's time to look into other options that will work for you both.

I disagree. I've heard of this problem commonly with caregivers... 20 oz in 10 hours for a 3 1/2 month old might be overfeeding.

Your mom has no other tools to soothe a crying baby than feeding?

The least she can do is not feed after 5 or so, so that your DD is ready to eat when you get home.

[rhiOrion]

20oz should be enough. More than enough. I mean, each baby is different, but that's a lot of milk. My DD generally takes 12 oz in 9 hours. The rule of thumb, I believe, is an average of 1-1.5 oz per hour.

Could it be that baby is starting to consider a bottle to be comfort like she considers nursing to be? In which case, how about more, smaller, bottles each day? That might also help your mom feel like there is something she can do, but baby gets less at each feeding. So, if you normally send 5oz bottles- how about 2.5 oz bottles, instead? Someone can correct me if they see an issue with this.

I also suggest a pacifier. And some good ol' distraction.

[RaeDyCo]

20 oz over 10 hours is way too much.

Have you read this info from kellymom?

http://www.kellymom.com/bf/pumping/milkcalc.html

Also, how to bottle feed the breast fed baby:
http://www.kellymom.com/bf/pumping/bottle-feeding.html

There is a copy to provide caregivers. Maybe you could give that to your mom.

The only thing I would add is that it may be hard to drop all the way down to the correct amount. You may need to reduce amounts slowly as baby is now used to being "over-stuffed". I would leave smaller bottles that your mom can feed more often.

[stephbrownthinks]

Yes i think your mom is overfeeding her Most babies that age drink between 24-30 oz per DAY. The formula my LC gave me was for a 4 month baby you take their weight, and multiply it by 1.9 (gives you the approx amt your baby needs for the day), then divide my the number of feedings and that is approx amt per feeding. So, say she weighs 15lbs: 15x1.9=28.5 ounces for the day. If she's feeding 10 times, its 2.8 oz per feeding, or 3.5 oz for 8 feedings.

Obviously it will vary from baby to baby, but thats a good general estimate. Another good rule of thumb is 1 oz for every hour you are gone.

I work 10 hour shifts and by the time you add in lunch and the commute I'm gone for 11 hours. My mom also watches my DS. He usually has three four ounce bottles. At first my mom was waaaaaaaay over feeding him too.

Because its easier to get milk from a bottle they get the milk faster. And babies have such a big sucking need, they'll keep "needing" to suck even after they're full. On the breast a lot of times they'll do some non-nutritive comfort sucking which doesn't work on the bottle.

I understand what your mom is saying about not wanting to ignore a hungry baby. But there are a few things she can try to lengthen the feedings. First, make sure you are using really slow flow nipples. What kind of bottles are you using? You're probably fine using stage 1 nipples. She can burp your DD after every ounce which will give her a little more time to feel "full." Also I'd try a 3 or 3.5 ounce bottle and give her a pacifier (or finger) to suck on after its gone. 3.5 ounces really should hold her over for a few hours.

I'm sure your mom is probably feeding her more often than she's hungry. Can you give her some tips about what you do when your daughter fusses? My son at that age started getting really mouthy because I think his gums were hurting. Teething? Nursing/bottle would calm him down but so would chewing on a damp washcloth or his Sophie Giraffe. Sometimes he would cry because he was just ready for something else, a walk, tummy time, cuddles.

If your mom really feels like she is hungry that often, give her the 1 ounce per hour guideline. So if its been 2 hours and she seems hungry, try a two ounce bottle!

As long as your mom is feeding her, she's not going to starve in 10 hours. Make sure your mom understands that! She still has 14 more hours in the day to make up anything she missed out on.

I would also tell your mom that if your DD is starving before you get home, to give her one ounce to hold her over until you get there. My mom feeds my DS ALL THE TIME within 30 minutes of me getting there. And she breastfed all her kids! Its like she forgot how it works.

Good luck!

Edit: I also wanted to add that I had a lot of BFing problems so went to the lactation consultant a lot and had a lot of weigh ins to measure his intake. Sometimes it would only be 1.8 ounces, and sometimes 3.8. So the amount they take in really varies.

[stephbrownthinks]

Originally Posted by RaeDyCo

20 oz over 10 hours is way too much.

Have you read this info from kellymom?

http://www.kellymom.com/bf/pumping/milkcalc.html

Also, how to bottle feed the breast fed baby:
http://www.kellymom.com/bf/pumping/bottle-feeding.html

These are both great articles with a lot of useful info!

[staceychev]

My 7 month old eats one feeding of solid food plus between 8 and 12 ounces each day at her caregiver's house. She's there for between 8 and 9 hours. Even before she started with the solid food, she was still between 8 and 12 ounces--and in fact, she really is more around the 8 ounce mark except when she's having a growth spurt.

20 ounces sounds like a huge amount of milk to me. I can't imagine pumping that much every day!

[Annie Mac]

Originally Posted by blake201

I work too far away to nurse her during lunch--it's a 45 minute each direction commute, and I live in Brooklyn and work in NYC, so my mom would have to bring her to me on the subway, something she can only do occasionally.

I've read that bottlefeeding is different than breastfeeding--that it's very easy to overfeed with a bottle, whereas you can't overfeed by nursing. And all the advice I saw on work and pump and kellymom leads me to believe I'm leaving MORE than enough milk, and she should be able to

I forgot to add that pumping is EXCRUCIATINGLY painful for me (I have thrush and other issues), and it's already hard to get three 20 minute breaks to do it in.

I know she's dairy and soy allergic because I did an elimination diet--until I stopped eating dairy and soy she was having bloody stools and colic-like symptoms which vanished magically with the elimination of dairy and soy. And even if she weren't allergic, I feel like it makes no sense that even with my oversupply she is drinking more than I can pump.

Aw, that sounds miserable!

I hope you figure something out that works for all of you. I agree with the other posters about using other comforting techniques. Worth a try, if your mom isn't already doing so.

[Teenytoona]

Thank Kellymom link is a great guide. Maybe even print it out and give it to your mom. Babies don't need that much milk during 10 hours. I never was able to pump more than 15 oz at max, and that's all that was needed for DD during my 11 hour-days away. I mean I know every baby's different, but if she does need more, she might just be a heavier nurser when you're home in the evenings and nights. That's what my DD did. She got used to standard bottle feedings and could vary the evening and night feedings as she needed to fit growth spurts and whatnot.

I second the previous posters' suggestions to tell your mom to find another means of comforting baby. Probably she would nurse if you were there, but she might just need sucking for comfort rather than sustenance.

[Qestia]

I'm all for feeding hungry babies--but the feeding right before you show up would drive me crazy! I want to suggest maybe trying a slower nipple on the bottle, so the baby has to work a little harder for it? Also the pacifier--and other options for soothing her.

[MeepyCat]

I am not a fan of that freezer stash article.

I pumped while working for my son's first year, and largely didn't worry about freezer stash, but I don't think that taking a few ounces a day out of your stash will cause your supply to "plummet." It won't go up, and you will eventually run out - taking milk from the stash is generally a sign that you need to pump more or take other steps to increase supply. Taking milk from the stash won't do anything to your supply (presuming you don't just feed from the stash and forego pumping while you're away).

I see your concern about overfeeding, though, and about wanting to nurse when you get home.

I know this is MDC and all, but in this particular case, I am going to advocate a feeding schedule. Since you want the babe to be just getting hungry just when you get home, you probably want her to have eaten, oh, two hours before then. If you want her to eat two hours before you get home, you also want her to have eaten two hours before that, and two hours before that, and so on. (Pay attention this weekend and see how often she eats - modify planned feedings accordingly.) Discuss this with your mother.

On Monday, get up early if you have to to feed the baby in accordance with the schedule. Then carry on with your day. Leave your mom bottles for the scheduled feedings, and one, one ounce emergency bottle, to be used in the event that you get stuck in traffic or on the subway or if the baby is really monstrously fussy. (You say you have oversupply, so if you can arrange for this bottle to be all foremilk, do that.)

Nurse on demand at night, but try and make sure that she gets a big morning feeding that fits the schedule. Expect to abandon the schedule when the baby is sick or teething or having a growth spurt. You just want something that gets everyone through 80% of the days without going into the stash.

In terms of comfort techniques - talk to your partner about what s/he does to comfort your child without offering food, and pass those suggestions on to your mom. And maybe give them a try yourself - if your only comfort technique is nursing, other caregivers will have to fall back more on offering food when the baby is upset.

[Ellien C]

I had the same problem with my caregivers when my baby started day care at 5 months. They blew through my COMPLETE freezer stash in a week. (I was also very sick when baby started, so I wasn't pumping the usual amount either). I think they were totally misinterpreting his feeding cues. They were feeding him like 4 oz every 2 hours. Now he gets 3 4-oz bottles per day. He is 7 months and 16+ lbs. I talked to them about how nursing takes longer than bottle feeding so his "sucking on an empty bottle" could really just mean that he wants to be held and rocked longer. Eventually I talked to my director who was EVER so helpful. She was like - I breastfed, I understand. And some how they got down to every 3-3.5 hours. It made a huge difference! For us, a loose feeding schedule is very helpful. That and my kid takes a good bit of table food now. He totally loves it.

"But my mom keeps saying "how can you expect me to withhold milk from a baby who is crying with hunger?" and I don't know what to say in return! "

Ask her what he is doing that makes her think he is hungry? Does he want to be held, cuddled, rocked or sleeping? I would push on that idea that he is hungry.

[texmati]

Originally Posted by Annie Mac

It seems to me that when the baby is hungry, you feed her. If you can't keep up with her demand via pumping, I think it's time to look into other options that will work for you both. Is it possible to come home at lunch and nurse her? How about a milk bank? Do you have access to one to augment your own supply? Other than that, it seems like you will either have to pump more until your supply meets the demand, or supplement with formula. I'm curious, how do you know your 3 1/2 month old is dairy and soy allergic? Has she been tested? Has she actually had these things and had a reaction?

This kind of advice can really sabatoge a working mom's breastfeeding relationship.
20 ounces is about double the ounce an hour that most breastfed babies/moms drink/produce.

I would look up bottle nursing-- don't have time to find a link. I also recommend a pacifier, and trying to get your mom to be more supportive of your bf relationship. Kellymom and llli have pumping forums and free membership that have great mom's that post their that might be able to help.

[One_Girl]

I suggest getting a nipple that is at a level one or two. I didn't realize that nipples came with levels until I started working in the daycare I am at now, but they do and the lower levels make the bottle last longer. I also suggest giving her a front pack carrier to carry the baby around in to calm her or giving her a stroller so she can go for walks if she is willing to. Walks and being carried in a front pack carrier can be very soothing to fussy babies.

There are some babies that really need that much milk in a ten hour period, but it isn't typical for this age on a daily basis. When you pump you get only about half of what your baby would get out so she may need more than you are pumping. Have you tried pumping or hand expressing one side while she nurses? I always got better let down by hand expressing while my dd nursed. It was messy at first but I quickly got the hang of it and was able to do it without any mess. I liked the book Working Mother, Nursing Mother when my dd was that age also. You may find that it is a good resource.

[smeep]

What nipple flow are you using? If I can recall right (DS hasn't had bottles since he was 4 months old and he's almost 5 years old now) there's one for 0-3 mo, 3-6 mo, etc. I would start with the newborn (0-3) first. The slower the flow, the longer it will take, and the more likely she will be to feel full with less. Bottles flow so fast that their bodies don't have time to signal that they're full until they've already taken in too much. The slower the flow, the better. She may protest the slower flow nipple, but she WILL "get over it." She may throw some fits (very similar to a baby who has nipple preference and doesn't want to nurse because they want the faster flow of a bottle) and it will be hard, but she'll get used to it. Though I would think if she doesn't have nipple preference already with you and the bottle, she'll probably show no problems with a slower flow nipple. You can also have your mother fix her bottles in smaller sizes (i.e., if she gives 4oz at a time, have her give 2oz at a time, so baby has additional time to recognize the "full" symbol while your mom is making another bottle).

ETA: For the thrush, check out this link. http://www.drjacknewman.com/help/Candida-Protocol.asp Gentian violet saved the day for us, and I had a SEVERE case of thrush.

[texmati]

You can double check the flow of a slow flow nipple. Fill the bottle with water and turn it upside down (with the nipple/collar attached). The bottle should drip at the rate of one drop per second for a true slow flow nipple. FWIW, I found the medela nipples to be really fast-- the evenflo purely comfi nipples are the only wide based standard (fit on a medela/ameda pump) slow flow nipple that I have found.

We also replaced the bottle with a paci after a feeding to make sure he wasn't just sucking to suck. Also, my husband and nanny always bottle nursed-- no bottle propping! DH sit's down to nurse, checks when he's done half a bottle, burps and switched sides after half a bottle. This means that baby is still getting cuddling even though they are not being nursed, and it reduces the temptation of the caregiver to give a bottle for a break, or to get something else done.