Keeping milk supply up what would you do in my situation?

[BRmama]

I'm sorry if this is an obvious question but I need to know what to do about it.

Here's some background:

My one month old has gotten into this pattern where he'll nurse and fall asleep very fast at my breast. He seems more awake in the evenings (though sleeps through the night) since he's fussier and we're going through cluster feeding. I understand that at his stage one month olds sleep a lot and all but it just seems to me like he's not nursing enough because he doesn't empty my breasts. He just drinks whatever is enough for him and falls asleep. I burp him and he wakes up then goes right back to sleep. If I offer him my breast again after his burp he'll take it just for comfort and sleep or he'll refuse it and get angry and cry until I leave him alone. 

I know the sensible thing to do would be to pump and this brings me to my question. Should I leave my milk alone for the next time he wakes up, or should I pump to let my body know to make more but then run the risk of him waking up when my breasts are still trying to get full again? Not sure what to do and I really want to keep up my milk supply especially because the medication I take though safe for breastfeeding don't allow me to take any herbs that could react with it. Any advice would be highly appreciated. TIA

[PatioGardener]

 If I were you, first I would confirm that baby is / is not getting enough milk.

I would count pees. Is baby having 5-6 heavy wets in 24 hours? (a heavy wet is ~3 tablespoons of liquid.)

I would count poops. 2-3 a day?

And I would check baby's weight. At 4 weeks old I would expect baby to weigh at least 10-14 oz over birthweight and be gaining about an ounce a day.

If all these things were fine, I'd know that baby was getting enough milk, and I wouldn't even be looking at the pump

[Llyra]

If baby is gaining weight, peeing and pooping regularly, and is otherwise healthy-- I wouldn't worry about it. Baby will take just exactly what baby needs, and your supply will adjust itself accordingly. If you pump, you may wind up with too much, which sounds great, but in reality too much can be as bad as not enough-- oversupply often leads to baby having digestive discomfort.

It's normal for them to do nothing but eat and sleep. That'll change soon enough, in the time between two and four months, when baby will start to take more notice of the world and spend more time awake.

It's around six weeks when your supply will start to settle down and regulate itself to baby's needs. If you feel like your breasts aren't "empty," that's because breasts are never empty. They keep making milk continuously as baby nurses. But that full feeling is part of the newborn period-- once your supply settles in, you will start to make just what baby needs, and no more, and may stop feeling so full. This is all normal. It's also normal, that if baby starts to need more than baby is getting, baby will naturally spend more time awake and nursing, and demand to eat more often-- you may see that happen occasionally in the next few weeks and months, when baby is growing particularly quickly or reaching important developmental stages. And then your supply will readjust itself, and baby may go back to less-frequent nursing.

If baby isn't gaining, or isn't peeing and pooping regularly, then I would be working on encouraging more awake time and more nursing. But if there isn't a problem, there's no reason to go looking for one, or to go to any special effort to maintain your supply. Baby will do that for you.

[etsdtm99]

your breasts dont need to be full  for your baby to eat - do you have any reason to pump ? (going back to work etc)  any reason to believe your baby is not getting enough ?  (as others have mentioned, pee/poop counts weight gain etc)

if there are no concerns about baby getting enough overall, i would just chill out and feed your baby when he wants to eat and if he doesn' want to eat.. that is fine too..

[1stTimeMama4-4-10]

I agree with previous posters.  If there is a reason you need to start building up a supply of expressed milk, you may want to do so just after baby's first feeding in the morning as you will likely feel the most full in the AM and baby likely won't come close to emptying your breasts then. Avoid pumping too often though because oversupply is not a good thing - if you settle into a routine of once per day after baby's first morning feeding, your supply with adjust to that, but if you pump multiple times per day, that can send the wrong message to your body.  Breastmilk supply is constantly adjusting to your baby's needs, but since your little one is so young, your body hasn't settled down yet and is making lots.  If baby is gaining appropriately and is healthy - do not worry about it. 

[BRmama]

Thank you everyone for the responses. I guess at the heat of the moment I tend to forget those details. Last we checked his weight was on track and he does have lots of wet diapers. The reason why I worried was because at his two week appointment with his pediatrician I asked him how do I keep my ds from using my breasts as a pacifier? At the time it was still hurting to nurse and I have a friend who is against pacifiers so she let her babies use her nipples as a pacifier. Anyway he said the baby should nurse for like ten minutes on each breast and that should be enough to empty them. But then I kept noticing that my breasts never got empty (which I guess is a good thing) even when I pumped. I don't like his advice to nurse for just ten minutes I would rather just do it for however long the baby needs to be in there. My worry was that if I wasn't emptying them enough I'd either get engorgement or dry up. I'm more relieved to know that I don't need to pump everytime especially now since my toddler is sick. Thanks again

[Llyra]

Your pediatrician's advice is wrong, and contradicts everything that you would hear from an expert in human lactation. Baby should be allowed to stay on the breast until baby lets go on her own, or until baby is soundly asleep. Limiting time on the breast can and will undermine your milk supply. "Using you as a pacifier" is nonsense. A pacifier is a substitute for the breast-- not the other way around. Lots of time spent on the breast-- even non-nutritive suckling-- is the only thing you need to do to ensure a bountiful milk supply (assuming an otherwise normal situation.)

[BRmama]

Thanks Llyra, that's so true, I'm not sure why I didn't think of that before I mean I've been going to my LLL meeting for a while when I was pregnant and I felt in my gut that his advice wasn't right. When it was hurting to nurse I almost quit because the pain was sooo unbearable but now I'm glad I didn't and I love nursing him now. Thanks again

[PatioGardener]

Don't let your pediatrician get you down!  Sounds like you are doing really well, Mama, and that baby of yours knows just what to do .  You two know more than the ped!

Keep nursing, and please pop back in here any time for advice, encouragement, support and an occasional cheer.  Here's one for hanging in there and working through your breastfeeding issues with a toddler as well!!! 

[BRmama]

Aww thanks PatioGardener  you're too kind and very knowledgeable. I love that I can come here and get expert advice from all of you smart mamas  

[myk]

and don't forget, your breasts really never quite get "empty" anyway.. they just keep on producing. if there's still milk in them when baby's done, they'll pause. if you remove the milk, you'll make more soon. my breasts have felt empty and 10 minutes later, wow, there's some more milk! so express if you want to build supply more, or if you want to have a stash for when you introduce cereals, or whatever other reason you have, but you likely don't have anything to worry about if the diapers are looking well used ;)

nothing wrong with baby using your breast as a pacifier. it's doing what comes naturally. if you don't mind it, there's no problem.

[Springshowers]

My baby literally stayed on my breast for weeks or maybe even months after she was born. I think it really helped to make my milk supply strong! I never considered it a problem, and advice like "how do I keep my ds from using my breasts as a pacifier" to someone with a newborn is just ridiculous. Definitely someone that does not have any real knowledge of breastfeeding.