Need advice: transition back to PT nursing from EPing

[preemiemamarach]

I've been EPing for my 33 weeker from the start when he was in the NICU. He was too small and weak to BF back then, and we've been chugging along, trying to learn to BF for over 3 months now with daily nipple-shield sessions. (Read my recent post in the EPing tribe thread for more. )

Well, as of last week, he FINALLY gets it and is taking the naked boob! Right now, we're only nursing once a day, after I get home from work, because anything more than that reduces how much I can pump- which cuts in to what I send him to the nanny's house with.

I'm glad he can get enough milk to reduce how much I pump- but I'm paranoid about sending him to her house without enough, KWIM?

Here's my pumping and nursing routine (weekdays only, I'm letting him have the boob on demand on the weekends so far):

6:00 pump- 6-10 oz (usually 8)
10:30 pump (at work)- 5-8 oz (depending on the 6:00 yield)
3:00 pump (at work)- 4-6 oz
5:30-6:00 nursing for as long as he'll go, at least 1 side but recently both (around 30 minutes)
7:30-8:00 pump- 4-5 oz, but as low as 3.5 if he nursed longer
11:30 pump- 4-6 oz (again, depending on his earlier nursing)

My total daily yield is usually around 30 oz, sometimes closer to 27, sometimes up to 32 or slightly more.

His daily intake is usually 28-32 oz of EBM; it's been 32 oz consistently for the past week (he's 14 weeks, 7 weeks corrected age, and 12 pounds). Mind you, this is the first week he's nursed daily for a minimum of 20 minutes, too, so I think he's getting a lot. My output is down 2-3 oz after he nurses. (Yay!)

He usually takes about 15-18 oz of EBM at the nanny's house (he's there from 7:30 to 4). It's hard to know if this is going to remain a pattern, though, because I just went back to work and this is only his 3rd week away from me (.

If anyone else has successfully gone from 100% EPing to the more 'standard' combo BF method for WOHM, I would *love* some advice. Here are my ultimate goals:

1- BF to a minimum of 12 months, preferably 24 months
2- BF exclusively when we're together
3- master night nursing in bed (he will nap on me on the couch and nurse/nap/nurse/nap, but he won't do it in bed.)

I should mention that we co-sleep part time (from his final overnight feed until we get up, which can be none at all up to 4 hours of co-sleeping). I take medications that make me drowsy enough early in the night to make full-time co-sleeping a little risky, IMO (meds have largely worn off by the time he wakes to feed). He sleeps next to our bed in his cradle swing, though.

My biggest problem with just going whole-hog on the goals right now is that my pumps at work don't match his intake during the day when we're apart. And I don't know if his intake will increase or decrease during the day- his routine is still too new.

Also, I feel like the 6:00 AM pump needs to be the last to go because (a) he's not yet efficient enough to empty me fully and I don't want to end up killing my supply by leaving myself partially full, and (b) we leave the house at 6:30 (which SUCKS, btw) and I don't think I can add BF to our current routine. If we BF in the AM it needs to replace that pumping session (which is about 25 minutes to really empty me).

Any thoughts? Suggestions? I'm cool with this being a long process- for me, *any* direct BF is a cause to celebrate. But there just aren't enough hours in the day for 9 hours working, 2+ hours commuting, 6 pumping sessions *and* directly BF him at each feed. (no, we don't sleep enough.

ETA: He HATES slinging. He refuses to be in the Moby, but he likes the Ergo. Alas, my boobs are way too big for him to nurse in it. WAY too big. If I could wear him while he nurses, that would be fab, but I haven't found a way yet.

Also, he won't nurse in any position remotely akin to being NOT upright or on his tummy- he has pretty bad reflux that's under control with medication, but it flares up when he's reclined too much.

[natural_mama89]

I haven't done this (the swithching from EPing to nursing part-time thing), but could you maybe nurse him on one side while pumping on the other? That way he would get to nurse, but you would still get some milk to store. You could do this one feeding at a time until he gets used to each, them switch to full nursings when you are sure he will get enough. I just know that many women can pump more if nursing on the other side. Could you also maybe squeeze in a few pumping sessions on the weekends to build a more stable stash?

[lainey]

I EP'ed for my first son, a 32 weeker who came home at 35 weeks with major nipple confusion, for 8 weeks . We did make the switch to nursing and me pumping at work, but based on that experience, I did things differently with my 14 week old who just started nursing independently last week. My younger son was tongue tied and fairly small (5lbs 14oz) and then lost over 1lb until the tongue tie was discovered. He would latch, but was very inefficient - I wound up pumping and bottle feeding, then switching to pumping and using an SNS out of fear of losing his ability to latch. Long story short, I intentionally forced myself to overproduce and although I am paying for the downregulation now with mastitis, but I was able to nurse on demand and still pump enough for work days. I know how tough it is, but can you add another pumping session during the day or night? I know what it is like to drag yourself from sleep to pump, but even a few ounce yield adds to your stash, and then maybe you could nurse in the morning before work. On weekends, I would probably nurse first every time, then pump after your DS was finished. You may have to literally sit in bed and nurse all weekend one weekend which can also boost your supply. I've always responded way better to the stimulation of the baby for increase in supply than the pump. Good luck.