Expressing - after birth

[Purple Hugs]

Hi all,
Was wondering if you had any advice / tips on establishing expressing as well as BF after birth.
As you know (most of you) I want to BF, but am at college 3 hours a week at the moment, and am looking to get some experience on an oncology ward by volunteering too.

So am thinking from the offset I need to ensure baby is comforatble taking a bottle as well as breast. And establishing expressing as well as BF with DH giving the expressed milk so baby is familiar.

I've been wondering if I'd have to give top up of formula initially till my milk came through enough to pump - to get baby used to bottle also.

Also what the verdict was on the pumping before birth - I tried googling it, but couldn't find any info.
Thanks girls

 

[Kitteh]

it isnt reccomended for the first 6 weeks due to nipple confusion tbh.. when dyl was in the nicu he was fed by syringe or cup to avoid this, but its only really meant to be used in an emergency really, cos it isnt easy..
i would reccomend getting an electric pump, as they are amazing.. a medula swing i think they're called, are good.. they're yellow..

why would you need to give a top up of formula..? i dont get it.. lol..
xxx

 

[spooky]

You probably won't lactate fully till after the birth. Pumping before might stimulate contractions for the onset of labour but won't produce anything bar colostrum.

I would do as Kitteh says and give via a cup or syringe, but it might take a couple of weeks for your supply to settle for you to efficiently do this. Try not to give formula if you can help it, it might jepoardise your supply.

If you want to pump then Medela pumps are good, you can usually hire a hospital grade electric one quite cheaply, but when I expresed for Lauren I used a manual Avent Isis pump.

 

[Purple Hugs]

Thanks both - I have a manual pump (tommee tippee) but got it for £2.50 (in wilkinson 75% off after they'd already done 50% off would you believe! lol I don't mind if I have to invest in another/ better one.

Kitteh the idea of formula was as a 'back up' in case DH had a screaming hungry baby and I hadn't pumped enough to satisfy her.. just for emergencies only.

I have oral syringes from my DD and foster babies, so perhaps having a few sterilised would be a good idea when going to college to get him to syringe it at first till BF is established.

Depending when she arrives depends how many weeks I am at risk of missing from college, I just can't afford to miss too many. I'm due in the xmas hols so hopefully she arrives on time ... or not far off.

 

[shelbell]

We talked about combination feeding at the NCT classes. One problem is that some babies can't combine feed, the different actions needed to get milk from breast and bottle is too much for them. You won't know if your baby has this problem until you try it unfortunately and once you've given a bottle may struggle to get back on to breast

Are there any breastfeeding groups near you? We have loads of bumps and babies BF groups here, if there is anything like that you could try going along to a couple as they tend to have trained breastfeeding counsellors who can give you more accurate advice.

 

[Sunflowers]

Right, just to blow the other side of the argument - some people support the teat/nipple confusion and a lot of people dont. I am one of the "don't" camp. Both from personal and professional experience.

Personal - when Jocelyn was born she dropped 14% of her body weight by day 4 due to withdrawel from morphine I'd taken for spd. I was therefore needing to bf her for 20 mins, top her up at 60mls/kg with expressed milk and then express for the next feed. This was done on a 3 hourly routine until we went home and then I changed it to 4 hourly (recalculating her topup amount accordingly). After a week we bit the bullet and went back to demand breastfeeding.

She never had ANY problems with teat/nipple confusion, at all! She went back to demand bf no problems and is still bf now at 17 months!

Professional view - some babies get on with bf and take to it like a duck to water. Others prefer the easy option of a bottle - they don't have to work so hard at it in the same way they have to work a breast to feed. So - if you have a baby who latches well and enjoys bf then I don't think you'd have a problem introducing a bottle of ebm early. If you have a baby who struggles and finds a bottle easier then yes, the bottle will be the preferred option of the two.



In terms of expressing, hand expressing only until your milk comes in and, once it has, fire away with a pump! Some mums tend to express one breast while feeding from the other - the act of the baby feeding helps them express more as you'll have more letdowns while bf, there's no love felt for a lump of plastic expressing milk in the same way there is for a baby doing the same (well, better!). Your milk volume will be better in the mornings so you might want to express after a morning feed, see how you go!

You can get a number of different things to store it in, breastmilk bags are probably the easiest to get hold of, you'll get those from supermarkets, boots etc. When storing in the fridge it needs to be in the back of the fridge (never in the door) and used within 72 hours of expressing. If you freeze it, freeze on the day you express and use within 3 months. Sometimes milk that's been frozen and defrosted can have a particularly off smell to it if you've got a lot of a certain enzyme in your milk, apparently boiling it does get rid of the smell but what that does to the nutritional value I wouldn't like to say! When defrosting milk, either defrost in the fridge or at room temp if you don't want to use all of the milk in one particular feed or in warm water if you're using it immediately/within an hour. Same as formula, any milk left in the bottle has to be thrown within an hour and you can't reheat it more than once. Once defrosted, milk has to be used within 24 hours.

Hope this helps!

 

[shelbell]

@ hand expressing till milk comes in. I was given a double electric pump in the hospital with my son and told to pump every 3 hours day and night from 24 hours after birth when he was taken to scbu. Absolutely hate the idea of hand expressing. Can't help but feel that it would be easier to just go straight on to bottles as the hospital said they do hand expressing and cup feeds in the hospital and it isn't what I want at all. Don't think I will be able to breastfeed from one side anyway as have had longstanding problems with pain and sensation on one side.

I want to do whats best for bean and it seems the extreme pro-bf position in the hospitals is going to make that really really difficult.

 

[Purple Hugs]

Thanks so much both of you.
Shell there are two BF support groups 'near' to me.. I say near loosely but within travelling distance as long as I can drive. I don't want to entirely go with what I'm told if they are not supportive, I know that sounds odd, but I will go partly with what works for us, and what my MW's say. I do think sometimes 'one' professionals viewpoint can be a restriction.

Sunflower - thanks so much for the personal account of your system with LO.
and the professional side of things too... also storing tips!

Would I be ok with a manual pump (I have a tommee tippee as bought it cheap in wilko's sale), or should I look for a 2nd hand automatic - Medela is good I've heard. Or wait till I get established for this?

Feels like such a minefield still and really hope I manage it, but then know it won't be easy! lol

 

[Sunflowers]

Shell - I've only ever been able to feed from one side, it can be done! My thought on it when I started was if it's possible to bf twins with 2 (and even triplets with 2!) then it's possible to feed one with one! If the side you don't feed from still lactates (I didnt) then you might find it a bit sore for a while but your body will soon work out you're not feeding from that side and adjust accordingly!

With the express and cup feeding - are you planning on bf at all when you get home? (I remember you saying about feeding a bit and then mix feeding, moving towards full formula quite quickly) If you're not planning on putting the baby to the breast then they should support you with giving that expressed milk in a bottle - we've had mums in who want to give breastmilk but have no intention of breastfeeding and we're more than happy to give that in a bottle! See how you go - could you maybe talk to the bf support midwives at the hospital itself (there should be a few senior midwives there who specialise in bf and are the ones we call when we've tried and failed to help a mum bf her baby) they'll be the ones who write all the guidelines etc so might be a good point of reference and, in particular, reassurance for you?

PH - different people get on differently with different pumps! My only concern about buying a second hand electric pump is the breastpump kit you'd be using - if you could buy a new kit direct from the manufacturer then absolutely, the actual pump itself doesn't come in to contact with the milk so you'd be fine to buy that second hand, just buy a new breastpump kit and bottles to express in! Medula should be able to advise you on buying that!

You also might want to consider hiring pumps too through the nct, you'll be able to "try before you buy" and work out whether you get on with a certain pump or not! I know I've said it before but I didn't let down for pumps at all, only with hand expressing - everyone is different!

 

[Purple Hugs]

Thanks again - will wait and see then. I know you can buy the replaceable parts as spares so could look into that if I need to, or hiring. Will see how I get on as may be worrying over nothing as usual! lol
I have a new hand pump so that'll be handy if hand expressing doesn't work. At the moment I wouldn't have a clue what to do but that's what the BF support is for! lol