5 mos so far
So here's my story.
I went to a BF class at the MWC with an IBCLC. When DD cried all night her 2nd night at the hospital, and a nurse says its bc she's hungry and I'm not making enough milk yet, I knew enough to say no thank you. There was a LC at the hospital who saw us in the morning, and helped with lots of tips on latch. We had trouble still with latching at first, and it hurt. I got some scars, and met with another LC at DD's pediatrician. They helped us with a BF magazine, triple ointment, and a nipple cover. It felt so much better to use the nipple protector, but when after a day DD wouldn't take my nipple without the cover I decided I would not use it and be patient with it. It still hurt for almost 2 months I had pains shoot through my shoulder when I BF. I knew if we got better at latch it would get easier, and it did. I planned on returning to work when she turned 2 mos, but we had just gotten the hang of things. She eats every hour still, at 4 1/2 mos. It doesn't hurt anymore, except sometimes my nipples hurt when I pump. The day after she turns 5 mos, I return to work AND nursing school, with a clinical day at the hospital. I'll be gone 40 hrs a week and may only be able / have time to pump on lunch break, in the car on the way, in the morning before I leave, maybe once at night if I'm not too tired? I plan on nursing more at night to make up for it too for being away from her during the day. Any other nursing students out there making it work?
Received some conflicting advice recently. Her ped says to give her bottles now to get her used to it? DMIL says she needs big 8 oz bottles to feed her, that's what her babies all took and she worked in a DC, too? Also she says CIO and she needs to sleep all night by now. DB says it'll just be easier to give formula, but I am dedicated to do the best for DD! I will try my best for at least a year. Thanks for any input from those of you who have BTDT! We never would have made it this long without all the help of many LC's. It's tougher than I thought it would be.
Re: 5 mos so far
Congrats mama, on overcoming the rough start!!
I don't have any experience with nursing school or pumping but I'm sure some experienced mama's will show up to help you.
As for your last paragraph...
- Some people find that introducing the bottle before you need to makes the transition easier. Others find that it doesn't help as baby might not take a bottle from mama when the breast is so close, ya know? This one is totally up to you :)
- 8 ounce bottles are an absolute no-no. Even with formula. The recommendations have changed. A breast fed baby should be fed 1-2 ounces of breastmilk for every hour away from mom - in 2-4 ounce increments. Babies tummies are tiny and 4 ounces is a lot of liquid. I'm not sure what the WHO says, but doctors in my area encourage feeding on demand whether you're breastfeeding or bottle feeding and using smaller amounts more frequently to encourage better digestion.
- CIO... this one makes me cringe. I can't imagine not answering my baby's cries. I can't imagine my son crying for me and knowing I'm not going to show up - because it's dark :( I don't really want to get into the CIO debate... BUT it's not common for a 5 month old to be sleeping through the night. This usually comes at 6-8 months or later AND all night is defined as a 5 hour stretch.
Good luck mama!
Re: 5 mos so far
:ita Perfect advice from the PP. I can only add that if you are going to be away from your baby 40 hours a week, restricting night nursing seems like throwing a wonderful opportunity out the window. You'd be giving up the chance to snuggle and mother your baby all night long, and also giving up the stimulation from night-nursing which would help you maintain a better milk supply even during the day, when your pump times will be so tight.
Re: 5 mos so far
I think you have worked far to hard for your breastfeeding relationship with your DD to allow it to be undermined now by outmoded baby care ideas. I agree with pp, during separations it is very important that baby be fed in a breastfeeding supportive way (which is also far healthier overall for all babies) and also to be sure your baby is not overfed which will make it doubly difficult for you to keep up. See these articles and share the pertinent info with you baby's caregivers.
Remember that you pump during separations for two reasons-to make milk for your baby to drink when you cannot be together, AND to keep up supply for the future. Every mom is different in how much she is able to produce when pumping. Pump with as much frequency as you can during separations. Maybe you can find time to hand express here and there as well. and your plan to nurse lots when with baby is very smart. This will help lots with supply.
If, despite your efforts, you cannot pump enough to meet baby's needs during separations, then formula, as a supplement, is one option. Formula can be added as needed without changing your goal of continuing to nurse and give what you can exresss to baby.
Your choice to delay your return to work and work so hard on exclusive nursing means you are returning to work with breastfeeding & milk production well established. This will help you a lot with this transition.
As far as when to start bottles, When to start bottle introduction is always up for debate as each baby is so different in how they take to bottles. I would suggest you give yourself enough time to take it slow and troublesoot any issues so you can feel comfortable with your return to work. maybe two weeks? Also your baby is old enough to skip bottles and go right to a sippy cup if need be. Also how much of a freezer stash you want to build up ahead of time is up to you as well. You may want to make sure excess lipase is not an issue before you stash/freeze lots of milk.
Pumping should not be painful. I suggest you troubleshoot your pump, check breastshell size, consider a better pump if needed/possible.
The Womanly Art of Breastfeeding 8th edition has excellent info on handling separations and pumping. An older but very helpful book is Nursing Motehr, Working Mother.
There is not one shred of evidence that a 5 month old "should" sleep any particular stretch at night. Some babies this age are naturally starting to sleep about 5 hours at a time at night, which is the definition of "through the night" for infants under a year. A few may even sleep longer. But many babies do not sleep even that 5 hour stretch until they are older. All normal.
Re: 5 mos so far
Thank you so much for the encouragement and advice. You ladies rock! I'm going to look into getting those books, especially the Womanly Art of Breastfeeding.
Troubleshooting the pump: I was measured for the nipple protector, so I'm assuming the breastshield is the right size (24mm or med.) Is it possible that the size I need has changed since losing some of the pregnancy weight (changing bra size several times)? It only hurts at first. I use my homemade hands-free bra, and after a couple minutes its not painful anymore. Like the initail rubbing against plastic, maybe if I use some lanosil cream before pumping it will create less friction and be slightly more comfortable?
Also there's a "let-down" button on my PISA, should I be using this a lot during pump sessions?
I can hand express, just haven't done more than a minute or 2 of hand expressions before. Can I save what I hand express to feed baby with or is that just to empty some milk to continue production? Is this something I would have to do in the bathroom if it's an only option a few times a day? I'll pump more if able to... I'll be able to in the hospital work. I was told there is no lactation resources at my school, and am waiting to hear back and speak with the dean about this.
I agree I could not leave my baby cry without being there for her, at night or ever. Great info you all shared, thanks again. It is definitely an opportunity at night for cuddle time and extra nursing to help keep supply. Maybe I can study while nursing LO during the evenings or weekends, to keep up with classes at the same time.
About Lipase- can I just pull a bag out of my small freezer stash to test for lipase, or is it better to test a fresh bag in the fridge for how long it lasts? What am I looking for, is soapy an indication, or will it taste very bad if there is lipase and then I'll need to find out how to scald my milk if neccessary?
Re: 5 mos so far
the WAB suggests olive oil for 'lubing up' a pump flange but this is temporary fix for a too small flange. Your nipples should idealy not rub at all but move freely back and forth in the tunnel, on the other hand, you do not want too much areola getting pulled into the tunnel either. yes breast size change would typically require flange size change. some moms need differnt size for each breast. if pain is temporary and there is no bruising or injury it may not be a big deal but generally best if pumping is comfortable. I don't know enough about the specifics of your pump to comment on if you need to use that particular function, I usually suggest moms start pumping at a low setting and gradually dial up to the highest setting that is still comfortable. Many moms cannot comfortably pump on the highest setting.
hand express-this was a suggestion of an easier way to give yourself a little extra milk extraction for supply concerns and your own comfort since your pumping time is so limited. Where you do it would depend on your situation. If you can also save what you express, great.
You may want to look to see if any pumping in the workplace laws in your area would apply at school. A lactating mother who cannot pump regulary not only will lose milk production but is at increased risk of becoming engorged & developing plugged ducts and mastitis. So not allowing you a place/time to pump is a health concern for both you and baby. there are articles on here about negotiating pumping accomodations in the workplace.
Here is an article about lipase and other milk storage info. http://kellymom.com/bf/pumpingmoms/m...expressedmilk/
others on here know more about this but I believe the primary issue with excess lipase making milk taste funny happens post freezing, so test a bag of frozen milk. I think In some cases it can happen after just being in the fridge, its a matter of degree which varies mom to mom. Remember that excess lipase is not a health concern in any way, the milk is entirely safe, but the trouble is some babies object to the soapy smell/taste & refuse to drink it. Yes it is a soapy smell, rancid milk that has gone 'bad' due to bacteria will smell very bad, like spoiled cow milk. This rarely happens with properly stored breastmilk.