Re: Feeling uncertain....
hi mama, congratulations!!
the rule of thumb is that babies will take 1-1.5 oz per hour while away from mom. so if you're gone 9 hours (i'm guessing?) then you'd want to send 9-14 oz for the day. most caretakers over-feed babies, but it is definitely possible that she actually needs more than 9. most pumping moms need to pump extra times to make that amount, because we just don't respond to the pump as well. every 3 hours is ok, every 2 - 2.5 sometimes is better if you have the flexibility at work. other moms add a pump first thing in the morning (when yield tends to be highest), in the middle of the night (yuck, but we do what we have to do!), and on weekends.
it's definitely an excellent idea to nurse her as much as she wants in the evenings and overnights. in general, setting a schedule for nursing (like the every 3 hours your ped recommended) is a recipe for reduced supply. hardly any babies actually get hungry on exactly that schedule, and since demand = supply when it comes to milk, restricting demand by following a strict schedule often results in lower supply long-term. (also - extra evening nursing for a 9 weeker is generally NOT just for comfort, but also for calories!) especially when you're full-time working, the scheduling can result in a cycle of supplementation.
of course, any milk is better than none, and if you're willing to supplement and have maxed out the times you can pump, then you'll just have to wait and see how long your supply holds up. some moms might do fine with this pattern, but particularly since you're starting when your baby is so young, i would guess you will end up gradually increasing the supplements and decreasing the milk by 6 months, if you go that route.
also, pump output is a terrible indicator of supply. 3 oz per pump is normal, and not an indicator of what she's getting "from the tap".
good luck, hang in there!! we have all been there and hardly anyone enjoys pumping - it is WORK - but it is also worth it :)
Re: Feeling uncertain....
Hi Maymeb and welcome to the forum!
I agree with auderey. Nursing on a schedule may have been working well for you up to your return to work, and at least every 3 hours around the clock kept you nursing with something close to a normal overall frequency. But it is not natural for a baby to eat every such and such hours and scheduling has been shown to be potentially harmful to milk production and weight gain. Scheduling tends to discourages comfort nursing and cluster feeding, both of which are entirely normal and necessary aspects of breastfeeding.
I would add that, if baby has been gaining well on your milk, your milk production is almost certainly fine at this point. The challenge now is to keep it fine now that you are back at work, which is often a bit more challenging but doable.
What kind of a pump are you using, does it fit you correctly, and is it new? More often than you would think, there are mechanical pump issues that are not immediately obvious. While 3 ounces is a normal amount to pump at a time, it may not be quite enough overall for your baby, so increasing your pump output a bit if possible would be good. If you determine that your pump is working fine, then adding some hand expression may increase your pump output. www.kellymom.com has very good articles on maximizing pump output, and you can try getting tips for the moms on the work and pump forum here.
Here are some other ideas for keeping milk production in good shape after the return to work, maximizing pump output, and making sure your baby is fed enough by your caregiver but not too much.
For your caregiver-bottle feeding the breastfed baby and fussy baby ideas: http://www.llli.org/docs/00000000000...astfedbaby.pdf and http://www.llli.org/docs/00000000000...ybabyideas.pdf
I would also suggest adding at least one more pumping session during the work day. Another option, if possible, is to arrange to see baby to nurse one time during the day.
I would also suggest keep letting baby nurse at will in the evening and overnight. Try to nurse at least once overnight. Try a dream feeding if baby does not wake. Also if you swaddle or if baby has a pacifier at night try cutting back on those sleep extender techniques to see if baby naturally wakes more often to nurse.
Another thing that helps keep milk production in good shape after mom returns to work are taking nursing 'vacations' on weekends-relaxing with baby and nursing a lot!
It is very important to address these issues not only so baby has your milk during the day now, but to protect your milk production going forward.