Re: Expressing milk issues and how to mixed feed
First of all, your wife is NOT failing. She is succeeding at something very, very difficult. She is providing her baby with her own milk, and if it comes in a bottle a lot of the time then so be it. Just because her success looks a little different from the way you both envisioned it does not mean that she's failing. Okay?
It is entirely normal for a baby to seek the breast whenever he is held by mom. It doesn't mean that baby thinks moms is "only for food"- it's that babies are programmed to multitask, simultaneously bonding and nursing. It can be extremely exhausting for mom, particularly when she is struggling with sore nipples, but biologically speaking it is what is supposed to be happening right now.
As to your specific questions:
1. There is no set limit for how long a mom can go without expressing/nursing. The breast's ability to store milk differs greatly between individuals. Some moms will be able to go long time periods between pumping/nursing sessions and not have that impact their supply, while others will not. I understand completely your desire to get out of the house, but right now nursing and maintaining milk supply should be your priority. If you do go out, I personally would suggest not going more than 3 hours without pumping. Doing that once should not present a problem, but doing it regularly certainly might.
2. kellymom.com has some links on paced feeding and how to bottle feed the breastfed baby which may be helpful to you.
3. Again, one shouldn't try to separate "cuddle time" and "nursing time" with such a young baby. Nursing time IS cuddle time, and the more baby nurses the better he will become at it and (hopefully) the better things will become overall.
4. A mom should discontinue breastfeeding if she has a contraindicated medical condition (HIV, active tuberculosis), or if SHE feels that the time has come to give it up. For some moms, nursing is "worth it" even if the breastmilk they provide meets only a fraction of their babies' nutritional needs. For others, breastfeeding is unendurable even if everything is going smoothly. There is no one right answer to this question. If a mom feels unable to continue to nurse, she should at least consider combination feeding; that is, some breastmilk, some formula. Combination feeding has special challenges and some drawbacks, but confers many of the same benefits as exclusive breastfeeding.
5. Pumping in public is a definite challenge. It can be done, though. Mom needs a portable electric pump, a car adapter, a shawl or poncho, a manual pump (for times when there's no power), and the willingness to pump with pride no matter where she is- in a car, in a restroom, on a plane.
Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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