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Thread: Newbie Questions - Feeding Frequency, Oversupply, Pumping?

  1. #1

    Default Newbie Questions - Feeding Frequency, Oversupply, Pumping?

    Hello everyone. This is my first post here. I discovered these forums a few days ago and have been absolutely devouring the information provided here. What an incredible resource...thank you SO much for all of this priceless advice!!

    I am a first time mom, so I am completely new to breastfeeding. I must say, I have gained tremendous respect for any and every mom who makes the breastfeeding thing work. There's SO much more to this than I ever imagined. My little one is 4 1/2 weeks old (born 10/26). She was 7 lbs 3 oz at birth, but was down to 6 lbs 10 oz at 12 days old. She did not surpass her birth weight until 3 weeks old, on Nov. 16. During that low weight period, she was having lots of wet diapers but only a poopy one every 4 days.

    After reading here, I now know that her low weights were at least mostly my fault. We were only getting in 7-8 feedings/day. Not enough. I feel awful about that :-(. I just truly had no idea how MUCH time (a LOT apparently) had to be devoted to feeding a newborn. (Also playing a role may have been the nipple shields the hospital lactation consultants sent me home with because of my poor bloody nipples. And the fact that she came home jaundiced and incredibly sleepy). Once I figured these things out, her weight has been rebounding, gaining at least an oz a day, with 1-2 substantial poopy diapers/day (and still lots of wets). At her last weigh in, on 11/25 (when she was 4 wks, 2 days old), she was 7 lbs 13.5 oz. So that's our background.

    Some question I have though:

    If I don't wake her up, she will sometimes sleep in 4-5 hr stretches at night. Should I be waking her more often during the nighttime hours? I have been trying to get her up at least every 4 hrs (the 5 hr stretches have happened when I've slept through my alarm...). Will these longer stretches hurt my supply? I do not feel like I have a supply problem right now. I often wake up, after going for 4 hrs w/o feeding, feeling uncomfortably full. Which leads to another question...

    My left breast is SO much bigger than my right, and often feels overfull...especially in the morning. I've thought that it's like having a bowling ball attached to my chest. Is this weird? Is it maybe oversupply in one breast?

    Something I've wondered about the # of feedings/day: For example, this morning, I started a feeding at 9:30 am. She ate well until 10am or so, at which point she started dozing off. I let her doze for a little while without setting her down, and then switched breasts at 10:45 (she was waking back up again). She ate well for 10-15 minutes during this episode. So...would something like that count as 1 feeding, that got interrupted? Or 2 feedings? I often feel like I'm not sure when she is actually done eating, so am not sure about my current daily feeding numbers.

    One more question :-): This morning, I struggled to get her to eat well at her 3am feeding. She kept dozing, despite the fact that I'd woken her up by changing her and stripping her down. She also finished things off by spitting up most of what she'd just eaten, and then refusing to be roused to eat more. So I gave up and put her back down to sleep (it was almost 4:30am at this point, and I was soooo tired). I still felt full though, so I decided to pump for a short period. I got about an oz. (Her dad usually does her 5-6am feeding with EBM). Is pumping after such a frustrating feeding session ok? Sometimes I also pump in the morning, after she eats around 8am or so...just getting enough for the one bottle at night. I'm kind of worried about creating an oversupply issue (especially w/ my left breast, which often feels overfull anyway). But it is really, really nice to have him give that one bottle/day, and he likes being able to contribute in that way too, allowing me to get just a few hrs of continuous sleep.

    Anyway, I apologize for the length of this post. I know that these questions probably make it really obvious how little I know about all of this. I'm still way at the bottom of the learning curve. Thank you, again, for being here to answer questions. I feel like I can tackle this with a resource like this available.
    Last edited by @llli*babyrora; November 28th, 2012 at 01:56 PM.

  2. #2
    Join Date
    Jun 2009
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    5,260

    Default Re: Newbie Questions - Feeding Frequency, Oversupply, Pumpin

    Hi, welcome to motherhood and this forum! It is so great you are still nursing despite initial difficulties and concerns!

    So I will try to give real quick answers to two of you ? . The other 2 are a little more complicated.

    night sleep stretch-So generally, as long as baby is gaining well and nurses a minimum of 10 times in 24 hours (more is fine) then a single long stretch per day of 4-5 hours is perfectly fine and normal. (Also normal for a baby to not do that at this age.) If baby does that stretch at night, so much the better for momma. If you are waking up feeling extremely full, that is a clue the stretch may have been a little long. But the remedy for that would be to nurse more, not pump, if at all possible. Hand expression is less problematic than pumping and can be used instead of pumping if baby just will not nurse and you are very full.
    I would suggest, watch out for things that create unnaturally long sleep stretches, like pacifiers or swaddling, at least for a few more weeks until things are totally back on track.

    what counts as a feeding-this will often go by how you feel about it. As you get into this more, you will probably find that all you really need to do is nurse when baby cues or your body cues and you will not need to count sessions. As long as baby is healthy, cue feeding should ensure baby gets enough and that your milk production is fine. I would probably count what you describe as two sessions, but since it never hurts to offer to nurse more often, when in doubt, count it as one.

    OK, so the breast feeling full-yes it is normal for one breast to produce more. But this sounds more like engorgement to me, which can cause problems, so you want to get a handle on why that is happening.

    Is latch still painful? Do you still use shields? Does baby favor one side? Do you leak on one side but not the other? Many things could be causing this lopsidedness. Generally, you can avoid engorgement by nursing frequently. So maybe offering that side more for a time will help.

    if you are really full and baby won’t nurse, again I suggest hand expression over pumping. If you must pump, do it for a very short time on a low setting, just to relieve pressure. If you keep pumping while nursing as well, you do risk overproduction.

    Unless you need to pump or supplement for some reason-such as, baby needs supplements due to poor weight gain, I would strongly suggest not doing so for a few weeks until 'normal' breastfeeding is more firmly established.

  3. #3
    Join Date
    May 2006
    Posts
    20,813

    Default Re: Newbie Questions - Feeding Frequency, Oversupply, Pumpin

    with LLLMeg. I just want to add that it sounds like you have things going pretty darn well for a brand-new mom, and that it really sounds like you only have to tweak a few fine points (the pumping, the overachieving left breast). Meg mentioned shelving the pacis, swaddling, pumping, and supplementing- I'd also put Dad's 5-6 am feeding on that list of things to avoid for now. Your baby is still a little young for the bottle, and as Meg said, you want "normal" breastfeeding well-established before you introduce interventions like pacis, supplements, and bottles.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4

    Default Re: Newbie Questions - Feeding Frequency, Oversupply, Pumpin

    I apologize for taking so long to get back to this post. We were traveling some over the past week. Thank you for your helpful replies! To follow up on the things you asked:

    My left breast seems to have modified it's oversupply issue some over the last week. It no longer is as huge, or hard, so that is a relief.
    I am not still using the shields. I eliminated them as soon as I realized they might have been contributing to her weight gain issue (though I think it was mostly me not feeding her often enough...). So I've been without them for over 3 weeks now. It was INCredibly & acutely painful when I first got rid of them, but has gotten better. Now, occasionally, it doesn't hurt at all. But more commonly, her latch causes just mild soreness. I can deal with it, but it's not enjoyable (though I do enjoy the breastfeeding experience overall, despite this). I know it is because her latch tends to be too shallow (I end up with the "lipstick" looking nipple after she spits it out), but I struggle getting her to do it right. I've read about making the "sandwich", and will occasionally get her to take that big mouthful of tissue. Then, it doesn't hurt at all (hooray!). But inevitably, she squirms around (she has a LOT of gas--poor thing), unlatches, and we're back to square one. I am hoping this will improve as she gets older? Unless we've already established a bad habit....

    I do generally try to get her to both breasts at each feeding, though sometimes it ends up being just one. And I try to swap which side she starts on with each feeding, though once in a while I think I forget and start with the same one twice.

    Is there a time when breastfeeding is considered to be firmly established (she's 6 wks old now)? I dearly love my husband's turn at one bottle of EBM each night, and would be sorry to part with it . She does eat eagerly at the breast, so doesn't seem to be suffering from nipple confusion. Though I'm not 100% sure I'd recognize it, since I'm new at all of this. I also feel it helps her get what she needs because I have SUCH a problem waking up well for all of her feedings at night. I have a bad tendency to sleep through alarms, and through her more mild fussing, and she will often sleep for a 5 hr stretch at a time without waking up. It was my guess that this is too long, given her previous weight gain issues? We have been swaddling her at night because she seems to have an impressive startle reflex, and will frequently (2-3 times/hr) throw her arms skyward and wake herself up unless she's wrapped. I didn't realize that this could cause artificially long sleep spells.

    I often feel very uncertain about when I should follow her cue....even when she goes for these longer stretches, or when I should just feed her because it's been more than 2 hrs, even if she's not cue-ing me. I wonder this during the day as well. My parents have been visiting, so there' s no shortage of comforting arms to cuddle her all day, and suddenly I'll realize it's been over 3 hrs and she's not asked to eat. I need to step it up because the last few days, she's only gotten 8 feedings, and we're back to no poopy diapers for over 2 days. Her weight gain has still been over an ounce a day though, and is now up to 8 lbs 14 oz as of Dec 5, up from a low of 6 lb 10 oz on 11/7 (weigh in previous to 12/5 was on 11/25 at 7 lbs 13.5 oz). It could be that I'm just inexperienced at her cues, and am missing some of them. Sigh. The timed 2 hr intervals (at least) seem to be what I need to stick with right now, I guess.

    One last question...Is there a way I can pump once a day, at most 2, without creating an excessive oversupply? Does it help to do it at regular time periods (approx 10am every day, for example)? Even if we don't do the one bottle of EBM at night, I would like to build up a small stash of milk in the freezer in case I need am delayed while out or something.

    Thank you, once again, for all of your help. This forum is a tremendous resource, and I am very grateful for it. I'm sure it's helped many a mom continue breastfeeding when they were otherwise thinking it was impossible. . Sorry this post is so ridiculously long...
    Last edited by @llli*babyrora; December 6th, 2012 at 04:23 PM.

  5. #5
    Join Date
    May 2006
    Posts
    20,813

    Default Re: Newbie Questions - Feeding Frequency, Oversupply, Pumpin

    Don't worry too much about "bad" latch habits right now. Babies tend to get better and better at latching as time goes on, their mouths grow, their muscle control improves, and their ability to tolerate a rapid milk flow or to change the flow of milk by changing their sucking pattern improves. As long as nursing is tolerable right now, I think you have every reason to expect that it will only improve as time passes.

    Breastfeeding can be considered to be well-established... Well, when both mom and baby are comfortable, baby is gaining weight well, and everyone is more or less enjoying nursing. For some moms this takes just a few weeks, while other moms may need a few months to really get breastfeeding established.

    When it comes to long sleep stretches, sometimes it helps to focus less on meeting some artificial goal, like feeding every 3 hours at night, and to focus more on making sure baby is nursing at least 10-12 times a day. That may mean that baby feeds every hour, or even more frequently, during some portion of the day. However, if 2-hourly feedings are working for you, don't be afraid to stick with them for a while longer!

    You can almost surely pump once or twice a day without creating an oversupply. Choose one time of day, and pump after feeding the baby, stopping when you have about 2 oz even if the breast is continuing to yield milk. Keep pumping that same amount consistently, at the same time, and you'll train your body to make just a small amount of extra milk.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

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