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Thread: Another "is she getting enough" question!

  1. #1
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    Oct 2012
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    Default Another "is she getting enough" question!

    I read in the other "Is she getting enough" post, that the rule of thumb is 1 - 1.5 oz for each hour away so given I'm away 9 hours, that's 9 - 13.5 oz. Is that right? I have a hard time believing it! My daughter is 7.5 months and on solids (about 3 oz/day) so it's probably hard to guess how much milk she needs (Kellymom suggest a wide range for babes 6+ months http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/ )

    I've been providing 3 bottles with anywhere from 4.5 - 5 oz. I feel compelled to leave three 5 ounce bottles, but it's often a struggle to make that quota with extra pumping sessions to make the last ounce or two. When I leave three 5 ouncers, she generally drinks it all, so one might assume she needs it...

    I feed her 5 - 6 times a day (so 2-3x she breastfeeds, 3x bottle) and my breasts are not providing a big meal at the end of the day, I'm pretty sure. I wish I could be more confident about she is getting enough, and I'm REALLY sick of trying to make ends meet with all the pumping!!!!

    I have tried Shatavari 500mg x 2, which has had a noticeable impact in the past, but less now. I could take x3 according to lowmilksupply.org.

    Or do I not really have a real issue? What do the wise mammas think?

  2. #2
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    Default Re: Another "is she getting enough" question!

    Hi lbc. Several points:
    1) Actually, before 12 months baby's breastmilk needs are the same regardless of their solids intake, because breastmilk is their primary source of nutrition up to 12 months (then solids GRADUALLY start to take over). 24-32 ounces per day, that's where the 1 to 1.5 ounces/hour number comes from.
    2) Just because LO drinks a 5 ounce bottle doesn't mean she NEEDS a 5 oz bottle. If offered, many babies will drink 5 ounces or more. But that just means she'll drink less with you later - so you're having to pump more to keep up, and getting less stimulation at the breast in your non-work hours. That's the rationale for trying to keep baby on a physiologic feeding schedule with the bottle. Try providing 4 ounce bottles and see how she does. You may even be able to back down a bit more, but since she's used to getting 4.5 to 5 ounces, you might want to back down slowly.
    3) Feeding 5-6 times per day is on the low end. Most babies will continue to need 8+ feedings per day. The fact that you are struggling to keep up suggests that you may not be getting enough stimulation at the breast, which is generally better for keeping up milk supply than the pump. Can you up the number of times you are feeding her when you're together? A dream feed at night may be a lot less work than trying to add more pumping sessions in the day. Nighttime feedings are the WOHM's best friend! (Well, sort of - I know it's not fun to wake up at night to nurse, but it really is good for supply!)
    4) In terms of your pumping, how often and for how long are you pumping? Extending your pumping sessions may help, and adding breast compressions. If you commute to work, you might want to consider pumping while driving as a relatively painless way to add in more pumping time.

  3. #3
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    Default Re: Another "is she getting enough" question!

    I agree with the PP. Babies are often willing to take more by bottle than they really need or would eat if being fed on demand "from the tap". Breastfed babies generally don't need more than 4 oz per feeding, and often less.

  4. #4
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    Default Re: Another "is she getting enough" question!

    Thanks for these.

    Re: bfwmomof3's comments/questions:
    Slight correction: I offer to BF 4x with her not being too interested for one of those, and she gets 3 bottles otherwise (so, 7 feeding opportunities).

    I actually do a dream feed around 10p and then feed her between 4 - 5 am (as another concern, I'm thinking of trying to wean that early morning feed, but I'm worried about changing much right now). I offer again at 7 am when we get up, but she really doesn't want much then (so re: dropping the 4 - 5 a.m. feed, I assume she'd transfer that feed to 7 am). I pump whatever's left after the 7a feed (which isn't much lately, 1 - 2oz) and then I pump at work at 9, 12, and 3 for about 10 minutes each time. I often hand express after pumping and get another 1/2 - 1 oz and really empty the breast. When I see LO again at 6p she isn't that into eating (maybe because she's had more than she needs...?) and then we do a feed before bed at 7.

    In sum, I'm emptying the breast as much as possible during work hours which should be stimulating more production I thought, plus I have that additional pump at 7a, post feed. But it's possible, especially if she's on the low end of needing 24 oz/day, that her biggest meals are when she's away from me, as you point out. When I do the math, if she only needs 24oz, then she needs only 9 direct from me over 3-4 feedings.

    And why is it that babies will take more from a bottle than they need? I figured that and always wondered-- not to introduce to many different concerns into this one thread!

    In any case, both posts are helpful. Any additional thoughts based on what I've said here is much appreciated. Otherwise, I think the idea of backing off a little might be good-- though a little scary and counter-intuitive when you're worried about not providing enough-- but it actually makes sense.
    Last edited by @llli*lbc; December 18th, 2012 at 10:44 PM.

  5. #5
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    Default Re: Another "is she getting enough" question!

    When is she getting the last bottle of the day? It should be AT LEAST an hour before you see her, so that you can nurse immediately when you're back together. I think it is likely that the overfeeding (and possibly timing) is the reason she's not interested in nursing when you first see her. That's kind of unusual.

    With respect to why babies will take from a bottle more than they need but don't do that at the breast: remember that with the bottle, the milk comes out regardless of whether they actively suck or not. So it's more a willingness to swallow versus active wanting.

  6. #6
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    Default Re: Another "is she getting enough" question!

    Her last bottle is while before she sees me, usually around 2:50 - 3 pm. Actually, when I'm with her on weekends she often goes a longer stretch after that feed, too. I'm also using Dr. Brown #2 nipples with the hope that the milk doesn't just flow out without her sucking--- it doesn't seem like it does.

    Looking forward to having a week off for the holidays and getting in a lot of nursing!

  7. #7
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    Default Re: Another "is she getting enough" question!

    So as you point out, if she gets 15 oz during the day, and then takes 3 oz per feed with you (which would be a typical amount for a nursing session), then it makes sense that she may only be interested in doing 3 feeds with you. But if you back down to 12 oz in her daytime consumption, then she'll be more enthusiastic about doing 4 feeds from you. That 3 oz will probably make a big difference in you being able to meet her needs with the pump, especially with the extra stimulation at the breast! As long as you are trying to sort out these supply issues, I definitely would not cut out the 4-5 am feeding. If she's sleeping between 10 pm and 4 or 5 am that's already a long sleep for a 7.5 month old! (Check out the sleep forum, and you'll see that lots of the nursing babies around here that are that age are getting up every couple hours at night!)
    In terms of your pumping, I think of 10 minutes as really a bare minimum. Even if you're initially pumping dry after 10 minutes, adding in another 5 to 10 minutes can really help your output pick up without too much of an additional investment in time. Do you ever get a second letdown?
    A #2 nipple is actually a fast nipple. Many breastfeeding mamas keep baby on a 0 nipple even as they get older, because as manitobamommy mentions, any artificial nipple is going to be a lot faster than the breast. There was a study published recently that babies drinking from the bottle do lose the ability to self-regulate how much they are taking in (regardless of whether the bottle contains breastmilk or formula), presumably because drinking from a bottle is such a passive process compared to drinking from the breast.
    And yes, being able to nurse full-time over the holidays is going to be great for your supply!

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