Expressing affecting supply?

[@llli*shootthepigeons]

My LO is just over 6 weeks and I've have been attempting to express since she was 4 weeks old. I was advised to express in the morning, either during or just after a feed, from the side LO doesn't feed from. I've been using a manual pump and getting anywhere between 2-4oz in total, depending whether I pump at 1 or 2 feeds. I find that I only have success first thing in the morning so it does depend how organised I am! I've then been freezing a bit but mostly using the expressed milk for a bottle later in the evening. This is all working well but I want to know if this is having effect on my supply and LOs feeding habits.

Basically, she feeds really well and goes a decent time between feeds in the morning and then after the expressed feed at night. However, from lunch time she feeds very frequently, mostly every hour, and seems really crabby and constantly hungry in between. The only thing that settles her is the expressed bottle. I know it's very rare not to produce enough milk but it genuinely does feel like that! Sounds silly but I'm not particularly well-endowed so I can't help but think that I have a fairly low maximum capacity! Plus I really would love slightly longer between feeds as, when she does, it really feels as though my boobs have time to restock properly and it is currently really hard to do anything or go anywhere after midday! Could it be that pumping so much in the morning is affecting my supply later in the day? And will giving the bottle at the end of the day also have an effect? I'm trying to give it at the end of these massive cluster feed sessions so that baby has spent enough time on me and therefore sending the right supply signals but I have to say I'm unsure it's working!

I also wondered of its a good idea to only pump occasionally, as I'm not sure I will be able to consistently pump every day. Is that going to confuse my supply? I didn't pump today and had a really good day for feeding, followed by a horrendous evening/night where LO wouldn't settle and just wanted to feed. Bit of a shock as she's been going down at about 9pm recently and sleeping for a good long stretch!

Any advice would be brilliant!

X

[@llli*bfwmomof3]

Hi mama, welcome to the forum!

So first, a couple questions: why are you pumping? Are you building up a stash to go back to work, or is it solely to give bottles of expressed milk as you describe? How has baby's weight gain been? How does nursing feel? Do you have any pain? How is baby's latch?

Unless you are trying to build up a stash of milk for going back to work in the near future, I would suggest ditching the pump altogether. If you anticipate a separation from baby then you can just pump at that time. No need for daily or even every few days pumping. Nurse on demand and your supply will match what baby needs. Your baby is still tiny! It's both common and completely normal for baby to nurse more frequently during certain parts of the day than at others, and also normal for baby to nurse constantly at times, including at night. It's tiring but normal and it will not be like that forever! Baby being fussy does not indicate you have a low supply. There are many reasons for baby being fussy! Here are some ideas on soothing a fussy baby: http://www.llli.org/docs/00000000000...ybabyideas.pdf As the sheet notes, nursing is often a wonderful way to soothe baby!

The newborn period can be a really difficult time. It does feel like you nurse and nurse and nurse, doesn't it? Again, it will not be like that forever. As baby gets older she may become more efficient in her feeding and although she may still have times where she wants to hang out at the breast for long periods of time, she'll also have times where she wants to play and explore and, in fact, some older babies are so distractible it's hard to get them to nurse during the day! So rest assured, it won't continue like this. At this point though the best thing to do is simply to nurse baby as often as she wants and do not try to stretch out feedings, as that is likely to lead to a decrease in supply.

How do you feel about nursing in public? Many mothers are uncomfortable nursing in front of others but with practice it gets easier. That gives you more mobility in terms of getting out with baby. Although also you'll probably want to time outings for times of the day when baby is less fussy. Some mothers find that practicing first in a safe environment, perhaps around a friend or relative around whom you feel comfortable, or at a La Leche League meeting, are good ways to start feeling comfortable with nursing in public. Or practicing in front of a mirror. Check out the "Nursing in Public" forum to get more ideas on what to wear and encouragement from other mothers! http://forums.llli.org/forumdisplay....ursing-Apparel

The size of your breasts says absolutely nothing about how much milk you have or your storage capacity. Breast size is determined by fat and the fat cells are not the ones that make milk. As you say, it's rare for mothers to have an inadequate supply if they are using good breastfeeding practices - feeding often and on demand, usually 10-12 times at least in 24 hours, including night feedings, and not scheduling or stretching feedings or limiting them in any way.

[@llli*mommal]

with the excellent post above. I just want to reemphasize that afternoon-evening cluster feeding and fussiness are both absolutely normal and in no way an indication of low supply. Babies generally wake up in a pretty good mood, but as the day goes on they get tired and cranky, just like their moms do! And the best way a baby knows to soothe those cranky feelings is to nurse. And nurse and nurse and nurse and nurse!

Some things to try, when the fussiness really ramps up and nursing isn't defusing it:
- calm house- lights, TV, and stereo down or preferably off
- white noise- vacuum cleaner sounds, radio static
- motion- rock, bounce, stroller ride, swing
- closeness- snuggle baby up in a sling or close to your bare skin
- warm water- bath in the sink or in the tub with mom
- fresh air- take baby outside in a sling or stroller

As you can tell from the list above, the key to coping with a fussy baby is to change up the incoming sensory stimuli. This is why the bottle tends to work- not only is it a new type of sensory input, but it also delivers a lot of milk relatively quickly and with little effort on baby's part, leading to baby more or less "passing out" with a very full belly.

When it comes to fussiness, no soothing technique is likely to work for long, so you have to keep changing it up.

[@llli*TimsMom]

The size of your breasts says absolutely nothing about how much milk you have or your storage capacity. Breast size is determined by fat and the fat cells are not the ones that make milk. As you say, it's rare for mothers to have an inadequate supply if they are using good breastfeeding practices - feeding often and on demand, usually 10-12 times at least in 24 hours, including night feedings, and not scheduling or stretching feedings or limiting them in any way.

Do you have citations on the details of that? I'm simply curious. I'm smaller than a AA, and some case studies of oversupply talk about women pumping quantities of milk that are vastly beyond the size of my breasts. It wouldn't be remotely plausible for me to hold that much milk. I would expect breast size to provide some kind of upper bound on capacity. I'm curious what the research says on extremes.

[@llli*bfwmomof3]

I like this article about storage capacity: http://www.dhss.delaware.gov/dph/chs...number2011.pdf

It refers to the following article: http://www.sciencedirect.com/science...6952307001948#

ETA: I don't know whether the latter link will work for you... apologies if it doesn't, I figured it was worth a try

[@llli*sonogirl]

Do you have citations on the details of that? I'm simply curious. I'm smaller than a AA, and some case studies of oversupply talk about women pumping quantities of milk that are vastly beyond the size of my breasts. It wouldn't be remotely plausible for me to hold that much milk. I would expect breast size to provide some kind of upper bound on capacity. I'm curious what the research says on extremes.

My smartphone won't let me open the links above, but I just wanted to share an anecdotal story--I have a coworker who has smaller than AA breasts, and she had one of the most insane cases of oversupply I have ever heard of. Like, we are talking 20 oz a pumping session kind of oversupply. You could actually watch her breasts inflate over the course of the work day. Totally wild, but it can happen!

[@llli*mommal]

My understanding is that most of the breast's size is dependent on fat. Big breasts = fatty breasts, small breasts = lean breasts. The amount of glandular- i.e. milk-producing- tissue doesn't really differ between the two types.

[@llli*bfwmomof3]

Right, so according to that article I linked to, on average there is approximately twice as much glandular tissue as adipose tissue in the lactating breast. But, there is great variability in this ratio, and in some women, up to half of the breast is comprised of adipose tissue (presumably, women with larger cup sizes!). Interestingly, they did not find a relationship between the amount of glandular tissue in the breast and storage capacity of milk production, so there must be other factors that influence those parameters.

[@llli*TimsMom]

Fascinating. When DS1 was an infant, I visibly inflated over a work day, and there was nothing near 20 oz in there. I guess our skin is more flexible than I give it credit for. I just can't imagine growing by 2.5 cups. That's amazing.

[@llli*TimsMom]

Is there a method to distinguish storage capacity from pumping/nursing output? The latter would include milk produced during the session.