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Thread: newborn BF and pumping issues - please explain best ways, supply/demand

  1. #1
    Join Date
    Feb 2006
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    13

    Default newborn BF and pumping issues - please explain best ways, supply/demand

    I gave birth 2 weeks ago. DD will only take the breast with a breast shield (after 6 appts w/ LC in hospital). We initally did the finger feed method to prevent starting the bottle the first 8 days. LC wanted us to stop that and start using the shield and supplement w/ EBM via Avent newborn bottles.

    My bigger problem is with the pumping. Please explain this "supply/demand" of pumping. It seems no matter how often or long (15 mins/3 hrs is my goal) my boobs can still be hard & lumpy, as if not enough is coming out. I use the heating pads before/cooling after - and I get 180-240 cc every time. Which I'm starting to freeze, as DD is seeming to never going to finish. Also, I don't always seem to get the hindmilk out - should I keep pumping?
    The LC said to pump until I feel "comfortable", but I really think I could be hooked up 24/7 then! I do offer her the breast for 10-15 mins before I pump, which she'll only take with the breast shield, and then gets fussy and "falls off". Are there any drawbacks to long term shield use?

    Is it ok to go longer without pumping? It's now been about 5 hours since I last pumped, and I'm starting to feel uncomfortable. It's just getting a little overwhelming every 3 hours, plus feeding/diapering combined with sleep deprivation.

    Thanks for any advice you can give.

    Leslie

  2. #2
    Join Date
    Jan 2006
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    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    Leslie, That does sound overwhelming Unfortunately you do need to pump every three hours, maybe you can go 4 in the night... Supply and demand is the right term, the more that you call on the breast to make, the more the they make etc. As far as pumping my LC said to pump at least one minute after the last drop. You can also try breast compressions to help get all of the milk out of those ducts. You can see the difference in the hind milk it is very thick and a darker color than the fore milk which resembles water with a milk tint. I hope that makes since?? I do not know much about a shield, I am sure that others will come with advice about that also. Blessings!

  3. #3
    Join Date
    Dec 2005
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    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    Did your IBCLC suspect any reason why your baby prefers to nurse with the shield? Did she give you any suggestions for transitioning from nursing with the shield to not? If no, would you like some info on weaning from the shield?

    On average, how many total ounces are you pumping per day over how many sessions?

  4. #4
    Join Date
    Feb 2006
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    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    DD keeps her tongue on the roof of her mouth, and we do sucking exercises as instructed by the LC (put pinky finger pad side up, slowly pull it out which makes her suck it back in). The LC did instruct after DD latches on with the shield, to remove it and let her try just the breast. However, she really won't do this despite all the positions, etc I try and just starts wailing with only the breast. She'll suck maybe 10-20 mins (with the shield). Are there drawbacks to long term use of the shield?

    When I pump every 3 hours for 15 minutes, I get *at least* 180-240 cc. Yesterday I tried to go 6 hours between pumpings (just to see), and I still got 240 cc the next 2 times (and no pain as I thought I'd have, just leaking).

    I'm also wondering about the 8-12 feedings that's recommended, as we average 8 times. I also give 60cc EBM via Avent Newborn bottles after trying the breast since she still seems hungry at times (but if she gets anymore she spits up). Should I call the Ped for feeding advice?

    Any help is much appreciated!!!

    Leslie

    btw, we're not using pacifiers

  5. #5
    Join Date
    Feb 2006
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    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    Leslie ~ We also did finger feeding and used a shield. It does get better!!

    For the first 4-6wks I think anything goes as far as what your breasts feel like and how long it takes to drain a breast. At that age my DS would nurse about 45min. I could also pump 4-8oz. Sometimes it took 10min, sometimes it took 30min. It's very discouraging when you're spending all your other time bf'ing and trying to sleep. It sounds like you're pumping 6-8oz. That's great. Your supply is still building which is why you get so much. (My DB is 6mo now and I can get only 1-2oz max after he's eaten). This will even out over the next few weeks/month as your body learns when and how much to respond. Your breasts will also be less sore.

    Here's how my LC described knowing you've drained a breast: when you start pumping the drops come out slowly, then you may notice your nipples actually spraying milk or you'll feel a letdown, then it will slow again to a drop every few seconds. After it slows it's ok to stop. Also, eventually you'll just get a sense of when you've gotten most of the milk out (b/c the bottles will suddenly start filling fast) and that you can stop pumping in a few minutes.

    The benefits of the shield outweigh the drawbacks in my opinion. DB would not have eaten or learned to latch if we hadn't used it. It can affect supply (because the suction isn't as great as if DB were right on the breast) and there is often some loss of milk that dribbles away. I was so tired of using the shield after 2mo, and my LC gave me some strategies for weaning: At least once a day (to start) have DB try to nurse w/o the shield; try nursing w/o the shield when DB isn't hungry and is willing to play/comfort suck; try nursing w/o it when DB is drowsy; try nursing in the bathtub. After a few days I could get DB to latch on for the beginning of one feed. If he came off I'd have to use the shield as he would then be too tired/frustrated to relatch w/o it. After about a week we could do one whole feed and part of another. Eventually he got it. After 2.5mo he was completely weaned!

    I remember being so anxious about losing the shield (in the sheets, when NIP, in the diaper bag, on the ground, etc.) so I got two, which really helped my peace of mind. I always kept the shield I was using folded in my bra so I knew exactly where it was and could get set up quickly.

    Good luck. It does get better, I promise! Let me know if you have other questions.

  6. #6
    Join Date
    Feb 2006
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    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    Beth,

    Thanks for the help and words of encouragement. It all seems so hard at times, but then sometimes it works and I try to keep hope this will work! Ultimately, I want to make sure DD is being nourished appropriately.

    Take care!
    Leslie

  7. #7
    Join Date
    Feb 2006
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    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    Don't worry, babies won't starve themselves. I have one friend who decided to go cold turkey with the shield and DB took to the breast after a day and a half (it was hellish, but that's what worked for her).

    >>It all seems so hard at times, but then sometimes it works
    Yes, they are learning machines, so if something doesn't work today, it might in a day or two. Don't get discouraged - it's a confidence game!

  8. #8
    Join Date
    Jan 2006
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    863

    Default Re: newborn BF and pumping issues - please explain best ways, supply/demand

    I know your lc asked that you stop finger feeding and start the bottle. Did she explain her reasoning? I'm wondering if dd is pulling off and crying because of nipple confusion?

    One thing that helps me get more while pumping is to nurse on one side and pump on the other.

    Keep us posted! Congrats on your little bird!
    Kristie L.
    LLL Leader
    (the poster formerly known as fezzik812)
    Wife to Brett, Mommy to Seamus (5.1.05), and Emelie (1.18.08)
    "You must be the change you wish to see in the world."- Ghandi

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