Happy Mothers Breastfed Babies
Results 1 to 3 of 3

Thread: From Bottle to Breast

  1. #1

    Unhappy From Bottle to Breast

    Hello All--
    I'm new here so a little background info...
    I am a first time mom. I became pregnant in Aug 2015 and was diagnosed with incompetent cervix in December due to a cone biopsy I had done to remove cervical cancer in 2011. I had a cerclage placed at 19 weeks and my cervical length was stable until 28 weeks when it started to shorten and then 31 weeks I funneled to the stitch. At 32 weeks my water broke and I spent a week in the hospital until giving birth to my daughter, Lulu, at 33 week2days. She was 4lbs1oz and needed to be intubated at first but was quickly extubated (45 mins later), on cpap for a day, and other than that and a touch of jaundice, she just needed to feed and grow. She spent 12 days in the NICU.
    After she was born, I pumped right away and supplemented at first with formula for the first 4 days until my milk was in and since then she has been on my breast milk only. We attempted breastfeeding twice a day with the help of lactation consultants in the NICU but couldn't establish a good latch. I focused mostly on bottle feeding because it seemed to be what was helping her to thrive and got her home so quickly. She's now home and at 6 weeks old weighs 7lbs2oz. She is doing so well.
    We've been home for a month now and a few days ago I decided to make a real go at getting her to take the breast. We've established a good latch and she has been successfully breastfeeding twice a day but I'm struggling with a few issues that I am hoping to get some advice for:

    1) my let down is very fast and my milk shoots out which frustrates her in the beginning of each latch. I've been taking her off and hand expressing into a bottle until it slows down. How can I slow it down without losing too much of my supply? I pump around 8oz every 4 hours and she has been taking 3-4oz a feed by bottle.

    2) she will only feed from one side. It seems the one breast has always been a bit lazy, the initial let down is super slow, but once it's going it seems strong, and it produces less. Afterwards, I have been pumping both sides for 5 mins, then the side she doesn't feed from for an additional 10.

    2) she breast feeds for a good amount of time and looks like she's starting to get tired and ready to settle down, unlatches and then when I think she's going to fall asleep, starts to cry and gets herself so worked up that she won't Relatch. This goes on for a while. I've tried burping, it's not gas. We both end up so frustrated that I just end up giving her a bottle, she takes a few gulps and out like a light. I end up feeling defeated bc my short term goal is to have one feed with no bottles involved and is has yet to happen.

    3) she gets hiccups in the middle of feeding (she has always had frequent hiccups). She suffers mild reflux that we've been working out somewhat successfully. I've cut out dairy and been giving a probiotic. I've tried feeding in different positions, slightly upright seems to work best but once she has the hiccups she won't relatch and gets very frustrated and the only way I know how to get rid of them is with a bottle. A few gulps and they're gone and she will breastfeed again. But again I feel defeated...


    4) how do I phase out bottles once she is ready?

    Thanks in advance for any response. I am determined to breastfeed exclusively and know it's best for everyone involved. I see the progress but these small setbacks are starting to become very frustrating. I keep telling myself it's only been a few days but without sleep it feels like months.

  2. #2
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: From Bottle to Breast

    Hi and welcome!

    It sounds to me that you and your baby are making great progress with getting baby back to the breast. I think it might help if you could be a little more patient with yourself and baby. Transitioning for bottle to the breast is usually a process and it can take a while. It's ok. Try not to see every time you use the bottle as a defeat. Rule number one is always, feed the baby. As baby begins nursing more, you can reduce the bottles with more confidence.

    Babies learn to nurse by nursing. My first suggestion is to start offering the breast/trying to get baby to latch more often. This does not necessarily mean give baby less in the bottle yet if that does not feel right yet. Babies nurse for many reasons and encouraging "comfort" nursing is a great way to encourage more nursing. BTW "comfort nursing" does not mean baby is not getting milk! This is a common misconception. It just means baby is nursing because nursing feels good and not only because baby is necessarily hungry.

    Do you need tips for encouraging baby to nurse more often? To get a better latch? Let us know.

    What strikes me about your post is how much of it sounds like normal newborn behavior. Nursing, almost going to sleep, or going to sleep for just a moment or two, and then waking and wanting to nurse again shortly in order to comfort into a deeper sleep is very normal. Since your baby is not very used to nursing yet, baby may not be able to latch as well when baby is tired and just wants to sleep. If you want to avoid the bottle (and I think you can if baby has just nursed pretty well) and baby is too upset to latch, have you tried offering your pinky for baby to suck on instead? A pacifier? Then maybe offering the breast again when baby is calmer? Or just comforting baby to sleep another way?

    For fast letdown, the best way to avoid that is to nurse very frequently! The more frequent the milk removal, the less milk there is built up in the breast the next time baby nurses, and the less fast the letdown.

    Obviously if baby is not yet nursing much, and you cannot get baby nursing more often, you could try pumping more often. But you might be too tired to do that. Also it is probable pumping more often would act to increase your overall production and that might make a fast letdown worse. Nursing often does not do this, because more frequent nursing would lead to smaller meals, so overall production stays about the same. You could try pumping more often but not as much milk each time, but it is tricky.

    Other ideas for fat letdown: Leaning back to nurse. You lean back to a degree that is comfortable and works. It can be a little or a lot, but not flat on your back. Baby can be in any position. This helps a lot with fast letdown.

    When baby objects to the letdown, try taking baby off and let the milk flow into a cloth and then put baby back on. Do not worry about "losing" this tiny bit of milk. Keep your eye on the goal, and that is baby nursing at the breast. If a fast letdown is preventing baby from doing that, it is worth losing a tiny bit of milk to get there. Make sense?

    Some moms hand express or pump a little right before baby nurses to make the letdown less. Personally I think this is way to much work, but it is something that works for some moms.

    If baby will only nurse on one side at this point, do not worry. We are all asymmetrical and when bringing baby back to the breast, one side usually comes first. It is also normal for production to be lower on one side. You can help that by pumping more or longer on that side, especially if baby takes a while to start latching on that side, this will be important for keeping production in good shape on both sides.

    Hiccups are also normal. Nursing helps hiccups very well. If baby will not latch and you do not want to use a bottle for hiccups, that is another time using your pinky or a pacifier may help.

    When a baby is upset- hungry, tired, hiccuping- it can be harder for baby who is just learning how to breastfeed to latch. At those times, using a little milk in the bottle to settle baby so baby will nurse again is fine! This is a tried and true technique for encouraging baby to nurse. A pacifier or your pinky can also be used. You can also try what is called "instant reward" techniques- encouraging baby to latch by dripping a little milk onto your nipple or hand expressing until a little milk comes out.

    You phase out bottles gradually. How gradually is impossible to say, but very generally, the more your baby nurses, the less milk baby needs in bottles. And the less bottles, the less pumping is required. So transitioning to nursing is going to help you in the tiredness department even if baby nurses very often as would be normal at this age. While making the transition, you can watch your baby's poop and pee output to see if it shows signs of reducing. Sometimes reductions are just normal fluctuations, especially with poop. But this is still information you can use. You can also take baby in for regular weight checks on the same digital infant scale. Maybe every two weeks? Not too often to make sure baby is continuing to gain normally. Remember normal gain does not always mean very steady gain. Weight gain rate naturally fluctuates.

    You could also see a board certified lactation consultant who has experience helping a mom and baby transition from bottles to the breast.

    I would also suggest a breastfeeding support meeting like LLL meetings. I think it will help you tremendously to see other moms with young babies. When a baby is born early or there are breastfeeding issues of any kind, moms often think something that is perfectly normal and common is cause for concern. If you are not yet bringing baby "out" you might consider going to a meeting without baby or simply talking to a LLL Leader on the phone.
    Last edited by @llli*maddieb; May 1st, 2016 at 07:11 PM.

  3. #3
    Join Date
    May 2006
    Posts
    24,794

    Default Re: From Bottle to Breast

    Welcome to the forum and congratulations on the baby! Thanks for sharing your story- it's an interesting one! Though I suppose you'd probably have preferred a less dramatic experience...

    1) my let down is very fast and my milk shoots out which frustrates her in the beginning of each latch. I've been taking her off and hand expressing into a bottle until it slows down. How can I slow it down without losing too much of my supply? I pump around 8oz every 4 hours and she has been taking 3-4oz a feed by bottle.
    The key to reducing flow speed in this case is going to be to reduce supply a bit. On average, exclusively breastfed babies need about 20-30 oz of milk per day. It sounds like you are producing around 48 oz per day, so roughly 1.5-2.5x more than you need. So you're going to aim to slowly throttle back on pumping. Instead of taking 8 oz every time you pump, I would shave about 0.5-1 oz off that amount. Give it a couple days, then throttle back another 0.5-1 oz, and so forth. Eventually, you should be pumping closer to what you need. You can decide for yourself when you're ready to stop trying to cut back on pumping and start focusing on maintaining your supply at the desired level.

    2) she will only feed from one side. It seems the one breast has always been a bit lazy, the initial let down is super slow, but once it's going it seems strong, and it produces less. Afterwards, I have been pumping both sides for 5 mins, then the side she doesn't feed from for an additional 10.
    Only wanting the slower-flowing breast makes perfect sense considering the amount of milk you are producing and the fast flow generated by the hgh supply. Work on taming the oversupply, and she will probably come to nurse on the other side.

    2) she breast feeds for a good amount of time and looks like she's starting to get tired and ready to settle down, unlatches and then when I think she's going to fall asleep, starts to cry and gets herself so worked up that she won't Relatch. This goes on for a while. I've tried burping, it's not gas. We both end up so frustrated that I just end up giving her a bottle, she takes a few gulps and out like a light. I end up feeling defeated bc my short term goal is to have one feed with no bottles involved and is has yet to happen.
    This is a pretty common pattern with babies who get a lot of bottles. They expect feedings to conclude with a bottle, so they fuss until they get one. It might help to give the baby a gulp or two from the bottle and then try to relatch her; that approach might eventually rewire her brain so that she expects feedings to conclude at the breast.

    3) she gets hiccups in the middle of feeding (she has always had frequent hiccups). She suffers mild reflux that we've been working out somewhat successfully. I've cut out dairy and been giving a probiotic. I've tried feeding in different positions, slightly upright seems to work best but once she has the hiccups she won't relatch and gets very frustrated and the only way I know how to get rid of them is with a bottle. A few gulps and they're gone and she will breastfeed again. But again I feel defeated...
    I think the goal here is not to feel defeated. Instead of thinking of the bottle as your enemy, think of it as a tool that you are using for the time being, while you get over this tricky patch of newborn nursing. Your baby's adjusted age is just 39 weeks, right? At that age, most babies are still in the womb. Moms of babies who are born full term are often struggling with more fundamental nursing challenges than fast letdowns and what sounds like a mild reliance on the bottle in order to facilitate nursing...


    4) how do I phase out bottles once she is ready?
    At this point, I think there is every reason to think that she may already be ready. At 39 weeks, most babies are more than ready to breastfeed, and obviously you have more than enough milk! Since your baby came so early, I think the conservative course of action is to see a lactation consultant, preferably an IBCLC, for some hands-on help as you transition from doing mostly bottles to exclusive breastfeeding.

    My guess is that the LC will suggest nursing as often as possible, while watching diaper output and weight gain very carefully. A normal nursing frequency for a baby this age would be around 10-12 or more sessions per day. Those nursing sessions will also be somewhat erratic compared to the eating habits of some bottle-fed newborns. That is, a breastfed newborn may sometimes take a long pause between feedings, and may sometimes "cluster feed", nursing very frequently over a short time period.

    If it is important to make sure the baby is eating enough, the LC may have you monitor the baby's intake using a scale to do weigh-feed-weigh measurements. We can walk you through doing measurements and what they mean if necessary.

    I see the progress but these small setbacks are starting to become very frustrating. I keep telling myself it's only been a few days but without sleep it feels like months.
    No sleep and lots of worry over a new baby can make small setbacks seem much more frustrating than they really should be. Go easy on yourself, and call in your helpers if they are available. Now is a good time to have someone else scrub your toilets and walk your dog and prepare meals, while you focus on nursing and on taking care of yourself and your baby.

    ETA: Jinx! MaddieB posted while I was writing my post, so apologies for any repetition!

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •