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Thread: Worries about supply after bottle feeding/pumping

  1. #1

    Default Worries about supply after bottle feeding/pumping

    Hello, brand new mom here. My LO was born 3/24 and we successfully breastfed exclusively until 1 week, when I had to stop because of cracked/bleeding nipples that made it too painful and stressful. Because I had breast surgery 12 years ago (reduction) I saw several lactation consultants at the hospital who said LO had a good latch. At 5 days we did a weigh-feed-weigh and she transferred ~1.5oz, and had great output in diapers.

    When the pain became so great two days later (this past Friday), LC at the hospital advised me to pump exclusively to give my nipples time to heal. Over the weekend my supply diminished significantly to where I could not keep up with baby's needs. I saw the LC again Monday and she re-fitted me with new larger flanges for the pump, saying the small flanges could have been the problem with production. I have been using the new flanges since Monday and they are definitely more comfortable, but my production is not increasing.

    I have had to supplement my DD with formula to keep up with her needs and I'm pretty devastated, especially since BF had been going so well early on (despite my fears about the breast surgery interfering). I still have scabs over my nipples that are healing but I am worried about production dropping off completely. My instinct is to just get her back on the breast ASAP, but I'm worried about repeating the whole cycle again? LC advised against going back to the breast until they are healed but it is killing me to give her this smelly formula & I worry that if I wait too long we will never get back to the breast. LO is 12 days old now.

  2. #2
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    Jun 2009
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    10,754

    Default Re: Worries about supply after bottle feeding/pumping

    Nipples can typically heal once latch issues are corrected without having to rely on pumping and avoid nursing. Taking a break from nursing where baby does not nurse at all can be good advice, but it is pretty extreme. What are you and the LC doing to improve latch? After all, even if you wait until you heal to nurse, if baby's latch is still off and still injures you, than the whole cycle will happen again anyway.

    The other issue is your production and whether or not there really is a problem there. Because if there is, it may not be solved entirely by going back to nursing. You may have to pump as well for a time if there really is low production. But many times a mom thinks there is a problem when there is not one.

    Can you explain:

    What kind of pump you are using?
    How many times in 24 hours you pump and how much you extract each day
    How many times baby is given a bottle and how much each bottle
    How baby is gaining- exact numbers, if you have them.
    Last edited by @llli*maddieb; April 5th, 2017 at 07:07 PM.

  3. #3

    Default Re: Worries about supply after bottle feeding/pumping

    I am using a medela pump-in-style, I usually pump every time baby eats which is what the LC recommended, so approximately 7-8 times a day. I usually extract about the same amount, about .5 oz or less than that on the left, and about 1oz on the right (sometimes 1.5 in the morning on that side). I have tried "power pumping" a few times to stimulate the nipples. She gets a bottle about 7x per day and is taking about 2.5 oz at each feeding (starting with the breastmilk I can pump and then finishing with formula). Baby was 7lbs 12 oz at birth, and 7 lbs 4oz at discharge. At the pediatrician on Monday she weighed 7lbs 10 oz.

    I feel like the pumping/bad fit caused the production problem, because there wasn't one before I stopped BF exclusively? Maybe baby did a better job of expressing the milk & stimulating production, so going back I know I may have to continue to supplement initially but hopefully production would go back up? LC did not check her latch or mouth at our last visit (this monday) since baby was asleep and she wanted me to focus on pumping to increase my supply.

  4. #4
    Join Date
    Jun 2009
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    Default Re: Worries about supply after bottle feeding/pumping

    When baby was nursing was baby only nursing seven or eight times a day?

    I'm confused I thought you were pumping to give your breasts a chance to heal. Is your LC telling you to pump to increase production or to give your breasts a rest?

    Also, I understand your baby was asleep at your appointment this is a common problem. But the fact is something caused your baby to injure you when baby nursed, most likely a shallow latch, and that has to get fixed. You can try working at home yourself to fix it on your own or you can also work with the lactation consultant, but Pumping is not going to solve that problem.

    A newborn typically nurses between 10 and 15 times in 24 hours. Frequent nursing is important for production and so baby can learn to latch properly and is able to latch properly. The softer (less full) the breast the easier it is for baby to latch typically.

    When a mom is only pumping- baby is not nursing- mom is usually told she must pump at least eight times per 24 hours. This is because pumping is considered much more difficult and time-consuming than nursing. In other words pumping eight times, which is actually less frequent than normal nursing frequency is a compromise so mom is not killing herself with pumping. But If mom is not able to keep up with her babies needs when pumping eight times a day she might just have to pump A little more often- after all if baby was nursing typically baby would be nursing much more often than eight times per day.

    Also a pump in style is not the appropriate pump if mom is only pumping. Did the LC talk to you about renting a hospital grade pump? this is a very important time for your milk production so if you were only pumping it is pretty important to have the right equipment and for you to pump it often enough.

    I agree with you the simplest and probably best thing now would be getting baby back to the breast. If baby can latch effectively and extract milk without injuring you, then you can nurse baby with the appropriate high-frequency necessary and that would make it unnecessary to need a better pump or to pump more often, in fact hopefully you could pretty quickly no longer pump at all.

    If you continue to need to supplement, you have to keep pumping as long as you are supplementing. otherwise supplementing will continue to harm your milk production even if baby is nursing. The less you need to supplement, the less you need to pump.

    I strongly suggest you talk to your lactation consultant(or preferably have an actual consult we are breast-feeding is assessed and helped) before doing anything that I suggest – they have seen your baby and you and I have not. However given your concerns about your production and how long you have been not nursing I think it is time to take more proactive steps getting baby back to the breast.

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