New Mom...Lots of ?s

[alexmommy]

Hi all! I'm glad I finally found a place to talk to people about what I've been going through with my new baby! :)
I'm sorry if this is long, but I've got a lot to get off my chest... :)

My son is about 3.5 months old, and is breastfed. I had to return to work recently, so he had to start taking bottles. But its still my milk, so thats good. I'd really like to bf until he's at least a year, if not a little longer. One problem is that I'm not able to pump that much. I've gone through almost all my reserve milk I had pumped while I was off work, and it seems that everything I'm pumping now has to go to the babysitters each day. I have no extra. I thought that by pumping more often at work (every 2 hours) I would build up my supply, but I still can't get more than a couple ounces each time. I thought it was a supply and demand type deal, but it doesn't seem to be working.
And now I seem to be running into another issue....I don't know thats he's getting enough when he does nurse. It really stinks that breasts don't come with built in guages so you know how much your little one is getting...
But even after he nurses, he still acts hungry all the time. I'm not concerned about weight or anything, cuz he's growing like a weed! Just that he's not getting enough to be satisfied at each feeding. He was going 4 hours between feedings, but just this week, he's started wanting food every 3 hours again. I don't withhold from him, I let him nurse when he's hungry, but man...Between pumping all the time, and nursing as much as possible, it feels like by breasts are going to fall off!

The sitter told me she's giving him 6 oz. at a feeding, and he takes every last drop, and goes right to sleep. At home, when I nurse him, its turned into a fiasco, because he pulls off, and screams. So I put him up on my shoulder and burp him, and we do this about 5 or 6 times until he settles down, and gets to business. Even then, I don't think he's draining me. But he pulls off, and smiles and coos, and loses interest. I've also tried switching when he does lose interest, and it doesn't help. I'm not sure if its because he has to work harder at getting the milk from me then he does the bottle...ya know?
I just dont' know if he's getting a good full 6 oz from me. I asked the doc, and they suggested I start him on cereal. So he gets 2 little servings of cereal a day. One in the morning, and one before he goes to bed. But the last couple nights, since he started getting cereal, he's been getting up every 3 hours to eat! I did better when I would just nurse him. THen he'd sleep a good 5 hours, get up at 2 to eat, then sleep til 6. Which meant I only had to get up once to feed at night. These last few nights, I feel like we've taken a huge step backwards! Mommy needs some sleep!! But again, I can't deny him if he's hungry. I always try the pacifier first, as that has put him back to sleep in the past. But these last 2 nights, he wanted to eat, and that was that.
So there are some of my woes....I will love to hear any and all advice!! Its not easy, but I really would like to continue to bf him, cuz I feel its the best for him. And I enjoy it...its our special time together.
Well, this is long enough. Thanks for listening, err...reading! :)

[destiny]

Great job nursing, with working and all! I give you a lot of credit. I'm a SAHM with a 4 mo. old, first baby and had to pump in the beginning because of BF struggles and I know how challenging pumping is! Your baby sounds a bit young for solids (according to my research), but I know all babies/situations are different. Keep up the good work and hope you find tools to help it go more smoothly.....Oh, one thing about being fussy while nursing..it took me a while to discover that when my baby acts like she doesn't want to nurse, she has to poop:) Knowing this has helped with frustration!

[Nipple_nectar]

Welcome to the boards and congrats on your success with BFing! The previous poster (PP) is right, according to the American Academy of Pediatrics (AAP), solids should not be introduced until at minimum of six months old for a whole host of reasons, let's leave it at that. Your PED is not following the guidelines offered by the AAP, I would ask them why?

They gave you misinformation, your baby is hungrier because the calories from cereal is not as nutritionally dense as breastmilk. Ounce for ounce, breastmilk is more calorie dense and will keep him full longer. I would suggest reading alot more on the introduction of solids before you give him another spoon.

You sound like you are getting a great pumping yield, how long are your pumping sessions and what kind of pump are you using? The secret to a high yield is frequent sessions not longer sessions and your supply is at it's highest in the morning, so, if you can squeeze in an extra session there, it would be great. I always pump immediately after the first session of the day, there is always milk left over.

Lastly, I think your sitter is overfeeding your baby and that is very easy to do when you are bottlefeeding a breastfed baby. I am going to give you two links, one is a milk calculator and it will help determine how many ounces you should be feeding at each session, how many times do you nurse in a day? www.kellymom.com/bf/pumping/milkcalc.html

Next, I am giving you a link on how to bottle feed a breastfed baby, there are measures you can take to maximize the session without overfeeding. Don't be confused by his insatiable appetite for sucking, this does not always indicate hunger and babies this age tend to want to suck non~stop;-)

www.kellymom.com/bf/pumping/bottle-feeding.html

[madelsmama]

Nipple Nectar and destiny mentioned everything I was getting ready to say:
1. Your baby is being overfed with a a bottle--see the links provided
2. Stop the cereal immediately--he's way, way too young and shame on that doctor!

Milk supply is demand based, you are correct. If he is having 5-6 wet diapers a day, he is definitely getting enough milk!

What kind of pump are you using?
How often are you pumping during the day?

[ima062002]

6 oz is too much per feed. Nipple nectar already posted the relevant info on that.

I think that he might have developed a bit of bottle preference, hence the "acting out" at your breast. I hope your sitter is willing and able to learn how to bottle feed a b'fed baby.

I agree on the remarks make re. solids. If that was my pedi I'd be shopping for a new one...

Some of my babies woke often and for us cosleeping was the best solution.

A good way to get ahead with pumping is pumping after the first morning feed. Pump the breast that has been nursed from less. Moms tend to have the most milk in the mornings. Do that on the weekend too and you'll have some extra to start the work week.

What pump do you have? How do you pump (where, how long, what do you do to prep yourself)? Have you checked that all parts are working? A bit more info momma and we'll be able to help you better.

Hang in there.

[Stephanie]

I agree with everything pp said.

I have pumped for 2 dc. A couple of oz at each pumping sessions is just perfect.

I would read the link about bottle feeding a breastfed baby and share with your dcp. I would also consider a paci at daycare. Sometimes baby just wants to suck, even though they are full. Dcp misread this as a hunger cue. Pacis can be a working mom's best friend.

My first had a big bottle preference, and I made the mistake of letting him have a bottle when I was around. Do not do this, it caused many problems for us. I would suggest a strict when mama is around, only boob rule. It will really help him with any bottle confusion. If he gets stressed out, just unlatch him and try again later. I would also try nursing in a warm bath or dark room to help.

If you aren't using a double electric pump, I would switch to that.

[alexmommy]

Wow...you all gave me a lot to think about! Things I hadn't even thought of! THank you!!

First off, I'm using a Medela pump in style double pump. And when I pump, I do use both at the same time. I've found that easier than trying to do one at a time. I have tried pumping right after my son has nursed, and I barely get a few drops out.
When I'm at work, I pump every 2 hours for about 10 minutes. I have an office with a door, so it works out well, for privacy, anyway.
I was thinking the same thing about him having a preference for the bottle. Mainly, I think, because it comes out a lot faster from the bottle, than it does me! A couple times I ALMOST gave in, but thought better of it. I can't stand to bottle feed my little guy. I've been weathering through the fussiness, until he finally nurses. I'm going to read up on those links. But my friend has a daughter thats about 1 month older than my son, and she said her ped started her on cereal and solids at 4 months. But I do plan on asking when we go next week.

Overfeeding is a concern of mine, but again, because I'm not sure how much he gets a feeding with me, I wasn't sure how much to give. I had been giving 4.5 oz bottles at first. Mainly because before I started pumping more often, i was only pumping every 4 hours at work. (the same time my son would have been eating) and when I did that, I got 4.5 oz each time. So I assumed thats what he was getting as well. But I've also read you can't pump as much as they eat. There is always milk the pump won't get out.
How true is that?

As for the cereal, he's only gotten it about 4 times now. I've spoon fed it to him, and sometimes he likes it, sometimes he doesn't want it, so I don't force it on him. My thing before was if he's really fussy, and nothing else is working, I figured he's hungry. But he also has a tendancy to throw a tissy when he's super tired. He doesn't want to go to sleep, so he cries and yells. It takes a while, but the second he calms down, those little eyes start closing. I'm afraid that if he's doing this by the babysitters, she's just feeding him. Since he's been there, she's been feeding him about every 3 hours. I'd like to keep a schedule, but we don't live by it. I let him set the schedule, but we had been doing good at 4 hours. And that was before cereal. So I don't really know. LIke I said, I'm going ot check out those links. And I may have to have a talk with the babysitter about feeding as well.
I nurse about 6 to 7 times a day when I'm home with my son all day. When I work, I always nurse him in the morning before he goes to the sitters, then I try to get in at least 2 at night. One when I get home, and another around 9, when he usually goes to bed. Then, depending on what kind of night he's having, 1 to 3 feedings overnight.
Thanks again for all the info!!!! :)

[madelsmama]

A baby that age probably needs only 3-4oz in a bottle. He would probably suck down any amount of milk offered to him in a bottle; the flow is fast and easy, so it's no true indication of what he gets from the breast. At 14 months old, my baby takes in 4-5 ounces in a bottle/sippy when we're apart. Try some of the techniques suggested within the link provided above to help the feeding last longer, giving his brain enough time to get the message that his brain's full.

As to the solids, you'll probably find that most pediatricians recommend starting cereal at 4 months. I highly recommend that you do your own research on this topic, as starting solids early has been medically linked to a host of issues, from diabetes to food allergies. For that reason, the American Academy of Pediatrics, World Health Organization, UNICEF,
US Department of Health & Human Services, American Academy of Family Physicians, Ameriican Dietetic Association, Australian National Health and Medical Research Council,
Royal Australian College of General Practitioners, and Health Canada all recommend exclusively breastfeeding until six months of age (NOT 4-6 months of age) before introducing ANY solids (including cereal).
http://www.kellymom.com/nutrition/solids/delay-solids.html
http://www.kellymom.com/nutrition/solids/index.html

In addition, there are certain milestones that a baby should meet before starting any solid, found on the above link.