C.W. asks from Newport Beach, CA on September 29, 2011
Bottle Feeding Breast Milk: Baby Wants More Milk than I Can Produce on Weekdays
On days he's with me all day, he's always satisfied from breastfeeding and nurses every 5 hours or so. The problem is that my LO is demanding more milk in bottles on weekdays when I am not with him than I am able to express. His typical schedule on a weekday is:
5:30 AM or earlier - Breast feed
8:00 AM - cereal mixed with fruit and breast milk, followed by a "goodbye" nursing before I leave for work
10:30 AM - 4 oz of pumped breast milk
12:00 PM - solid food (mixed veggies, usually)
3:00 PM - 4 oz of pumped breast milk
5:00 PM - usually hungry and cranky and sometimes demands more milk
6:30 or 7:00 - breast feed
7:30 PM - solid food for dinner (veggies, avocado, sometimes chicken)
8:00 PM - breast feed before bed (mostly just to comfort)
He drinks his bottles so fast I don't think he's realizing how much he has had.
I am only pumping around 8 oz. in 3-4 pumping sessions per day, and when he has bottles of 4 oz each, sometimes he gets upset that there isn't more in the bottle. Sometimes he's satisfied. Sometimes he wants a third bottle in the afternoon. I really think that since he isn't acting hungry all the time on weekends (when I only nurse him and he gets no bottles) that he's just wanting a bottle for comfort because he misses nursing.
I have tried pumping extra time, more frequently to try to increase my production, but it doesn't seem to be working.
Any suggestions for how to keep him satisfied with just what I am able to pump? We are quickly going to run out of the extra milk I froze before I went back to work. I don't want his caregiver to deprive him -- he gets so upset when he wants a bottle and she doesn't give it to him, so she always gives him one.
I am opposed to giving him formula.
So What Happened?™
I don't think he's being "underfed" as someone suggested. As I mentioned, on weekends, he nurses with about the same frequency as I pump when we are apart, so the volume he is getting is about the same, and he is never fussy on weekends. He is gaining weight well. I can tell that my breasts are being emptied by the pump and I am pumping frequently enough when I am away from him.
We are going to try giving him all of his solids during the day when I am away from him, and only nursing when I get home (instead of nursing, then solid, then nursing before bed). I'll also try skipping solids during the day on weekends and just doing nursing with maybe some solids before bed to help fill up his tank for overnight. I have been using Mother's Milk tea, I eat oatmeal every day, and I leave the pump on for at least 5 minutes after no more milk is coming out for each pumping. I recently replaced the valves on my pump and it seems to be doing an efficient enough job. We'll also try the slower flow nipples on his bottles because I suspect he's drinking so fast, the message that he's actually had enough is not getting from his belly to his brain.
Believe me, I have no intention of starving my baby and I'll never understand why some women feel the need to respond with such vitriol on this board -- aren't we supposed to be here to support and help each other, not berate and patronize?
Breast milk is a supply for demand system. If I'm producing enough for him on weekends, then the amount I pump during the week must be enough for his nutritional needs. I really think it's his emotional needs that are driving the demand for the extra bottle. If his nutritional needs are increasing due to a growth spurt, then my supply will start to inch up (especially with the help of the pump, tea, etc.) and we'll pick up the slack.
Thanks for the helpful suggestions from those who offered them!
Jessica: I never said that I was pumping "at the same rate" -- I realize that how fast he empties my breasts is different from how fast the pump does the job. I pump much longer than he usually nurses. Nevertheless, my breasts are going to make the same amount of milk whether he's removing it or a pump is removing it. My breasts feel empty after pumping. In fact, sometimes my breasts feel more empty after pumping than they do after I feed him. I'm not sure what gives you the idea that the mechanism by which the milk is removed affects how much total milk comes out -- that's just plain wrong. Perhaps a baby is better at getting it out faster, but the pump will get all the milk eventually if you let it run until the milk stops coming out (which I always do).
It's scientifically proven that if you eat too fast, your brain doesn't get the message that you are full even if your stomach is already full. That's why sometimes people who eat too fast overeat -- they don't realize they have eaten enough until after they have eaten too much because the message of fullness hasn't made it from stomach to brain yet. That's why the suggestion to use a slower flow nipple makes sense. By requiring him to suck harder and longer, he will get more satisfaction from sucking and may realize he's had enough by the time the bottle is empty.
Also, according to this site, he likely doesn't need the 8 oz per bottle one mom claimed he needs: http://www.kellymom.com/bf/pumping/milkcalc.html (Thanks AV), but more likely 4 oz should be enough. It also says, as some of you suggested and I suspected:
* Fast flow bottles. Always use the lowest flow bottle nipple that baby will tolerate.
* Using bottle feeding as the primary way to comfort baby. Some well-meaning caregivers feed baby the bottle every time he makes a sound. Use the calculator above to estimate the amount of milk that baby needs, and start with that amount. If baby still seems to be hungry, have your caregiver first check to see whether baby will settle with walking, rocking, holding, etc. before offering another ounce or two.
* Baby's need to suck. Babies have a very strong need to suck, and the need may be greater while mom is away (sucking is comforting to baby). A baby can control the flow of milk at the breast and will get minimal milk when he mainly needs to suck. When drinking from a bottle, baby gets a larger constant flow of milk as long as he is sucking. If baby is taking large amounts of expressed milk while you are away, you might consider encouraging baby to suck fingers or thumb, or consider using a pacifier for the times when mom is not available, to give baby something besides the bottle to satisfy his sucking needs.
* If, after trying these suggestions, you're still having a hard time pumping enough milk, see I'm not pumping enough milk. What can I do?
M.L. answers from Houston on September 29, 2011
Would you be opposed to adding a touch of water to his milk? I breastfed only on demand as well but produced more milk than baby could handle, so I don't know how much a 'normal' feeding should be :)
Also, around 5:00pm, would be a good time to feed him some baby food, maybe a small jar of peaches and veggies or something, since he goes from, 12pm to 7:30 pm without any solids.
S.C. answers from Des Moines on September 29, 2011
ETA: If he's drinking his bottles fast use the slow flow nipples-- it might frustrate him a little at forst when you switch back but it'll stretch the bottle out and slow him down!
I ran into the pumping slump after starting solids too. We got through it.
The first thing I did was wake him up and nurse him every 2 hours when I was home and awake-- not only was he slurping down bottles while I was at work, but all I EVER saw was a sleeping baby, I was getting VERY jealous of the baby sitter!
The second thing I did was rearrange his schedule so he got ALL of his solids and juices while I was at work-- anybody can spoon up the Gerber but only I could make milk. I nursed a LOT more that way and he didn't need as much pumped milk. The more you nurse when your together the less milk he'll need while you're apart AND the better you're supply will be. I even went a couple of months where I didn't give him ANY solids on my days off-- JUST nursed, until he got old enough and interested enough to demand solids.
I also started pumping last thing at night (you won't get anything but it "puts in the order" to make more and first thing in the morning, every day and pumping during nap times on my days off. If you're using the Pump in Style I HIGHLY reccomend going to Target and getting the SoftFit shields and/or a larger size shield.
I also did Fenugreek and Lactation Cookies (http://www.food.com/recipe/peanut-butter-lactation-cookie...) That helped too, especially the Fenugreek, but if you take enough for it to be effective your sweat will stink like a mixture of maple syrup and gym socks!
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S.H. answers from Honolulu on September 29, 2011
All I know is, my kids as babies, at that age... (I nursed) were drinking more than 6-8 ounces, per session/bottle.
And, even if on solids at that age, my kids were nursing every 3 hours, or less.
My kids, were drinking only 4 ounces when they were infants.
At 6 months, they were drinking lots more.
Your son, at that age, needs more than just a 4 ounce bottle of breastmilk. 4 ounces is not enough for him. He is 6.5 months old.
And this is a growth spurt time.
And needs to nurse/have bottle, on-demand.
And, the frequency of feedings, also increases. It is not just the amount they drink.... it is also the frequency.
My kids, had GINORMOUS appetites. As babies at that age too.
They drank way more than 4 oz.
You may need to supplement with Formula.
For the 1st year of life, breastmilk or Formula is a baby's primary source of nutrition.
Your baby's intake of breastmilk is not keeping pace with him.
Feeding frequency and amounts... needs to keep UP with the baby. Not the baby feeding on bottles depending on how many there are available.
Your baby is hungry.
My son had a huge appetite. He'd drink me dry at the breast and then I also topped him off with formula. I nursed using both breasts per session. And I had a lot of milk. Still, he drank me dry.
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J.S. answers from Hartford on September 30, 2011
It doesn't sound like he's getting enough breastmilk in his bottles, so he's being underfed. How do you expect an infant that's ONLY 6.5 months old to "realize" that you can't pump enough to keep up with his nutritional needs? He's not comfort eating, he's eating because he NEEDS to eat more than you're putting in the bottle. You either need to try to express more breastmilk or supplement his bottles during the week with formula. Or find a wet nurse or breastmilk bank to pick up the supply slack.
EDIT: Something you need to realize quickly is that you are NOT pumping "at the same rate that he eats." A baby expresses milk from your breast MUCH MORE EFFICIENTLY than what you get from a pump. That means that he could be getting twice as much from your breast by sucking as you're getting from pumping. So yes, if you're not filling each bottle with twice as much milk as you already are, you're underfeeding him.
Based on your own feeding schedule JUST on weekends, he should be getting a minimum of 6 ounces of breastmilk per bottle, ideally 7 ounces to make sure that he's not sucking the bottle dry. If a baby sucks a bottle dry that means he's being underfed. A bottle should always have a little bit left in it, which indicates that the baby ate enough. When a baby consistently sucks a bottle dry that means he's ready to start taking more milk in a bottle.
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S.S. answers from Los Angeles on September 30, 2011
Please, under no circumstances should you water down the breast milk bottles. I can't believe that was suggested.
It's true that babies drink more from a bottle than they do from the breast.
To increase your production, you can increase your water intake, eat oats (I prefer oat-based granola instead of oatmeal) and make sure you're getting plenty of rest. You can also try supplements like More Milk Plus (you can get it at Henry's or other whole food type stores).
But... have you noticed there's a seven hour break between lunch and dinner? If you're opposed to formula, that doesn't mean the baby shouldn't be fed because you're afraid of losing your stash. How about a reasonable dinner time? If you're not willing to compromise on that, at least give the kid a snack! As my lactation consultant said, a fed baby is a happy baby.
I understand the fear of a dwindling stash. I went back to work when my youngest was six months old and my "awesome" stash only lasted until she was about 8.5 months old. Pesky bottles! I did end up supplementing with one bottle a day for about two months (I'm off for summer and was able to go back to exclusively giving breastmilk).
1 mom found this helpful
A.V. answers from Washington DC on September 29, 2011
Look at kellymom.com. How long is your work day?
Make sure he's being fed right. If he doesn't normally use a pacifier, offer one. He's also at the right age for the 6 mo. growth spurt. I had to argue with DD's daycare that 5-5.5oz (which was about all I could do) bottles was enough. Had to be enough. Breastmilk changes.
In a few weeks, she evened back out to 12oz per day (9hr workday and commute) and she took more solids. Also, if I had to short one of her bottles, I made it the last one b/c I was going to be close to her soon. Have you tried 3-3.5 oz for the first two and a "snack" of just a couple of ounces later? Does he get any water with his meals? That might also help, just a couple of ounces to go with the solids.
And, if it would help, what about offering the cereal with just water? My DD always preferred it that way, and it might be worth trying. Then use that milk for bottles instead.
Have you also tried fungreek? I drank Mother's Milk tea and it seemed to help. I also ate oatmeal breakfast cookies.
If he goes to bed at 8PM and generally sleeps well at night, what about trying to pump before YOU go to bed? Or pump one side while he nurses the other? A little tricky, but he can help your letdown.
And make sure the pump is in good order. Those little valves can go bad and mess up the suction.
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R.G. answers from Los Angeles on September 30, 2011
I would offer solids in midafternoon, around that 3 PM time when he gets a bottle. Also, if he needs more milk but you don't want to do formula, you might look into goat's milk...I've had friends use that for bottle fed babies who were sensitive to every kind of formula. I also would pump late at night before you go to bed, pump after you nurse...just to try to have more to offer him.
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J.C. answers from Anchorage on September 29, 2011
IF it comes to a choice between watering down his milk and formula I would go with the formula, in fact, I did. I was not producing enough so I supplemented and it worked well. If you are really against formula I have heard of some people using goats milk, but I would check with your child's doctor about it. Also, try talking to a lactation consultant, she may have some ideas on herbs and teas that can increase your production.
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K.M. answers from San Diego on September 30, 2011
Do the fenugreek, make sure you are eating healthy high calorie foods (avocado's, whole grain bread, etc), try to sleep. When I had this problem the lactation nurses had me pumping every two hours when I wasn't nursing (as if i had a newborn) and pumping 10 minutes more after my daughter nursed. That tricks your body into thinking it needs to produce more. It's really difficult, but it did work for me, I ended up nursing for 9 months.