Advice on Combining Breastfeeding and Pumping

Hi J.. First of all, congrats on wanting to keep up with the breastfeeding- so many people give up way too early, either because they don't want to try or because they can't pump enough milk to satisfy the baby. So good for you. I was in a similar situation last year, although I had to pump because I was taking a class and couldn't be there when my son needed to eat for one feeding two days a week. If you are a stay at home mom I would try pumping just before he is ready for his next feeding. That way you can give it to him right away and there is no need to heat his bottle. Also, you won't have to worry about swirling the milk to blend the proteins and carbohydrates together like you do if you freeze or refrigerate. I liked the freedom of pumping so much I did it for a couple of feedings a day up until I weaned my son at one year. Good luck!

I had the same problem and my doctor told me to use a nipple shield which helped A LOT. You can get one at any drug store.Good luck.
D.

One suggestion I might have, not related to pumping, is using LilyPadz nursing covers instead of regular cotton nursing pads. I used them when nursing my daughter - slather on the lanolin then apply the LilyPadz. They stick right on your skin, help hold in the lanolin so it canreally absorb, and they don't slip around and rub like the cotton ones. This may help with the sore nipples in between feedings. They are a little expensive - about $20/pair, but you only need one or two pairs. Good luck

Talk to someone at Le Leche about you possibly having too much milk or read about it on Kellymom.com. My son had what looked like a good latch but was clamping down (painfully hard!) with his gums to slow the flow. Dr. Smilie in Stratford, CT was a HUGE help to me. Eventually ended up taking Sage Herbal Tea (a natural form of estrogen) to reduce my supply. I did use a nipple shield on and off for the first few months at the beginning of the feeding. DS is now 7 months and while I still make more milk than he needs its much easier. As they get bigger they can open wider and handle more milk quickly. Hang in there and get help regarding oversupply issues the hardest month or two is almost over! I also took the extra strength tylenol (600mg) that my OB gave me at discharge for my nipple pain.

Hi J.,

Congratulations on your brand new baby! I exclusively pumped for my youngest for the first nine weeks because he was a no latch/no suck baby.
At this point, I would say not to worry about having some extra milk. It's good to have a freezer stash. Also since the pump stimulates your breast less effectively than a baby, when you pump often, you may find that you have a decrease in supply, so I would keep pumping as you are and store that extra milk in the freezer in case it is needed at a later time. At your baby's young age, I'd make sure that you are breastfeeding or pumping every 3 hours around the clock so that your breasts receive the normal stimulation for someone exclusively breastfeeding a newborn.
Good luck, you are doing a GREAT job!

J.,

At this point you should not worry about increasing your milk, it will only help you if anything. For now you should go ahead and pump inbetween feedings untill you have a few stocked bottles (3or4) and then you can give one of those to Zachary and pump while he gets a bottle and you will be all set. Have no worries it is all a little easier than you might imagine.

S.

HI J.-

I personnally disliked the nursing pads. I used the breast shields that have been suggested to clear up a nasty cut I had on my left side (her favorite of course). I would use bacitracin and wash before we nursed. The lanalin cream helped keep things soft and supple after healing.

As for the "how to" part of your question, the best thing to do is to pump when a feeding would be ocurring or immediately thereafter. The easiest would be to see if you can you enlist some help by giving a bottle with BM to Daddy or a friend, Mom/MIL, whoever might be visiting and pump at that time. At five months, I would bet nursing makes the baby sleepy so you could pump after you put him down to build up a supply so that you could bottle feed and then pump. Alternatively, split the time in half to build up a supply (i.e. feedings at 3 hours spaces so pump after 1.5 hours) and then pump immediately after a bottle to keep fresh milk in the fridge for the next bottle feeding. Once you have a store, it should be the same as breast feeding normally. It should not lead to engorgement.

Good luck.
~C.

Hi J., DD is 5.5 months now, but I remember thinking my nipples would never get better. I know it seems like it'll never get better, but it will. Can't advise you on the pumping/feeding schedule. I just nurse emma whenever she wants - but I can tell you the nipple pain either goes away or you simply get used to it. (then she starts teething!)
Good luck. OH< I almost forgot!!! I used nipple shields for the first 2-3 months! duh! they're available at babies are us, in two different sizes. My lactation specialist recommended them (also, DD is a little "tongue tied" and her frenulum is short (tendon under her tongue). The NIPPLE shields saved my life. How soon we forget!!!!!!

My 1st daughter never latched on so I exclusively pumped for 6 months ALOT of milk (built up a frozen supply). I stopped pumping at 6 months, but she had enough milk to get her to the 9 month mark.
Excellent website: kellymom.com for more info too...
my 2nd - I saw a terrific lactation consultant and LLL and BF completely. In the beginning, I had to wear a shield too...before going back to work, I pumped once after the morning feeding to build up a frozen milk supply...
So for work, my schedule was this:
5am BF
730am BF
1030am pump
2pm pump
5pm BF
630p BF
8pm BF
(BF on demand overnight, usually 1-2 times a night)
*Your pumping/feeding schedule should be 8-12 times a day to mimic the baby's normal feeding pattern.

Your body will make more or less milk - whenever...but when you feel engorged, go ahead and pump until comfortable, not when you fill up the bottles...

Hang in there, you're doing great...it IS a lot of work, but there is so much satisfaction in it...let me know if you have any questions...

I would question the advice that you have been given. I would think that pumping would irritate your nipples more than your infants palate. Have you tried changing positions to feed? Have you eliminated yeast as a cause? Yeast sometimes causes sore nipples, without other signs. When you say sore, do you mean that they are painful, or cracked & bleeding? It sounds like you are nursing very well to be able to pump that much milk. I am assuming that your son is gaining weight and thriving. Have you tried lanolin based nipple creams that do not need to be wiped or washed off for feedings? Starting to pump and bottle feed starts the cascade away from the breast, and you have been doing so well so far, that I would try everything else first.
L.

I had extremely sore nipples until week 6, when the pain slowly started to subside... so hang in there! During week 5, the pain was still mind-numbingly terrible and I couldn't imagine it getting better, but it did.

Also, in these still early weeks, I would recommend only offering 1-2 bottles/day. Since you don't want to increase milk supply, I would suggest only pumping only in replacement of a bottle feeding. In the beginning (also so that I could get some more sleep), I would have my husband take care of the middle of the night feeding and sometimes the first feeding when he would return home from work. When he bottle-fed, I would pump only for an ounce or two more than what she was consuming or for 10 minutes, depending on how much time I had. If you pump more often than that, you are telling your body to produce more milk than what your baby is consuming. I personally think pumping only 1 hour after a nursing session is too soon, unless you are trying to increase your milk supply.

Also, FREEZE your extra milk in airtight containers as soon as possible in order to keep it as fresh as possible. By the time my daughter was 2 months old, I could easily pump 10 ounces in just 6-8 minutes, and I am so glad that I could store the extra milk. (My body did not get fully regulated until about month 3.) Now that I am back to work, I am only pumping just barely enough for her bottles during the day, so I am relieved to easily be able to defrost a bit when I am short 1-2 ounces for the next day.

My daughter is 10 months old and has never had any formula, but breastfeeding was definitely a challenge in the beginning. I worked with a fantastic lactation consultant, and I would highly recommend getting some professional advice...it was well worth it for us!! Best wishes...even with all the pain in the beginning, I couldn't be happier that I am breastfeeding my baby.

hi J.;

my exp of using a pump was very poor and very good; the pump worked but it totally goofed up my nursing.

here's what happened. i used, by direction from my LC, a hospital grade Medela Classic which i rented from a surgical supply store; it was an incredible machine and i often got up to 10 ounces out per sitting.

the engorgement skyrocketed in a week and i got into a treacherous cycle where i kept making more and more and more milk; it reminded me of the broom scene in "Fantasia." i couldn't leave the house for more than an hour because my shirt would be soaked.

the LC came back and helped me wean off the pump in about a week, thank heavens. the whole purpose of the pump for me was to have my husband help w night feedings, but the truth was the bottles were also a disaster. my son would spit up half of what he took from every kind we tried. and i ended up getting up at night anyway.

so i ended up at La Leche Leage Intl and that was where i really learned what was going on with nursing. i can not urge you strongly enough to go to a meeting. all you have to do is google La Leche League Intl and click on resources to find a meeting in your area. also the chapter leaders' phone numbers are likely to be on the page. feel free to call them, that's what they are there for.

keep in mind that not everything at LLL works for everyone but they are without question the real authority on breastfeeding. i breastfed my son successfully after the engorgement situation was remedied, without a bottle or any other interference, right through my pregnancy w my daughter, and until he was 3. my daughter is now 19 mos and still nursing. neither of my kids ever had a drop of formula.

if the LC that you consulted is not a board certified LC she may be behind the curve; many are. and sadly, even supportive pediatricians are not knowegeable about nursing even if they insist that they are. i would bet money that the folks you consulted, tho surely well intentioned, may be wrong about your latch; you might need improvement. but at the same time, many people have sore nipples well into the third month of nursing; it's not unusual. just hang in there tho, and keep looking for the right answer. you'll find it. at LLL they will examine your latch and position and help you out.

i applaud you for your commitment to this incredibly important part of the care of your baby.

good luck!
J.

Hi J.,

I know what you are going through...I have two boys 2 and 6 mo and both I had to pump and breastfeed due to horribly painful/cracked and bleading nipples. What I found that worked was I would pump after every feeding except the ones where I breastfed them. I did that for a while and then I pumped all my breastmilk and fed through a bottle. This is a little time consuming, but if you want to continue with providing the breast milk and can't stand the pain, it is the best alternative. I did that for about 5 months (supplimenting a little formula too for those days where I didn't get enough breast milk) until I went back to work then switched to all formula...which is FINE too! Do what is best for you and your family!!! If breastfeeding continues to not work well, or if the alternating pumping gets to be too much - use formula...I know you want to do the best thing for your son Zachary, but your sanity is important too!!! Good luck!!!

For the first month of my son's life my nipples were horrible. By the time we left the hospital I right one was cracked all the way across and I had a blood blister on the other. The reason your nipples are sore is because they don't get a break. After you nurse, try leaving your top and bra open. Expose them to the air uncovered for as long as you can. The wetness of your bra and nuring pads may be more harmful then good right now. Let them air dry totally before "putting them away." When you can obviously. Get some lanolin. And massage it into your nipples after your dry. This will help as well. And you don't have to wash it off. The baby can have this in their mouth, it's perfectly safe. To keep your supply up get Mother's Milk tea at your local health food store and follow the directions. I never stopped nursing my son because I was sore. I don't think what your going through is abnormal. I would continue to try and work through it.

My daughter (now almost 7 months) had some issues getting latched on properly as a newborn, making it painful and frustrating for me. She never had an issue going between the breast and a bottle, so I pumped often and continued to try to nurse. I had sore nipples for about 6 weeks; the latching issues weren't making it any better. By the time she reached 6 weeks, she was getting pumped milk almost exclusively, though I would try to nurse, still with the same latching issues. It's only been more recently that I have been able to nurse almost exclusively, only pumping at night so my husband can give feed her before bed.

I can understand how frustrating it is - all I wanted to do was nurse my baby, but it left me feeling terrible each time. I was pretty committed to giving her breastmilk only, but kept the samples of formula we got on hand to alleviate the pressure to produce, which helped me mentally, which I think helped to make it easier for me to produce.

I am also a stay at home mom, so I had the time to try to nurse as often as she needed, and to pump frequently to get my supply established. If I nursed, I would wait to pump until an hour after she ate, and then if I bottle fed, I pumped right after she ate. I had a lot of milk; I don't know if it was the frequency of pumping or if I just produced a lot, and I still have a serious overstock in my freezer. I can understand not wanting to get engorged, but since you're just trying to get your supply established, I would try to get more of a supply going first and you can pump less often later. By the time my girl was 3 months, I was down to pumping only three times a day (usually pumping 10-12 ounces each time, much more than she needed), and she always ate every three hours.

There's lots of breastfeeding support here and you're getting it from your ped and LC, so I think as long as you remain calm and committed, it will work itself out. Good luck!!!

J.,
Congrats on the new little one. My son is 8 weeks old today, and I had the same problems as you. My son has been on bottled bresatmilk since he was 3 weeks old. He has a very high pallet and wasn't latching, and he was only taking my left breast and refused the right. So we started pumping and bottling. Not gonna lie to you, sometimes it's a blessing (my husband can get up and do night time feedings now) and sometimes it's a pain in the butt (essentially you are doubling the feeding work. When I would become engorged I would just pump even if it was every hour to an hour and a half. I would however buy the storage bags and end up freezing it. My little guy when he goes through the "growth spurts" he EATS like a mad man! So the extra breastmilk really helped. Unfortuneatly my milk production has come to a dry up (I was told that it happens to a lot of women) and yes I drank more and I pumped more and I still have dried up- anyways the frozen also helped to stretch my "breastmilk" feedings so he was getting it once a day and formula the rest.
I hope this helps you a little and good luck with your little one.