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First, I wanted to apologize for my long absence in posting – I found out a few months ago that I am pregnant again (um … oops!), and I have been pretty run down with morning sickness. I’m feeling better now and hoping to post more often now that that’s the case. In the meantime, I’ve gotten quite a few questions and am looking forward to posting them over the next few months. Additionally, I recently did a survey of exclusively pumping women, and I’ll be sharing some results with you.

Today’s first question is about exclusively pumping with a 6 day old baby – how to bring up supply and combine breast milk and formula. (Have a question about pumping breast milk? Ask it here!)

I am six days post-partum and have made the choice to exclusively pump. The doctors were worried about her loss in weight since she had lost 10% in 48 hours, and they were worried about her jaundice levels. They asked us to supplement with formula until my milk came in which it finally did yesterday. (Yay!)
So now I have two questions:

  • So far I’m only able to pump 1 oz (sometimes 2 oz) each time I pump. I know there are a lot of methods to increase milk supply, but is it normal for it to gradually come in? I keep hearing everyone talk about how they are able to produce four oz or more in one pumping session and I am not even close to that. I’ve been trying to stay hydrated, eating oatmeal, taking fenugreek, etc., but doesn’t seem like it’s helping quite yet.
  • Do you have any suggestions for transitioning from supplementing to strictly breast milk? It seems like my milk supply is not enough and she is
    still is hungry after she drinks even just my ounce or two I pump and wants the formula to fill up her little tummy. I’m hoping my breast milk will be plenty for her soon once I can start pumping more!

I think that your supply sounds pretty normal for six days post-partum, and it sounds like you are doing all of the right things with the water, oatmeal, and fenugreek. Regarding the fenugreek, have you noticed whether or not you have smelled like maple syrup? That’s the key to knowing if the dose is right, so if you take it and you do not smell like maple syrup, you may want to consider increasing the dose.

There are a couple of ways to combine formula and breast milk, but I would suggest feeding breast milk first and then supplementing with a formula chaser if necessary. You can also mix it together to get baby used to the taste, but then if they don’t finish it you have to throw the entire bottle out (versus a breast-milk only bottle, which can be saved for the next feeding).

My newborn is 11 days old and won’t latch consistently, so I am having to pump almost exclusively. We have been feeding her using a syringe that holds an ounce, but she is consistently drinking two or three syringes per feeding and she gets frustrated between syringe changes. Do you have any recommendations for bottles or nipples that we can use? I still want to nurse her so I am looking for something that I can go back and forth with.

With my first baby, I started using bottles pretty early with my first baby because I was exclusively pumping, and what I found was that I had to try a bunch of different bottles to find ones that he liked when he was your baby’s age. When he was older, I was able to get him to take the Medela bottles that came with my pump all of the time (which makes pumping and feeding much easier given that you’re using one set for both). Also, I nursed and pumped with my second baby, and I was able to go back and forth pretty easily with the Medela bottles that came with my pump.

I don’t know if you saw this list, but I tried most of these (except the Mimijumi, which is new since I had a baby is looks sort of cool). Maybe try some of these and see if any of them work?

My little one is four months old. I started exclusively pumping when she was in the NICU. (She was born 10 weeks early and spent 60 days in the hospital). During this time, I used a rented hospital grade pump most of the time and my personal pump when I was on the go. Now that she’s been home for 2 months, I’ve used my Medela pump, which I purchased new when she was born, every day 6-10 times a day and it’s starting to do weird things. Have you ever had a pump run down this quickly?

A pump should definitely last for more than a year, and I am almost positive Medela will replace it for you if you call their customer service. I have actually used my Freestyle pump for 27 months (14 of those were as an exclusive pumper, and the other 13 while at work) and it still works.

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Today’s first question is about feeling overwhelmed by exclusively pumping, and dealing with guilt about needing to cut back. (Have a question about pumping breast milk? Ask it here!)

Hi! I’m almost 4 months post-partum and have been exclusively pumping for about 2 months. My baby got used to the bottle REALLY fast and wouldn’t latch anymore, and we had latching problems from the beginning. I’m a single mama, so exclusively pumping isn’t ideal, but so far I’m doing okay. Luckily, I have an amazingly calm baby, but still … often times he’ll need me while I’m pumping, or when it’s about time to pump. I currently pump 5 times per day, and I’m able to do that, just not always on time.

Also, I’m an RN, so finding time at work without compromising my patients is super hard as well. I only work 3 days a week, so I’m managing so far, but it’s all starting to wear on me. I’m super stressed and feel like my life revolves around when I have to pump next. I’m shooting for 6 months of this at least, but I don’t know if I’ll make it that far. Is feeling guilty normal? I have horrible guilt just thinking about not giving him breast milk. I need advice and/or encouragement on how to juggle pumping, work, baby, life, etc.

This might just be me, but in my experience, feeling guilty about my performance as a mother and what I did or didn’t do is totally normal. With my first I felt guilty that I was exclusively pumping instead of nursing, with my second I felt guilty that I couldn’t give her as much attention as I did my first – it goes on and on.

Let me say that it sounds to me that you are doing a great job. It’s really hard to exclusively pump when you are a single mom, especially if you are working in a role where it can be difficult to take pumping breaks. What do you think about dropping a session or two to give yourself a break, and just supplementing the rest? That way you’re giving breast milk but not needing to pump so much at work.  I think that whatever works for you is good for your baby – a happy YOU is more important to your baby than an extra 5 oz (or whatever amount) of breast milk. In addition, if you’re not super stressed, you’re more likely to feel able to manage things and be able to pump for longer than you would have if you’d continued to feel overwhelmed. Good luck!

I planned to breastfeed and had several troubles early on with latching, pain, and cracked bleeding nipples and now what I think is a clogged milk duct – this has led me to the decision to pump exclusively. Today is day 5 with my newborn, and my milk came day 4. 

I am worried about establishing my supply effectively with the pump only. I don’t really feel the letdown when I pump versus when I was nursing, am I still letting down if milk is coming out? Will I pump a larger output holding my baby? Also, I can only produce about 1-2 oz milk each session right now. Is this a normal amount of milk for day 5? Will pumping help with the clogged duct or is the suction not powerful enough? (I cannot empty the breast that is clogged fully). I have been pumping every 2-3 hours during the day and 3-4 hours at night. Will my output increase daily?

I’ll take any advice for pumping in the early days. I am feeling kind of helpless and hope to not have to use formula.

Congrats on your brand new baby! I’ll try to answer each of your questions:

  • I don’t really feel the letdown when I pump versus when I was nursing, is still happening if milk is coming out? When you pump, does the milk at first just drip out and then start coming out more forcefully? If so, yes it is. The fact that you are pumping the amount that you are leads me to believe everything is okay.
  • Will I pump a larger output holding my baby? Possibly – it might be worth trying it with your baby and without to see. I held mine when I pumped when he was a newborn, because that was just our routine (I held him after he ate, while he was falling asleep). Later, when I went back to work I didn’t see a decrease, so it’s hard to say.
  • I can only produce about 1-2 oz milk each session at this time. Is this a normal amount of milk for day 5? Totally normal. This should increase as the days go on – 5 day old babies can’t eat more than 1 or 2oz, so that is perfect.
  • Will pumping help with the clogged duct or is the suction not powerful enough? Yes, pumping will help – I cleared a few clogged ducts when I was exclusively pumping. I would start pumping ONLY your good side, while you apply warm compresses to the clogged side. After a few minutes, attach the pump to the clogged side and massage it while you pump. Hopefully that will help!
  • I have been pumping every 2-3 hours during the day and 3-4 hours at night. Will my output increase daily? That sounds like a great schedule. It’s hard to know exactly what will happen, but I think it will increase slowly at first, then go up to a higher baseline by week 2 or 3.

Good luck!

Please feel free to add any suggestions or thoughts in comments!

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