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PostPosted: 05 Sep 2009 22:00 
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I have read different articles about how long you should wait before expressing milk...is it right that I need to wait six weeks? Its just that tyler is going between 5/6 hours between feeds that my boobs are so full of milk its getting painful he is only 2 weeks old so I'm not sure if I should start using breast pump yet or not? I have the breast flow bottles which are brilliant so I'm just not sure if I can start now or not?


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PostPosted: 05 Sep 2009 22:16 
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Hello
Im not an expert hon, but I expressed while i was still in hospital with Rohan a day after he was born, not sure why I cant exactly remember, but I THINK you should be able to do it as soon as, but maybe the other bf mothers will be able to give you more idea. Sorry not to be much help x

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PostPosted: 05 Sep 2009 22:38 
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muffintot wrote:
I have read different articles about how long you should wait before expressing milk...is it right that I need to wait six weeks? Its just that tyler is going between 5/6 hours between feeds that my boobs are so full of milk its getting painful he is only 2 weeks old so I'm not sure if I should start using breast pump yet or not? I have the breast flow bottles which are brilliant so I'm just not sure if I can start now or not?


Hiya hun,

There are different things to consider with expressing, and with introducing a bottle, at this stage. In general the recommendation is 6 weeks for both, this is because by 6 weeks your feeding is established and working on a supply & demand basis, and your normally comfortable that you achieving a correct latch and positioning and that the tissues in your breast arent as tender or delicate as within the initial few weeks. In relation to introducing the bottle the concern there is 'nipple confussion' as the baby sucks differently from the bottle which is easier for them, and can then make them become 'lazy' on the breast causing problems for the continuation of feeding successfully. However as you said you have the breastflow bottles these are slightly different so may be easier for baby to swap between. 5/6 hours between feeds is a long time for a 2 week old baby, the recommended frequency of feeds is 2 - 4 hours so it sounds like your breasts are getting engourged.

I have being expressing by hand since 2 weeks and havent had a problem, I found it easier to express by hand rather than with a pump as it wasnt as painful when my breasts were tender, and as you are totally in control it can help reduce the chance of tissue damage or possible nipple trauma, but its very much a personal preference. I'd suggest using a warm flannel on the breast first, then gentle massage to encourage let down before trying, however you may find it easy without this if you are very full. Initally I froze my milk rather than bottle feeding, as your milk will keep in the freezer for 3 months, however having tried to introduce a bottle at 6 weeks (I also have the breastflow) my baby now isnt interested in them, and I do know of other mums who introduced infrequent bottle feeds early and had no problems at all so its a balance.

For the official guidelines the La Leche League also suggest you can prevent or minimize the effects of engorgement by:

•Nursing early and often. Nurse as soon after the birth as possible, and at least ten times a day after that.
•Ensuring that your baby is positioned well and is latched on properly. (See How do I position my baby to breastfeed? for more information on proper positioning and latch.)
•Nursing "on cue". If your baby sleeps more than two to three hours during the day or four hours at night, wake him to nurse.
•Allowing baby to finish the first breast before switching sides. This means to wait until baby falls asleep or comes off the breast on his own. There is no need to limit baby's time on the breast.
•If your baby is not nursing at all, or is not nursing well, hand expressing or pumping your milk as frequently as baby would nurse.
For some mothers, the normal sense of fullness continues, their breasts becoming hard and painful. Most mothers find that frequent nursing helps to relieve any discomfort. Additional suggestions for dealing with the discomfort of engorgement include:

•Gentle Breast Massage
With the palm of your hand and starting from the top of your chest (just below your collar bone), gently stroke the breast downward in a circular motion, toward the nipple. This may be more effective when done while you are in the shower or while leaning over a basin of warm water and splashing water over your breasts.

•Warm Compresses, Massage, Cold Compresses
Some mothers find that applying a warm, moist compress and expressing some milk just before feedings helps to relieve engorgement. Using heat for too long will increase swelling and inflammation, so it is best to keep it brief. Cold compresses can be used between to reduce swelling and relieve pain.

•Cabbage Compresses
A popular home remedy for relieving the discomfort of engorgement is cabbage leaf compresses. Rinse the inner leaves of a head of cabbage, remove the hard vein, and crush with a rolling pin (or similar). They can be used refrigerated or at room temperature. Drape leaves directly over breasts, inside the bra. Change when the leaves become wilted, or every two hours. Discontinue use if rash or other signs of allergy occur. There have been anecdotal reports that overuse of cabbage compresses can reduce milk production, therefore some experts suggest mothers discontinue the compresses when the swelling goes down.

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PostPosted: 06 Sep 2009 00:48 
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Thanks for all the info think tomorrow iwill see if feeding him more frequently will help I don't like to wake him when he sleeps that's all but if he should be eating more then I will wake him up. I'm waiting for my health visitor to contact me but I think I will end up contacting her before the next baby clinic. I do leave him on the first breast until he either falls asleep or comes off it then burp him a little then put him on second breast which he doesn't stay on very long but he has been bringing some milk up quite regularly now and suffers terrible withhiccups! Am I doing something wrong?


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PostPosted: 06 Sep 2009 01:34 
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hiya hon...
i expressed from when Nathan was one day old as Ryan played a part in his feeds from the vrey beginning...

during the day, i breast fed him from the boob and would express and refrigerate whilst he slept so than Ryan could do the night feeds

i used Dr Brown's bottles mostly (the tiny 4oz ones) and we had one Tommee Tippee with the Nuby teet that we alternated...

never had any nipple confusion, his teething was fine and he speaks very well [smilie=001_icon16.gif]

hope this helps xxx

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PostPosted: 06 Sep 2009 09:12 
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muffintot wrote:
Thanks for all the info think tomorrow iwill see if feeding him more frequently will help I don't like to wake him when he sleeps that's all but if he should be eating more then I will wake him up. I'm waiting for my health visitor to contact me but I think I will end up contacting her before the next baby clinic. I do leave him on the first breast until he either falls asleep or comes off it then burp him a little then put him on second breast which he doesn't stay on very long but he has been bringing some milk up quite regularly now and suffers terrible withhiccups! Am I doing something wrong?


I dont think that your doing anything wrong hun :D What your describing sounds completly normal. The hiccups are a sign of the diaphram still developing, and although all babies tend to bring back some milk, whilst the diaphram is weaker the amount of sick will be increased - This is also nothing to worry about as what your describing doesnt seem as aggressive as reflux where the baby is projectile sick and appears to be be bring back the whole feed. My youngest, Eliana, seemed to spend at least 4 hours a day hiccuping on and off for the first 6 or so weeks :)

You will also find that over the next few weeks he should start to become more elert and have more awake time in which case his feeds will probably increase in frequency at his demand. I also hate the idea of waking a sleeping baby but I wanted to include the standard guidelines so you could make up your own mind, I would suggest if you dont want to do this to try and make sure he is feeding as efficently as possible whilst awake, try tickling his foot or cheek whilst he is feeding to stimulate him to suck more, and this also helps to keep him awake a little longer, also just keep an eye on his weight gain every 2-3 weeks to ensure he is getting what he needs,

It could be that he is feeding extremly efficiently when he is on the breast which could explain why you have so much additional milk inbetween feeds, as you milk works on a supply and demand basis - i.e. it makes enough milk for baby based upon the amount your baby takes, so the more baby sucks the more you will produce, However its likely that as our body does tend to expect 3 hour feeds you milk will therefore be building up before your baby is ready for it, as such expressing would seem to be the best responce to this.

Are you comfortable that you have a good position & latch? If you feel that your baby is feeding well then there is no real reason why you couldnt introduce a bottle if that is what you want to do, my only recommendation would be to keep an eye on any changes to your breastfeeding pattern or latch, as although a lot of babies are totally fine swapping between the two, some do become less efficient on the breast as it is easier for them to take milk from the bottle, which can result in your milk supply reducing, nipple trauma from incorrect positioning or the baby rejecting the breast totally, however these really are worst case, and if you are looking out for changes in the way baby is feeding they can generally be overcome before reaching this stage by reducing or removing the bottle feed for a few days before trying again.

I know breast feeding can be quite stressful, I worried myself sick with Izzy over whether she was getting enough, and poor weight gain so good support can be a great advantage even for just peace of mind, I'd recommend attending a breast feeding support group or baby bistro, there will be run by a NHS trained breast feeding support leader, and they will also sometimes have La Leche peer supporters too who are mums that have breast fed there own children and had training to help other feeding mums - sometimes this support is more benificial than just the HV as they can sometimes become overly focused on weight gain only.

HTH

Lizi

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PostPosted: 06 Sep 2009 16:44 
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I went against everything I was told/read and started to express a week after my LO was born. Purely because BF works on a demand and supply basis, and Oscar, being a 10lbs baby was a very hungry one, so I started expressing just to help things along and for me to make more milk for him. The milk itself was rarely used in the early days, at that point, I never could express more than 125mls at a time and I was happy to BF in public, so my OH occassionally used to feed Oscar to give me a break. When LO was 2 weeks old and had colic, we introduced a dummy and gave him a nightime bottle of formula to keep him fuller for longer throughout the night. By 5 weeks, he was sleeping through the night and he never experienced any nipple confusion. As I was expressing regularly in the mornings, by then, I could easily fill up a bottle in 10 minutes, which was then used when my OH finished work. He fed Oscar, whilst I could have some 'me' time.

I BF up until Oscar was 6 months old, he is still teething rapidly, and is still a happy and hungry baby!

I never had the problem of engorgement, as Oscar never went longer than 2 hours between feeds, but I think when it comes to expressing, just use your own instincts and judgement. x

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PostPosted: 07 Sep 2009 08:51 
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I need to start thinking about expressing soon, so I can freeze it and get a stock built up for the childminder for when I go back to work at the start of December. Now there's a depressing thought ! :roll:

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