Confused

Hullo every one. I need some advice. My little Amber was born a 33wker she is now 8wks after birth,she looks pretty well for her birth date and no one can tell she is a premie. She does what mostly all newborn full term babies do and act. Am abit concerned because I will be resuming work four weeks from now. Am still breast feeding her exculsively though some times my supply is abit low and this gets me really worked out. I tried to start on formula three days ago as I had to go sort out some things at work but it all didn't go well..we gave her some formula which she eat properly but as soon as I got back n put her on breast she throw up all what she had eaten I was so scared but when I called my brother who is a doctor he mentioned that she could have been reacting to the formula and he suggested we hold it till she is steady enough which keeps we wondering what will I do when the time comes for me to start working and when I pump I don't bring out that much. Her ped always insists on breast feeding her which I know is the right thing for her but what can I do coz I really have to go back to work to survive. Please fellow mums help me if any of you did go through such a situation..And also of late she is awake for long hours in the evenings and mostly struggles to get back to sleep and always wants to be on the breast and I don't know why but when she does that my milk supply totally becomes low and she has to suck hard to get a flow..could she be having a problem with sleeping? Please advice me on what to do.thank you

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For pumping, you may get more if you have her physically nearby or can visualize her, so that the milk "lets down" properly. I pumped for a month, not knowing that the milk wasn't "letting down" and that's why it took so long to get anything.

It would be tiring but if you pump more in these weeks, you could freeze a stockpile. While nursing, I could pump extra first thing after nursing in the morning and then add pumping sessions during the day, in between feedings. You would have to be careful and perhaps work with a lactation consultant to increase pumping while feeding. Also, it's possible to pump while working, but may not be easy. Laws are increasing to protect pumping mothers, but of course many employers are woefully (I might even say shamefully) unprepared to provide comfortable pumping space and refrigerator storage for pumping workers.

For sleep, many new babies are upset in the evening and have trouble settling. Preemies tend to be harder to settle than typical babies:
http://www.boston.com/lifestyle/health/childinmind/2012/10/new_study_asks_w hat_happens_to.html

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Sounds advice from @Florinas_Mom.

As for throwing up - has the baby been examined for reflux or GERD? This could be a culprit. Talk to your pediatrician about that.

And I hear you on your concerns as you head back to work. You will find that many a mother on here has had similar challenges. If you can pump at work, I highly recommend it. I did this and it worked out fairly well. Just make sure you get a space with no windows or at least windows you can properly cover as well as a door to shut and lock for privacy. Oh and you will need to bring a pump, milk pumping materials as well as a travel freezer bag to transport the milk. And then a must is a fridge in the office where you can store the milk to later take home. I took my hospital-grade pump with me for the first few days and that was hard because the thing was so heavy. I ended up getting a portable pump and it worked out pretty well (though the hospital grade pumps are better, at least when my daughter was born in 2003).

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I would suggest a hospital grade pump, if you aren't already using one. They are much more efficient than even the motorized ones you can buy. I had an excellent supply for both of my children, but even so, the hospital grade pump was noticeably better. As well, are you drinking lots of water (or other healthy liquids such as milk)?

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Try a hospital grade pump they are stronger ! Sometimes your local hospitals rent them out too moms from the NICU. What helped me alot to maintain my supply was taking fenugreek combined with mothers milk tea. I did oatmeal and granola and yogurt to help. They also have lactation cookies. Try taking a piece of clothing with your babies scent on it sometimes the smell can help or recording your babies hungry cry and play it while you pump. Hope things get better for you.

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Some hospitals have pumps to rent to whoever wants them, regardless of NICU status. I rented a hospital grade pump from my local small town hospital (don't even have an NICU) after my full term son was born. He nursed like a champ, but I knew I quickly needed a stockpile, so I started as soon as I could.

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You can look into donor breast milk as well to help supplement as you figure out pumping at work. Check with the La Leche league in your area and see if they can connect you to someone!

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You need to to gradually increase your milk production. For this you should fry feed/pump every 3 hours around the clock for a while. The milk production is greater during the night. Don't stop trying to pump and avoid formula/skip feedings. It is not easy at first but it is so worth it. Even if there doesn't seem to be a lot of milk at first, pool together and store as much as you can. The more you feed/pump, the more milk you will produce but it takes ~24h for your breast to adjust. Don't over do it at first, go gradually a little bit more every day. A consultant is a most! Or mothers associations that can share a lot of tricks and support (I was a support mother back in Montreal few years ago an received government health training..!). Trust your ability to produce milk. After your production is sufficient to feed and store some milk, you can gradually reduce the pumping.

If your baby stays on the breast too long, it might be for comfort and that's a part of the feeding too. A great trick to minimize it is to practice breast pressure (my own traduction from French). The way to do it is to observe your baby during the feed, when the sucking slows down and the swallowing is not important (no much milk) or that your baby seems to fall asleep slowly, you press relatively strongly on your breast and hold the pressure for ~5s. Relax ~5s. Repeat. More milk will flow out and your baby will start drinking again more avidly. If no more milk is needed, the baby will let go. Then try the other breast. This way, you will reduce the time of feeding and make sure the baby doesn't stay there forever without really drinking.

To start working so early after birth is something I will have to experiment myself soon for my third baby (I am 24w now) and it is certainly not an easy thing to do. I mentionned it to my doctor and she said it was going to be fine, I only needed to pump. Don't forget that the milk production is greater during the night. I was planning on preparing myself to pump at least once per night for a while to ensure I keep my milk production. But it also depends on how the baby is drinking. If the feed during the night is great, then pumping during the day would be more important. All of this is solved case to case and with progressive adjustment. To give formula is not a good solution, there is a lot of tricks for breast feeding. Trust yourself, you can do it. And your bb is just going to be more happy and more healthy. All the pumping will become part of your schedule. Pump both breast at the same time with good electric machine is the best to get the most in 20min. Don't forget to sleep and relax. This is all temporary and in no time (even if it doesn't seem so now), your bb will eat and drink homogenized milk and you would be able to breast feed much less (morning and night) if you desire, to keep your bb's health at the top (eat from 6 months and homogenized milk gradually after 9). Don't hesitate to ask me more.

My second bb was born at 30 weeks and I pumped my milk non-stop for a couple of weeks, started breastfeeding from 34w gradually from tubing feeding with my milk. During hospitalization, she was having a bottle of my milk (from my stored stach) everyday so I could go spend the evening with my older daughter of 19 months. Before getting out of the hospital (before 37 weeks), she was drinking to the demand as needed only because her weight gain was on track (gaining regularly enough). I stopped pumping regularly because I was home for a while and had a full freezer of milk! I didn't even know what to do with all this milk. The important thing was just to get a good milk production until my bb could feed properly. I think that the trick for a working mommy is to get a small reserve of milk before starting working, then continue pumping enough for 2-3 feedings a day.
I hope this help.
Best.

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Thank you so much for your responses and advices. In regards to pumping at work unfortunately it might not be possible since the type of work I do doesn't give me that time to pump at work. Am still confused on what to do and I think my baby might start on formula quite early but I will put her on the breast when I always at home n also pump before I leave for work. I would like to hear from a mum who also had to put her premie on formula alone and how it all went

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Re:
Her ped always insists on breast feeding her which I know is the right thing for her but what can I do coz I really have to go back to work to survive.

I am a mom who switched to formula for several reasons - I had poor production, I had hormonal issues, and I work full-time. I worked on construction sites and there was no way I was pumping in a port-a-pot. Just one of my many personal reasons. Regardless of your reasons for switching, I would recommend to you to make the decision, don't second guess it, and move on. If you truly don't think pumping is an option at work or after you return to work b/c it will be too difficult, then don't do it. I recommend a slow transition to formula if you can (mix it with breastmilk.) My daughters were 100% formula fed from week 6 (36 weeks gestation) until their first birthday. They did very well on it. They did have some reflux and some gas, wo did lots of things to help with this (frankly, they had this on breastmilk too, so it is what it is.) We made sure to hold them on their bellies on a slight angle after feedings. We fed smallish bottles (never over 4-5 ounces) more frequently to help with reflux. We burped them all the time throughout the feedings - every 1/2 ounce or so which helped alleviated gas and reflux. Sometimes you have to try a few different formulas before you get the right one, but when you do start one kind of formula, your baby will need to stay on it for several weeks (at least 2-3) before they adjust.

Best wishes going back to work and motherhood. It's not always easy, but it works itself out!

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How much formula was she fed while you were gone? It's very easy to over feed a newborn and cause them to vomit. Babies at her age usually only can take an ounce or two at a time. However when they are used to breast feeding the eat for 20-30 minutes at the breast. But the bottle flows faster so they think they need to bottle for 30 minutes, when they might finish what they need in 5 to 10.

Best of luck momma! You are doing a great job, keep pumping what you can. Every drop in liquid gold for your little one.

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Thank you mygirlsmom and crystallynn for your response it has made feel much better and am now more than ready to starting work. I will surely pump what I can for my little one..thank you once again every one for your responses they have helped a great deal..

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@Amber1carol

I will also add in here that when you are ready to stop pumping let go of any potential guilt you might have. I had had enough of the pump at 3 months (okay really at one week starting lol) and realized that my daughter was growing well and that I also had to be present in her life and not just focus on pumping all of the time. My daughter was on Enfacare with the breastmilk so I knew she could tolerate the formula itself. She shifted over like a champ and continue to thrive. I like to think this is because I allowed myself that time to be with her just as I would have had I been able to breastfeed her. I hope this helps as well. You are doing great just by focusing on your child and figuring out what works within the time and the abilities you have.

Hugs,
Deb

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I agree, you'll do fine. If you truly believe that breast milk is the best and cannot pump during work time, you'll find a solution. Maybe try pumping before going to work like you said. Maybe once at another time and that might be enough for your bb during your absence. And you can do that as long as you wish. When this becomes too much, introduce formula following these above replies. It is your decision and you have to feel great about it. You can do whatever you desire.
IF you want to pump and it doesn't seem to work well, I have more tricks to make it much easier, If you want, just ask. Try to get a hand on before you go back to work, that's my advice. Best,

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