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Thread: BFAR help please!

  1. #1

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    Default BFAR help please!

    Hi BFAR buddies and experienced mummies.
    Ok. So DP goes back to work tomorrow and DD is 3 weeks old tomorrow. Usually at night, I don't bf but express ready for the next feed while DP gives DD ebm and formula top up. (During the say we are now able to bf then express while DP feeds DD her bottles)
    I'm still building my supply, taking motilium, fenugreek and lactation cookies so I guess you could say I'm doing everything possible to get to a maximum supply level in about a week.
    How will I/ we cope overnight? DP needs his sleep and has said he will help with the 5 am feed but wants me to do the 1 am feed myself.
    How am I gonna cope with feeding DD, burping and resettling her and then expressing?
    What has worked for you?
    Any ideas?

  2. #2

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    My DS was soothed by breast pump noises - so settling and pumping were sometimes the same thing.
    Try and get as much organized beforehand as you can - bottles made up in fridge, cloth nappies nearby, etc

    And after pumping just put the milky pump bits in a big zip lock bag in the fridge - you don't have to wash them every time, just once or twice a day.

  3. #3

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    Does bub need a bottle at night or can you BF one side while pumping the other? Sorry but i have no idea what BFAR is lol..

    And I agree with no washing pump bits.. It saves a little time

  4. #4

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    Sorry for my ignorance but what is BFAR? I'm a BFing and expressing mumma - I do wash the pump parts but mainly because I like to steralise each and every time because I think I get more milk when they are warm With your bub being so young, your supply is still establishing so in my opinion, if you want to get a good supply you should be resting as much as possible and also not missing feeds/expresses. Why don't you just BF your DD during the night and then express afterwards if you don't feel like you are fully drained? It's just one feed and it's not like you are missing a feed? If you do want to feed/express I would feed on one side and express the other at the same time. It's easier if you have an electric pump and quick too because as DD gets your letdown, it makes easy work on the expressing side. This will sound ridiculous but I found the easiest way to express and feed was to slouch in bed with a pillow behind me and prop my knees/legs up so DS was lying in that groove and I could just support his head with my one arm and hold the pump with the other.

  5. #5

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    BFAR is breastfeeding after reduction - in other words trying to maximize supply.

  6. #6

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    Ahhh okay. Sorry if anything I responded with isn't appropriate then. And I forgot to say a big congratulations on the birth of your daughter.

  7. #7

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    Default BFAR help please!

    Can you just BF and top up at that time, without expressing? Will that work? One less thing to do?

    Now that you are feeding 4hrly, you could squeeze in another pumping session to make up for it, maybe after the morning feed?

    Also - rest when DD rests!! So important!

  8. #8

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    Default BFAR help please!

    Thanks guys. I had a reduction 20 years ago so am only producing about 35 ml every 4hrs- about half what DD needs. Bf can take an hour then top ups and burps and resettling up to another hour... Mmmm a tricky one.

  9. #9

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    Hi, Things will change for you very quickly. Is your baby able to attach to the breast? This probably needs to be a priority and you may need an good LC to help you through. For a baby (and for a mother) breastfeeding is about much more than the milk. It's about comfort, its an experience for mother and baby - a learning experience and a loving experience. Breastfeeding gives you and your baby the right hormones for you to make more milk and for your baby to regulate him/herself.
    I would recommend you limit your baby's time at the breast (I wouldn't recommend this for everyone - these are special circumstances) For longterm breastfeeding success you need to keep your baby in love with the breast - teaching her that the breast is for comfort, not just nutrition. So, 10 mins each side, then 10 mins pumping each side - then use the breast to settle your baby if she is still unsettled after that. (Hey you probably have to do something to settle baby - the breast is a great way to do it) Fenugreek, motilium etc will all work to an extent, but nothing will be as effective as your baby at the breast. Have you read Diana West's "Defining your own success - Breastfeeding after breast reduction"?

  10. #10

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    Default BFAR help please!

    Congrats on the birth of your daughter. It's hard going with a low supply and expressing constantly but hang in there, it can quickly become a thing of the past. I had to pump with both my girls and BF (and comp fed) DD1 until 11.5 months and DD2 is exclusively BF and still going strong at 10.5 months

    You've been given some great advice already. I can't comment on BFAR but I did have to exclusively pump for 5 weeks with DD2 (due to an array of issues) and my DH isn't great without sleep or getting up overnight so I did do a lot of it myself. He helped with one of the feeds most nights but usually I'd just take DD2 out to the lounge and put the TV and a lamp on low so I had something to keep me awake and feed her EBM first then I'd put her back to sleep and then into her bassinet or rocker (usually her bassinet) so I could rock her with my foot and put her dummy in if needed. She seemed to settle fine most of the time. I only rinsed my pump parts and washed them properly in the morning. I was fortunate enough to have two sets of breast shields though which helped as I found that a hot water rinse of the other parts immediately after expressing was sufficient for the second middle of the night pump.

    It's tough going but you will get there.

  11. #11

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    Hey FL, Is your DH a heavy sleeper? Is your DD in the room with you? It is much easier in the night if your DD is right next to you, no need to get up out of bed - you can almost have a 'dream feed' yourself! I didn't even change DD2 in the middle of the night as she is a very light wetter and never poos at night. We do co sleep, which I found the easiest solution to the sleep/feed issue, but it's not for everyone. I actually did the opposite to Barb's advice, I had DD constantly at the breast. As I said in the PM I sent you, I out DD in the Close Carrier during the day and she suckled whenever she felt like it and at night I slept with my top open and it was an Open Bar policy. I found that the best way to increase my supply was to stimulate my breasts as much as possible and the best stimulation is baby suckling. I did not express overnight, just allowed DD to feed whenever she wanted to.

    Does your DD enjoy the breast? Is she a strong suckler with a good attachment? It certainly makes life easier if you have bub working with you! My DD1 was only 5lb 10oz and a little jaundiced, very sleepy and difficult to attach. Then when I got her attached she would have a couple of sucks and fall asleep! DS was a much better feeder, stronger and more enthusiastic. But I got lost in the cycle of feeding and expressing and in all honesty I made it too bloody hard for myself. DD2 came out sucking and latched straight on the breast. I worked with the theory that I would prioritise feeding from the breast over expressing and DD2 was only too happy to oblige! BF is far more pleasant and rewarding than pumping and bub is far more effective at emptying the breast than a pump - if she is happy to help out!

    How much Motilium are you taking? Most doctor's are not experienced in prescribing Motilium for supply issues and will prescribe a low dose. My research showed that you will need at least 80-90mg per day to see a marked increase in supply. I took 120mg per day and the response was good, I saw a definite increase in my supply. I tried to wean off the Motilium at about 5 months and saw a distinct drop in my supply so I continued taking them until DD2 was 12 months at which time I would have been happy for DD to wean (she obviously missed that email and is still BFing!!).

    I have the Diana West book which Barb mentioned, it's a fantastic source of inspiration and encouragement, lots of personal BFAR stories. I can have a look for it today if you like, I would be happy to loan it to you?

    I remember at 3 weeks it seemed in insurmountable task to establish a supply after a reduction. That is the age when I gave up with DD1, and I was terribly regretful that I didn't persevere. You can do this, you just need to take things one feed at a time. You are doing a great job, and it will get easier!

  12. #12

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    Default BFAR help please!

    :Hugs: Congratulations on the birth of your daughter. I knew you must have a bub by now but must have missed it on BB.

    It sounds like you're doing a great job. While my own experience is nowhere near comparable I do think it's important to compromise between getting as much pumping in as you can and maintaining your sanity. It's easily to stress out that missing one or two overnight pumps will make all the difference but it's not worth it if it makes the difference between you coping or being miserable.

    For me a handsfree pumping bra and bed sharing were the two things that helped the most.

  13. #13

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    FL, I am right there with you on this one.

    I too have been very reluctant to miss an expressing session, have also been using DP during the day for the bottle top-ups while I express, etc, but not at night...

    I agree with Barb - as long as baby is attaching and sucking reasonably well, limit the breast feeds to 10-15 minutes per side, and then give bubs the top-up. I was lucky enough to be able to do the weighing, on proper baby scales, as you know from other threads, and I found out by weighing DS at 5 minutes, 10 minutes, 15 minutes, 20 minutes, etc, into a feed (only did that a couple of times, otherwise just before and after), that he's gotten 70% in 5 mins, 95% odd within 10 minutes, and the rest by 15, and the extra time he would happily keep sucking, but really not be getting anything at all - 1ml at best, sometimes nothing in the last 15 minutes. Actually, I suspected as much from looking at swallows, because while there were swallows every 3-4 sucks in the first minute, they only came every 9-10 sucks after that until 10 minutes or so, then nothing... do you know how to see/hear/feel for swallowing? If you do, and can see when bubs is no longer swallowing, you'll feel much better about stopping the feed 'early'.

    Cutting down the feeding time therefore made no difference to the milk he got from me, but a huge difference to the time it took for each round of BF/Bottle feed/express. Also, he was far less tired after only 20 mins of breast feeding, and took the bottle feed much more efficiently as well! That meant we knew when he stopped sucking, he was full, not just knackered and too tired to suck more.

    So now, I do the whole lot myself at night, and sometimes during the day, but we can do it all in just under an hour. I am very lucky in that DS falls asleep again very quickly at night - He sleeps in the cradle in our room, but I change him first, swaddle him again straight away, grab the bottle on the way back from the nursery, do night feeds in bed, sitting up, and when I put him back in bed, he's usually awake, but quiet. I go to the lounge, where my pump is set up, and by the time I've put the milk away and washed the pumping kit, he'll be asleep. I think that the 'routine' of night feeds in bed, but day feeds usually in the lounge, helps him to know that he will go straight back to bed afterwards if he's fed in the bedroom in the near-dark.

    I don't know what the professionals will think of this, but we stopped warming the bottles, too - either EBM or formula, he'll happily take it either straight from the fridge, or with just sitting out for the 20 minutes of the BF. He's not bothered by it at all, and it saves time, energy, water... and when we have to feed when we're out, it makes it one less thing to worry about, too.

    In terms of keeping the time to under an hour, especially in the middle of the night, this was really strongly recommended by our paediatrician as well, and supported by my LC, because getting enough rest is also really important for supply. (I noticed on several occasions, when weighing, that at the early evening feed he seemed to get a lot more on the days that I'd had an afternoon nap!) I also think it helps us all during the day, because if he spends less time on feeds, it leaves a bit of alert time for 'playing', ie, lying on the play mat together, or holding him upright face to face with us and 'talking', or tummytime on our chests, or on the floor, etc. When the feeding routine took 2 hours, he was knackered by it as well.

    I respectfully disagree with the people who suggest cosleeping with an 'open bar policy', just because if you have to get up to get bottles, and pump, and put things away again in the fridge, and wash parts... it kind of defeats the purpose!

    Because I think this is working very well for us, I don't do what I am going to suggest to you - that you put on your double pumping tank/cami/bra top that you made, and do the bottle feeds at the same time as you are double pumping. If you can bend your knees up enough/use pillows to support bubs for the bottle, you then will have one hand free for the breast compressions/massage for pumping.

  14. #14

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    Getting up to express/wash up etc would mean getting out of bed even if you co sleep I should have clarified that DD2 would always happily settle after a BF with no top up overnight. Co sleeping is certainly not for everyone, but the more time you can spend with baby on you skin to skin (day or night!) has proven better BF outcomes.

    I was concerned (and Barb you might be able to address this one!) that by limiting BF's to 15 mins then topping up I would not have been allowing enough time at the breast. Not only to increase my supply or allow bub to empty the breast, but to encourage DD's interest in the breast. I fed DS for about 3 months (with top ups) and limited his feeds to 15 minutes but by 8 weeks it was a struggle to get him on the breast as he would sooner have gone straight to the bottle. I encouraged DD2 to suckle for comfort as much as feeding.

    Obviously, when you need to feed, pump and top up (EBM, formula or both!) you need to do whatever works for you and maintains your sanity!

  15. #15

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    Default BFAR help please!

    Thanks guys. We are doing reasonably well with lots of bf time! I'll respond more when I can get to a computer.


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