Helpful Book on Breastfeeding and Scheduling
When I found out I was pregnant with our first, Mary Kate, there was no question in my mind about whether or not to breastfeed her. I was nervous that I would not know what to do or how often to feed her. I am the type of person who likes to have some guidelines to follow when doing most anything. Several people recommended the book "On Becoming Babywise" to me when I was pregnant. After reading it through, Babywise quickly became my manual in nursing and scheduling. This book has a bit of a controversial reputation because some people claim it leads to babies not thriving properly, due to not being fed enough, however, it frequently says to feed when baby is hungry and to not watch the clock. I am a true believer in this method and recommend it to anyone who asks!
The premise of the book is to teach your baby to take full feedings, as opposed to snacking, and to sleep through the night sooner than most babies, which was critical in my eyes as a working mom! Full feedings are very hard with newborns, but it does make a difference if you can get your baby to do so. I won't get into details about how to keep a sleepy newborn awake enough to take in a full feeding, but check it out in the book if you're interested.
Babywise teaches that moms should implement the "eat, play, sleep" routine with their babies. Essentially, you nurse the baby, keep them up for a while, and let them nap for a while before repeating this cycle. We would keep Mary Kate and Mills up before their last feedings longer than normal before their last feeding of the night. If you do this too much, your baby will likely become overtired and more difficult to settle down to sleep. Ultimately, you are teaching their bodies to sleep through the night by using this routine. Keep in mind that the amount of time they "play" or nap is not set and will extend as your baby stretches out his/her feedings.
One last thing I love about Babywise is the healthy/unhealthy growth indicators it lists at different stages of the first year. This is a huge help because when you are exclusively nursing there is no way of knowing how much breastmilk your baby takes in during a feeding. It also gives you suggestions of how often to nurse at each stage during the first year.
There are plenty if great books to read about breastfeeding and sleep habits, but this is the book I both know and have had success with.
Scheduling/Nursing
Scheduling was extremely important to me when I knew I was going back to work. It was important for me to train both my children to eat full feedings at the same time everyday because I had limited windows of time in which to pump. I followed the appropriate hours to set feedings for each stage listed in Babywise. (Mary Kate was easy to schedule and followed the book to a T, but Mills was much more difficult! Keep in mind that every baby is different and do not stress if yours does not do well with this. The important thing is that you give it a try).I will concisely go through it here.
I fed on demand for the first few weeks and did not start eat, play, sleep until around three weeks with all of my babies. During the first few weeks, all three have averaged eating every two hours, sometimes sooner and other times later. I would also not let them go more than one four hour period during a 24 hour period and would keep that during the night if they would do it that early. After 3 weeks, I started eat, play, sleep with them and noticed they all stretched their feedings out to between 2 1/2 and 3 hours. I would not be strict about it being the same period of time between every feeding each time, but would not let them go more than 3 hours at this point. I also started letting them go as long as they would at night. Around 10 weeks or so, both Mary Kate and Mills seemlessly stretched to 3 1/2 hours between feedings. I went back to work at 13 and 14 weeks, so this is where they were feeding wise then. Around 5-6 months they both transitioned to eating every 4 hours and stayed there until they they were one and transitioned to cows milk.
One question I always had was how long is long enough to nurse my babies. Both Mary Kate and Mills averaged nursing both sides for a total of 12-15 minutes. Everything I read, including Babywise, talked about babies needing to nurse 25-30 minutes. Madden did nurse this long at first, but he to has also resorted to averaging 15 minutes total. After discussing this with both my lactation consultant and pediatrician, I learned that as long as your baby is growing appropriately, and having plenty of wet and dirty diapers, it is fine. Every baby is different, so each baby's needs are differenr. A great suggestion I received was to log feedings and wet and dirty diapers, like you do a newborn. This helped me to see everything that was going in with my babies. I also realized that I have forced letdown, meaning that my milk comes out very fast. It also means that my babies have gotten more milk faster than some others, resulting in shorter nursing periods.
Bedtime and Misc Info
The great thing about eat, play, sleep is that it doesn't have to be done at the exact same times everyday. Those moms who work will do that, but those who stay at home can start each day when baby wakes on their own instead of waking them at a particular time. As a mostly stay at home mom, this time I will not be as worried about the first morning feeding being at the same time each day.
Bedtime was/is important at our house. both kids required a lot if sleep and certainly did not get much at daycare, makinggoing to bed early a requirement for all of our sanity! After going back to work, I would put both kids to bed after they fed around 7-7:30. I would go into their rooms and do a dream feed around 10-10:30 every night until they dropped it at 4 and 5 months. A dream feed is when you don't wake them, but feed them and put them back to bed immediately after eating. This is essentially what you do with newborns, so why not do it with older infants? It gets them used to going to bed earlier and usually provides an easy transition to dropping that last nighttime feeding.
Pumping Info
Speaking of pumping, if you plan to go back to work you need to invest in a good pump. Fortunately for most people, insurance companies are now providing breast pumps at little or no charge. I have used a Medela pump-in-style with all three of mine and love it! This brand was recommended to me by my lactation consultant and, after spending a great deal of time doing my own research into the various brands, I think it is the best quality option available.
I became a pro at pumping and storing milk by the time Mills was born. After my milk came in with Mary Kate, I would pump every morning after her first morning feeding the entire 14 weeks of maternity leave. Some friends recommended doing this and it was hugely helpful in building up a good supply of milk! Somedays, I would pump 6 or more oz after nursing her. Other days it may be more like 3-4oz. What I didn't realize with her was how primarily pumping her feedings during the day, after going back to work, would effect my milk supply. After several months of doing this, I stopped producing a much milk as she was taking at a given feeding. My body was not responding to a pump like it would to her nursing, and that is normal. I tried taking herbal supplements and drinking mother's milk tea, but didn't see great results. I stopped nursing her altogether at 10 months when I found out I was pregnant with Mills. Aside from being pregnant, my supply was so low that she want getting much at this point.
When I had Mills, I never stopped pumping after the first morning feeding until I weaned him at 9 months. (He was so distracted at this point, he was extremely difficult to nurse!) This took a lot of dedication, but it was worth it! After months of being back at work with him, my supply started dropping a bit, but I had plenty of milk stored up from pumping an extra feeding daily and had enough to not have to supplement with formula.
Another option that works better for some people is to pump at night when your baby drops the last feeding before you go to bed. This feeding was around 10 pm for both Mary Kate and Mills. Mary Kate dropped it around 4months and Mills dropped it around 5 months. With Mary Kate, I should have just pumped that last feeding after going back to work at 14 weeks, but I did not know any better. Because I never stopped pumping that extra feeding with Mills, I had enough milk stored to give him brestmilk for nearly two months after he was weaned...pretty crazy!
When at work, I would pump when I had the kids scheduled to eat. This is important because I kept to the same schedule on weekends or breaks, as much as possible, to try to ensure the greatest success with pumping. Since my milk lets down quickly, I could usually pump a full feeding in around 10 minutes. I would normally continue pumping for an additional 5 minutes. The extra stimulation helped keep up my milk supply as much as possible while pumping multiple times daily. Ladies, it is required by law that your employer give you time to pump if you choose to do so. Certain professions are easier than others to make it happen, but don't not breastfeed because you think you won't be allowed to pump because you can push the issue with your boss.
Storing Milk
After pumping, storing, and wasting tons of milk with Mary Kate, I learned what I was doing wrong. With her, I would simply store what I had pumped in a milk storage bag, label it with how many oz and the date, and put it in the freezer. This led to random amounts of milk being stored. When I would make bottles, I would inevitably end up with extra milk that I couldn't use and would end up pouring it down the sink. That stuff is liquid gold people, and wasting it almost put me in tears daily! Fortunately, I learned that the best way to store milk was in four ounce quantities.
Here's why this storage method worked best for me. My kids were both on 3 1/2 hour feeding schedules from the time I went back to work, which was 3 months for both, until about 5-6 months, and they would take two bottles during the day. (I would nurse them as soon as I got home from work). At first, they were taking about 5-6oz at each feeding (I always sent a 6oz bottle just in case). When I would make bottles for them, I would thaw three 4oz bags of milk, using a whole bag for each bottle and 2 additional oz from the third bag for each bottle. This was great because I didn't waste milk! When they moved to eating 7-8oz at 4 hour feedings, I simply thawed four 4oz bags and used two bags per bottle, again not wasting any milk. FYI, milk stored in inside freezers attached to a fridge will keep about 3-4 months and milk kept in a deep freezer will keep about 6-12 months. If you have so much milk stored that you feel you won't use it all, you can donate it.
Breastfeeding is hard, no matter how rewarding it is, and I believe it is one of the most selfless things a woman can do! If you choose to nurse your baby, I highly recommend that you surround yourself with friends and family who are supportive. At times when you at over getting up in the night to fed, pumping, and cleaning pump parts and bottles, this support will help encourage and get you through. Good luck to you on this endeavor and know that there are many women out there that are more than willing to listen to your frustrations and lend a helping hand!
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