hi all - have some BF questions for you.  (background - i'm having baby #3 in a month via c-section.  i had twins for #1/#2 via c-section and produced about an inch of BM per day when i was pumping every 3 hours, and only did that for 2 months.  twins were given formula as supplement starting in hospital after dropping 10% of their body weights.  i took a fertility treatment to become PG with the twins and my br&asts never enlarged during PG; one LC told me i might not be able to produce milk based on this fact (the rest said i wasn't trying hard enough.))

for #3 i will try to BF (sigh - so not looking fwd to it, i know, bad attitude).  i would like to know:

how important is it for me to BF the baby right away in the hospital, versus sending him to the nursery overnight?  should i have them bring him to me every time he wakes up in the nursery?  or does it take a couple days for milk to come in anyway so i can just sleep and give him formula?  also, should i get a pump right away to try to build up supply?  i guess it boils down to - is there a critical period in BF-ing (meaning - pump/feed/go nuts right away hard core) that maybe i missed last time around?

I applaud you for trying to breastfeed this time!  As I've said before, I had a really hard time nursing #1, but #2 has been a totally different experience, so the first doesn't necessarily dictate the next. 

In answer to your questions:

- get baby to latch ASAP...it helps with everything, from stimulating milk production, to helping you uterus contract.  With the twins, they might have had to take them right away...when I had my c-section with DD, she never left me until I asked for her to go to the nursery.

- you can still send baby to the nursery at night and ask them to bring him/her to you to eat.  Realistically, they're in checking your vitals and all that all the time anyway...see if they can time all that to come together. 

- Ask for a pump in your room.  Try to nurse, then pump right away.  It really helps give your body the idea that baby needs more to have nursing and pumping happening as much as possible. 

- Take advantage of the 4 days in the hospital for the c-section.  I'd give it all you've got for those 4 days.  Your milk should come in while you're there, you won't have toddlers all over you, and you'll start to get a sense of the rhythm of nursing and pumping. 

- Use the nipple shield.  LC's hate for you to use it, but I found that it really helped with my confidence, which meant that I stuck with nursing longer, and soon wouldn't need it.  I'd use the shield on the first side, when baby was hungrier and less patient, then would try without it on the second side.  Within about 3 weeks, I wasn't using it at all, but it helped me get more confidence.

- if baby's getting frustrated trying to latch on, give some pumped milk/formula (I'd do an ounce or so) then try again.  Like the above advice, if s/he's too hungry, it's hard to concentrate and there's more screaming.  When there's more screaming, it stresses you out, and there's less milk.  I would give about an ounce before a feeding to keep the baby calm...and again, after about 3-4 weeks, we knew what we were doing together, and I could drop that pre-feed. 

- Don't be afraid to supplement and keep trying.  I have a low supply, so I would offer a bottle after every feeding, just to see if he was still hungry.  After a couple of weeks, I got a good sense of when he needed it (mid-day seems to be my worst) and when he didn't (mornings and evenings, we were all good)...now with daycare, it works great, b/c I nurse when I'm home and he's getting bottles in the daytime.  I only pump twice a day at work (now 5 months PP) and give myself a chance to get pretty full between pumps/feeds.  Even though it's a mix of nursing and formula, I still find it so much easier (and so many less bottles to wash) doing the combo than I did doing all bottles (mix of pumped and formula) last time.

- they way it works for others may not work for you.  My pediatrician kept telling me to nurse then pump then supplement.  I hated that routine, so I figured out my own.  Benefit of it not being the first time around is that I had more confidence in my skills as a parent and was more willing to figure it out for myself, and less afraid of the baby or that I was failing somehow.  Confidence is huge!!

 

 

Stefani - the first few weeks, even more so the first few days of newborn life are the most important when nursing. The baby learns to latch and suck and your body starts to work on making milk. Most woman start to produce milk within the first few days (Mine came in day 3). The more you nurse, the more your body will make (for most). I think its perfectly fine to let your baby go to the nursery, but I would have the nurses bring the baby back for every feeding. You may want to hold off on formula/bottle feeding to avoid nipple confusion for the first week, if not longer. If you don't think the baby is latching correctly or if your not sure anything regarding breastfeeding, ask to speak to a lactation consultant. The hospital I delivered at all the nurses were consultants. It was very helpful to have them take a look every so often while I was there to give me a 'high five' when things were going well and tips to make it more comfortable when things weren't. Have a discussion with the nursing staff regarding the last go round with breast feeding and maybe they have some suggestions (ie. using the pump after a couple of feedings to help boost supply while you are there. You may want to look into renting a hospital grade pump for the first few weeks home so that you can help increase your supply if you feel it is too low before you have to supplement. Each pregnancy and baby is different. I've heard lots of people with twins have difficulty with nursing, but I know a few people who have had twins that had no problem exclusively breastfeeding twins. It could be a totally different experience with your singleton. Maybe go to the hospital with a list of concerns so that while you are getting to know your newborn you can ask the questions and get the extra support while you are there. Best of luck.

I nursed both of my children (still nursing #2) and my first was harder in that I had low supply in the beginning, plus bleeding nipples, clogged ducts all in the first 6 weeks... and what I found most helpful were: it is easier the second time, but even then, it still took me 6 weeks before I felt like it was not so hard. My supply was still slow in coming in, but not as slow and I was better armed with having a pump (and knowing how to use it), lining up support for when I got home, the herb tea and such that are suppose to help with supply. And this time, I really also made sure to drink and eat no matter what... I was a little dismissive of my OB's "drink down that pitcher" advice the first time, but second time, I was better about that.

Breastfeeding is really a demand and supply system - so it is especially critical to attempt to nurse as often as possible in those first days. The colostrom that comes before the milk is just as important for the baby so if possible, you want the baby to get that too. The more the baby latches and sucks, the more you will create. period. If you don't nurse that often, then most of the time, your supply will drop (there are a few women that tends to run to oversupply).

If you are not able to nurse, then you need to be sure to leave the guilt behind and move forward. You will still have bonding time with the baby. Nursing is really important to me so I do everything I can and I have been able to make it work well for me even as a full time working mother but I know it does not work out for everyone, and you have to remember that babies thrive in all situations. But at the same time, if you go in anticipating it will go badly, your subconscious mindset may affect its success. Just something to think about too... and also support from your husband is important. DH would wrangle with DS while I nursed the baby, and he would keep encouraging me to keep going even when I was so tired and sore from some really bad nights (and I mean some really bad nights second time around - where even our pediatrican cringed when we told him how those nights went for us).

 

 

I totally agree that you can both send him to the nursery and still have them hold off on formula.  My DD didn't really fuss about the lack of food at first.  Also, my milk was very late (day 5?) with her, so she did have formula, but the nurses at the hospital showed DH how to feed her with a dropper syringe.  The quantities were so teeny at first that it worked fine for those first few days to satisfy her but without a bottle nipple.

The only other thing I would say is that you'll end up doing what works for you, but if you do want to try BF'ing, keep in mind that it might not be the same annoying experience you're dreading.  If you get a different experience this time and it goes well (enough milk, baby latches okay), it's really convenient.

Everything everyone already said -- they said it so well!

 

Plus, I would recommend having the baby stay with you in the room.  I did with both of mine because it made it easier to respond to them when they needed to eat.  Brigham has a policy of not feeding infants sugar water or formula int he nursery unless specifically requested to, but not all hospitals do.  Still, when they took the babies to measure them/weigh them/ do tests or whatever, even when I requested they be in-room with me, they seemed to come back to me about 10 minutes AFTER they were ready to eat.  This led to them being very worked up and panicky and less able to latch on.  So keep in mind even if everyone is on-board with you breastfeeding, they might not be able to get that baby to you between when s/he wakes up and indicates hunger and when the nurse wheels the baby down the hall to you and the kid is freaking out because it's been 4 minutes and now s/he's REALLY hungry.  So rooming in is easier, in a lot of ways. 

Good luck!

Also, babies can be totally different--you never know what your experience will be a second time.  My second was a much better eater and latched much more easily than my first did. 

Great advice here. I struggled for 6 mos with nursing my DS and he's been a formula-only baby since then. Though I'm still a year or so away from trying for #2, I'm already worried about going through the whole thing again. Like Stefani, I can see myself having a pessimistic attitude about it when the time comes. So, for future reference (and hopefully to help Stefani, too!)...

Luv -- You mentioned a marked difference between your experience with #1 and #2. Did you have to fight that pessimism b/c of your struggles with #1? How did you do it? I can just see myself either succumbing to the same obsession over nursing as I did with DS or going 180 degrees and refusing to let myself get invested in it...

Arcain, I think less than pessimism it was realism.  With #1, I'd expected everything to be easy and wonderful, and never, ever had envisioned I would have the trouble I did.  With #2, I went into it knowing that #1 ended up fine and that if nursing didn't work out again, it was okay.  She was proof to me that it would be okay, and my experiences with her gave me confidence to try things with my son that I didn't with her.   I really think that confidence of being a parent that comes with the experience of having done it before made the difference for me the second time around. 

thanks all.  unfortunately, i was hoping your advice would give me the uplifting kick in the pants i needed to get psyched, but it is just reinforcing my feeling that i don't want to deal with this at all.  i have a really high-pressure job, pressure to return after 2 months, 2 year old twins, a major house renovation, getting my current house under control to try to sell, and an impending move.  i just want to be able to not fuss with a pump during any free time i can muster, and crack open a can of formula!  that's SO bad of me... and DH will be upset if i tell him that. 

are there any books i should read to get jazzed?  !!!  i wish i could say i really wanted to try.  i'm trying to get there.   it's just... ugh.

Stefani2, I just want to say, it's OK if you don't want to BF.  I know that there can be a lot of pressure, but ultimately, YOU are the one who has to decide what's best for your family.  Even your DH should respect that.  It sounds like you have a lot on your plate, I encourage you to make choices that work for you.  

I really struggled with BFing (and the accompanying pressure), and after so much stress I found that formula feeding was really the best solution for us.  I stopped dreading feedings and bonded better with bottles, my husband got to help out and enjoy some baby bonding, and my kids were happy and healthy.

I know BF has benefits, I respect other people's choices, but I think it's important to support moms in making the best decision for them.   I wish someone had told me that it was ok if we had to take a different route, It would have spared me a lot of pain and sadness and guilt. So I'm telling you now.  Good luck!

Hi Stefani, I don't have too much to add as my 1st DD is only a month old and I really struggled with BF and pumping (and switched to formula after about three weeks). BUT I've started a list that I can share of what I'll want to have on-hand at home and to bring to the hospital if/when I have more kids that will hopefully get us started off on the right foot. These might be things that you already know to have/bring but even in the breastfeeding class that I went to none of this was mentioned as things to have/bring.

Home:
Steel Cut Oatmeal

Mother's Milk tea

Fenugreek

Big waterbottles

Books/games on my kindle or iPad for pumping sessions

Hospital:

nipple shield

boppy pillow

snacks (at BWH I couldn't order food after 7:30PM and I was ravenous in the middle of the night)

supplies for DH to stay overnight at the hospital (my DH left to take care of the dog at home and sleep and I think if he had been at the hospital overnight it would have helped)

I'll also plan on ordering oatmeal at least every morning in the hospital for breakfast because that was really the only thing that I tried where I could see a real increase in my pumping output.

There's also some really great advice on the "Exclusively Pumping Moms" thread if you haven't already read through that. Best of luck!!!

DO NOT let anyone guilt trip you if the BF just doesn't work out.  Give it a good try and if your health or sanity is suffering in spite of making a good faith effort, then let it go. 

eta: i just re-read my last post and apologize for the little pity-party i'm throwing myself.  i know we are ALL busy and have a zillion things to do on top of BF-ing!!  sorry :)

Stefani,

Perhaps once you go back to work you do formula bottles (vs. pumping breastmilk) and only breastfeed when you are home (morning, night, weekends) - this will have you be able to feed the quick and convenient way of just "popping open" a brea$t without having to warm the bottle, but will mean you won't have to pump.  From reading what you are facing in the next 6 months, I'm exhausted and can't figure out when you'd pump!

Remember, I'm not a mother nor someone who ever breastfed, but I do know that your body will adjust to the amount of breastmilk your baby "needs" - so you'll still have some for nursing but you can toss formula in bottles and take them to childcare when you need to.

Does that help you get "jazzed up?" Dunno....

Stef, once breast feeding is established in the first few weeks you can nurse in the morning and evening and just give formula during the day.  I have friends who couldn't manage pumping at work but kept nursing while they were home.  They got all the breastfeeding benefits but a lot less stress.  If you have some success with nursing/latching in the beginning but hate the thought of the pumping and the craziness/stress that comes from trying to continue with exclusively bfing, supplementing with formula is always an option.

It's amazing how the women in the 60s and 70 fought for us to have "choices" and yet here in the 2010s we still feel locked into certain decisions.

Instead of feeling like you "should' nurse, or bottles are a cop out, start crafting a plan that will work for your needs and those of your family.

I have a friend who nursed her first for 11 months (then he self weaned). She nursed the 2nd for 8 weeks and decided it wasn't working with the other needs of her family and her job.

I have friends who have nursed at home and done formula while they are at work. I worked in an office for 20 years and not one new mom ever pumped. Don't know if it was the culture (investment bank) or just that they all decided it wasn't in their lifestyle or what. I have a friend who flat out said she had NO interest in nursing right from the get go. And I have friends who nursed for 12 months.

You say you want to nurse, but you don't sound like you want to at all. So have an honest conversation with yourself - setting aside the "guilt" that seems to come with formula these days.

BTW - I have a friend who was a champion nurser and she flat out told me to send the babies to the nursery and get some sleep! So obviously there is time for them to learn to latch.

As my pedi told me (a triplet dad!) the object is to get food into them. How you do that is up to you.

Stefani, congrats on number 3. I wish you all the best. I'm a little jealous you're going to get to experience life with a singleton baby!

hugs

Lily

thanks all.

(and thanks lily!  i know - the elusive singleton baby - !!!!!!!!!  i hope it's d@mn easy is all i can say.  ;)  )

and i think lily got it - i say i want to BF, but i really don't.  ugh!  i'm considering now pumping overnight the first few days but having the baby in the nursery eating formula.  then i can see if pumping increases my supply or if i have the same supply issue i did before (a thimble full of BM after a day's wroth of pumping).  then i can decide what to do from there.  that's a little more palatable to me than dealing with direct BF-ing. 

and i'm disgusted with myself that i am even feeling this guilt again, after going through it the first time, formula feeding and having perfectly healthy kids who have pretty much never gotten sick, have no allegies and have slept through the night since 5 months... so why am i torturing myself?  !!!  i hate to be back in this guilt spiral - i can't believe i'm letting it creep in again.

you just have to do what's right for you and forget the guilt (I know that's way easier said than done).  also, you mentioned that trying to pump seems more palatable to you than dealing with direct BF-ing... again, do whatever works for *you*, but in terms of saving time, BF-ing is way more efficient than messing around with the pump and then still having to feed the baby.  So if (IF!) you do want to try, you could always say, "look, I'll try this for 2 weeks, and if it's a pain we'll do formula and I'm not messing around with this pump stuff."  Might be good for DH, too, to tell him how rotten you're feeling and put a time limit on how long you can tolerate the experimentation.  Hopefully then he'll know what to expect and won't be encouraging more trials.

The other thing to remember is that with the first kid, you only have that one to take care of and can nap when they nap, etc.  With later kids, you also have to keep in mind your ability to take care of the others as well.  If you are a zombie you can't take care of them.

Think about it:  Hundreds of years ago, if BF didn't work or Mom was sick or died, either the kid had a wet nurse, or it starved to death.  And if the baby had trouble latching or drinking, in spite of the wet nurse it would starve to death.

Giving BF a shot and having formula as Plan B is infinitely better.  And I'd bet 80-90 percent of the people on this board were formula babies themselves and as far as I can tell they're all normal people.

I do like nursing DD who is my second because it allows me to create a cocoon with just her and me for nursing and gives me some downtime too where I can relax - so it is not always going to create a zoombie out of you with later children - there are rich rewards with nursing the second child too. Even with pumping - sometimes it is a drag but sometimes it is a nice break from the work chaos. And with me - DD is usually the only one who does not get that sick even when DS brings home yet another virus or when DH and I are sick... I can see the wave of sickness - DS gets sick, then DH and/or I get sick... and I wait for DD to get sick, but more often than not, she would be the only one not to get sick. (I rather deal with a sick toddler than a sick infant)

You should not guilt trip if you really don't want to BF, but I would hate to see you discouraged because you perceive it is harder or not worth it even before you try it out for more than a few weeks. Everything is harder those first few weeks, and if you dread nursing beforehand, then it will amplify your dislike of it during those weeks of remembering what it is like dealing with a newborn. Any amount of breastmilk you can provide is better than none at all. Formula is great and children do thrive on it, but it still is not the same as breastmilk.

 

It sounds to me that you don't want to BF but you feel like you are letting your DH down if you don't try.  If that's the case, i bet if you talk to him and make him understand your fears surrounding BF, he will be completely supportive and understanding of whatever you choose. Maybe it would give you peace of mind to just make the decision outright to FF and eliminate any feelings of guilt now before the baby comes rather than dealing with it post-partum.  Ultimately, it's your decision to make, IMO, since you are the one who will be most impacted by it.

It also sounds to me like you have a  lot of anxiety about the hospital and how to proceed while you are there in terms of feeding the baby.   If you ultimately decide you want to try BF, I'd try to have the baby nurse at least every 3 hours while in the hospital and when your milk comes in see how much it is and make the decision from there.  As a prior poster said, you can time it with other things like your BP check so to minimize your sleep disruptions.  The hospital will be able to tell whether the baby is gaining weight or not and based on that you will know whether you are able to produce enough milk.  Once you have that information, then you can decide how to proceed.  Personally, I think your plan to pump instead of bf while in the hospital may be problematic for a few reasons. First, the baby will be fed via bottles and there is a strong potential that the baby will get used to the bottle nipple and may refuse the breaast if not exposed early enough and second, most peoples bodies respond differently to a pump than a baby so if you are pumping you may not get very much milk but if you are bfeeding, you may make much more so it's not a great guage.

Good luck! 

Stefani - one last thought. And take everything I say with a grain of salt since I get an "A+" in failure to nurse, but I had a visiting nurse come weigh the twins the first week and told her about my problems nursing. Her comment was, "You'll never nurse those babies. Just put each one on the breast for 15 minutes and then suppliment." Then there's my pedi, who said, "Remember that the babies are the best little pumps you'll ever have."

So...maybe try nursing and supplimenting (if necesssary) from the start to see if your milk comes in. If it does, great!, you'll be on your way, if not, then at least you gave it the old college try.

Again, best of luck!

BTW - The first week I got about 3 or 4 cc of milk when I pumped. It seemed totally useless. Then it started coming in better and better. I never got more than 1/2 and 1/2 with the twins, but I was probably making enough to feed one if that had been the case.

Stefani2, I am all to familiar with low production and that crazy guilt cycle.  I went into #2 thinking I was prepared with a good plan (try bf and see how it goes, if it doesn't work out, ff is a totally fine option), but post partum hormones and pain medication (c-section) and pressure to bf does NOT help with rational thinking.  It's hard to make a clear decision in such an emotional situation, so talk to your mate (or trusted friend/parent) beforehand, or write down your ideas so you'll be clearer headed when the time comes.

For what it's worth, I actually enjoyed my time in the hospital when #2 was born.  I thought I'd be miserable without #1 (my first time away from him), but it was actually a nice, quiet few days with our new baby.  Do what you need to do to enjoy your new addition, and get some much needed (and deserved) rest!

I agree that you shouldn't guilt yourself into BFing if you don't think it's the best plan for you and your family.  I think it's worth a shot, but I respect that other people feel differently.  This thread has been kind of discouraging or overwhelming, so I wanted to say that there is every possibility that BFing will go great and you won't have to worry about half the suggestions on this thread.  I hope that's the case!  And I swear I am not looking at BFing through rose-colored glasses.  It did not go easy for us in the first few weeks, DD couldn't latch right, we ended up using a nipple shield for 3 months, and I never pumped enough at work.  But that doesn't mean it will be the same if we have another.  Some random thoughts:

- The best way to get the milk to come in, produce enough, and teach the baby to latch is to BF, so I wouldn't use the pump unless you have to.  The nurses aren't going to be looking for 2 oz of milk when the baby is one day old.  If things go well you won't need a pump at all unless you decide to pump when you go back to work.

- But I would have a plan in mind for what you will do if you need a pump.  Rent it from the hospital?  Buy in advance?  Run out and buy it if necessary?  I brought a hospital grade rental home from the hospital, which was something like $36 for 2 weeks.  Then I bought one, which I didn't use again until DD started STTN and I would pump before bed.

- I sent DD to the nursery and had them bring her to me when she was hungry.  Worked fine, so get some sleep if that's what you prefer!  I don't recall her feeding super often in the hospital because she slept most of the time.  I do recall that the feedings would take a while because we were figuring it out, but what else do you have to do during those 2-4 days? :o)

- It's great to know that a nipple shield is an option and maybe have an unopened one that you can return later, but I wouldn't use it unless you have to.  It didn't bug me at first, but it made it more difficult to nurse in public, so I wouldn't want to deal with it unless I absolutely had to!