August 30, 2015 at 12:01 am #5577SylviaFounder
@kibbeth or any other great IBCLCs! This was posted in a forum I’m in, and the mom asked me to post here. I’d love your thoughts!
“Breastfeeding question for PMGs who feed their LOs both formula and breast milk! I’m returning to work this upcoming week and have been both breastfeeding my almost 4 month old (usually 7 times a day for 20 min) and supplementing with formula (10 oz, or five 2 oz bottles after daytime feedings) due to inadequate weight gain. Now he’s gaining weight like a champ (basically a pound a week since we started supplementing at 3 months, and back on the weight curve). I’m going to try pumping at work but ideally wanted to transition to just nursing in the morning and night when I’m home and formula during the daytime. Can you wise PMG mamas tell me how to go about this transition? (Or what worked for you when you went back to work?)”August 30, 2015 at 7:59 am #5580
It’s all about a gradual approach here. If mom stops emptying her breasts too suddenly, then she will trigger involution and lose what supply she has. My recommendation is to work down gradually to not pumping during the day.
In the first few weeks back at work, pump at feeding times, as the adjustment away from baby will be enough for mom’s body to deal with. After about 2 weeks or so, start to wean down on pumping. Stretch out the time between pumping sessions by 30 minutes to an hour, and keep the new schedule for a week or two, then stretch again by 30 minutes to an hour. Rinse and repeat. This way mom weans pumping the same way her baby would wean from breast, and her milk supply will adjust accordingly. Eventually she will be at her goal of breastfeeding twice a day.
If she wants to try moving the process a bit faster, she needs to monitor her supply carefully and if she notices a sudden drop, go back 2 steps and increase pumping for a bit.
Things to look out for: when moms go back to work, babies can react in many ways. The most common two ways of reacting are: Baby wants to breastfeed all night to make up for missed time, or baby goes on a nursing strike as a way communicating how much they miss mom. This mom should be prepared for either to happen and not to stress, time will work out the kinks, as it usually does. If she has more questions, she is welcome to ask.August 30, 2015 at 9:06 am #5581Jennifer South IBCLCIBCLC
I agree with Sonya…a gradual approach is the best on your baby, who will be transitioning to the new schedule, and on your body, which is used to nursing multiple times per day.
Be protective of your milk supply. It’s easier to reduce supply than it is to build it up.
Best of luck!August 30, 2015 at 10:22 am #5582TanyaParticipant
This was my question and thanks for your input! I’m not sure I’ll be able to pump that frequently when I go back to work (I currently feed him basically every 2 hrs so would have to pump 4-5 times when I’m at work, which doesn’t seem very feasible, but I’ll try to fit in at least three sessions maybe?). Do you recommend increasing formula if he does go on a nursing strike? He currently takes 10 oz of formula already in addition to what he gets from breastfeeding (last time I went to a LC and he was weighed before/after feeding, he took in 2 oz of breast milk after a typical time at breast – 10 min each side).August 30, 2015 at 10:43 am #5583
I think 3 pumping sessions is a great place to start. You would need to increase his food intake anyway if you didn’t breastfeed at a particular feed. So, if during the day he typically breastfeeds and then gets 2 ounces, but you are not going to breastfeed at that feed, then you would start to give 4 to 5 ounces in a bottle. A full feed for this age group is about 4 to 5 ounces per feed, and yes, if he is not breastfeeding, then I would offer him more at that feed. So, if he does have a nursing strike, I would offer him a bit more at each feed. Let’s hope he opts for option 1 🙂September 2, 2015 at 9:27 pm #5600Linda S. Grace, IBCLCIBCLC
Keep in mind that a typical 4 month old baby nurses at least 6 times in 24 hours, so this is the amount of times you need to fully empty your breasts in order to protect your milk supply and keep it from decreasing substantially. It is also reasonable for a baby this age to take one long 6 t 8 hour sleep stretch in the middle of the night. Dropping below the 6 times of emptying your breasts, no matter how slowly, will bring your hormone, prolactin, too low to maintain much of a milk supply. This information is based on your baby’s age. Now a typical 8 month old baby sometimes nurses 4 times in 24 hours and this is enough for the mom to maintain an adequate milk supply at this age.September 3, 2015 at 8:20 am #5601
I have to smile, I guess my babies never read the textbook, both of them nursed every 2 hours 24 hours a day for years :)They also never slept a good 6 to 8 hour stretch for at least 10 years, thank goodness for teenagehood and longer sleeps, of course I am older now and the one doing all the night waking. Did you know that in most cultures around the world an 8 hour sleep is considered abnormal? It’s only here in the Western World that we consider it the desired amount of sleep, elsewhere they sleep in shorter periods with an awake period in the wee small hours.
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