Transitioning to EBP--how do you do it?

mharrima · January 2012

I've had my darling son home from the NICU a little over a week. Since then we've been trying to increase the number of feedings to be breastfeeds vs bottle feeds. The little guy was 40 weeks, 3 days when he came home (born at 30 weeks) and was able to breast feed, but would usually only manage one breastfeeding session at a time (rather than two back to back). We've had some stumbling blocks with breastfeeding since arriving home--one was that he would get so worked up about being hungry that he wouldn't latch (I resolved that by giving him a small amount of breastmilk in a bottle and then offering the breast). Now he's feeding ok, but seems not to get enough to be satisfied for more than 15 or so minutes of sleep (sometimes up to an hour). But I'm only managing to get him nursing twice or three times a day.

My question is: how do you coordinate nursing in order to ramp up to exclusively breast feeding? When I give him a bottle, he sleeps 3-4 hours. I was told to pump every 2-3 hours when he was still in the NICU. I think I can stretch it up to 4 hours since I have him home with me. But if I pump and miss his window of hunger then I end up having to give him a bottle. If I don't pump I risk losing my supply, right?

Help!!

mt1927 · January 2012

offer him the breast at every feed, that way your body is getting the signal that its feeding time. have a bottle with a little milk in it it in case he gets frustrated. and do a "bait and switch" to get him to eat from the breast. then pump after he feeds or pump the opposite side while he nurses on the other. if he is hungry 15 minutes later give him what u pumped. eventually u guys will work up to no pumping. he is still little so its going to take time.

if u find yourself having to pump in between feeds because u are uncomfortable, just pump a little for comfort. then feed him/do a full pumping session at his next feed.

ugh its so exhausting.

if he continues to not eat a lot at the breast i would call an LC. my LO ended up being tongue tied, even though he did awesome nursing in the hospital. but once he needed to eat more and my supply regulated the tongue tie became an issue

rednelson · January 2012

I started off trying the every other feed at the breast but that got frustrating since he would always decide he was hungry right after I pumped and I had nothing left in the boob to give. What worked for me was picking a block of time, say from 8 in the morning until 2 in the afternoon to exclusively breastfeed. No matter how often he wanted it, he got it. If he didn't drain my breast and I began to feel engorged I would hand express just enough to take the edge off. Then I would bottle feed the rest of the day just so I didn't worry that he wasn't getting enough. Gradually the block of time got longer. Also I started to going to a breastfeeding support group where I could do pre and post-feed weights, that way I could prove to myself that he was getting enough at the breast. To take the final leap I met with the lactation consultant and got a weight, the exclusively breastfed for two days before meeting with lactation again for a weight-he gained two ounces over the two days. We now do all breastfeeds with the exception of his two high calorie formula feedings. BTW-my son came home at 37 weeks 5 days (born at 29 weeks 6 days) exclusively bottle feeding, he's now been home 6 weeks and it took 4 weeks to get to where we are now with breastfeeding. Have patience and it will happen!

haziedaze · January 2012

Hang in there! There are so many great stories on this board. Def check out UrbanFlowerPot's story on the blog, which is linked at the top of this page. My LO was actually better at the breast than the bottle when he came home at 35 weeks, but I still think some of my experiences about regulating supply might be helpful.

When H came home I was nursing 5x per day and he was getting 3 bottles in the NICU. I was still pumping between or before feeds 5-6 times per day. All the pumping was just too much and I knew my supply was WAY above what he was taking. I was worried that if I let my supply down regulate to him it might never increase again when he needed it. It turns out that was not at all true for me.

To regulate to baby while nursing I started block feeding (feed for 2-3 feeds on one side only) hand expressed a TINY bit to keep the other side from being too painful but was definitely engorged. Pumped ONLY as much as he took by bottle. Over about a week my supply decreased to what he needed. It has increased appropriately as he's grown. We're now nursing or giving unfortified milk only (I exclusively nursed for about 5 weeks while on leave).

So, I totally like pp suggestion to get an LC, check frequent weights and start doing blocks of time where you nurse only. Spend lots of time skin to skin and offer the breat frequently to help with preference for the bottle (lots in the blog about this!). But you may want to only pump to match any ounces your LO take by bottle instead of pumping all the time. In the end if you match the ounces, it doesn't matter how frequently you are pumping. HTH!

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Transitioning to EBP--how do you do it?

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