If you love nursing but can’t be with your baby for every feeding (#HelloWhoCan?), we’ve got the strategy that’s right for you.
Looking
back, I realize I wasn’t being “hormonal” or hard on myself. “Many
women plan to exclusively breastfeed, but if they find themselves
needing to supplement or add in formula, they are not really sure how to
do both,” says Stephanie Nguyen, R.N., founder of Modern Milk, a
breastfeeding clinic in Scottsdale, Arizona. And the health halo
surrounding exclusive nursing can make women feel they shouldn’t
consider other options. Well, I’m here to tell you there’s another way:
Fifty-nine percent of new mothers opt for combination feeding—when Baby
gets both breast milk and formula—reports the Centers for Disease
Control and Prevention. Find out how using bottles can help you be the
nursing mom you want to be.
Nurse at birth
Put your baby to your breast immediately after birth, and
nurse her as much as you can.
This will help her learn to feed properly while giving her colostrum,
the immune-boosting, disease-fighting liquid that your breasts first
release. This nursing practice during these first few days primes your
breasts to produce milk. Every time you do it, the nerves in your
breasts send a signal to your brain to release prolactin, the hormone
that’s behind milk production. If you’re having a hard time at the
hospital, speak up. Ask the nurses who come into your room to examine
your latch. Don’t be shy! And get contact info for a lactation
consultant to call, in case you have trouble later at home.
Before your milk comes in
Supplementing
with formula during the first few days after delivery might help give
you the confidence to nurse longer, according to a study in
Pediatrics.
Researchers had moms whose babies had lost about 5 to 10 percent of
their birthweight (a typical amount to lose after delivery) either
exclusively breastfeed their infant or top off Baby with 2 teaspoons of
formula after every nursing session. Both groups did this until their
milk came in.
Three months later, 79 percent of moms who had
topped off their babies with formula after nursing were exclusively
breastfeeding, compared with 42 percent of moms who only had nursed at
the start. But sticking to just 2 teaspoons of formula appears to be the
key: Another study found that the more formula given to a baby in the
hospital, the less likely the mother would continue to breastfeed. “Less
is always more when it comes to any early formula supplementation,”
says Diane L. Spatz, Ph.D., R.N., a professor of perinatal nursing at
the University of Pennsylvania School of Nursing, in Philadelphia. “If a
newborn gets filled up on formula, he won’t wake and feed well at the
next meal.” Since
your milk production
increases only in response to your baby’s demand, a negative cycle can
begin. To stay on track, give just a bit of formula in those first few
days after nursing.
Day 5 through 30
This is go time!
It’s when you want to try really hard not to give your baby a bottle, so
that the nerves in your body that promote breast-milk production get
stimulated as much as possible. You can do it! How will you know you’ve
made it? When your baby’s latch is comfortable for you, your nipples are
no longer sore, your baby is gaining weight, and he’s producing five or
six wet diapers a day. Basically, you’ll start to feel like you know
what you’re doing. “If you begin trading a breastfeeding session for a
bottle of formula before this point, your body may recalibrate its milk
production and not make enough,” says Nguyen. The less milk your body
makes, the slower the flow for your baby when nursing. If your supply
continues to decrease, your baby may start refusing to nurse because he
has to work hard for a small amount of milk.
Figure out pumping
Once
your baby is about 4 weeks old you can start pumping, as your body is
better at regulating your milk supply. Or, if breastfeeding is going
well, you can put it off with no repercussions. There are no strict
rules about pumping, but if you want your baby to have expressed breast
milk
when you’re back at work,
start pumping about two to four weeks before your start date. Returning
to work, though, is only one reason to pump. A survey conducted by
Lansinoh, a company that sells nursing products, found that many women
pump to have an in-case-of-emergency stash and to involve their partner
in feedings.
Pump for five minutes after a good nursing session,
or for about ten minutes if your baby didn’t nurse well or took only
one breast. “Completely emptying the breast is important for getting out
all the high-calorie milk that comes at the end of a feeding or pumping
session,” explains Dr. Spatz. While pumping after any feed can help
build your refrigerator supply, the most productive one is after your
first a.m. nursing session, says pediatrician Tanya Altmann, M.D.,
author of
What to Feed Your Baby. “Overnight, your levels of
prolactin and oxytocin—the hormone that’s responsible for your
letdown—are high, so you’ll generally have a lot more breast milk in the
morning than in the afternoon.”
To maintain enough milk for your
baby, you should pump whenever you miss a feeding session. Otherwise,
your supply can decrease. However, as your baby gets older, a decreased
supply may work in your favor. For instance, once an infant starts
eating solids, some moms nix the pump and choose to nurse only in the
morning and evening, while the baby gets bottles of formula and food the
rest of the day.
Time the first bottle
Whether you plan
to use breast milk or formula, introduce the bottle when your baby is
between 4 and 6 weeks old. You have given your body time to build a
strong supply, and your baby has become an expert nurser. “The physical
action of breastfeeding is very different from the physical action of
drinking from a bottle,” notes Dr. Spatz. “It’s not nipple confusion—I
don’t like that term.” From the breast, Baby needs a deep latch to drink
up the milk that flows from a nipple’s many showerhead-like ducts. Your
baby first suckles quickly, to get the milk flowing, and then he slows
into a rhythmic suckling pattern to empty your breast. With a bottle, he
doesn’t need a deep latch, and the milk comes out at steady flow from
start to finish. Essentially, drinking from a bottle takes a lot less
effort. “Asking a baby to jump back and forth between two different
suckling techniques can be tough for a newborn,” says Dr. Spatz. Waiting
to introduce a bottle will reduce the risk of your baby getting
frustrated with the breast.
The flip side is that if you wait too long
to introduce a bottle,
your baby might reject it, preferring the comfort and familiarity of
nursing. “I see a lot of moms who don’t offer their baby a bottle until
between 2 and 4 months old, says Dr. Altmann. “Then, when the mom goes
back to work, the baby goes on a bottle strike.” (This happened to me.
It wasn’t pretty.) Instead, give your baby a bottle once a day, starting
by 6 weeks. “Even if you’re not going back to a job, I still recommend
it,” Dr. Altmann says. “Families often need that flexibility.”
Compared
to breastfeeding, bottle-feeding sessions are lightning fast. It takes
most babies about five minutes to down a bottle, compared to 10 to 40
minutes to finish nursing. “To slow down bottle feedings so your baby
doesn’t start to prefer them, hold him upright instead of cradling him,
and keep the bottle almost horizontal to the floor to reduce the fast
flow. Look for bottles with a soft, wide-based nipple (to resemble the
breast), which promotes an extra-slow flow. If you can, have another
caregiver or loved one do the deed, for the obvious reasons that you’ll
get a break while allowing someone else to experience the pleasure of
feeding a baby. Plus, your baby won’t be expecting to be nursed if he’s
not in your arms.
At
first, offer a bottle when your baby isn’t super hungry, about an hour
or two after a regular feeding. “If your baby is starving, she’s going
to be in no mood to try something new,” says Nguyen. And only give about
half an ounce to start. After the first few successful bottle feeds,
offer the bottle at the same time of day, specifically when you expect
to be gone—you know, doing that work thing you do to pay the bills.
Finally, you may have heard not to mix breast milk and formula in the
same bottle. But there’s no medical or health reason why you can’t, says
Dr. Altmann. Expressed breast milk is so precious—you worked so hard to
pump it and store it—that it’s unfortunate to waste if your baby
doesn’t finish a mixed bottle and you have to throw it out. “If you’re
confident Baby will drink it all up, go ahead and mix them,” she says.
In the end, being flexible with whatever feeding challenges come your way will help you the most, whether you
combo-feed or nurse exclusively. And it’s okay if what you were planning to do turns out not to be what you want after your little bundle arrives.
Me?
After I got over the shock and disappointment of my own foray into
exclusive breastfeeding, I bought formula. I continued to listen to the
hum and suck of my breast pump until my baby’s first birthday. I nursed
him every morning, every evening, and every weekend for a year. And when
my second son was born, I did the same thing. Except I had a larger
supply of breast milk in my freezer when I returned to work. And the
formula was there, ready to go. What wasn’t there? My guilt.
Source : fitpregnancy.com 
