Explain bottle-feeding a breastfed baby as if I were also a tiny baby

June 2, 2016 8:29 AM

My parents are visiting to meet my 3 week-old baby, and we're all hoping they can introduce a bottle of breast milk to her while I run errands. Can some seasoned parents please explain the finer points of how and when to pump so that I don't mess up my milk supply and breastfeeding relationship with my baby?

My daughter has been exclusively breastfed since birth. I've also pumped here and there to produce a supply of about 18oz of breast milk in the freezer. My parents are coming into town tonight to meet the kiddo and one goal is for them to introduce her to a bottle of breast milk when I'm out. This would allow me to run errands and possibly even have a date night with my husband.

However, I am worrying about (and possibly overthinking) the issue of milk supply. I have had no problems maintaining a good milk supply, and my kid managed to gain an entire pound between her first and second-week pediatric appointments, so she's clearly got the hang of eating. But I'm worried that since we're still only 3 weeks into this whole mom-baby thing, I might mess up a good thing.

My concerns are: If I am out of the house around the time my daughter eats, should I bring an electric pump with me and try to pump somewhere? If so, what do I do with the expressed milk assuming I won't have access to a freezer? Or do I just wait until I get home and feed her the next time she's hungry? If I skip a couple feedings during the week while my parents are babysitting, could that reduce my milk supply?

My husband is also anxious to be able to feed our daughter a bottle, particularly a couple nights a week so that I can get a full night's sleep (she only wakes once in the middle of the night to eat thanks to cluster feeding from 6pm-12am). My instinct is that even if he feeds her a bottle, I should try to pump during that time to prevent engorgement and to keep my supply high for the nights when I get up with her.

I'm staying home with the baby for a year so we don't have to worry about pumping in preparation for long separation periods, but I'd still like to have an idea of how to plan for afternoons and evenings away from the baby. Any other tips or advice for making this process as painless as possible are much appreciated, too.

posted by Viola to Health & Fitness (20 answers total)

i exclusively pump (we tried breastfeeding and it was a no go). at the 3 week mark i was pumping every 2 hours to drain each breast and help boost up my supply. so i think it would be good to pump right before running errands and the giving yourself a 2 hour window to be out of the house before pumping again (or nursing if baby is hungry). If your baby goes 3 hours between feedings, you can go 3 hours between pumping without hurting supply. As baby goes longer between feedings, you can extend the amount of time away as well. At 3.5 months, i pump every 4 hours to keep my supply up and it works just fine.

At night, i always get up when baby feeds to pump - basically any time the baby eats and you arent breastfeeding, you should pump.

We really liked the Dr. Browns options bottles with the size 1 nipples. When he was little we took out the air suction things so we coukd slow down his eating. At about the 3 month mark we put them back in since had a decent control.
posted by Suffocating Kitty at 8:39 AM on June 2, 2016

I can only talk about what worked for me and my baby because this stuff is wildly individual. We introduced a bottle at around 2 weeks mainly because I was having a monstrous time breastfeeding and pumping and bottlefeeding every now and then gave my nipples a much-needed break from my son's terrible latch. He took to it like a duck to water but it never damaged his ability or desire to nurse straight from the tap. This is one of those things that you really won't know until you give it a whirl. Some breastfed babies will reject anything that isn't a boob until they're old enough to drink from a cup. Some will be like my son and suck on anything that's got milk coming out of it with no problem. And some will be somewhere in between with finicky preferences for type of bottle, temperature of milk, person delivering the bottle, etc...

How long you plan to be out running errands will probably determine if you need to stop and pump at some point. Newborns nurse constantly so if you pumped as much as you'd normally nurse, you'd never get unstrapped from your pump. But your own breasts probably won't be too happy if you go longer than about 3 hours without pumping. If your milk supply is already well established and you're not having supply problems, your body will likely let you know that it's time to pump at intervals that are sufficient to maintain supply.
posted by soren_lorensen at 8:40 AM on June 2, 2016

Pump before leaving, but take a pump with you just in case -- your breasts will let you know when you need to pump.

Most pumps come with an insulated bag, bottles, and an icepack so you can just store the milk in there until you get to a fridge. If your pump didn't come with one, Target or Babies R Us (or Amazon) has milk storage options.

Just pump whenever it's convenient for you. If you haven't had supply issues, your supply should be just fine.
posted by rabbitrabbit at 8:40 AM on June 2, 2016 [1 favorite]

At this early stage, pump when you'd be otherwise feeding her. It keeps your boobs from getting engorged/mastitis/leaking and maintains your supply. Almost. Expressing/pumping never gets you as empty as a hungry baby though. Things will change in this time period, 3 weeks is still very early.

If you've got a truly great supply, missing the one middle of the night feed won't hurt you in a few weeks. So long as you do the early morning one pronto. I do suggest that on the days you're feeding after a night off... that you drink a good amount of fluid more than usual. You can even try fenugreek pills/tea.

One thing to know... even if you accidentally utterly screwed this up and your supply went south badly... you can get back on track within a week with lots of breastfeeding and water drinking and failing that some off label prescription drugs.
posted by taff at 8:41 AM on June 2, 2016 [1 favorite]

There are a few ways to go about this. A friend of mine brought her pump with her on date nights and pumped in the bathroom at the right time. Not ideal, but it worked for her.

My breast pump came with a freezer pack for milk storage. If yours didn't, just get a travel cooler or thermal lunch bag with a cold pack. There should be tons available at this time of year. This is how working moms pump at work.

Breast milk is wonderful for having a lot of antigens present. It stays fresh way longer than mixed formula (3-4 days in the fridge vs. 1 day for formula, for example), so a cooler will be more than enough to get the milk home for a date night.

Also, I have found that since becoming a mom, date nights are not 4-5 hour evenings. More like 2 hours to get dinner, maybe 3 if it's a movie and a quick dinner.
posted by Pearl928 at 8:41 AM on June 2, 2016

Use a slow flow nipple for bottle feeding and be prepared for more burps and spitup than usual.

The Dr Browns bottles with a #1 nipple work well but have two parts more than a normal
bottle, which makes them a bit fussy to clean and assemble.

Lansinoh momma bottles are good too for feeding a kid who is used to the boob.
posted by zippy at 8:50 AM on June 2, 2016

If you haven't had any issues to this point, I wouldn't worry about it too much. For your own peace of mind, take a pump and an insulated bag with a freezer pack with you and pump in the restroom of the restaurant, if you like. I'm certainly no expert on this, but my experience as an outside (but close) observer is that one missed feeding on one day isn't going to notably affect your supply. Repeated missed feedings on one day or missing one feeding on repeated days can have an effect, but not so much a one-off thing once a week.
posted by Betelgeuse at 8:52 AM on June 2, 2016

For 2-3 hours away, you don't need to pump while you're gone. Feed the baby before you go, leave a bottle of something you've pumped beforehand. You might find it helpful to add one pumping session a day (you could probably even mix it up daily depending on your needs, since you're not going to be working outside the home), and then you can use that milk anytime you're going to be out for a short period.
posted by ThePinkSuperhero at 8:53 AM on June 2, 2016 [1 favorite]

On, and I meant to say: Nthing Dr. Brown's bottles; they have been great for us (although we haven't tried any others).
posted by Betelgeuse at 8:53 AM on June 2, 2016

A manual pump can be helpful in these on-the-go situations because it can be difficult to find an electric outlet in a suitably isolated spot to set up with a pump. However, you can get battery packs & car adapters for your pump, which improves your options, and you can also choose to not care and just set yourself up wherever you want (go you!)

Here are the milk storage guidelines from Kellymom. Some people go with the 6/6/6 rule, which is easy to remember: 6 hours for milk at room temp; 6 days for milk in the fridge; 6 months for milk in the freezer. You can bring a cooler/insulated bag with your pump with or without a cold pack, or you can just put the bottle into your pump and pop it in the fridge/freezer when you get home.

My kiddo did not take kindly to a bottle (he hated the Dr. Browns!), but I think this is a great time to start trying it out and getting a date night in. Definitely take it easy on your plans- 2-3 hours will feel like a long date, especially if you can't find a place to pump and end up engorged & uncomfortable. But even if you skip a feeding, you will not affect your supply longterm. It will be fine!
posted by aabbbiee at 8:55 AM on June 2, 2016

Congratulations! My little one is almost four weeks old and she was a preemie so I've been pumping and occasionally breastfeeding. So take this with a grain of salt, this is just my experience, etc.

How long are you trying to be away from your baby? If you're away from your baby when she usually eats but you'll be home in 30 minutes and you fed or pumped before you left, I don't think you need to plan to pump. I'd bring breast pads in case you leak, though.

I've been able to go about six hours without pumping or breastfeeding, though I've leaked a little when that has happened, and pumping afterwards has been kind of ridiculous. If I go that long (has happened maybe a few times now), I just try to get back on schedule and pump again about 2-3 hours later. I don't think it's affected my supply.

My husband and I try to feed the baby about every 3 hours at night, so that usually means one of us will feed her around 3 am and the other will around 6 am. If I'm relatively up, I'll try to pump. If not, I'll just try to get back on schedule with pumping or breastfeeding every 2-3 hours. Good luck!
posted by kat518 at 9:30 AM on June 2, 2016

To build up a supply in the freezer, the best time to pump is right after the first morning feed because that's when your milk supply is highest.

As ThePinkSuperhero said, you shouldn't need to pump while out if it was only for a couple hours (probably up to 3), just nurse right before you leave. If baby doesn't want to nurse when you get home because she had a bottle, and your breasts are full, go ahead and pump.

If you must pump while out, see if a manual pump will work for you. The double electric pumps are awesome for regular pumping, but are cumbersome and very loud.

For your first trip out, don't be gone longer than the usual time between nursing sessions in case baby can't deal with taking a bottle.

I do think you should continue to nurse or pump at night for awhile to avoid losing your supply.
posted by Safiya at 10:02 AM on June 2, 2016

Yeah you should be pumping before this day.

There are two ways to go about this: pump right after feed or create an extra feed. If you're creating an extra feed, I'd pump regularly. Nthing you'll pump more in the am.

Then try to feed right before you go and enjoy your free time.

Some people are bad pampers or moderate pumpers. I know a woman who can adequate supply for twins but couldn't pump a whole ounce all day at work. She stuck to morning/night feeds and supplemented. While pumping is great for some, don't torture yourself if it's not working for your body.
posted by Kalmya at 10:09 AM on June 2, 2016

Just so you know -- if Grandma and Grandpa are confronted by a darling young thing who screams the house down when offered a rubber teat, infants can also be fed milk via finger with a tube set-up, with a small cup, and with a spoon.

Baby may not want to eat at all, and nobody should panic over this (here is another useful page) -- many young babies go for hours sleeping and do not perish over going several hours without milk. (My daughter pulled a trick where once a week she would sleep her age in weeks, up to 11 weeks; the 11-week stretch was certainly surprising...)

I spent a good while with an oversupply and it can be a problem; do not go too crazy with the pump. Kellymom.com has good advice on dealing with an oversupply and good advice on pumping in general. Do know (as this is a thing that is not widely advertised for some reason and which leads a lot of mothers to freak out) that engorgement, leaking, and other hassles of early days are generally temporary things; eventually your breasts will start to feel normal again and there will be no more "Yikes, I've got cartoon tits, this kid needs to feed NOW" -- this is normal; your supply has adjusted to making what the kid needs and no more. Lactating breasts are constantly making milk; in theory one could have an infant attached 24/7 and be feeding for the full 24h (what a horrible thought...). So if you feel 'deflated,' do not rush to panic and blame pumping.

(Good metrics here for Is My Baby Getting Enough Milk?)

Don't forget to bring extra nursing pads while out...! I kept a box in the car. (Lansinoh were the best ones I tried.)
posted by kmennie at 10:54 AM on June 2, 2016 [3 favorites]

Best answer: If you're feeding from 6 p.m. to midnight without a problem and then only once between midnight and 6 a.m. (ish), it sounds like you have pretty accommodating boobs that produce on demand and don't get too fussed when demand isn't super-regular. An awful lot of pumping advice is intended for moms who are either pumping on a regular schedule or who are having a lot of trouble with supply and pumping to boost it. If you've had no supply problems, and you're going to start by missing maybe one feeding, one time (and it sounds like the time you'd be away won't be longer than she'd go between feedings normally during her "long" sleep), I wouldn't worry too much about losing supply or messing up the breastfeeding relationship. Pumping and bottles can seem really intimidating because so much of the advice is geared towards the "this is not working properly" end of the scale where people really do need to be super-diligent; if you're towards the "easy eater, robust supply" end of the scale, a lot of that advice won't apply to you.

I primarily pumped when I wanted to relieve engorgement (having accommodating boobs and a robust supply, I didn't worry a whole lot about timing), so I don't have great advice on timing a regular pumping around the baby's eating schedule. I used a hand pump because I pumped so rarely, which is easily transportable in a large purse and entails no hunting for outlets, but it's hell on your wrists to use very frequently especially if you want to get EMPTY. (tbh later on, like after six months, I just hand expressed it down the sink enough to relieve the pressure and moved on; pumping with the hand pump was so much hassle and I had more issues with oversupply than undersupply.) That was before pumps were covered by insurance, though, so you probably have a much nicer one for much less money. I just wanted the cheapest possible thing to get the job done. :)
posted by Eyebrows McGee at 11:43 AM on June 2, 2016

You should really relax about pumping. It's not hard, it's not dangerous to your milk supply, and it's not an exact science. Your breasts are pretty good at adjusting to whatever you do and whatever the baby wants. Unless you have serious supply issues missing a feed, or pumping to simulate two feeds, or pumping to replace a feed, is not going to make much of a difference in the long (or short!) term. Think about how unpredictable your baby's schedule is, it's not like she eats at exactly the same intervals or time every day. Now, if you wanted to exclusively pump that's a different story, but just pumping here and there to have a small stash is not a big deal. The best time to add a pumping session if you want a reliable freezer stash is in the mornings.

If you're going to be out for a couple of hours there's really no need to bring the pump (unless it makes you feel "safer" to have it in the car or something, in which case bring it!). See how you feel in terms of engorgement right before you leave and maybe pump (or nurse, I guess, but that defeats the purpose of leaving to introduce the bottle) first so you're not in pain while running errands. It'll normalize, I promise. But yes, bring extra nursing pads!
posted by lydhre at 11:52 AM on June 2, 2016

If you have a strong supply, you might want to express for your comfort. Yeah, you can bring an electric pump, but also hand expression is a useful tool to have, and I wish I'd practiced it more in my daughter's first year. That way, even if you don't have a pump, don't have a charger, don't have an outlet, you can pop into a bathroom and unobtrusively relieve yourself. There is nothing worse than angry oversupply breastfeeding breasts.

Seconding the Lansinoh pads.

Another thing that you should try is paced bottle feeding. It's not unusual for old school grandparents and caregivers used to feeding formula to accidentally let a child blow through a freezer stash in a few hours. Your baby needs no more than 1-1.5 oz of milk per hour while you're out.

On the other hand, my daughter refused a bottle until she was like a year old and didn't need one, so what do I know?!
posted by PhoBWanKenobi at 12:14 PM on June 2, 2016

A+ for the recommendation to get a hand pump for quick pumping sessions / travel.

It's very easy to overthink everything related to breastfeeding, especially in the early days when it is life consuming and you're still learning.

You will absolutely not mess up your supply if you go out one night. You're more likely to feel uncomfortable after 3-4 hours (maybe stretching to 5!) and need to pump as a result of that.

All the recommendations for KellyMom are great. Also check out r/breastfeeding, which I have found to be generally supportive, informative, and positive.

Congrats on the babe and best of luck!
posted by kellygrape at 12:49 PM on June 2, 2016 [3 favorites]

For my daughter it was all about the bottle nipple shape. The Playtex breast shape with the Playtex nurser was the only one she would have. I sent bottles to daycare and with grandparents then nursed in the evenings and at night.
posted by PJMoore at 5:52 PM on June 2, 2016

I have a breastfed eleven week old who gets a bottle of expressed milk maybe five times a week. I highly recommend paced bottle feeding and a slow flow bottle. The idea is that the baby works equally hard to get milk from a bottle and your breast - if the bottle is too easy (just pouring milk into her mouth), babies sometimes end up preferring that ease and it makes breastfeeding more difficult.

You might want to get a few types of nipples to try out - my baby likes the Avent ones and refuses the Dr. Brown ones, other babies have different preferences. Your parents or husband should attempt to bottle feed her for the first time when she's calm, and ideally when you are home (even if you are sleeping). There's a chance that she'll refuse the bottle and you'll need to breastfeed her and try the bottle again later, again when she's calm and not too hungry.

As for supply, since I have plenty of milk / somewhat of an oversupply I don't really worry about it. My baby will take a bottle when she's hungry, but usually only drinks a little and makes up for it when I go home. Also, I generally only leave the house right after she eats and return within two hours, three at most, so my breasts get full but not in a way that's a problem. While I'm out, the baby often ends up taking less than half an ounce from the bottle, so it really just shifts the breastfeeding time more than replacing it. I only go out (or sleep through a feeding) in the afternoon though, because I do get painfully full / engorged in the morning a lot more easily. I've tried sleeping through a morning feeding and I end up with blocked ducts - not worth it.

If I do start to get too full while I'm out, I hand express milk into a sink. I have enough supply and don't need to build up a freezer stash so I don't mind wasting the milk. I agree that hand expressing is really useful - I frequently need to express into the sink in the middle of the night for my comfort, and it's WAY less hassle than a pump.

Sorry this is a bit scattered - I'm on my phone w a sleeping baby on my lap.
posted by insectosaurus at 1:10 PM on June 5, 2016