BF interval stretch longer = milk ss drop?

fennho

fennho

Registered User
hi there

have a problem at hand now. Have been breastfeeding for 2months now since my bb is born. She has been on a 3hourly interval. Recently, she has sometimes stretched to hours interval during certain feeds. And in the night, she has nicely settled into sleeping longer stretches at night. She slept from 9pm to around 4-5am! My breasts will feel so engorged by then i need to pump it out. She will usually feeds on one side and i pump out the other. Usually i will get about 150-170ml per side. But i fear that my supply is dropping due to longer interval, prob the brain is telling my breast not to make so much milk as there's no demand during this stretch cos jus now when i woke up to pump, my supply dropped to 125ml! I am so worried that if this goes on, my supply will drop tremendously and i will not be able to BF my bb any longer if it "dries up". I tried using the alarm clock to wake up earlier, but useless mommy probably didnt hear the alarm as it goes off as i put it at its softest, not wanting to wake my bb up as well (she sleeps in the same room as me). Ironically, it only take my bb to whimper softly and i would wake up!

The other problem is, i hesitate in pumping during the day when she sometimes take a longer afternoon nap and stretch her feeding interval to 4hours becos as i mentioned in my other thread, she is currently rejecting bottles, so for certain mommies, pumping out is not a problem becos if bb wakes up, they merely jus feed the bb with the freshly EBM. For me, if i emptied my breasts with pump to regulate my supply and bb wakes up, i wont have enough in my breasts to feed her and she wont take the bottle!

pls help! i'm so worried....
 
Dear Fennho,

Please stop worrying ? you are not loosing your milk. The changes you are seeing are very normal and desirable around the two to three month mark. Around this time your body gets use to lactating and a number of things happen. Your breasts start to feel softer, you stop leaking and the oversupply you had reduces.

Your milk supply is now fully established and you actually find it very difficult to stop your milk. It is estimated to take about six weeks for you to have no more milk after the last breastfeed. The way breastfeeding works is that you replace the milk that is taken out - so long as you (or rather the baby) keeps taking the milk out you will keep replacing it.

Unless you have a reason to keep your oversupply (for example to give the milk to another baby) I would suggest that you slowly let the over supply go. If you find yourself too full we usually suggest either waking the baby and asking him to drink some so you are comfortable remember (it is a two way relationship) or expressing only a little (maybe 20 to 30mls) until you are comfortable again.

Ideally your body will be able to supply the milk without the hard over full feeling. This usually happens by four months ? even when the baby sleeps for a number of hours during the night.

Best wishes,
SARAH
 
hi sarah

thanks for your advice. Can i ask, if my breasts have adjusted into supplying milk without feeling too full and engorged, how will i know when i have "full" breasts and when the bb has appropriately emptied it? Right now, i feed based on the feeling of which is fuller, alternating between left and right breast. And during and after feeding, i will check to see if my bb has emptied it sufficiently (ie she has a proper full feed) by checking that the breast she fed on has turned soft (which was engorged earlier). So if my breasts have adjusted and no longer feel hard, how will i know? Sorry for the long questions.
 
It is not actually necessary (or even possible) to ?empty? your breasts. And if you do try it tends to take longer for your body to adjust to the ?normal?, as apposed to the ?early? (round about the first 12 weeks), stage of lactation.

The reason that the ?empty your breast? advise is given is that before mothers were told to stop feeding after ten minutes on each side. This casued problems as babies weren't drinking enough milk - so to overcome this problem mothers were told to ?empty? their breasts.

I would recommend that you feed until the baby comes off (or falls asleep) on one side and offer the second side. If the baby takes the second side that is fine and if the baby doesn?t take the second side that is also fine. And even if the baby feeds on one side, changes to the second side and then wants the first side again ? that is also fine.

Sometimes it is difficult to know which side to feed on next. Some mothers use a safety pin on their bras, others swap a ring on their fingers. There is even a company making special bracelets so you know which side to use. But if you make a mistake and feed on the wrong side it quickly become obvious and you can stop and swap sides.

Best wishes,
SARAH
 
tks again Sarah. So ru saying I shudnt pump if I don't need the oversupply and jus let my breasts adjust itself? I thot that as babies grow, they will need more milk, if the supply drops how do they feed?

This morning she slept till now 6am!!! Her last feed was at 705pm!! Its been 11hours!!! Is this normal and is it good for the bb to be going without food for so long?? I'm worried. She has not been taking any afternoon naps for long, I fed her last at 705pm and put her to bed at 10pm. U mentioned earlier to wake bb if I feel umcomfortable? Is that advisable?would it interrupt their sleep (which I said earlier some told me tat babies are growing when they r sleepg)
 
tks again Sarah. So ru saying I shudnt pump if I don't need the oversupply and jus let my breasts adjust itself? I thot that as babies grow, they will need more milk, if the supply drops how do they feed?

This morning she slept till now 6am!!! Her last feed was at 705pm!! Its been 11hours!!! Is this normal and is it good for the bb to be going without food for so long?? I'm worried. She has not been taking any afternoon naps for long, I fed her last at 705pm and put her to bed at 10pm. U mentioned earlier to wake bb if I feel umcomfortable? Is that advisable?would it interrupt their sleep (which I said earlier some told me tat babies are growing when they r sleepg)
 
A month old fully breastfed baby drinks about 750 mls (28 oz) in 24 hours and a six month old fully breastfed baby drinks about 750 mls in 24 hours. This is one of the ways that breastfeeding and formula feeding differs. The quantity stays the same but the quality changes to suit the age of the baby with breast milk whereas the quality stays the same but the quantity the baby drinks increases with formula feeding. So if you have enough milk your baby now and continue breastfeeding you will also have enough as your baby grows.

Most babies but not all decrease the number of feeds through the day and increase the amount drunk at each feed.

If your baby is gaining weight well and has six or more wet nappies a day then it is fine to let her sleep. But if you are worried I?d suggest an extra feed as she goes to bed.

It is also fine to wake your baby occasionally if you feel over full. Generally when you do this the baby wakes, drinks and goes straight back to sleep. And while it is true that babies need their sleep ? just as we do ? they are great at managing to get this sleep in many small periods rather than one long period.

Remember that breastfeeding is a relationship between you and your baby ? both sides have to be happy. It is not just you always giving to the baby.

I recommend that you join some of the LLL gatherings in Hong Kong so that you can meet other mothers who are breastfeeding. The schedule of our meetings is available at http://www.lllhk.org/Meetings.html

All our meetings are free and it is not necessary to be a member to join our meetings. Of course we do encourage membership as money from memberships and donations are our major sources of revenue. The format for all the meetings is similar. We spend the first part of the meeting discussing the meeting title topic and the second part of the meeting the topics which the mothers attending bring up. Thus every meeting is different depending on the needs of the mothers there.

The article Why La Leche League? http://www.wiessinger.baka.com/bfing/others/whylll.html
gives a nice description of why our meetings may be helpful to attend.

Best wishes,
SARAH
 
hi sarah

thanks very much for your advice again. I truly didnt know BF babies drink the same amount at 2 month and 6month! Do u mean, they really dont increase? So why is everybody telling me to pump pump pump to avoid milk supply decreasing? So does that mean that i dont have to feel engorged to know there's milk inside and that IT IS OKAY to jus have enough even if baby feeding schedule is erratic?

How about growth spurt? I tot growth spurt is nature's way of making babies nurse more in order to increase our milk supply?

Thanks for the invitation for your meetings, i would love to come, but at a feeding of 3hourly interval, i cant seem to find the time to do my own things, household chores, and as my bb is rejecting bottles right now, i cant be away from her for more than 3hours...cant bring her along as well, cos hubby is quite mindful of bringing her out due to the recent flu outbreak among kids. Sigh.

Talking about schedules, when will she feed at a longer interval and shorter time? Sometimes she nurse for 30-40mins still, sometimes, she's done at 10-15mins, i'm not sure at all if she has had enough!
 
A lot of people are surprised that breastfed babies don?t drink more as they grow older but it is milk quality that changes not the quantity. Your milk changes from the beginning of the feed to the end of the feed, from the beginning of the day to the end of the day and also as the baby grows ? so that it is always prefect for your baby.

I don?t know why people are suggesting that you ?pump pump pump? because if you pump as well as breastfeeding you will end you with too much milk. (Over supply has just as many associated problems as under supply ? if not more.) And if you pump instead of feeding you will find it much harder work and may end up with under supply problem because direct breastfeeding is much more stimulating to your body than pumping.

?So does that mean that I don?t have to feel engorged to know there's milk inside and that IT IS OKAY to just have enough even if baby feeding schedule is erratic?? ? YES

When a baby goes through a growth spurt she isn?t increasing your supply but rather feeding more because she wants to eat more. If you suddenly wanted to gain 2 lbs in a day you too would need to eat more calories and the easiest way to do this is to fit in more meals. It is the same with the baby during the growth spurt she has more feeds. Your body just replaced the milk she takes out so as she takes more milk out ? you replace more.

Please bring your baby with you to the meetings ? all the other mothers do. I think the flu season will be over very soon, maybe even by 25th March (our next meeting in Central) but if not definitely by 8th April (next meeting in Happy Valley).

It is really difficult to say when she will feed at a longer interval and for shorter time. Some babies are doing so by three months and other not by six months. It is very usual for a baby to have three different patterns of feeding within the day.

Often the morning time is quite regular with feeds at say 7:00 am. 9:30 am and 12:00 noon (regular pattern of 2.5 hours between feeds). Then there is a part of the day where they sleep longer ? maybe even 5 hours ? and, of course, you hope this is during the night but it isn?t always. The third pattern is one of making up for the feeds they missed while asleep and so they cram lots of feeds into a short interval ? maybe 5 or 6 feeds in just 3 or 4 hours. This is called cluster feeding but I tend to think of it as a Chinese Banquet. (see thread entitled Not enough milk - Top up bottles, http://www.geobaby.com/forum/not-enough-milk-t119515p2.html)

Best wishes,
SARAH
 
oh yes, another potential problem i have in mind is the "foremilk, hind milk imbalance". If i keep waking baby up to jus nurse a bit and putting her back to sleep, wouldnt this cause baby to keep taking in the foremilk and no hind milk?
 
hi sarah
thanks again! Sorry for the many questions...just wan to equip myself with the RIGHT knowledge. Erm...you were saying "Your body just replaced the milk she takes out so as she takes more milk out – you replace more." Wouldnt this cause an oversupply or at least increase the amount of milk inside me? For eg, pls correct me if i'm wrong.. say my breasts have accustomed itself to storing 750ml per 24hours, subject to baby taking it out in whichever schedule she'd like, every 2-3 hours, taking 100-150ml per feed, rite? Then, during growth spurts, she will nurse more often, thus creating "the bank" (my breasts) to store more than 750ml, correct? Maybe increased to 850ml. So does that mean, from there on, my breasts will store 850ml worth of milk from there on, and then after growth spurt periods, will decreased back to 750ml?

What are the problems associated with oversupply? I pump partially becos i'd like to have my hubby get in the task of feeding baby as well. Becos he's at work mostly, during weekends, he felt he's not bonding well with baby. Baby cries when he tries to carry and coax her to sleep. :(

As for the meetings, i'll try!! :) but i stay in Kowloon, and we havent dont drive, so right now, the furthest i'd venture outside of home is my mall downstairs...HK island is a tad too adventurous for me right now :p
 
Fore Milk and Hind Milk

The relationship between how much sugar and fat is in your milk is much more complicated than saying ?the hind milk comes after x minutes?.

When your breasts are full the milk has more sugar in it (this is called foremilk) and as your breasts are emptying the fat content of the milk increases (this is called hind milk). The change ? a decrease in sugar and an increase in fat ? occurs smoothly. There is no jump when the milk suddenly has more fat and becomes hind milk.

If your baby manages to take most of the milk in your breasts when he feeds then at each feed your milk will have more sugar at the beginning and more fat at the end.

If, however, you have more milk than the baby can take in one feed (the usual case) then your milk will have more sugar in the morning and more fat in the evening. And it is possible that the milk at the start of an evening feed has more fat content than the milk at the end of a morning feed!

What I really want to say is please don?t worry about foremilk and hind milk. Your baby is already two months old and doing well. You have no problems with your milk or your breastfeeding. Try to relax and enjoy your baby - you are doing great.

Best wishes,
SARAH
 
The way the breast works is NOT like the way the bottle works. With a bottle - it is full, partially full or empty ? and once empty you have to refill it. Whereas the breast is never empty because YOU ARE ALWAYS MAKING MILK. The only time you stop making milk is when your breasts are so full they can?t hold any more.

It is not volume that can be stored but rate of making the milk that is important. You don?t have to hold the 750 mls the baby drinks each day all at once. But you do need for your breasts to be making milk at an average rate of around 30 mls per hour (= 720 mls per 24 hours) - remember that is only 15 mls per hour per breast.

Milk is being produced at all times, with rate of making depending upon how empty the breast is. When your breast is full your milk production is slow. But when your breasts are empty your milk production is fast.

Milk collects in your breasts between feedings, so the amount of milk stored in the breast between feedings is greater when more time has passed since the last feed. The more milk in the breast, the slower the rate of making milk.

To speed the rate of making milk and increase daily milk production, the key is to remove more milk from the breast and to do this FREQUENTLY, so that less milk accumulates in the breast between feedings:

In practice, this means that a mother who wishes to increase milk supply should aim to keep the breasts as empty as possible throughout the day. And the mother who wants to decrease her milk should leave longer between emptying the breast. Leaving longer between feeds can be difficult as babies still want to feed often so we suggest block feeding where you feed on one side for x number of hours and for the next x hours on the other side ? thus leaving more milk in the breast and slowing the rate of making the milk.

Linda Smith explains how this works with her 80:20 concept. The 80 percent is the usual amount of milk taken by baby each day. The 20 percent is the residual amount of milk that remains in mother's breasts. If more than 80 percent of the milk is removed, supply increases to maintain the 80-20 ratio. If less than 80 percent is removed, supply decreases to maintain the 80-20 ratio.
How Mother's Milk Is Made
http://www.llli.org//llleaderweb/LV/LVJunJul01p54.html

Another good article is How does milk production work?
http://www.kellymom.com/bf/supply/milkproduction.html

Best wishes,
SARAH
 
fennho said:
What are the problems associated with oversupply? I pump partially becos i'd like to have my hubby get in the task of feeding baby as well. Becos he's at work mostly, during weekends, he felt he's not bonding well with baby. Baby cries when he tries to carry and coax her to sleep. :(
Click to expand...

Problems for the baby with forceful let-down and oversupply:

  • Gag, choke, strangle, gulp, gasp, cough while nursing as though the milk is coming too fast
  • Pull off the breast often while nursing
  • Clamp down on the nipple at let-down to slow the flow of milk
  • Make a clicking sound when nursing
  • Spit up very often and/or tend to be very gassy
  • Periodically refuse to nurse
  • Dislike comfort nursing in general

Problems for the mother with over supply:

  • Prolonged engorgement
  • Repeated plugged ducts – possibly resulting in repeated mastitis if not treated quickly.

Pumping occasionally to let the baby’s father do a feed should be no problem, especially as your baby is now two months old. We recommend that this practice isn’t started before the baby really knows how to breastfeed – usually around the four to six week mark.

If your baby isn't use to the father holding her I'd suggest that he try to hold her as much as possible, especially while she is calm and happy (when she is asleep is ideal). My husband used to love holding our babies and watching the TV at the same time.

Best wisehs,
SARAH
 
one more word of advice from one mom "who's been there". if you always worry that you have to pump to empty the breast, plus you have to nurse every 3 hours, you'll soon find bfeeding a very tiring task, and taking you too much time. pls try to set a plan of how frequent you nurse & pump, so that you don't over-demand your breast, hence oversupplying, hence overworking yourself. try to spend your energy enjoying nursing your baby instead of worrying too much. as Sarah said yoyr bb is 2 mths & you seem to be doing a good job with your milk & all. you will only be nursing for such little time & it will be one of the best & most treasured time being a om when you look back.

my bb is 3 years old now. i bfeed her until she was 16mths. she weaned herself. she now obviously still has fond memories of nursing & so do i. i wish i was still nursing her sometimes....especially when she's sick. i so want to give her my anti-bodies!! and when you see that your baby has gained so much weight & grown so much in the first 6 mths before he started solid, you know how much nutrients you have given him. it's an amazing feeling that cannot be described. i think all mom's hwo have breastfed their babies would agree with me.

good luck, relax, enjoy & keep up the good work!
 
btw, i see that you have loads of questions, but don't we all when we first breasfed. we don't have tribes of women to help us, most of us are on our own. that's where Sarah & her other LLL leaders come in. they are the most supportive & iinformative breastfeeding support you can get. they've all been there so you don't have to feel intimidated. i feel forever grateful for my LLL leader for being there to listen & give me suggestions when i was lost.

so ask away, girl!
 
hi sarah
my gratitude to u again for your patience in explaining the concept to me. I have read thru your latest reply and again, some questions arise:

As u were saying, it's not the volume but the rate the milk is produced that is important, ie how quickly its being replenished, rite? So if the breast is empty, it produces faster. Now, this is wat i'm always worried about...that my breasts are not making the milk fast enough if my baby sleeps longer and interval stretching longer! I guess this is why people advising me to pump to empty it. Back to my situation, so, does that mean that if baby is sleeping a long stretch at night, say an interval of 7-8 hours from her last feed, i shud jus leave my breast as it is and NOT pump, but pump only to relieve any discomfort and not to empty it? But wouldnt that cause the milk production to slow down since the breast is so full?

And when baby starts stretching longer interval as they grow, say from 3hourly feed to 4hours interval, wouldnt this slow the milk production rate as well? but since the quantity baby feeds stay the same eg 750ml per day, how would the breast cope?

I am sorry if some of the questions seems a little dumb and obvious, but it's jus that there's soooo many info flying here and there from "well-meaning" people that it confuses me! As i'm doing direct latching, needless to say, i have no idea how much she's drinking exactly. So, am not even sure if she's taking in the recommended amount per 24hour! She's quite a chubby baby now, and if in the past, i was worried about her not getting enough, now i'm worried if she's gonna be overweight or obese..i have read that BF babies DO get obese as well. She is now 6.2kg and have not even reached 3month mark yet! I read the weight chart and realised she's in the 95th percentile.

I am eternally grateful as well for your guidances, so far it makes a lot of sense to me, thus am asking more to educate myself more!

Your list of problems associated with oversupply hit quite a few points with me. My baby have 4 out of the 7 symptoms u listed! Perhaps i started with low supply (or at least i think i was cos my breasts were not reacting well to the pump i bought) hence my paranoia of keeping up my ss for fear of not being able to BF my baby for at least 6months.

BTW, if i really am hvg tis oversupply issue, how do i solve tis problem?

joannek
thanks for your response as well. I really do want to BF my princess for at least 6months and beyond. But sometimes i do find it so tiring and permanently attached to her. I cant be away from her for more than 3hours cos of her feeding interval. I love her to bits, but sometimes i admit i do feel a little "trapped". I feel guilty to have these thots! Which is why i was asking Sarah earlier when approximately do babies usually start having longer feeding intervals, and shorter feeding time..at least i can have something to look forward to! My bb is feeding at 3hour interval, sometimes even 2 (and it's not a growth spurt!). Sometimes i feel i'm a useless mommy cos i till now, i dont think i'm able to identify her hunger cries and distinguished it with her other cries (tired, discomfort, etc)

Sorry for the long rant, and thanks again for listening...u all have no idea how much it means to me!!
 
Dear Fennho,

I?m a little confused by your questions. If your baby is going longer between feeds you must have some milk stored to give to her so why are you worrying?

Let?s say you?ve just feed your baby and she took lots of your milk so that there isn?t much left in the breast. So now your breast is nearly empty thus you are making milk very fast. As your breast fills up the rate of making milk slows down. So after a while you are half full. But it could take the same time again to get to three quarters full (because the rate has slowed). Then the same time again to get to seven eights full, etc. Remember you have to go through the fast rate of making milk to get to the slow rate and will only get to the slow rate when you have quite a lot already stored in your breasts.

It doesn?t really matter when the baby feeds if your breasts are full or empty. As it is the vigorousness that the baby feeds with that determines how much milk the baby gets out. When talking about breastfeeding never forget the baby in the equation.

I think I?ve complicated the whole situation by trying to explain how the breast works because it doesn?t matter. The breast still works even if we don?t understand it (just like gravity). All the knowledge we have these days is getting in the way of natural breastfeeding.

Let?s stop and think about how mothers managed hundreds of years ago. They didn?t know about fore milk and hind milk (only discovered 15 years ago), they didn?t know about pumping and storing milk, they didn?t know exactly how the milk was made (again only learnt inthe last 20 years). All they knew was that if you kept feeding your baby your body looked after the workings for you and the baby grew.

From everything you?ve told me I can tell that your baby is getting enough milk and so you have a healthy milk supply. Let your body do its work ? the only thing you need to do to keep your milk is to keep feeding your baby.

As your baby grows your body is expecting your baby to grow. Part of the baby growing is that there is longer between feeds ? your body is expecting this and will cope with it.

When your baby is between 12 and 24 months the number of feeds will be a lot less than now (maybe just one or two feeds a day). But if you continue to feed her your body will continue to make milk. As babies wean themselves it is possible to have gaps as long as a week or even two between feeds and there is still milk there for when the baby wants to feed ? no pumping is required ? just a baby growing up.

The only time you need to pump is to collect milk for a time when you will not be with your baby to feed her. There is no point pumping when you are planning to stay together. And as you are now worried about possible over supply I?d stop all unnecessary pumping.

It usually takes a couple of days for the milk supply to settle down. If you still have the over supply symptoms then give me a call on 2548-7636 and let?s chat about exactly how you are managing the feeds. I need to know what you are doing now to give information about reducing the oversupply symptoms.

Breastfeed babies have a different growth curve to bottle fed babies. They tend to put a lot of weight on in the first three months and then slow down. So don?t worry if your baby looks cubby at the moment by the time she is one year old she?ll look much slimmer.

Best wishes,
SARAH
 
hi sarah

sorry for the confusion...what i was trying to ask is if the baby taking longer to feed, the breasts will be full with the milk, rite? So, when the breasts are full, it will not make any more milk rite? And after a while, it will slow down production, correct? So when growth spurts is around, then what?

Today i dunno what happened, she fed at 545pm till 620pm, emptying my breast thoroughly (went all soft), then i burped her, changed her diaper, and tried to pat her to sleep cos she was yawning away earlier, she struggled abit and was abit unhappy, i realised she was doing the rooting thing again, pick her up and indeed, when she was in my arms, she turned towards my breast...i latched her on and she suckle away! Tat was at 7pm. I am wary of feeding her too much. Can a BF baby feed too much? I know most people say babies are smart enough to know how to stop but i am still worried cos she seems to be so chubby now. Even my PD was saying he HAS seen BF babies that are obese! :( I feel like such a useless mommy, sometimes i dont even know if she's crying for food, or other things. If a baby is crying for something else other than hunger, and u give her the breasts, she will STILL suckle rite?
 
Dear Fennho,

It doesn?t sound to me that you are a bad mother ? it sounds like you are doing a great job. You are with your baby and feeding her when she wants to be fed.

fennho said:
sorry for the confusion...what i was trying to ask is if the baby taking longer to feed, the breasts will be full with the milk, rite? So, when the breasts are full, it will not make any more milk rite? And after a while, it will slow down production, correct? So when growth spurts is around, then what?
Click to expand...

On a normal day the baby will take about 75% of the milk you have stored in your breasts. So when there is a growth spurt you have the other 25% to give her. After she has fed you make milk very fast and so even if she wants to feed 15 minutes late you still have loads to give her. If you truly think that she has drunk all the milk ? give her the other side ? it will definitely have milk there. Why do you think we were made with two breasts? After all having twins isn?t common.

It really doesn?t matter why your baby wants to nurse ? she may be hungry, or thirsty, or bored, or lonely, or too hot, or too cold, or frighten by something, or sleepy or almost anything. If she wants to nurse letting her is never the wrong thing to do. And breastfeeding will solve all these problems so it doesn?t really matter what the problem is.

Some breastfeed babies are fat but as I said yesterday they loose the extra fat. My third child weighted 19 lbs at four months but by the time he was 12 months he only weighed 22 lbs. Breastfeed babies tend to put on loots of weight in the first three months and then slow down ? don?t worry about this ? it is normal.

Did you read about the chocolate cake syndrome I mentioned? (It is in the thread entitled Not enough milk - Top up bottles, http://www.geobaby.com/forum/not-eno...t119515p2.html) It sounds like your baby wanted some chocolate cake this evening ? that is fine ? it is always nice to have a dessert.

Best wishes,
SARAH
 
You must log in or register to reply here.
Back
Top