Expert: Sally Wendkos Olds - 8/13/2007

Question
Hi I am currently breastfeeding my 7 week old baby full time and she has tons of wet diapers and about 4 bowel movements a day. She is gaining weight great and weighs 9lbs 10oz she was born at 7lbs 11oz. She seems like she is always hungry she refuses to take a pacifier and I feel like I cant do anything and i am tired of family saying oh god your nursing again she is not getting enough and then it makes me start to second guess myself I pump and follow every tip and no results i am happy if i get an ounce my nipples swell in the shield so i bought several sizes and still and tried several expensive pumps. now i am about to go to work in like 3 weeks and scared i am going to have to wean her to formula and i am devastated! what should i do? and why does she always seem hungry if she is gaining weight, lots of wet diapers, and bowel movements?? please help

Answer
Dear Eileen,

First, congratulations for giving your daughter the best start in life by breastfeeding her!

It sounds as if you do have plenty of milk. Don't be misled by the fact that you can't pump out much breast milk; a vigorously nursing baby is much more efficient than even the best pump!

I'm not sure whether your question is that you want to stop nursing after you go back to work, or that you will have to wean her to formula because you're not pumping enough. I'm guessing it's the latter, so I'll respond to that. If you have tried renting a hospital-grade pump and you still can't get much milk, you may have to give your baby formula during the day while you are at work. However, you don't have to wean her from breast milk. You can still nurse her morning, evening, and during the night. And you should still pump during the day to keep up your milk production.

Also, you say she always seems hungry, but if she is gaining so well and has so many wet and soiled diapers, she is probably not hungry. She may just love to nurse. Try other ways to soothe her when she cries. I have a lot of suggestions in my book (see below). Meanwhile, I am attaching an excerpt from my book about pumping. Maybe some of these suggestions will help.

Good luck!

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
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ENHANCING MILK PRODUCTION WHEN EXPRESSING OR PUMPING

You may want to try one or more of the following methods to increase the amount of milk you can collect for your baby. Different ones work well for different women in different situations. If you're pumping at work, for example, some of these suggestions will not apply. As with the rest of this book, take the suggestions that make sense to you, see which ones work, and stick with them.
  * First, take care of yourself: get as much rest as possible, and be sure you're drinking enough liquid throughout the day.
  * For two to five minutes before you begin, do deep breathing or some other relaxation exercise.
  * Drink a cup of hot tea before beginning. If your baby is not sensitive to cow's milk products that you eat or drink, you might try warm milk or cocoa.
  * Make yourself as comfortable as possible. If you can, sit with your feet up.
  * Try pumping one breast while you are nursing your baby on the other breast.
       * If you have time, massage your breasts. Just before you begin, if possible, lay a warm towel on your breasts for a minute or two. (The towel is helpful, but not essential.) Then massage your breasts gently, one at a time, starting from the top and moving around the sides and the bottom, moving your fingers in a circular motion. With your fingertips, stroke yourself lightly from the armpit, from above and below the breast, and from the middle of the chest toward the nipple. You don't need to massage or stroke the nipples themselves. (If necessary, you can massage your breasts even while you're dressed.)
  * Pump both breasts at the same time, using a good electric pump.
  * If you are expressing one breast at a time, switch breasts at least once during each session and preferably twice, to insure maximum draining. Usually the second expression on each breast is briefer than the first.
  * Pump frequently. It's better to pump three times for no more than 10 minutes each time than to pump twice for 15 minutes each time. It yields more milk, it's more efficient, and it's also more comfortable, since it will cut down the likelihood of trauma from too much pressure exerted for too long a time. Some women get sore nipples from pumping more than seven or eight minutes on a breast.
  * Prop a photo of your baby in front of you. Look at it and remember what it feels like (or imagine what it will feel like) to have him at your breast. (Or use a photo of you nursing your baby.)
  * Visualize your baby in your mind. Imagine what she looks like, sounds like, feels like, smells like when she nurses.
  * Make the time go faster while you're expressing or pumping by talking with a friend, listening to the radio, reading something light, or watching television.
  * If your baby is present but cannot suckle and if you don't need two hands to express, hold him while you're pumping.
  * Wear comfortable clothes that open up or pull up but still cover your shoulders, so you don't get chilled.
  * Listen to a musical record that you associate with nursing. This works best if you play the record initially during actual breastfeeding sessions; then when you're expressing, hearing the same music may help evoke the memory and the sensations you felt then. (Handel's "Water Music" gets high marks from women who enjoy classical music.)