Do you have advice for exclusively bottle feeding using breast milk?

Exclusive pumping is hard. So I WOULD have to encourage you to take a long hard look at your sitation and see if there is ANY way to nurse your baby rather than pumping and bottlefeeding.

If that's not possible --

First, if it IS possible, try to nurse directly for at least the first couple of weeks. Your baby is more efficient than the pump at stimulating your supply, so nursing will get you off to a good start. After a few weeks, you can begin pumping at times when baby would normally nurse, and gradually make the switch over.

If you can't nurse at all, then you would pump often from day one. Because the pump isn't as efficient, you'll probalby need to pump more often than you would nurse -- at LEAST every 2 hours around the clock. As you get better with the pump and your letdown improves, you may be able to pump less often after your supply is well established.

Of course you will want the best pump you can afford -- renting a hospital grade pump would be ideal. Otherwise, buy a top quality double pump.

Good luck. EPing takes a lot of dedication, and I have great admiration for women who commit to doing it.

EDIT: To clarify another persons post -- microwaving doesn't 'zap all the good nutrients' in the milk, any more than it zaps the good nutrients in your hamburger. It DOES kill the living cells that provide immunities, and that's why it's not recommended to use the microwave. (I sometimes used it, but my daughter got VERY few bottles, so I figured that missing out on immunities once in a blue moon wasn't a big deal. But for EPing, you would not want to use the microwave. )

Well done on your baby girl! First - don't give up! If you are able to breastfeed, then persevere as sometimes it can be hard to start. If your husband wants to feed baby too, just get an electric breast pump and save the milk into a bottle for him to give baby. I did this with both my kids. It's always great to freeze some and you can give a bottle to the babysitter too so they can feed the baby. I hope you can breastfeed. It's great. I supplemented with the odd bottle of formula too, even though some people said it was a big no-no, but my kids are both totally healthy and normal now!! Good luck

I am an exclusive pumper of a 16 week old. It was A LOT of work at first! I would be in tears alot. But my husband and I talked and agreed I would do it for 4 weeks, and if it was still hard for me, I could stop and formula feed. But I'm still going strong at 16 weeks, and have a goal of six months now (I'm goal oriented - lol). At first I was pumping every two to three hours for 15-20 minutes each time, I would pump once during the night (around 3am usually).

But now I only pump three times a day for about 45 minutes each pump, and I get anywhere between 35 and 40 ounces of milk a day. I have not had to supplement with formula. I pump at 6am, 2pm, and 9pm (or somewhere around those times, depending on what is going on) - this allows me to pump before my son wakes up, during his afternoon nap, and after he goes to bed at night.

Start with small amounts in a bottle - I started with putting 2 ounces in a bottle.

I would pump when my son would get up for his middle of the night feedings - I would set him in a boppy pillow next to me on the couch, and pump and feed him at the same time. That saved time so I could get back to sleep!

I rinse out the bottles and horns each time I pump and I put them in plastic bag in the fridge. I wash them every other day. No need to wash everything every single feeding (unless it makes you feel better to do so).

Good luck!

Well, one thing I was surprised to hear that a lot of mothers didn't know is that breast milk can't be microwaved. microwaving zaps all the good nutrients out of the milk. Instead, microwave a bowl of water for about 2 minutes and set the bottle of breast milk in the warm water for a few minutes. good luck!

Establishing and maintaining milk supply when baby is not nursing

By Kelly Bonyata, BS, IBCLC

It is important to express your milk to establish and maintain milk supply if your baby is not nursing at all or not nursing well. By expressing, you will also have your milk available to feed baby - every bit of moms' milk that baby gets (even the tiniest amount) is like liquid gold.

When should mom start pumping?

* If baby does not nurse immediately postpartum, mom should begin pumping within 6 hours of baby's birth -- starting early makes a difference for future milk production.

What pump is best?

* If baby is not nursing, seriously consider renting a hospital-grade pump (such as those made by Ameda or Medela) that will allow you to pump both breasts at the same time. A hospital-grade pump is the best choice for maintaining or increasing milk supply.

* If you are not able to rent a hospital-grade pump, consider buying a pump (preferably a quality double pump) and/or hand expression.

How much milk should mom be pumping if baby is not nursing?

* Aim for pumping 750-800 mL (25-27 oz) per day by 7-10 days postpartum. If you have twins or higher order multiples, aim for pumping 800-950 mL (27-32 oz) by 14 days postpartum.

* It's useful to evaluate mom's 24 hour pumping output at 10 days. If supply is borderline (350-500 ml / 11-17 oz) or low (less than 350 ml / 11 oz), then galactagogues (prescription meds or herbs to increase supply) or other interventions should be considered.

* The research tells us that milk production at 2 weeks is an indicator of breastfeeding outcome, so it is important to get a good start. Even if milk production doesn't start out well, however, don't get discouraged--many moms will see an increase (even as late as 9-15 weeks after birth) if they continue with regular pumping.

How often should mom pump?

* 8-10 times per day: Until supply is well established, it is important to get at least eight good nursing and/or pumping sessions per 24 hours. Ten sessions per day is better, particularly if you have twins or higher order multiples.

* These sessions don't need to be evenly spaced, but you should be nursing/pumping at least once during the night in the first few months or anytime you notice a decrease in supply. Avoid going longer than 5-6 hours without pumping during the first few months.

* When pumping during the night, milk yield tends to be better if you pump when you naturally wake (to go to the bathroom or because your breasts are uncomfortably full) than if you set an alarm to wake for pumping.

* If you are having a hard time getting in enough pumping sessions, adding even a short pumping session (increasing frequency even if milk is not removed thoroughly) is helpful.

How long should mom pump at each pumping session?

* If baby does not nurse at all:

o The first few days, before mom's milk comes in, hand expression is often the most effective way to express colostrum. Double pump for 10-15 minutes per session for additional stimulation.

o Once mom's milk is in, pump for 30 minutes per session, or for 2-5 minutes after the last drops of milk.

* If baby nurses but does not soften the breast well

o Double pump for 10-15 minutes after nursing.

* Empty the breast as thoroughly as possible at each session. To ensure that the pump removes an optimum amount of milk from the breast, keep pumping for 2-5 minutes after the last drops of milk. Use breast massage prior to pumping, and massage and compressions during pumping to better empty the breasts and increase pumping output.

Additional tips

* Rest & relax as much as possible.

* Skin-to-skin (Kangaroo care) can make a significant difference in pumping output.

* If double pumping is difficult to coordinate in the beginning, then single pump, alternating sides. Move to double pumping as soon as you can.

* Avoid any medications that might interfere with milk supply (hormonal birth control, pseudoephedrine, ethanol/alcoholic beverages, bromocriptine, ergotamine, cabergoline)

* If supply is not increasing as expected by 7-10 days after birth, consider the use of galactagogues. Fenugreek, metoclopramide (Reglan) or domperidone (Motilium) can be helpful for increasing milk supply.