I forgot to account for the interval. My baby feeds 2-3 oz every 1.5-2 hours. But it’s impossible to pump every 2 hours at work, so I ended up pumping every 4 hours instead, which means I needed to pump from both boobs. I end up getting 4oz from one side each time (before heading to work and at work), which seems to work for my supply. Some days I can’t get 4oz, and have to settle for 2 and try to pump the other side as well, which is annoying. Ideally, I would be pumping both sides simultaneously, saving myself some time.

I don’t use the maximum setting on my pump, so I could convert my single to a double following some instructions I found on youtube and other forums. I basically need 2 tubings (because Medela is annoying and has a different connector for each pump) and a splitter, which should be available at the aquarium store. I’ll report back when I get a hold of everything. Shopping is hard these days with a little one…so is blogging.

But my point is don’t bother buying the single electric pump. The double can be converted to a single, but not the other way around.

The post Forget about the single electric pump appeared first on My Breastfed Baby.

I’ve been pumping according to my proposed schedule: middle of the night, before work, and at work, and the milk is flowing alright for now. My baby has been eating 2oz every 1.5 – 2 hours while I’m away, so I’ve limited myself to pumping only that much. The pumping hasn’t been too difficult until the past 1-2 weeks, when I’ve had times when I couldn’t pump even though the milk is there. On those days, I break into the freezer stash and try to pump extra at the next session to make up. Early on, I learned that the membrane on the pump needs to be good…I don’t know how to tell when it’s gone bad until I can’t pump properly with the same membrane multiple times (they have numbers on them so that you can keep track of the different ones). It doesn’t have to be torn to be less than effective. But I seem to also have a letdown issue now.

Making sure I only BF on weekends

While on maternity leave, I used to give a bottle when we go out on weekends because I didn’t feel comfortable breastfeeding in public. After going back to work, I forced myself to breastfeed in public because I wanted my baby to have access to all the milk she wants at least a couple of days a week. I worry that she is not eating enough while I am gone due to a preference for the boob.

The last couple of weekends, I’ve noticed that my boob feels very different at the end of the day. On weekends when I BF on demand, the boob is still at least partially filled at the end of the evening. But on working nights, I worry whether she wants another feeding because my boobs feel very empty.

6 weeks later, supply decreasing?

At work this week, I was talking to another pumping mother (we have a  common pumping room, and many of us seem to have a similar schedule), who told me her supply started dropping 6 weeks after she returned to work. With my recent pumping issues weighing on me, I’ve started to panic slightly, and decided to reconsider my pumping schedule. If I’m still filled on weekends, it means I am making enough milk, but something is wrong with my weekday schedule.

When I first started working part-time, the pumps before work and at work were just enough to take the edge off the engorgement. At some point I’m not sure when, I stopped feeling engorged, which is the right response from the body but I don’t want my boobs to stop making milk. Perhaps instead of pumping in the middle of the night, I should be focusing my pumping efforts on the morning pumps to make sure I drain my boobs sufficiently – meaning at least 3oz per session to match what baby eats, and possibly more. I’m pumping on the low end, and my colleagues tell me that their kids eat 10 oz in the same period (which is way more than 1.25oz per hour). I’m keeping the MOTN pump in case I have pumping issues in the morning.

Two days into the new schedule, things feel fine. I am pumping more than she eats, but I still have plenty of boob juice towards the end of the night. I’m wary that my supply will decrease as I continue to pump, so I am going to overpump and build up my stash with the leftovers. Let’s see how the next 2 weeks go.

The post Rethinking my pumping schedule appeared first on My Breastfed Baby.

Fast forward 10 weeks. Baby has grown a lot since birth, going from 50^th percentile to 95^th at her 8 week check up.  My brother-in-law, who is doing his internship in pediatrics, wonders how my breastfed baby managed to get so chubby. I’m leaving pumped milk in the fridge so that my mom can feed her while I’m gone at work. Grandma is strict: 2 oz every 1.5-2 hours. No more, no less. I think my baby is slightly underfeeding coz she wants to eat as soon as I am home, and every 1-1.5 hours till she falls asleep for the night. She has a touch of reflux, so she throws up sometimes after nursing.

“You’re overfeeding her because you can’t see how much she’s eating. She’s throwing up.” Said my mom. I still think my baby is underfeeding because she prefers the breast. I hold my tongue.

The post I just can’t win: breastfeeding edition appeared first on My Breastfed Baby.

I already had multiple practice runs starting 6 weeks – I’d leave for a few hours to attend to various matters, leaving baby with grandma. Everything seemed good. But at the end of the first week, I’m exhausted. There was a bit of learning along the way, so bear with me.

Mistake #1: trying to feed the baby before leaving

Although she is only 10 weeks old, baby sleeps through the night from about midnight to 11:30am. She has gained a lot of weight since birth, going from 50^th percentile to 97^th percentile at her 8 week check up. While our pediatrician told us not to let her go longer than 5 hours without feeding, my friend, who is a pediatrician, thought it was ok to let her wake when she wants feeding. That’s how we figured that she can go 6-8 hours without a feed. The downside is that I still have to wake up to pump.

The baby currently wakes up around 11:30am. She rouses around 6-8am on her own for a dreamfeed before going back to sleep. I don’t know why I thought I would be able to fit in a dream feed at 10am, and get out of the door by 10:30am. That was the first day. She ended up waking up instead of doing a dreamfeed, and she wasn’t hungry so she threw everything up. I forgot to mention that she doesn’t have much of an appetite in the morning. I decided then that I can’t count on being able to feed her, so I’ll have to pump before leaving.

She was waiting for me

Since she’s not that hungry her first meal, we figured it’s a good time to have TummyTime, and any other play and possibly a shower before eating. Even then, Grandma had to coax her into feeding about 2 oz, and the last bit takes forever to go down. A bit later, she’s hungry again but only managed to down another 2oz. And she takes a 3^rd 2oz feed before I get home. So I’m gone from 10:30am to about 3:30pm, which is 5 hours. 6oz is reasonable, except she doesn’t eat at night. She’s only taken in ¼ of her estimated daily intake of 24 oz in 5 hours, which is over 1/4^th of her waking hours. When she registers that I am home, baby indicates that she wants milk from me, and she ends up feeding every 1 – 1.5 hours until bedtime. So I think she gets her daily needs met, but it makes me feel bad that she’s decided to accommodate my schedule.

I could wake her up to dreamfeed, but it hasn’t been going that well – I sometimes end up waking her up too early. I’ve given up on changing her diaper at night.

There are babies who prefer to starve

Maybe I should consider myself lucky that my daughter is reasonable enough to want a snack when I’m gone. I talked to my cubicle mate the first day I was back, and asked her how the pumping room worked out. She said she didn’t pump; her baby only eats from the boob, so for the first 4 months, she had to go home every 4 hours. They started solids early.

Most babies will take a bottle, although many mothers worry about nipple confusion. What is usually unsaid is that babies can also have nipple confusion the other way: they don’t know how to use the bottle. However, just because babies can take a bottle doesn’t mean they want to take a bottle. Even if the caretaker is a familiar person, the baby will wonder what happened to the nice warm person with boobs.

I guess this is really a rant about maternity leave. 4 months seemed generous, but I now ask myself why I have to be gone before my baby can even sit up or crawl. I never thought about being rich or earning a lot of money, just enough to be comfortable. If I could go back 10 years, I would tell myself to work for the big bucks so that I can be a stay-at-home mom for as long as I feel needed. I never thought I would ever want to be a stay-at-home mom, but it’s not about what I want. It is more about what the baby needs.

I still like working, and I appreciate being outside of the home for a few hours each day. But there is still that guilt that I am not there for my helpless child, even if she is in good hands. I’m making it up by being extra attentive evenings and weekends, but I don’t think it’s healthy to over-indulge in the child because of my guilt.

I guess I’ll cope somehow. Because so many women have gone through this test, and survived.

The post Going back to work appeared first on My Breastfed Baby.

What this is is a bottle with a long skinny tube that you attach to your boob with surgical tape. Who it is for is women who have low milk supply and need to bottlefeed formula but want to breastfeed. This way, baby gets food, and the breast gets the stimulation it needs. There is also no nipple confusion. Hopefully after some use, your supply will increase and you can ditch the SNS.

I found a good youtube video explaining how to use the Medela SNS with tips. For people waiting for their milk to come in, the starter $20 system is probably sufficient.

The post Supplemental nursing system appeared first on My Breastfed Baby.

Do you need a giant freezer stash?

A few weeks ago, I was preparing to transition to working part-time, and one of the issues that came up was creating a freezer stash. I read up about how to create a substantial freezer stash painlessly, and got started a couple of weeks early (thinking I was late to the game actually). In the meantime, I was also starting to go out some times in the afternoons to leave my baby with grandma for practice. Those days, I just leave the pumped milk in the fridge instead of freezing because my baby wants her milk ASAP, and my mom doesn’t always have time to thaw frozen milk if she runs out. It seemed a superior system to me – I don’t have to buy a ton of milk freezing bags, and take up a ton of space in the freezer. I know there are people who leave fresh milk for their babies, but everyone on the internet forums seemed obsessed with pumping up a stash to use. You can tell pumping large quantities is an obsession when “How I pumped and froze 1000oz of breastmilk” is next to the “How I earned $100,000 working from home” ad spam on the sidebar.

How do you use your freezer stash? I am under the impression that people take out the oldest milk, and freeze the day’s pumping, keeping the supply constant. Of course, there are those who freeze 6 month’s worth of milk so that they can stop pumping but continue feeding their LO breastmilk. In the latter case, you will need to freeze your breastmilk. But for most people, the freezer stash is more of a just in case they run low on milk that one day or that one afternoon. If this is your situation, you don’t need more than a day’s worth of milk in the freezer.

Freezing kills the white blood cells in breastmilk

I’m a biology researcher, and in my work we have to carefully consider how to store biological samples depending on their purpose. The freezer is usually an inferior form of storage. Freeze-thawing kills many types of samples, and we usually have to include additives to keep things in good shape. But you can’t add stuff to breastmilk to freeze it.

So what exactly is in breastmilk that will die in the freezer? White blood cells for one. If you remember from high school biology, an animal cell is just a fragile bag of water and stuff. Water expands when frozen, disrupting the membrane and bursting/killing the cell. Those white blood cells in breastmilk are all killed by freezing.

Slightly more complicated are the proteins. We don’t know all of the proteins in breastmilk, but there are probably hundreds of them. Some of them, like amylase and lipase, survive freezing. Those are rare examples. Most proteins will be damaged by the freezing process and inactivated. This is why you can store your freshly expressed milk in the fridge for 5 days, but your thawed milk won’t last 24 hours in the fridge. The antibacterial properties are much diminished by freezing.

Age appropriate breastmilk

There is the other consideration of age of milk. One of the best things about breastmilk is that your body tailors the composition to your baby. There is more fat in breastmilk for older babies, more water in breastmilk in the summer. By rotating your frozen milk out and your fresh milk in, your optimized breastmilk is no longer optimized. An occasional feed of frozen milk won’t make a difference, but if you are feeding your baby frozen milk everyday for 8 hours unnecessarily, you should think again.

My intended milk cycling system

My current freezer stash is ~10 bags of 3oz, saved over random pumping sessions when I was engorged and had to remove the milk (ate oatmeal cookies without realizing how potent they were for instance). I think this is more than sufficient for emergencies.

My plan for when I start work again next week is to pump exactly what my baby needs each day. I’ll be gone for about 5 hours, so it’s 5 x 1.5 oz = 7.5 oz. It seems a little ambitious for one pumping session, so I’ll be pumping in the middle of the night, once at work, and possibly when I get home/before I go to work, depending on when my baby feeds. I’ll store the milk in the fridge for the next day. Friday’s milk will be used sometime over the weekend when we go out – I haven’t figured out how to breastfeed in public, so we bottlefeed when we go out.  Any extras will be frozen, and if we need more than 7.5oz, we will take it from the freezer – this also means I will have to start pumping more than 7.5 oz.

As for the freezer stash, if we don’t end up using it along the way, I plan to cycle the bags after a month. I care about the changes in nutritional content as my baby ages, so it would be better to cycle it regularly. If I end up using an emergency bag, I will be replacing it that same day as much as possible.

It will become a lot more challenging when I have to work full-time, but the plan for now is to increase the number of pumping sessions at work. One should be pumping every 3 hours to keep the milk supply, so I would probably have to increase it to at least twice at work, and immediately after reaching home/before I leave for work to last 9 hours (13.5 oz!). I’ll work it out properly when that time comes.

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Cluster feeding during growth spurts

The first few growth spurts are very closely spaced: at 7-10, at 2-3 weeks, at 4 – 6 weeks. Sometimes, it felt like the growth spurt never ended: there was always a time of the day when she wanted to be fed every hour. Sometimes it was the afternoon, and other times it was the evening. I fed her on demand.

She recently turned 8 weeks, and she still feeds hourly at some point everyday. Apparently, that is not normal. I happened to talk to a friend who had a baby a few days before me, and she said that her baby doesn’t have to eat every hour. Doesn’t her baby clusterfeed? Not everyday. She thought I should check it out with the pediatrician.

The night before the ped appointment, daddy had to stay home with baby while I attended an event. I left them pumped milk, and came back to an exhausted daddy. Baby girl had apparently been suckling on the bottle without drinking much for 3 hours. We know that she can eat 2 oz in less than 10 min, so it wasn’t an issue with the nipple.

Comfort feeding is everyday

The pediatrician called it comfort feeding. Of course. I had read about it too, but I didn’t know what it was supposed to look like. The pediatrician said it is appropriate to use a pacifier in such situations. Oh.

I didn’t grow up with a pacifier. In fact, my mom is irrationally strongly against the use of pacifiers. “Looks indecent.” I was agnostic, but if my baby needs one, she gets one. I just needed to find out more about what I was going to give her.

Issues related to pacifier use

Pacifier use has been linked with lower SIDS incidence (although others say that no such effect exist if we correct for some factor). A pacifier is used to soothe the baby, which is fine by me. The pacifier is supposed to replace the thumb or hands as a soothing device. More importantly, self-soothing by thumb/hand leads to orthodontic issues, and it’s harder to wean off since you can’t take away the baby’s hands. Fair enough…I’m sold. Besides, there are other issues while putting her to sleep. Like how she seems to magically awake when I take my boob away. S so it’s not a bad idea to have a detached fake boob that I can leave with her till it falls out. Plus, I can introduce the pacifier while she is in the crib, so I don’t have to move her after she falls asleep.

It’s still not clear to me when to use it, in case I misread real hunger for comfort feeding. But there is a certain hour of the night when she is stuck to my boob for 2/3^rd of the hour which I am sure is a good place to introduce the pacifier. Now, she just needs to actually take it – she much prefers the boob to the bottle. She can probably tell the difference between the pacifier and me.

In case you are worried about affecting milk supply, many sources say that pacifier use will not have any effects if introduced after supply is established, after 4-6 weeks. We are safely in that zone. I hope she falls asleep more easily tonight.

The post Cluster feeding, comfort feeding? appeared first on My Breastfed Baby.

Before baby arrived

• A set of Dr Brown’s newborn feeding bottles

This came with 2 x 4oz bottles, and 3 x 8oz bottles. I bought into the hype of the special Dr Brown anti-colic bottles – they are designed so that the baby doesn’t suck in as much air while feeding. Why would I buy feeding bottles if I’m planning to breastfeed? Well, these will be useful if I decide to switch to formula. I also wanted the option of pumping and giving a bottle for the times I will be away. What is very nice about the Dr Brown bottles is that they are compatible with the Medela system, so you can use a Dr Brown bottle with the Medela pump instead of transferring the milk.

• Sterilizer

The pump parts and feeding bottles need to be sterilized. The old fashioned method is to boil them in hot water, but it’s a lot of hot water to boil. I chose a steam sterilizer – one button to turn it on, and it’s auto-turn off. The microwave bags are just too expensive. With the actual sterilizer, you can hit the button whenever, and keep on using it – it happens to me that I forget to sterilize some part, or find that I sterilize the wrong number of components, so I need to sterilize just one more thing. We have used it a lot, and will continue to use it often even after she starts solids.

• Bottle warmer

I wasn’t planning on buying one since it’s not hard to boil water, and then mix with cold water to get the right temperature water bath for heating up milk. But my cousin had his old one, and he’s done with the kid-rearing, so we got this for free.

We haven’t used it much, and we don’t find it that much more convenient. I think we may use it more when I start working, and grandma will have to heat up the milk to feed.

• Medela Harmony – the manual Medela pump

I actually bought 2 of these because I wanted to ensure that I have a spare of all the parts at home. The manual pumps are fairly cheap, so I thought it was a good place to start when I was unsure of how long I would be breastfeeding for. There are people on Amazon who say that they used a manual pump quite frequently because it’s very quiet and portable – meaning this initial buy will still be useful if I decide to breastfeed for a long time. Some also claim that the manual pump gives them more milk than the electric (which seems true in my case.)

What’s nice is that each box comes with 2 bottles, so I have plenty of bottles for storing milk in the fridge, without buying a separate set of bottles. Also the Dr Brown bottles work for storing in the fridge too.

I initially thought it would be a while before I needed to pump, but it turned out I needed to pump pretty early on when my baby wasn’t feeding well due to sleepiness (Day 4), and later when she was warded for phototherapy for her jaundice (Day 5). It was good to have these ready to go at home – I easily managed 3 pumping sessions (just need 1 oz) for the first afternoon, and then 4 more involved sessions when I needed to supply her milk while she was in the hospital. (I borrowed the hospital pump a couple of times, and I was allowed to nurse a couple of times, so it wasn’t 8 pumping sessions.)

• A pack of 10 wash cloths from Ikea

These looked generally useful, and were cheap. I ended up using them a lot – as a bib for my boob when I breastfeed. The baby gets her mouth dirty, but the excess milk tends to run down my boob instead. I tuck these into the bra, and they are super absorbent. I rinse them out before laundry because there is so much milk in them.

• A galactagogue

In my case, I’ve always had seaweed in the freezer, and it works for me. You probably own oatmeal (which is also a galactagogue). In case you don’t, you should get a galactagogue for the times you need a boost to your milk supply. Besides seaweed and oatmeal, fenugreek capsules seem popular among breastfeeding mothers.

• A cooler bag

I got a cooler bag for groceries a long time ago, and this has been repurposed for breastmilk. I use cool packs from CVS (meant for iceing injuries) that I had in the fridge. This has been useful for when we go out, and I want to bring milk along with me to feed my baby (I bottlefeed when we go out because I can’t figure the breastfeeding in public thing out). When I go back to work, this cooler bag is coming with me to keep the pumped milk. I’m not trusting the office fridge.

Along the way

• Breast pads (disposable and washable ones)

The morning after the milk came in, I woke up to a wet t-shirt. I somehow thought that only the women with oversupply will be dripping in their sleep, and I didn’t expect to be one of them. Fortunately we had some disposable breastpads at home (samples from the hospital), so I used those and went out to get washable breastpads. You definitely want these. The washable ones are very absorbent, and are good enough to soak up the letdown while you breastfeed with the other side. After 6 weeks, my 4 pairs of washable ones are starting to look a little used although they still work. I think they will make great gifts if your friend decides to breastfeed. Can’t get enough of the washable ones. The disposables are much thinner and nicer, but pretty expensive. I use them if I am going out and wearing something nice.

That said, some women on the internet have mentioned that breastpads are not sufficient for them.

• Breast shells

When your milk first comes in, you’re likely to be engorged. This means that you’re probably going to be leaking milk from the side you are not feeding your baby with. I read about breast shells, and some people think these are super useful because you can collect letdown milk and store them (you should sterilize the shells). Their official purpose is to help air out the nipple, and prevent them from rubbing against fabric (which can use useful if you have sore nipples).

In my case, I initially had about 0.5 oz of letdown milk, so it was a great way to collect milk for the freezer stash. However, your body stops over-producing milk, and I stopped leaking so much from the unsuckled boob by the end of the second week. There wasn’t any point in collecting a couple of drops of letdown (leave it to the breastpads), so I stopped using them.

I’ve also been fortunate not to have sore nipple issues, so I haven’t used the breast shells for this purpose. So I guess these have not been very useful for me, even though others may find them useful. It kind of sucks that they were so pricey…makes a good gift though.

• Nipple cream

I probably should have purchased this at the beginning, to prevent my nipples from chaffing. Instead, I spent 6 glorious weeks with no issues, and then developed chaffing, and it’s taking forever to go away. I bought Palmer’s cocoa butter nipple cream because it’s lanolin-free. Most nipple creams are pure lanolin, but some of us are allergic to lanolin.

• Milk storage bags

Because I was collecting all this letdown milk but not using them, I had to buy milk bags for freezing. I delayed buying them since I wasn’t committed to breastfeeding, but these are definitely essential. It’s good to have a freezer stash that you can use for the random trips or absence those first early weeks.

• Medela Swing pump (single electric pump)

I only recently bought this (at 6 weeks) now that I know that I am committed to breastfeeding. This is the portable cheapest Medela pump that is only for single side, which is probably all I need till my baby hits 6 months. It may not be what you should get after you commit to breastfeeding depending on your work situation, and you may already have a fancier double pump from your insurance (which I don’t get).

Just so it’s out there, I’m committed to breastfeeding for 6 months for now. I only intend to work at most part-time for the first 6 months, so I’ll only need to pump once while I’m working part-time (I also block feed, so only one boob needs to be emptied). After 6 months, I’m not so sure about breastfeeding (I’m nervous about feeding a baby with teeth). While I’m happy to continue pumping after 6 months, it’s hard to maintain my supple with pumping alone. I’ll consider a double electric when the time comes.

The nice thing about the Swing is that it is compatible with the Harmony (manual) system that I have – just replace the manual lever with the vacuum tubing and pump, and it’s good to go. I usually have to pre-express my engorged boob in the morning (which makes for an easy start to a freezer stash), and I use my manual pump for this. It usually takes a quick 5 min. I’ve switched to using the electric pump instead, and the vacuum is much more gentle, but it takes me 10-15 min to pre-express 1.5 oz these days. While it does take longer, I don’t have to use my hands so I’m happy to sit for longer. It also makes me worried that I was being too rough with my manual pump previously. In case anyone was wondering, the pump is promised for 275 hours only, so it’s not a good idea to use it if you pump multiple times everyday.

The post Buying equipment for breastfeeding appeared first on My Breastfed Baby.

I have written about my newborn’s jaundice experience, where I complained about the lack of information about supplementing (pumped or formula) in the early days. In our case, it thankfully didn’t matter. But others have not been so lucky.

Spread the word: Fed is Best.

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I did my research, and attended classes. It seemed that the key was getting a good latch – the baby will feed well and your nipples won’t be sore and cracked. One should expect to get mastitis at least once. You may have supply issues, but keep working at it. If you’re engorged, use cold cabbage leaves to relieve the pain.

When my baby first arrived in my arms, she latched on perfectly and suckled for an hour. Lucky me, I thought. It turned out that there were still challenges to be met. This is the first of a series of stories about my breastfeeding challenges.

Sleepy baby, breastfeeding jaundice?

After the first 24 hours, the baby will start to get sleepier.  This is normal, and you can keep the baby awake during feeding by undressing her so that she gets cold, or constantly touching her to keep her awake. Neither of these, or the other techniques suggested (I didn’t use the ice cube method), worked on my baby. I wasn’t too worried though – she was too sleepy to feed in the afternoon, but she did wake up sufficiently to feed for about 15 min the rest of the day. Surely that was sufficient? Besides, her stomach is the size of a cherry, or a walnut, and I’m just producing colostrum.

This was when I got introduced to a new concept untouched by most resources: breastfeeding jaundice. Did you know that more breastfed babies get jaundice than formula-fed babies? I didn’t.

There are two types of breastfeeding-related jaundice: breastmilk jaundice, which is caused by components of breastmilk, and breastfeeding jaundice, which is due to insufficient feeding since the milk doesn’t come in until 3-5 days after birth. The yellow of jaundice is caused by a substance called bilirubin, and to excrete it, the baby needs to either pee or poo it out. The breastfed baby is consuming way less than her formula-fed cousin, who is getting 2oz every 3 hours from day 1, so there are fewer opportunities to get the bilirubin out.

My baby’s bilirubin levels were relatively high on day 2, but she didn’t require treatment. We had to follow up with a check 2 days later to make sure that her levels stayed low, but they thought it would be fine. The nurses didn’t warn me about breastfeeding jaundice.

At the day 4 check up, her levels were borderline for phototherapy – we should probably admit her. We discussed her feeding with the pediatrician, and she thought that my baby was not consuming enough, and thus not peeing enough. One issue with jaundice is that it causes babies to become sleepy. Double whammy for the sleepy newborn.

The pediatrician gave us one more day to try feeding the baby properly, especially during the sleepy afternoon feeds. Since I didn’t have an issue with milk supply, she suggested expressing the breastmilk and feeding the baby after we try feeding her in the afternoons. Bottle, syringe, spoon, whatever: just get the milk into the baby. She also thought the 10-15 min feeding we were able to achieve was insufficient for our baby.

I knew that jaundice is not a major issue, easy to treat, but to admit my daughter into phototherapy felt like it would be admitting that I was an insufficient parent. That day, I pumped and fed my baby 1 oz of milk during that small window of 2 min that she was awake for in the afternoon (we completely skipped trying to breastfeed first), and religiously woke her up every 2 hours for feeding, even at night. I was thankful that we bought a lot of stuff early on just in case, so we didn’t need to shop on the way home – a steam sterilizer, a manual Medela pump (much cheaper, and it was really for just in case), Dr Brown feeding bottles, all in boxes waiting to be opened for when I go back to work, but now torn open for our medical emergency. That afternoon, I finally saw a real wet pee diaper, instead of the little orange splotch of concentrated pee she used to pass out.

We went in for another check the next day, and her bilirubin levels had inched up a little more. We had to admit her for phototherapy. There wasn’t time to feed her since her levels were so high, so I had to use the pump at the hospital – it was an electric pump, which I was excited to try, a Medela Lactina, and despite being hospital grade, it actually didn’t work as well as the manual Medela pump at home. But because I was breastfeeding, I was allowed to visit her to breastfeed during the breaks between therapy sessions.

It’s been almost 4 weeks now, and our baby is still visibly yellow. She has prolonged jaundice, and I think that even with enough feeding during the early days, she probably would have needed phototherapy anyway. But back then, I was upset that I didn’t have the knowledge to prevent breastfeeding jaundice, even though it was something I could have easily done.

Pumping and learning about my milk supply

I did learn about my milk supply in the process, which has been helpful for making me a more confident breastfeeding mom. I was pumping 1-1.5 oz per boob in 10-15 min on day 5/6, which would have been sufficient milk for our baby at that point – plus she’s more efficient at extracting the milk than the pump. Even though she had the correct number of dirty and wet diapers, it was still more reassuring to see the milk in a bottle than to guess how much our baby was drinking per session. I felt like a champion milk cow.

The post Underappreciated breastfeeding problems: Breastfeeding jaundice, sleepy newborn appeared first on My Breastfed Baby.