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.

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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.

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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.

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.

The post You should not be freezing breastmilk appeared first on My Breastfed Baby.

When do babies start to babble?

According to the internet, 4 months, which is why I thought our little bundle of joy was right on track. At 8 weeks, she looks like she understands what I’m trying to say when I have a conversation with her, and politely blinks or waves her arms and legs in response. She sometimes makes sounds.

At her 8 week well-check up, the pediatrician tries to have a conversation with her. The little darling stares at the lights on the ceiling. The ped tries a little harder, and our baby girl waves her arms a little, and eventually grunts a little, although she looks like she was paying attention. Verdict: no good. She is supposed to be babbling. What?

We will have a follow up in a month to check on her social development. In the meantime, I have to engage with her more. It’s intuitive, but someone should spell it out for me anyway: if the baby makes a sound, encourage her by responding and hope she makes more sounds.

These days, I explain to my daughter that she needs to be noisier. I don’t know how to make her less interested in lights than people though.

Baby has low muscle tone

We checked on her muscle development too, and the ped says that she’s behind as well. But how behind is she?

We found a useful video on youtube showing the typical development of a 2 month-old. I’m posting it here for your reference. Yup, she’s behind. But everyone I know swears that their baby didn’t get that far at 2 months.

Other Tummy Time moves

Another useful follow up video is this one which shows alternatives to the standard lay-on-flat-surface tummy time. We have tried them, and found that she responds much better to being placed on the lap.

We have a follow up appointment in 4 weeks instead of 8, and hopefully we will have caught up by then. I don’t know what happens if she hasn’t caught up, or how much catching up she needs to do. What did people do before the internet? I don’t think pediatricians used to spend hours with their patients explaining everything. Anyway, fingers crossed for the next 3 weeks.

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