Letting Go of Guilt and Doing What Works

1) Establish your supply for the first six weeks.

After your baby is born, it takes about six weeks for your supply to become established. Try not to supplement during that period. Those early weeks are a really important time when your nursing baby is helping your brain know how much milk to produce.

If you plan to go back to work at 6 weeks, start pumping when your baby is about four weeks old and feed the baby one bottle every 24 hours to get them used to it. Use a nipple that’s similar to the breast, such as MAM or Comotomo (slow-flow nipples preferred).

2) Put baby to the breast first.

If you’d like to continue nursing when you’re able, always put your baby to the breast first when you do a feeding. Then you can top off with formula if you need to.

This contact between the baby and the breast is important, especially if you’re having supply issues. Your brain has to be in on this situation. Having baby at the breast cues the brain and says, “We’re still breastfeeding.” We’re just not stressing about it.

3) Know which feedings to keep at the breast (if you can).

If you’re going to replace a feeding by supplementing with formula, remember it’s totally OK. However, there are two feeding times when it is best to keep baby at the breast if possible.

The first is the early morning feeding, usually between 4 and 7 in the morning. This is super important. It sets the tone for the day, and the breast is as expanded with milk as it’s going to be. If your baby completely drains that breast, a sensor in the brain goes off: “We need to make more milk.” If you skip that early morning feeding, your milk-making hormones will decrease.

The second most important feeding is the one right before bed. This is when your body produces the fattiest milk, and the hormones in it help set the circadian rhythm for baby. They help your baby sleep. And BONUS! They help you sleep, too.  Win-Win.

4) Do not measure success by how many ounces you pump (if you’re pumping).

Even if your baby is getting two or four ounces of breastmilk, that is a win! If that’s all you have, that’s enough. As long as your baby’s mouth has touched your nipple, you are creating milk that has amazing immune properties. It’s like one giant vitamin.

As babies get older, volume goes down on purpose. The fat content and calories go up, and your baby’s not eating every 90 minutes. Four ounces for a 6-month-old is different than four ounces for a 6-week-old. It’s like a bowl of mac and cheese versus a bowl of chicken broth.

A lot of people quit because they’re “only getting four ounces.” Don’t stop because you’re feeling inadequate. (But if you want to stop, then stop! Remember — whatever you need to do to maintain sanity!)

5) Feed pumped breastmilk first without mixing with formula.

If you have expressed/pumped milk, make sure your baby gets that first. This means that, ideally, you shouldn’t combine pumped milk with formula.

I know, it’s appealing to mix the two to get the number of ounces you need for the next day, especially if your baby goes to a daycare center. A lot of daycare providers won’t mix formula, so you have to prepare both expressed milk and formula ahead of time.

My experience as a mom and a nurse has taught me that it’s best to keep expressed breastmilk and formula separate. Think of it this way: If you combine pumped milk and formula to get a 6-ounce bottle and the baby drinks only four ounces, you’re wasting some of that precious breastmilk.

6) Rally your supporters.

Your partner and daycare provider should be on the same page as you. Having a supportive partner helps with any breastfeeding issue.

When it comes to husbands, I suggest giving them specific tasks that will make your life easier. For example, you can say, “It would really help me if you’d wash my pumping equipment.” Let them know how to be involved.

As far as daycare providers go, if you have both pumped milk and formula, it can be extra work for them. They might find it annoying, but you have to stand your ground. The daycare workers will figure it out.