What to do while you are waiting for lactation and infant feeding help

Congratulations on the birth of your baby - this is an amazing time! But, it can also be a very stressful time - especially if you are worried about feeding your baby, your milk supply - or both.

My first recomendation is to reach out to an experienced IBCLC - we help with latch, supply, pumping, bottle feeding and so much more. But, sometimes this help is not available for a few days, or even a bit longer. So, what can you do while you are waiting?

Feed the baby and move the milk!

Your baby needs strength and stamina by taking in your milk and/or formula - usually 8-12 times per day to keep refilling their tiny tummies.

If breastfeeding is comfortable and effective then continue to nurse. But if breastfeeding (full-time or part-time) is unsustainable at this time - painful feedings, breasts never feel relieved, baby not getting enough milk, feeding sessions taking so long there is no time for anything else - or honestly anything else that is concerning you - then it’s fine to nurse less, or even take a break from nursing and exclusively pump. In that case, you want to use bottles (or any method of your choice - such as finger, spoon or cup feeding) so that the baby gets milk comfortably and easily. How much to offer depends on your situation, but paced feeding usually helps to customize the amount for your baby. And, if you are not getting enough milk to feed the baby from nursing and/or pumping, then add in formula or donor milk.

Your body needs to have the milk flowing - this will build/maintain your supply, and keep your breasts comfortable. You want to move the milk effectively 8-12 times per day. This might be from all nursing, a combo of nursing/pumping, or all pumping. If you are exclusively pumping, I recommend starting with 8 times per day, and then re-evaluate the number from there after you see how your body responds. You can also use hand expression instead of pumping. In fact in the early days, it’s often easier to hand express than to pump because colostrum is thick and often easier to collect by hand expression.

They key is effective milk removal - no matter how you are moving the milk, it’s incredibly important that it’s moving well. If the baby or the pump are not pulling the milk out effectively, then the stimulation to your supply will be lower than you think, or you may develop breast/nipple pain, engorgement or other issues.

When you are feeding the baby and moving the milk - there is time to solve the problem.

Many people are advised to “triple feed” - nursing, bottle feeding and pumping at every session. Sometimes this is a good approach, and sometimes not! In my experience, triple feeding is only helpful in the short-term - if it’s used to identify which aspects of your feeding/pumping plan are helping (and which aspects are not helping!) - and then use that info to customize the plan over time. If it’s working to nurse the baby often throughout the day while also pumping and bottle feeding - great! But, they key point to ask here is - is it working? (I’m including comfort, sanity, use of your time and more!)

If nursing is unsustainable for now - too much pain, baby not getting milk, no time for nursing and pumping/bottle, too stressful, or any other reason - it’s okay, and sometimes even important, to take a break! I know that people worry about a baby getting used to a bottle and then not nursing. In my experience babies do not forget how to nurse - they have so many instincts to do so and can almost always go back to nursing if that’s what the family wants.

The main things we will work on when we meet will be to figure out why the baby is having trouble getting milk, or why nursing is hurting, or any other issue that you are dealing with. We will also make a plan that feeds the baby and moves your milk that is customized for you.

In the meanwhile here are some of my favorite resources - I hope they help make this time between now and when we can meet a bit easier:

Skin to skin holding - very snuggly and comforting for the whole family.
On my Nursing Effectively and Getting Enough Milk page, there are many resources, but these two are my first go-tos:
- Is baby getting enough to eat overall?
- Is baby getting milk while nursing?
Engorgement, Breast Massage, and Hand Expression to relieve full/engorged breasts.
- Hand expression is amazing because your hands are always with you, and once you learn how you may even like it more than pumping!
Pumping - pay close attention to flange fit. We now know that most people need much smaller flanges than come with the pumps! We will do a full flange fitting at our visit, but in the meanwhile if pumping is hurting or if you are not getting enough milk - try some of the ideas on that page to help.
On my Paced bottle feeding page, there are many resources, but this is one of my favorite videos.
Deeper Latch page - there are many resources on this page, but this video is my first go-to.
Nursing Positions page with a variety of ideas to try.
Nipple Shields, when used in the right situation, can be a “bridge” to breastfeeding. If the one you are using fits you well, keep feedings more comfortable and helps the baby get milk, great! If not move the milk and feed the baby (see above) in whatever method(s) work for you and we will figure it out together when we meet.

<——- Combining Breast/Bottle —————- Breastfeeding Positions ——->