Breastfeeding case study of Baby Aaron – 4 weeks

Birth

  • Born at 38wks + 2 days
  • Natural birth, no issues or complications
  • Birth weight 3.2kg
  • Was back at birth weight by Day 5
  • Had jaundice over the first 2 weeks, but seems to be better now

Breastfeeding journey

  • Aaron was born with a tongue tie. This was diagnosed and snipped on Day 2
  • Breastfeeding was very painful with poor latch in the first 48 hours. Cracked/bleeding nipples
  • In the first week, we did mix feeding. Breastfed + formula top ups. This was because it was so painful to breastfeed
  • Started pumping from Day 2. As breastfeeding was painful, I stopped directly breastfeeding and exclusively pumped (minimal direct breastfeeding). Pumped 6-8x a day for 4 weeks
  • As of 4 weeks postpartum, I was producing 750-800ml per 24hrs via breast pump and was pumping 8x a day. This was roughly the amount Aaron was taking per day from the bottle. From time to time we may top up with formula if I didn’t have enough breastmilk in the fridge (this was occasional)
  • At 4 weeks postpartum, I have wanted to move to direct breastfeeding and drop pumping as much as possible. A local lactation consultant showed me some breastfeeding positions to help me on my way, including encouraging me to breastfeed at night by lying down and co-sleeping. She seemed satisfied with Aaron’s latch and the way he was breastfeeding. She saw how he came off the breast with his milk drunk face and milk dripping from his mouth. She said I had plenty of milk and not to be concerned, and to breastfeed on demand. She said I just needed the confidence/encouragement to leap into breastfeeding and that I could do it
  • I have now dropped my pump schedule to 2-4x per day. I put Aaron onto the breast whenever he looks hungry or is fussy. If I give him a bottle or provide a top up (of expressed breastmilk), I will always pump at the same time to ensure that my breastmilk supply is maintained. There are a few times we have given a bottle — e.g. in the evening before we go to bed, and occasionally in the day

My key concerns

  • I have worked so hard on the pump to produce 750-800ml/day which just about meets Baby Aaron’s needs (when bottle feeding). I’m used to “emptying” my breasts 8x a day with the pump. When Aaron feeds, I don’t feel as “empty”. Some feeds seem small and it doesn’t feel like he’s extracted as much as my pump. I therefore am concerned that he isn’t feeding efficiently and that my breastmilk supply may decrease
  • I’m concerned about whether I should drop from 8x/day pumping to 2x/day pumping immediately, or whether I should gradually do that (given the above). Today I’m only doing 2x pumping (morning and night only), and there is a concern that I’m not emptying the breast frequently enough in the day time even though I’m nursing on demand
  • Baby Aaron often looks hungry, often looks fussy and I’m putting him on the breast all the time (I feel like if he isn’t asleep, he’s on the breast!). While I know I have enough breastmilk and that having him on the breast all the time will boost breastmilk supply, I keep questioning whether he is successfully taking it and whether he’s actually filling up (maybe this is an insecurity / confidence issue, but it’s a key concern of mine all the time)

End goal

  • Ideally, I’d love the option to breastfeed directly or give the bottle. This could mean breastfeeding day/night, but my husband gives the bottle 1-2x a day. Or it could mean breastfeeding for half the day and leaving the Baby with Dad the other half a day with pumped milk
  • I’d like to make sure as I switch from pumping to breastfeeding that I don’t lose my supply that I’ve worked so hard to generate. I need to make sure Aaron is extracting efficiently as I transition and that he isn’t hungry
  • If possible, I’d like to have a slight oversupply so am keen to keep pumping 1-2x a day to put bottles in the fridge

Sleeping journey

  • This is all over the place… we do a lot of contact napping. Aaron likes napping on our chest, in the sling, in the pram
  • This time around, we bought the Snoo. At night he was doing OK in the snoo (it rocks him with white noise through the night). When he is tired, the Snoo can sometimes settle him and put him to sleep. Otherwise, we contact sleep and transfer him into the Snoo
  • However, as of 2 days ago I started trying to breastfeed through the night (previously we gave bottled breastmilk at night). Due to breastfeeding through the night, I’ve brought Baby Aaron into the bed and we have been co-sleeping together and breastfeeding while lying down. While Aaron seems more settled this way (less big wake windows at night), it’s uncomfortable for me co-sleeping beside him as our bed is too small and I am no longer sleeping deeply. I don’t feel this is a good long term solution and would like to breastfeed and then put him back in the Snoo to settle (but not sure Baby Aaron wants to do that, so might not be productive)
  • We are trying to figure out our sleeping arrangement

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