Sometimes breastfeeding takes an unexpected detour. It might come in the form of a hospital stay for Baby or Mom, a nursing strike, illness, pregnancy etc. And while many of these unexpected detours can result in getting back on track with breastfeeding in time, it’s important to address the immediate needs while also keeping the long term goal in mind.
When it comes to breastfeeding challenges, the motto to live by is feed the baby and save the supply.
Feed the Baby
Sometimes it’s necessary to feed the baby through alternate means for a time, and that’s okay, it doesn’t mean you’re a bad parent or a failure at breastfeeding. Feeding the baby is of utmost importance.
Some things to consider during urgent times include the “what” and “how” your baby will be fed. What your baby will be fed depends on if breastmilk is available or not. The first choice is always your own breastmilk. If this is not an option, or supply is low, then donor milk is the next best choice, followed by infant formula. If pasteurized donor milk from a milk bank is not available, you must thoroughly consider the pros and cons, and consult your pediatrician, before electing for private/informal milk sharing from a relative, friend or online milk sharing group (scroll to end of post for resources). If infant formula is the route you go with, consult your pediatrician for recommendations on formula brands and guidance around properly preparing formula, to ensure your baby’s safety.
*For information on finding a milk bank for donor breastmilk see: Human Milk Banking Association of North America https://www.hmbana.org/.
How your baby will be fed depends on a variety of factors. Your baby’s age, willingness/opportunity to breastfeed, medical needs, your comfort level, and if you have a good support system. For newborns, options include spoon feeding, cup feeding, syringe feeding, at the breast supplemental nursing systems and bottles. Bottles are often the first choice by parents and hospitals but can make returning to the breast more difficult for younger babies. Once breastmilk transitions from colostrum to mature milk, it is less practical to use spoons and syringes. Getting support from a lactation professional is always wise when dealing with unexpected detours and can be especially helpful when alternative feeding methods are needed.
For more information on bottle feeding a breastfed baby, check out Paced Bottle Feeding
Save the Supply
If your goal is to continue or resume breastfeeding, then keeping your milk supply up is very important during unexpected detours as well, so you aren’t dealing with supply issues in the future.
What does this look like? If your baby can’t or won’t nurse from the breast at all, or only nurses part time, then keeping your supply up means expressing milk anytime your baby misses a breastfeeding session. Ideally, expressing milk every 2-3 hours around the clock or, if your baby is feeding part time at the breast, then expressing the times he/she isn’t feeding from the breast.
For mothers who are in the “critical” time of building a full supply in the early weeks of breastfeeding, removing milk frequently and thoroughly is essential for creating a long term full supply. Remember, move milk to make milk. You must keep the breasts flowing to keep the milk machines going.
Expressing milk can look different for different moms and depends on the circumstances and availability of supplies. For moms with newborns or low supply in general, using a hospital grade breast pump combined with massage and hand expression often results in the greatest output. Some moms find their home-use double electric breast pumps are very effective at removing lots of milk without inhibiting supply and others prefer a manual hand pump or hand expression. Wearable pumps should not be used as the sole pump for most moms as they are often not as effective at removing milk full time and could result in a decrease in supply if relied upon for full milk removal. If you find yourself without access to a pump, hand expression is always an option and is often a solid choice if you know what you’re doing.
In urgent situations, “ideals” aren’t always met. Remember, any milk removal is better than none. Aim high, and if you can only manage to express 6x instead of 8-10x in 24 hours, just know that you can define your own success when it comes to breastfeeding and depending on your personal milk storage capacity, where you are at in your breastfeeding journey, and the duration of the detour, you might still be able to maintain your supply.
*If pregnancy is the unexpected detour, working with a lactation specialist to ensure your baby is getting enough breastmilk is key as pregnancy can cause your supply to drop.
Unexpected detours happen, and having a lactation professional just a phone call away can be a lifesaver when you are stressed and just trying to survive. Reaching out for help as soon as you can can make a world of difference.
The following resources have information that will help families & pediatricians weigh the risks vs. benefits of informal milk sharing so they can make an informed decision. Instructions for home pasteurization, if desired, are also outlined.
Eats on Feets
Mother’s Milk Alliance
Human Milk for Human Babies
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