New Mom needs some breastfeeding help

[osutuffy]

Hello, I apologize for the wall of text you are about to read. I wanted to be thorough so I could get some help.
 
My DD is 11 weeks old and I have been back at work for 5 weeks, we were blessed with an angel baby and she only cries when she's hungry, tired, or dirty and she usually makes a little noise to warn us before she starts to cry. It's always easy to get her to stop. When she was first born, she only ate from one side each feeding and I had planned on pumping the side that she didn't eat from to help maintain a good milk supply as my BF book advised. I never seemed to have the time after feedings. Now that I am back at work, I am unable to pump enough to feed her with while I am at work. The baby sitters have to supplement with 1 sometimes 2 formula bottles a day, which I don't mind but I am concerned that my supply is starting to go.  I know that she gets plenty at feedings, but I am no longer getting engorged in the mornings or when I take a shower and the let down feeling doesn't come as often. The other problem I am having (which isn't really a problem) is that she is now starting to sleep through the night and I am concerned that chopping off one more feeding will hurt my supply even more. I need some advice on getting the supply back up and on how to cluster feed. PS, I am also taking fenugreek, although I think it's just not working for me - 3 pills 3 times a day.

I thought I would post our daily routine to help you all understand what our week is like.

On Mondays and Fridays she goes to my friend's house while I am at work. She usually wakes up sometime between 430 and 7 for a feeding, although she has recently stopped doing this and is sleeping through the NF and waking up for the day between 530 and 7.
At 7 am, if she hasn't eaten for an hour or more prior, I feed her and then we head to the sitter's. It's about a 40 minute drive and most mornings she stays awake for it. According to the sitter, she eats really well all day but she doesn't like nap time. She takes 30 minute or smaller naps. They have to walk around with her to get her to sleep and if they stop, she wakes up. They say that she is always good and doesn't get fussy unless she is dirty or hungry. At 530, they give her a 'snack' of about 2 oz of milk to get her through the drive home when I pick her up and to make sure she is hungry when we get home. At 630 she gets dinner, stays awake, between 8 and 830 is bath time, followed by a feeding and bedtime. (Bath time was 9-930 until two nights ago, we decided to make it earlier)

On Tuesdays, she goes to Grandma's and it's mostly the same as above. She won't sleep for her grandparents either. I should add that when she is at home with us, she usually takes her naps in her swing, although I am starting to put her in her crib now. I started weaning her from this one nap at a time and now she takes one nap in the swing and the rest in her crib. She doesn't sleep as long in her crib but it's getting better every day. But at the baby sitter's and grandparents' she won't sleep in the basinet or in the swing.

On Wednesdays, Thursdays, and Sundays I am off work and we are together all day and is BF all day. I have just recently started to try to get her on more of a schedule. We've always had a routine where I feed her, and then I make sure she stays away for at least 30 minutes - she usually stays awake for about 2 hours though, then she naps and she naps between 2-3 hours (3 if she needs it but if she slept good the night before I wake her after 2). Rinse, repeat all day until 9 or 930 when she gets a bath, fed and then I let her nod off and carry her upstairs to bed. I have recently noticed that she is starting to put herself on more of a schedule and we're trying to arrange it to where she has a normal bedtime and nap-times. Her schedule with me recently is as follows:
7 am wake-up and eat
9 - 1030 sleep
1030 eat/activity
1230-200 sleep
2 eat/activity
4-530 sleep
530 eat, activity
730 eat, between 8 and 830 is bath, 830 eat and bed time.
We are on day 2 of this schedule and it fluctuates about 30 minutes here and there but other than that it has worked great. I love having an idea of when I can have me time and hubby and I can have some adult time. She slept for 6.5 hours on Monday and last night I put her in her crib (she was sleeping in a bassinet in our room) for the first time and she slept for almost 9 hours.
On Saturdays, she stays home with Daddy and has much of the same routine as I previously mentioned that she had with me, on the 2 hour awake, 2 hour asleep, rinse repeat schedule.
As for pumping, I pump right after her morning feeding and at work at 11, 130 and 4. For the morning pump, I get between 2-4 ounces depending on when she last ate and between 4-6 ounces total from the three work pumpings. I used to get a total of about 12 ounces from these pumpings, lately as you can see I am getting between 6-10 ounces and she is getting a formula bottle to make up for it at the sitter's.
So here is where I need the advice, should I add in a nighttime feeding at 630, on my days off? Making it feeding times at 530, 630, 730, and 830? I can't add a feeding on work nights as I feed her when I get home, workout, take a shower, give her a bath, feed her, put her to bed, and then I get some me time and go to bed myself. Should I pump on my days off? I tried to pump but it always seemed like I planned it wrong, I would be pumping and she'd wake up hungry and drink what I just pumped. Do I pump right after a feeding? Wait a while?

I never thought I would BF until I got pregnant and then decided I would give it a shot after reading the pros and cons for her. My goal has always been to feed her almost exclusively breast milk until she is good at eating solids. Depending on when she starts eating solids, I plan on BF for another month or two and then switch to pumping until the supply is gone (I plan of BF a minimum of 6 months no matter what). Once the supply is gone, she will get formula.

[lulunut]

I don't know about the times, however I do know that the more you pump the more milk you will produce.  In order to maintain your supply I think you should pump on your days off.

The beginning of the feed is mostly colostrum and water, the end of the feed is more fatty.  If you pump after a feed you can increase your supply and keep the fatty milk for bottles.  It's all good for them.

Good for you for keeping it up.  Whatever you decide will be good for you baby.

I hope someone else has some tips on feeding times for you.  Good luck!

[osutuffy]

I also forgot to ask, every thing that I read says that you should let the baby feed as long as he or she likes. Nothing says anything about a minimum amount. I mean realistically, should she be feeding 10 minutes on each side on average or what? The reason I ask is that I have always had to nudge her to stay awake while feeding, she's a sleepy eater, and I am not sure how long I should keep nudging her awake. A few times I have nudged her to stay awake until she would let go on her own. The first time she ate so much that milk came out her nose and she spit it up all over the place, it was about 2 ounces or more that came out. The second time she also spit it up all over us, my husband and I were surprised that she had that much in her. She soaked us both. I know that they say that spit up looks like a larger quantity than it actually is, but on both occasions it was a lot more than the usual amount. A third time I put her in the swing after nursing a long time and she filled her seat with spit up and we had to change her clothes and take the cover off the swing and wash it. I should add that the only time she seems to spit up is when she eats a lot. Usually right after I tell my husband that I can't believe how long she ate, she spits up

After a while, I realized that she will eat as long as I kept nudging her. I eventually decided that I would nudge her for 15 minutes and then take it away, anytime she woke up and still acted hungry, I would offer it again. For her it seems that if I stop nudging her after 15 minutes she is done and will wake up and have active time at this point.

Previously, DD was feeding for 10-15 minutes on one side every 2-3 hours. Recently, she is feeding for 10-20 minutes on one side and 5 to 10 on the other every 3 to 4 hours. At first I thought it was due to the supply decrease, but then I realized she is going longer between feedings. I know that the milk is flowing when I am BF, as she is a messy eater (let's go and looks around, then we both get milk all over us) and she is gaining weight. So far the supply issue is only when pumping.

So, do you ladies think that nudging her for this long is enough or should I nudge her longer?

[lulunut]

I don't believe that anything says how long because each baby is different.  Some are efficient and eat fast in 5-10 ans some are slow like 20-30.  It's also hard to estimate how much you baby is taking at each feed.  They get more than a pump would most times.  I fed on demand for both mine.  This was time consuming but it all worked out well.  My DD was a sleepy eater due to jaundice and I can't really remember how long I was told to feed her and nudge her but I think it was about 20-30 min.  Cold cloth on her head helped and stripping her down. 

I found with my DS that he ate very fast and when he did he would spit up a lot.  If I burped him for longer and didn't squeeze his belly too much he would eventually burp and there was less spit up.  The swing maybe too much movement for her after eating. Especially if she is full.

How old is she?  She maybe ready to just eat on one side at a time unless she is done with one and then move her to the other for dessert.  If she is going longer between feeds then she maybe also getting more at each feed. Which is good!

I hope this helps.  You can also look up your local Le Leche League online for additional info.