breast and supply changes over time

So our girls are now three weeks adjusted age, 12 weeks actual. I've had an oversupply for the past couple months but now they're taking 4oz expressed milk in each bottle and their demand has caught up to my supply. I have a few questions...

First, it used to be that after a few hours my boobs would be uncomfortably full and lumpy. Now it seems like they're still soft and not particularly full-feeling, but as soon as I let down they swell up and a lump forms on the side until they get drained. Is that normal? It's kind of uncomfortable when the milk rushes in like that (and the girls are basically drinking from the firehose).

Also, we've been playing around with what time of day they get bottles and when they breastfeed. They've generally been getting three bottles and breastfeeding five times per day, but they're starting to sleep longer at night so the frequency is changing. It seems like they sleep better after a bottle than after breastfeeding (I assume because they get a fuller stomach since it's easier to drink) so we've been giving them bottles at 8-9pm and again at 12-1am, then breastfeeding most of the early morning and day except for when they get their vitamins. I'm going back to work in a couple weeks though so they will start getting bottles while I'm away. I'm hoping to breastfeed before I leave and again when I get home, but they'll be getting at least 2 bottles while I'm gone or possibly 3 depending on how hungry they are and the timing. I'm wondering if we should try to breastfeed those two nighttime feedings, or if it's better to stick with the bottle so we can sleep more. During the day a lot of the time they only go 2 hours between nursing sessions, 3 hours if they get a bottle. I'm concerned about giving them too many bottle feeds in a row because I don't want them to forget how to nurse or to be fussy at the breast because it's harder to get milk out.

Last, I'm wondering about how it's going to affect my supply for them to sleep longer. I pump when we give them bottles, and I make sure I pump out 8oz total so there's enough to feed them, but I'm worried that if I don't pump or feed 8x/day then my supply will go down, esp. since when they breastfeed I don't think they get as much as they do when I pump. (They're nursing longer than they used to most feedings, but occasionally have an off one where they only nurse for 8 minutes.) I know as they get older they should eat more volume less frequently, but I'm not sure how that works in with my supply and feeding/pumping.

Anyway I guess I'm just looking for some advice about feeding them now that they're taking more volume.

 

The less empty feeling sounds exactly right for this stage (read more at Kellymom here). I haven't heard of that exact reaction to let down before but it doesn't sound "weird" to me either. If it's really uncomfortable or starts to become painful or the lump doesn't go away after the girls have eaten, I'd be inclined to see an LC.

When and how often you breastfeed once you go back to work I think really depends on a lot of variables, your long terms goals, etc. If it were me, I'd be inclined to have them be given less breastmilk at daycare (no more than 3-4 oz 2x/day) and then breastfeed on demand whenever I was home (so essentially encouraging reverse cycling), including overnight (I bed share with my babies/toddlers). I would err on the side of breastfeeding too much (which really isn't actually possible ) than breastfeed too little (which can cause long term supply problems). The benefits of this approach to me are that you would be able to pump less + breastfeed from the tap more = less work! :good: Anyway, those are my thoughts but I really don't think there's a "right" way to do it. I think you'll find your way with some thought & trial & error.

 

I agree with Rachel. Your supply is higher at night, so now that they are getting better at feedings, I would try to nurse for those overnight feedings. This will help your supply greatly and if they sleep longer it won't hurt your supply since your body will adjust to their needs. Mine were not preemies and I went back to work when they were 8 weeks old. I nursed in the AM before work, nursed as soon as I got home from work, did a bottle at bedtime because it was easier for my husband and I to get them down if we fed them that way, and then nursed through the night if they woke up. Once they got a little older and were not waking as much at night I stopped the bedtime bottle and just nursed them tandem at bedtime (by that point DD was sleeping through the night and I wanted to make sure my supply didn't peter out). Also, this page gives good advice for bottle feeding the breastfed baby. There are techniques to use so that its not quite so easy for them and they have to work like they do at the breast.