> I realize that pumping and giving breastmilk by
> bottle that evening would be the ideal but mom can't seem to pump much after
> baby is done eating.  Therefore, she doesn't have much stored.

I think the original poster asked because the mom was having trouble pumping
enough to leave a bottle of her own milk since she was also nursing the baby.   I
deal with this common "problem" in my routine anticipatory guidance to moms who
want their baby to be able to take a bottle at some point.

I discuss 4 phases of giving the baby bottles of mom's own milk as "one idea that
works" not as a "RULE".  This helps moms form a working plan of action and lets
then relax in the present "phase" of inniating lactation instead of worrying so
much about what they will do later.

I'll include an outline here as I find it helpful to print out and use ad
handout.   Moms will often want to know this on day ONE when I want to
concentrate on latch.  I find if I give it to them in print they relax and let me
go on to teach what they really need to know for day 1 and 2.     I also have
similar handouts for moms who are adamant that they will not pump at all or moms
who will only partially pump but still plan to give bottles.

4 phase plan for giving baby bottles of mom's own milk:

Phase 1:  Just the breast
Just breastfeed, give yourself and baby time to learn before starting bottles -
try for a month of good breastfeeding before initial bottle.

Phase 2:  Baby learns to take bottle
Teach baby to take bottle before s/he is three months old as it is commonly
difficult to get  a baby past that age to begin bottles.
Use your own milk in the bottle.   Pump one side just before an anticipated
feeding time and let future feeder and baby learn bottle feeding together.   If
it doesn't go well or baby is upset give the unpumped side, finish with unpumped
side if baby still hungry.  This has the advantage of the first pumpings being on
a "full" breast and enhances mom's confidence as well as reserving 2nd breast for
back up if first feeding doesn't go well.  Practice according to baby's response,
if baby hates bottle do more often, if baby does well do less often.

Phase 3:    "Robbing Peter to Pay Paul"
Know this can be a very demoralizing time if you don't understand it is a
temporary  and short phase.
Build up an inventory of frozen milk to hold in reserve for time when mom goes
out and leaves baby with another feeder.  Plan on not getting much in this phase,
expect fractions of an ounce per pumping session.  Pump when you can: this may
be; after a feeding, briefly before a feeding, on a side the baby didn't take,
briefly between feedings.   Freeze this milk in hard plastic bottles.  It can be
frozen in layers, just cool the second and subsequent aloquots  in refrigerator
and pour cooled milk over frozen milk.  Size the bottles as full feeds and
partial feeds; some 1- 2 ounce bottles and some 3 - 4 ounce bottles.  Plan on
1 -2  ounces of milk stored in freezer for each hour you will be gone from the
baby  ON THE FIRST DAY of Phase 4.
2 ounces per hour allows a nice buffer if spillage or waste occur.

Phase 2 may also overlap with Phase 3 and to reserve a small portion of the full
breast pumpings for the freezer.

Phase 4:    Mom is away from baby
The first time mom actually leaves and someone else feeds the baby the previously
frozen milk.   Mom pumps to replace, to maintain supply and for her own
comfort.   Now mom is pumping a full breast again (no more robbing Peter to pay
Paul!) and it is easier.   Expect ounces not fractions of ounces.   If mom is
away  briefly but baby is fed during her absence she can pump on her return
home.  If mom is away for more than 4 or 5 hours she will need to pump while she
is gone.  Decide if pumped milk is to refrigerated or frozen according to when it
will be needed next.  Full time working moms will refrigerate Monday's milk to
use on Tuesday, Tuesday's milk to use on Wednesday, etc...  Moms pumping for the
occasional baby-sitter will freeze milk.

Carla D'Anna, RN, IBCLC

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