Margaret asked about when  mom should start pumping and offering
breastmilk from either bottles or cups in a mom who will have 3 to 5
months maternity leave.  I would like to share my experience and some
thoughts on this matter.

This mom is pretty fortunate indeed to have a reasonably generous
maternity leave for this country, at least.  I had to return to school (I
was in college and my time track/financial aid situation posed some
constraints) six weeks after my last baby (#4) was born. Fortunately, I
was able to return part-time the first quarter back and was able to bring
my nursing infant with me to class.  However, by the time the winter
quarter rolled around, my son was too "grabby" and already becoming
mobile, at age 5 months, to take to class with me. Also, I needed to take
a full load of classes so I could finish my prerequisites for the nursing
program that I was starting the following autumn and have some time off
prior to taking on that program.

Ezra, my baby, had had a few bottles of my milk as a newborn (he developed
viral meningitis at age 10 days and was hospitalized) and had been the
only one of my children actually willing to take a bottle or pacifier. I
began expressing and storing milk for him a few weeks in advance of when I
knew I would have to start leaving him in daycare (I only had a manual
pump).  I pumped in the mornings when my milk supply was greatest, and it
was the easiest to get a large amount of milk.  Ezra did start out using
the bottle for my milk but within a few weeks wouldn't take it anymore. He
began using a sippy cup without the top on to take my breastmilk and there
were no further problems until about 8 months of age, when he would either
only take solid food or juice (in a cup) but would hold out until I got
there to breastfeed. He would no longer accept my milk out of a cup or
bottle. Luckily, around that time, the quarter ended, I got a respite from
school for six months, and when I returned to school with Ez at age 14
months, he ate regular food when I was gone and nursed when I was home.

I suspect that whether babies will accept bottles is probably a matter of
personality as much as any thing else.  Because of my experience with
Ezra, I try to warn moms that babies who initially accept a bottle may
change their mind about this later.  I try to encourage moms to spend the
first several weeks just nursing and getting to know their babies, if at
all possible.  I think it is helpful to express milk for storage a few
weeks in advance to have a stockpile in the freezer (it helps alleviate
anxiety about having enough milk to leave for the baby). I have had good
success with introducing 2, 3 and 4 month olds to the cup (the sippee cups
with the lids removed work fine -- in my experience, many babies try to
suck on the sippee lids).

Ione Sims, CNM, IBCLC