Leaving your Breastfed Baby
Leaving your baby for the first time can be stressful for any parent. However, leaving a baby who is exclusively breastfed comes with unique concerns about them being hungry or distressed without mum's milk.
Here is one ordinary mother's experience and top tips for leaving a baby with an expressed bottle:
When to introduce a bottle?
The official line is not until breastfeeding is established. So try waiting 6 weeks. My son took a bottle really well in the beginning (he had to one day when I was really poorly - thankfully I already had a pump handy!) And then nursing was easier so we never tried again. In hindsight, I wish I had offered the bottle regularly to keep him used to it as it may have solved some of our problems. But it’s a pain to introduce a pumping session if you could be nursing I guess...
Which bottles do you need? I had chosen a brand of bottle I liked for many reasons. I had one freebie from another brand which I did try a couple of times but other than that, I just stuck to the same brand and kept offering that. He initially took the bottle, then refused for ages, then happily took it again. I think the issue was more that he wanted to nurse rather than he needed a different kind of teat. It can be an expensive endeavour to try every bottle out there, and for us it wasn’t the main issue to overcome. So I would advise trying all the other steps first before you buy more bottles. We had success on a size 1 teat and stuck to it; otherwise my son seemed a little overwhelmed by the milk flow, but one midwife did say to try size 2 straight away because they may prefer the faster flow so that could be one change to try if all else fails.
Or what about skipping a bottle altogether?
Bottles can confuse breastfed babies. A small flexible cup can be used with very young babies, or even a half full spoon. Your baby should lap the milk with their tongue, rather than you pouring it into their mouth. If your baby is over 3 months, you could try a cup or simple beaker without valves. Some people also try using an oral syringe to gently drip milk just inside their lower lip. With any method, let the baby set the pace.
If your baby is over six months and has begun weaning, you could mix milk with solids to increase intake.
Offer the expressed milk when they are happy first! I was so grateful when I reached out to La Leche League because they gave me this advice and it made all the difference! To get your child used to the idea that a bottle equals food, end your nursing sessions with a bit of breastmilk in a bottle. If you only ever try to give him the bottle when you’re not there and they are hungry, they may well kick off, wondering why this thing is being shoved in their mouth. Basically, teach them that bottle equals milk when they are calm and already pretty satisfied after a feed.
Babies may wait for mummy! It is not uncommon for your baby to wait until you get home to feed. So they may refuse a bottle altogether and wait to nurse when you get home. They may feed more overnight as a result. I found anything less than 4 hours and my baby refused a bottle. The day I had to leave my son for 5 hours, he then took a bottle and has ever since. I know this may concern you if your baby is fed on demand. My son usually fed at least every two hours when I was there but seemed to be happy wait that bit longer in case I came home to breastfeed.
How much milk to leave? To stop me panicking, I left whatever I’d managed to pump fresh, and then just put some spares in the freezer! They are quick enough to defrost. That way, I never obsessed over how many ounces per hour. There would always be enough. But on average, breastfed babies take between 2-4oz at each feed.
Some Like It Hot! Again in hindsight, my son preferred the milk to be warmer rather than straight from the fridge so factor this in with your caregiver if you think your baby would prefer it more like room temperature (just ensure it is only out within safe timeframes).
To warm, put the bottle in a jug of warm water, or run it under warm running water. Test the temperature on your wrist before serving.
When to pump? Ideally, nurse just before you leave and immediately upon your return. Whilst you are out, you may need to pump when you would normally have nursed. I had a show once though and this wasn’t feasible so I pumped in my breaks when my boobs were full. Emptying the breasts helps you avoid blocked ducts etc. If you can take storage bags and store in a fridge or cool bag with freezer blocks, you then have a spare stash!
Oh how I wish I had known about this when I was actually pumping. My husband had mentioned before that my expressed milk smelled a bit funny. Whilst he never described it as soapy, I think this is an accurate likeness. I think my milk had excess lipase and so once it was expressed, it went a bit funny and would not taste nice for my son. No wonder he kept rejecting it! If you've never heard of lipase, it is an enzyme that breaks down fats in your milk. Normally this helps baby to digest it, but if you have excess lipase then the fats are broken down very quickly and this is what can make the milk taste funny.
If you have excess lipase, the milk must be scalded before freezing, as lipase is still active even at low temperatures. Unfortunately, many women find out that they have excess lipase after establishing a freezer stash and finding that their baby won’t take any of it. If you find yourself in this situation, consider donating as many babies will accept this milk, and it is often used in tube fed babies who can’t taste it.
The links at the bottom of the article may help you if you think you have high lipase.
We hope these tips help you feel more confident about leaving your breastfed baby with expressed milk!