My son is 8 months now, and I am still exclusively pumping. Baby have always been supplemented with formula since 3 weeks as I experience latching issues. I always try to give baby at least 60% of my breastmilk in a day and am still doing so today.
(Note that some of the tips apply only to those who experience low milk supply or have lactating issues)
What I wish I had known about breastfeeding before giving birth:
1. You should start to condition your nipple during pregnancy before you deliver. When your baby starts bf, your nipple may feel sore especially for first time mums but this soreness is not to be confused with incorrect latch soreness (sorry I can't explain the difference).
- Get any nipple cream (can get from any pharmacy) to keep it moist.
- Gently massage the nipple to toughen it (but take NOTE to avoid doing so when nearing delivery as it will trigger contractions)
2. No matter how tired you are, try to clean baby's saliva off your nipple after every feed as leaving it there will dry your nipple and may cause any sore to become worse.
3. LATCHING correctly is no 1 thing you must get right. No matter what anyone says, if breastfeeding hurts, the latch is not correct. Do not feel sad (easier said than done) if your baby cannot latch. Both of you need time to learn so do not give up.
4. If you know your baby is not latching correct, it is very important that you get help to get it right within the first week (if possible). My personal experience is everyone told me the latch is correct despite me saying that it really hurts. By time I realize it was already 3 weeks and baby have already developed habit of shallow latch so he couldn't get the amount of milk that he needs from latching - as a result I had to use bottle and supplement with formula. It was unfortunate I was not able to get baby to latch right until he was four months but by that time, he prefers the bottle (faster flow) than my breast.
5. Where to get breastfeeding help and support? There are many breastfeeding support groups, forums around. Even your friends or colleagues who has successful breastfeeding experience is a source of help. Many successful breastfeeding mothers are able to help you with your lactation issues. Professional help is also available (but of course at cost). Just bear in mind that both yourself and baby are first timers and it takes time to learn. So do not be shy to ask for help. You can always start from here.
6. If your baby experience signs of jaundice, you should bf your baby more often (every two hours) to ensure she gets hydrated. You should not stop bf and of course, you must consult your paed and closely monitor your baby's condition. If by this time your milk supply has not been established (note that this should not happen if your latch is correct), then it is alright to supplement with formula.
7. If you have to supplement with formula, just remember to use cup or syringe to feed. I never thought of using cup, and had been using the spoon. Feeding with spoon is very slow and baby was frustrated and seeing baby's frustration and pressure from family members resulted in me giving in to use the bottle.
8. You should invest in good pump if you are a working mum. Dual pump will save you a lot of time. I cannot emphasize this more as I started off using a single pump passed on to me by my SIL. As I experienced latching issues, I had to rely on pumping from very early on and have been using the single pump for several months. My milk supply could not establish and using a single pump did not help. I was very stressed out as I was persistent on giving my baby breastmilk, so I spent a lot of time was spent on the pump trying keep my supply going. It wasn't until I decided to get myself a dual pump that I realize I could have saved so much more time to spend more time with my baby during confinement than on the pump.
9. I should direct latch him at least once everyday, (even if baby could not get enough milk from breast) then use bottle to top-up. Even if baby prefers the bottle, as long baby is willing to take your breast even for short period of time, let him take it at least once in a day. The less time spent on breast, the sooner baby will completely reject it...sooner than you expect. Because I was so concerned that baby will be hungry, a lot of time I resorted to give my milk in the bottle. By 6 months, my baby totally refuse to latch. It was too soon for me and I really really miss the bond and the feeling of cuddling him close for breastfeeding.
10. Will nipple shield help with sore nipples? Yes. Will it help if you have latching issues? I don't believe so. Based on the research gathered from the Internet, I found that if you have sore nipples caused by latching issues, nipple shield will not help. It makes it more difficult for the baby to suckle the milk and will further discourage latching. Alternately, if you have good milk supply, nipple shield may help protect your sore nipples.
11. Lastly, it is very important to get full breastfeeding support from a family members or a friend (anyone one will do and it may not necessarily be your partner). This person must be someone who is always there for you to talk to, cry to, let out bf frustration, etc. You will feel stronger and will likely have a successful bf journey with good support. Of course if possible, your partner should support you and not let family members pressure you into giving up bf.
In summary, you will lose a lot of precious time to spend with your baby if you could not establish a good supply of milk. But there is nothing wrong with exclusively pumping. Some mothers choose to exclusively pump. In any case, any amount of breast milk for baby is better than none.
Hope this will help all future mummies. Good luck and stay strong mummies!