If your baby is breastfeeding effectively then he will get more when he breastfeeds than when you pump. Pumping is not the same as breastfeeding. The amount of milk you get from pumping is not the amount you have – it is only the amount you managed to get out by pumping.
When you breastfeed directly three things are working together to help the milk leave your body and enter the baby’s body.
- Your hormone levels are raised, especially oxytocin. Oxytocin helps the milk ejection reflex – this is the reflex that squeezes the milk out of the aveoli, the milk producing cells, and pushes it into the ducts which take the milk to your nipple. When you pump or hand express the levels of oxytocin are much lower.
- The baby uses suction to help the milk come out – the pump tries to duplicate this but hand expression doesn’t.
- The baby’s mouth milks the breast with its tongue and jaw movements. Hand expression tries to duplicate this but the pump doesn’t.
On top of this many mothers have difficulty getting the let-down to work well when pumping. It works with no trouble when the baby is breastfeeding directly but doesn't seem to work at all when using the pump. Thus things that don’t matter when breastfeeding directly can affect the quantity when pumping. For example, how tried you feel and how much stress you are under.
I think it is also important to understand how the breast works. Please see separate thread about this,
How the breast works
When you feed a baby with a bottle it is much easier for the baby to drink large quantities. (You can see this by the speed that a baby drinks from the bottle.) But fast is not always what we want. I often think of breastfeeding like having dinner at home, one plateful is enough. And bottle feeding (whether breast milk or formula) like going to a buffet, after the first plate full I go up for a second plateful or even a third! I only stop when my body is telling me I’m really full – by which time I’m actually overfull. Try to pace the bottle feeding. Stop every few minutes and give the baby a rest of a few minutes. This will slow down the feed and allow the baby to stop when has had enough rather than when he is overfull.
It is very normal for babies to feed in different patterns. See the thread, Breastfeeding after a C-section,
Breastfeed after C-section?
(6th post on second page)
This talks about the chocolate cake syndrome and Chinese banquet syndrome. Both these behaviours are very normal and nothing to worry about as long as you baby is growing well.
You mention that your baby hasn’t put on enough weight. I’m looking for around 170 grams per week taken from the baby’s lowest weight – not the birth weight. If your baby isn’t managing this it is important to assess the baby’s latch on technique to make sure it is as good as possible. It is also important to look at the number and lengths of the baby’s feeds and get help – preferably from someone who knows about breastfeeding management, either a lactation consultant or a LLL Leader.
I believe that nipple confusion does exist – I’ve seen it too many times to not believe in it. But there are lots of factors that play a part in whether a particular mother/baby pair will suffer from it.
Imagine coming to Hong Kong and trying to learn both Mandarin and Cantonese at the same time. A few people would be able to do this with no problems, far more however would get the two languages mixed up. If, however, you started learning Mandarin after you were already fluent in Cantonese you would find it much easier. Breast and bottle feeding is like this. Once the baby has mastered breastfeeding introducing the bottle has very little effect on the breastfeeding but if you introduce a bottle before the breastfeeding is going well there is usually a problem.
The factors I’ve found to influence the outcome when bottles are introduces are,
- When bottles are introduced, usually after 6 weeks has very few problems but rather than age of the baby it is really how well the baby is feeding that matters.
- The flatness of the mother’s nipples. The baby breastfeeds not nipples feeds so having flat nipples is not a problem unless the baby is introduced to the very point nipples of the bottle teat.
- The depth of the baby’s palate and whether there are any physical problems such as tongue tie.
- The mother’s technique of breastfeeding, if the mother has experience of breastfeeding then later babies often do well earlier with bottles (but I’m still talking at three to four weeks instead of six weeks) I think this is because the second baby is feeding better than the first one because the mother has more skill.
These factors are just things that I’ve found in helping mothers. I’ve found no research which addresses this issue. (If you find any please let me know.)
Best wishes,
SARAH
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