Since Anon is asking information on breastfeeding, then I will write a bit on my breastfeeding experience as a reply to her. More on http://mypreciousangel.blogspot.com/search/label/Breastfeeding

Many breastfeeding mothers reduce feeds or wean earlier than they would like - sometimes by choice, sometimes not. There are ways to reestablish milk supply after having taken a lengthy break from nursing, or if a mother feels that her supply isn't as strong as it once was

Yes! It really takes time to increase the milk supply. For me, my breastmilk is merely during the hospital stay because Amabel sleep 24 hours. When the nurse brings her to me for nursing, Amabel just refuse to latch-on for long, all she wants is SLEEP. Even my gynae Dr Khi, try to help me wake Amabel up, but failed. Being worry that she may not get enough milk as she never pee often and pass motion; the nurse asks me whether I want to give her formula. I firmly told them “NO”, I know once I said “Yes”, everything may not get to go what I really want which is give my baby the best food in the world called “Breastmilk”. So I told them to give her just glucose after I latch-on her. Out of the hospital, it improved, Amabel do latch on longer but very often fall asleep and stop suckler after 5 minutes of nursing. I tried to latch her very frequently to make sure she got enough milk, and encourage her to latch on. It does get better. The first 2 months my milk supply was just enough to meet my girl demand or slightly more to keep in a fridge. I not lazy, I hardly sleep, during the first 3 months. The most I sleep per day is 3 hours, because every 2 or 2 ½ hours I got to nurse Amabel.

This is what I have been doing when I breastfeeding my girl, Amabel;

• Frequent stimulation of breast; nurse (baby does this best by correctly latching-on and with a good suckling pattern at the breast) or pump frequently; at least 8 to 12 times a day. I nurse her at least every 2 or 2 ½ hours during the day and at least every 2 or 3 hours at night. I awaken Amabel to latch-on. If Amabel is available to latch-on, this is preferable to pumping; as baby will better stimulating breasts to produce more milk. For the first 3 months I hardly sleep much. Especially the first two month (yah including confinment period which I suppose to be resting and sleeping) I only sleep the most 3 hours per day ( lack of enough sleep could be one reason why my milk supply doesn’t increase much and fast);
• My daily routine while breastfeeding (especially the first 3 month maternity leave) is to;
  1. Prepare a pail of warm water and cloth to clean and massage my breasts for a few mins and a mug of warm water for drinking to replenish water loss through breastmilk. This will help the milk flow better and encourage the baby to continue feeding as it will help to achieve ‘let-down’ -> this already took me 10 mins for preparations and massaging breasts. See http://mypreciousangel.blogspot.com/2006/12/milk-milk.html
  2. Then latch on my girl for about 30mins, if she cranky it may even takes longer. I make sure I am using correct breastfeeding methods to position my baby and help her latch-on. Glad that I get to know more proper way of positioning baby and latch techniques from Mrs Wong (a lactation consultant in TMC, she is really a pro in breastfeeding). I consulted her due to blocked milk duct. See http://mypreciousangel.blogspot.com/2006/09/meet-up-with-mrs-wong-lactation.html. So if the baby is having trouble latching on, you may need a refresher in positioning and latch techniques.
  I let my baby to nurse on each side for 15 mins or until he pulls off herself or goes to sleep then I switch to another side to try. This will ensure that the baby is getting the proper balance of foremilk and hindmilk. If she refused to nurse the other side, she maybe is having enough of breastmilk already. Then I will judge whether she is having enough by seeing how long she has nurse on that side of the breast. If she latch on for at least 15 mins and I am very sure that she do suckle and swallow the breastmilk for continuously at least 15 mins. I will stop nursing her and let the pump do the job.
  3. I then need to assemble the breastpump and change another pail of warm water to clean and massage the breast again -> this takes me another 5 mins.
  4. Use pump to express out the excess breastmilk in the breasts. -> Took me about 35mins - 45mins depend how much milk left in the breast (I take so long because am using single Avent manual pump initially, the suction is not powerful to empty my breasts and my hands is damn aching. Then I changed to Avent electric single pump so that my hand won’t ache but it still takes me about 35 - 40mins pumping.)
  I would advise using a double, electric breast pump with a double collection system as told by my lactation consultant, Mrs Wong, that it could better empties the breast compare to low end electric pump. And double pumping has been shown to increase Prolactin levels. Prolactin is the hormone which stimulates milk production. So I changed to ‘Medela Pump-In-Style (PIS)’ breastpump which cost $700 and it took me about 20mins only. Pump right after you finish breastfeeding. Do this after as many feedings as possible. Using a pump gives extra breast stimulation. And, pumping after breastfeeding empties your breasts more completely which is helps increase your milk supply. At first you may not get any milk out when you are pumping. But within 1 week, your milk supply should increase.
  5. After I consult the lactation consultant. I added this step which is follow by manually use hands to squeeze out excess breastmilk till no single drop of milk in the breast duct. This will prevent and ensure no blocked milk duct. Emptying your breasts stimulates your breasts to make more milk. And, the amount of milk your body makes decreases if your breasts are not emptied. Making breastmilk is done on the "supply and demand" rule. The more milk taken from your breasts, the more milk your body makes. -> this take me another 5 to 10mins
  6. Lastly I still got to wash the breastpump and accessories plus milk bottles myself though I got maid but I worry she can never wash the things clean enough. I only trust myself so I got to do it myself. -> This took me 20mins (very long right? I wash very long cause I scare not clean enough.)
  Total time taken to increase supply, took me at least 1 ½ hours to finish the above things.
  Guess what? After playing with my girl for awhile or do a little bit of my stuff like cleaning my stitches etc very fast 2hours already, almost time for my girl to latch-on for milk again. The most I delay nursing her to rest for 30mins. And the routines repeat again and again, same for at night. Like that how to sleep right? After consult the lactation consultant and with continuing hardwork in latch on, pumping and emptying breast every feeds for sometimes. I do have ample of breastmilk. I can pump at least 900ml to 1.1 litres per day (if I remember correctly). During the 3rd month, I slowly drag the feeding interval- 3 to 4 hrs to next feed, and i reduced the pumping sessions per day. So after I go back to work, I only pump 4 times a day so my supply do drop abit to about 800ml per day after I went back to work.
• I do keep a breastfeeding diary. Include the times I have breastfed, and the times and numbers of Amabel’s wet and dirty diapers. I wrote down the amount of expressed breastmilk that I give her and the amount she finished. You can be sure that your baby is getting enough by counting his wet diapers and bowel movements. Till now even though I have stop breastfeeding her for half a year, I still recording what Amabel have been eating for her meal and her milk intake per day. I make sure she drink and eat enough daily.
• I ensure the proper way of handling breastmilk. See my precious post http://mypreciousangel.blogspot.com/2008/03/breastmilk-is-normal-food-for-babies.html
• Avoid supplements including solid food, water, juice, and formula. I do intro formula when my supply cannot meet Amabel demand. Amabel intake per day can hit up to 900ml + per day. I am working hard to increase more milk supply to catch up her demand and I can't meet her demand those few days that I need to intro one feed of formula milk to her per day for about 2 or 3 days while waiting for my supply to increase. Amabel milk intake do reduce abit to about 800ml per day after I went back to work and I still able to meet her demand. When she about to hit 6 months, I start intro her one feed of cereal with homemade fruit puree and therefore her milk intake reduce by one feed, but I still continue to ensure I produce the usual amount of milk supply for her. Those milk which expired, i will use to bathe. Hehe! Sometimes Amabel may have a period of time, where suddenly her milk intake increased for a few days and this is the time where I need to supplement her with abit of formula milk (one feed per day for some days). Another thing is that my PIL always ask me to offer her water. But I insist no water for her because breastmilk is already good source of water.
• I try to eat often on foods rich in protein and calcium.
• Rest as much as you can but I hardly lah.
• I know from some mommy that once they intro bottle for expressed breastmilk to baby, Baby start to reject latching on. For Amabel no problem, she can take on bottle and latch on as well. But I will suggest those who have this problem can baby expressed breastmilk by cup, syringe or dropper.

Some extra information which I know but never consume before.
We can Increase Supply with

1) Medicinal Herbs
In addition to frequent stimulation of the breast. Here are herbal remedies that have been reported as boosting milk supply: Herbal teas

• Try Mother's Milk Tea, which is said to promote "healthy lactation."
  
• Some mothers have found that the herb, Fenugreek, is helpful for increasing milk supply. It works best when combined with increased frequency of nursing and/or pumping.

2) Prescription Medication
There are a few prescription medications that, when taken while continuing frequent stimulation of the breast, have been found to raise prolactin levels. This, in turn, increases milk supply
My gynea prescripted ‘Domperidone’ to me when I complain not able to meet Amabel huge demand. But in the end I never consume it at all. Cause I still prefer the natural way of increasing the milk supply.

Here is what I search online for this medication:
DomperidoneThis is the option with fewer side effects; it has been approved by the American Academy of Pediatrics for use in breastfeeding mothers. Unfortunately, it is not available in regular pharmacies in the United States. It is used in Canada and other countries, but it is legal in America; a mother can obtain it by ordering (with a doctor's prescription) from compounding pharmacies in the U.S. Outside of the U.S. (Mexico and New Zealand), no prescription is needed. The typical dosage that is recommended is 20mg, four times a day.

Weaning breastfeed

When 3 meals per day of solid food is introduced when she turn 9 months... Amabel per day intake also reduced to 720ml to 780ml. While I also start to reduce pumping sessions to 2 times per day (still able to express about 750ml per day). The with the decision to wean off breastmilk in later part, I slowly introduce formula milk once per day and over afew weeks -increased to 2 feeds (whilst I will not totally empty the breastmilk, so my breastmilk will reduce slowly) then to 3 feed when she turned 13 months. This is when I totally stop breastfeeding. And I really feel very bad that i stopped so early; till now still regretting.

I very encourage mother to breastfeed as long as possible. I will definitely going to breastfeed my coming baby girl for at least 1 year and even as longer as possible.

K lah!! Very tired liao. Going to sleep soon.

Lol~. Amabel is so sweet! Wanna hug and kiss her now!

Labels: Breastfeeding