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document.writeln('<p><font face=arial,helvetica><font  color="#000099" size=2 family="SANSSERIF" face="Arial" lang="0"><b>GOING ');
document.writeln('        BACK TO WORK - Combining breast and bottle feeding <br>');
document.writeln('        <br>');
document.writeln('        </b></font><b><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0">Question</font></b><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0">: ');
document.writeln('        </font></font></p>');
document.writeln('      <p><font face=arial,helvetica><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0">I ');
document.writeln('        plan to breastfeed solely for six weeks. However, I want to go back to ');
document.writeln('        work after my six weeks are up, so I want to put breastmilk into a bottle ');
document.writeln('        only, I am not sure how to introduce the bottle to my infant. I don\'t ');
document.writeln('        know how long I should wait before I introduce it either. Could you please ');
document.writeln('        let me know the best ways of doing this? </font></font></p>');
document.writeln('      <p><font face=arial,helvetica><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0"> ');
document.writeln('        <b>Answer</b> </font></font></p>');
document.writeln('      <p><font face=arial,helvetica><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0">Congratulations ');
document.writeln('        on your decision to continue nursing after you return to work. It\'s a ');
document.writeln('        real labor of love, but well worth all the effort. When you say that you ');
document.writeln('        want put the milk in bottles only, does that mean that you are not going ');
document.writeln('        to pump while you are at work? If so, then it is going to be very difficult ');
document.writeln('        to maintain your milk supply for a baby who is only six weeks old. Or ');
document.writeln('        do you mean that you plan to exclusively pump after you return to work ');
document.writeln('        and not put the baby on the breast at all? That is also going to present ');
document.writeln('        difficulties. </font></font></p>');
document.writeln('      <p><font face=arial,helvetica><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0">The ');
document.writeln('        first month or so of nursing are a time of establishing and building your ');
document.writeln('        supply. At six weeks, you will have a good supply built up and your baby ');
document.writeln('        should be nursing efficiently. In order to establish an adequate milk ');
document.writeln('        supply, your newborn will nurse frequently (10-12 times or more in each ');
document.writeln('        24 hour period in the beginning). If you return to work full time and ');
document.writeln('        your breasts don\'t receive any stimulation for an extended period of time ');
document.writeln('        each day, your supply is going to diminish. There is no way to predict ');
document.writeln('        what any <br>');
document.writeln('        baby will do in a specific situation. Some older babies who are eating ');
document.writeln('        solids and only nursing a few times a day will do well with the "nursing ');
document.writeln('        when you\'re together and using formula when you can\'t nurse" regimen. ');
document.writeln('        Others will begin to lose interest when your supply starts to drop. Young ');
document.writeln('        babies who are totally dependent on milk to meet all of their nutritional ');
document.writeln('        needs are more likely to become frustrated and unwilling to go on the ');
document.writeln('        breast at all if your supply drops dramatically.</font></font></p>');
document.writeln('      <p><font face=arial,helvetica><font  color="#000000" size=2 family="SANSSERIF" face="Arial" lang="0"> ');
document.writeln('        It would be much easier to continue nursing after you return to work if ');
document.writeln('        you plan to nurse when you are with your baby, and pump <br>');
document.writeln('        at least once during the workday. The articles on "<a href="http://www.breastfeedingbasics.com/html/collecting_and_storing.shtml">Collecting ');
document.writeln('        and Storing Breastmilk</a>" and "<a href="http://www.breastfeedingbasics.com/html/returning_to_work.shtml">Returning ');
document.writeln('        to Work or School</a>" have lots of information about what is involved ');
document.writeln('        in choosing a pump, expressing your milk, and preparing to return to work. ');
document.writeln('        <br>');
document.writeln('        <br>');
document.writeln('        <b>If you know that you want to have the option of giving your baby bottles, ');
document.writeln('        this is what I recommend:</b> <br>');
document.writeln('        <br>');
document.writeln('        1) At 3-4 weeks (or 2-3 weeks if you are returning to work at 6 weeks) ');
document.writeln('        begin pumping after feedings for 4-5 minutes if your baby had a good feeding, ');
document.writeln('        or 8-10 minutes if he didn\'t nurse well or only nursed on one breast. ');
document.writeln('        This will get out the rest of the high calorie, fatty hind milk, and will ');
document.writeln('        not interfere with your baby\'s nursing schedule. It\'s important to be ');
document.writeln('        using a good double pump. With a less efficient pump, you are going to ');
document.writeln('        have a problem getting out the milk that is left in the breast after a ');
document.writeln('        feeding. If your baby consistently only takes one breast at a feeding, ');
document.writeln('        you can pump the other breast, but if you do this too often, you may overstimulate ');
document.writeln('        your supply. Mom\'s whose babies only take one side at a feeding generally ');
document.writeln('        have lots of milk to begin with. <br>');
document.writeln('        <br>');
document.writeln('        2) If you are bottle-feeding a newborn, I recommend a slow-flow nipple. ');
document.writeln('        I like the Medela or Avent newborn nipples. A baby older than a few weeks ');
document.writeln('        is very unlikely to forget how to nurse just because you give him an artificial ');
document.writeln('        nipple, but if the flow is too fast, he may get impatient when he has ');
document.writeln('        to work harder at obtaining milk from the breast. <br>');
document.writeln('        <br>');
document.writeln('        3) Try offering the bottle when your baby isn\'t starving. This may seem ');
document.writeln('        illogical, but when a baby is frantically hungry, he is going to be in ');
document.writeln('        no mood to try something new. He just wants to nurse. <br>');
document.writeln('        <br>');
document.writeln('        4) Let someone else offer the bottle at first. Your baby associates your ');
document.writeln('        smell and touch with nursing, and may insist on the real thing if you ');
document.writeln('        try to give him a bottle. You may have to leave the room entirely in order ');
document.writeln('        for the effort to be successful. <br>');
document.writeln('        <br>');
document.writeln('        5) Many babies associate the cradle hold, where they are cuddled against ');
document.writeln('        the breast, with nursing, and will refuse to accept the bottle as a substitute. ');
document.writeln('        This is especially true of newborns. Although some babies will accept ');
document.writeln('        a bottle more readily in the cradle hold, most will do better if you prop ');
document.writeln('        them up on your knees or in an infant seat. <br>');
document.writeln('        <br>');
document.writeln('        6) Offer a small amount at first. If he takes it readily, you can always ');
document.writeln('        offer more. If he doesn\'t take it, you won\'t have wasted much. <br>');
document.writeln('        <br>');
document.writeln('        7) Make sure the nipple isn\'t cold when you offer it. Many babies couldn\'t ');
document.writeln('        care less if the milk you give them is cold (and it doesn\'t cause digestive ');
document.writeln('        problems (that\'s an old wive\'s tale) but they don\'t like the feel of a ');
document.writeln('        cold rubber nipple in their mouth. Run it under warm water before you ');
document.writeln('        try giving him the bottle. <br>');
document.writeln('        <br>');
document.writeln('        8) When offering the bottle, tickle the baby\'s lips gently with the nipple ');
document.writeln('        until he opens his mouth and explores the nipple. Don\'t try to force it ');
document.writeln('        in his mouth. Most babies under six weeks will take a bottle readily. ');
document.writeln('        Older babies sometimes get set in their ways and don\'t want to settle ');
document.writeln('        for anything but the real thing. As long as you wait until your supply ');
document.writeln('        is established and your baby has started gaining weight well, you should ');
document.writeln('        be able to combine breast and bottle feeding without much difficulty. ');
document.writeln('        </font></font></p>');
document.writeln('      <p>View Past &quot;<a href="http://www.breastfeedingbasics.com/html/ask/index.shtml" target="_blank">Ask ');
document.writeln('        Anne</a>&quot; Columns</p>');
document.writeln('      <p></p>');
document.writeln('      ');
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