Disclaimer: All I'm about to share is based on my personal experience + tips and tricks shared by my obstetrician, my daughter's pediatrician, and my close friends who are also breastfeeding mamas.
Part 1: Establishing Supply (& Maintaining it!)
A. Unang Yakap (Skin-to-skin)
I had a C-section and the thing with having this is that your hormones are all out of wack - your body doesn't know you've had a Baby and isn't producing enough prolactin, you're also numb and then in major pain because duh - you just had a major surgery. So, you’re stressed out….. And all of these things can affect your breast Milk supply.
The good thing with St. Luke's is that they promote Unang Yakap - a few minutes after the baby is born, you are required to do skin-to-skin and breastfeed. This helps your body kickstart milk production. Kara (my daughter's nickname) stayed like this with me while the doctors were busy closing me up. I had no idea that breastfeeding would be crazy painful the first time (even if the latch is correct). I was literally gritting my teeth. I had no idea whether I was producing enough too. My lactation nurse and my OB would come visit me daily to see if my milk already arrived (by that I mean, they literally pinched my nipples... OUCH) and to check if Kara is latching properly. On the third day, we left the hospital and my Milk Supply was still not a lot so my OB gave me Pro-lacta. They also told me not to worry because Kara only needs a few ounces on the first 7 days.
B. Feeding on Demand
On the 4th day, even when my nipples were scabbed & felt like they were about to fall off, I just sucked it up and continued nursing whenever Kara wants. I just applied Lanolin and prayed to God that my nipples wouldn't fall off for real... Haha
On the 5th day (guess what - I didn't know it was physically possible to not sleep for more than 4 days!!!), my milk supply went up. My husband was in charge of writing down the details of every feeding since Day 1. We monitored the following:
which side she feeds on and for how long (it should be at least 15 mins and I push her cheeks softly to make sure she doesn't drift-off and that she gets enough milk)how many times she peeshow many times she poos
Since Kara is exclusively breastfed, this is our way of checking whether she is getting enough milk. St. Luke's gave us a guide & checklist for this - basically, during the meconium phase (the first few days after birth), your baby may have four or five tarry, dark, greenish-black stools spread out over two or three days. As your colostrum develops into mature milk, he or she should have at least two to five bowel movements in a 24-hour period for the first six weeks.
If you are out and about, make sure to have a reliable nursing cover with you. Nursing cover ponchos are the best option if your primary concern is modesty, because they provide coverage around your entire body. Other covers can slip off to the side while you’re nursing or pumping, but that won’t happen with a poncho. Check out the Kara nursing cover (it can be used as a car seat cover, a nursing cover, a shopping cart cover, and a scarf. This versatile cover is made of a high quality, stretchy, black and white cotton fabric).
C. Hydrate, hydrate & hydrate some more
I was nursing Kara every 2-3 hours from Day 1 and that made me feel all woozy so I started drinking lots of water, like 3-5 liters a day. I also discovered that buko juice helps maintain my supply and keeps me from getting dehydrated so we got loads of this.
D. Lactation Cookies & Mother's Milk Tea
During Kara's first 2 weeks, I also got lactation cupcakes (cheese-flavored) & cookies from Mama Chows. I was supposed to eat 3 pieces a day but I ate more because... Well, they were delicious.
It increased my milk supply & it was especially helpful when I started building my stash (when Kara was 8 weeks old already). I also drink Mother's Milk Tea from time to time because it contains Thistle & Fenugreek, both of which are known as herbal galactagogues.
Part II: Introducing Breastmilk in a Bottle
Don't introduce a bottle earlier than 6 weeks or until your milk supply is established. Otherwise, it will go down. Your body must get used to the demand first (and even if you think your breast is empty, it will still produce milk every time your baby wants to nurse). Make sure to choose a feeding bottle that feels almost the same as your nipples or the baby will most likely reject it. We tried several feeding bottles which claim to truly mimic the motion, flow, and feeling of the breast - the winner was Pigeon Peristaltic bottle (recommended by my friend). Also, the one who gives breastmilk in the bottle shouldn't be the mom as this will confuse the baby. I literally had to leave the house while my husband introduced the bottle to our daughter.
Part III: Going back to work and Expressing Milk
When you go back to work, make sure to express as often as you nurse your baby (like, every 3-4 hours). It helps to look at your baby's photos to initiate let-down. Expressing milk takes 15-60 minutes (depending on how slow the flow is) so bring a book or something to avoid extreme boredom :)
Just to share, I had a love-hate relationship with Ameda Purely Yours. I got mine from US and had it shipped here. I started using it when Kara turned 2 months so I can build my stash. It worked great, I was able to produce 6-8 ounces every 3 hours on top of nursing my daughter. In 2 weeks, I already had 90 ounces in my personal refrigerator and we started feeding Kara from the bottle. When she turned 4 months old, the motor just died (to my horror) so I contacted their customer care and my in-laws in US shipped the replacement pump to me. It's been working fine till a few days after, when it acted all funny again. Good thing I got back-up pumps the first time it broke (while I waited for the replacement).
I was planning to get Medela as my back-up pump but these were out of stock and I really needed one badly that time (I went out during my lunch break). The receptionist at work told me about The First Years so I bought it and I have no regrets at all. It helped me produce 6-8 ounces of milk every 3 hours (we have a lactation room at work, with our own refrigerator. I'm not the only one who uses it so I have to label my milk with my complete name, & contact info).
Anyway, my mother found me the Medela Swing Maxi 2.0 (available at The Parenting Emporium) woohoo!!! (as much as I'm loving The First Years, a single electric pump takes longer time and it consumes too many double A batteries - I did get the rechargeable ones but it's really a hassle especially with my crazy work schedule + businesses).
There you go - these are the major tips and pointers I'd like to share.