Hi, J.! I can answer some of your questions, but I really, really recommend you contact your local La Leche League Leader. You can find her number at www.llli.org. All services are free--a Leader can provide you with help over the phone or in person, and at a meeting you can talk with other experienced breastfeeding moms and cmpare strategies for dealing with any challenges you are facing. A lack of confidence is a major obstacle for many breastfeeding moms, since it's hard to trust your body is making enough when you can't see your milk to measure it. If your baby's urine and stool output is good, he falls asleep at the breast content after a good nuring session, your nipples are not sore or traumatized and he sleeps for least least one 3-4 hur stretch in a 24-hor period, you're doing OK. You can feel confident your milk is the superior infant food. You sound like a very responsive and sensitive mom to be so concerned about your baby's welfare.
Rest assured--you won't always feel like wearing a shirt is pointless! This early time is the investment period and your devotion now will come back to you as breastfeeding becomes simpler and more convenient! (I am also a mother of three children and I often joke that I love to do things the lazy way-- breastfeeding means I don't have to wash anything extra, because I was planning to shower anyway ;)
--When does your milk fully come in (besides the 3 day reply)? I know its 3 days where it starts to come in, but really really come in enough to pump and still satisfy the baby.
Your breasts produce colotrum near the end of your pregnancy and just after birth. Within the first few days after birth, your breasts begin to produce mature milk, following the law of supply and demand. The more your baby is nursing at your breasts, the more your body will produce. After a couple of weeks of nursing on baby's cues (10 to 12 times in a 24-hour cyle, not necessarily evenly spaced nursing session since babies don't know how to do long division ;) your body will tailor the supply level to meet your baby's needs.
A breastfeeding mom does not have to pump at all, uless she is planning to build a stockpile of stored milk for when she must be away from her baby. It's important to remember the amount of milk that can be pumped out is NOT an accurate reflection of the mother's milk production--the most high-powered, hospital-grade pump has nothing on a healthy, well-latched baby for getting milk effectively, and since breastfeeding is emotional as well as simply physical, many moms do not respond to their pumps as well as they respond to their babies. (Because, let's face it, a pump is just not as cute as your darling baby, and nothing gets a let-down started like your own darling baby!)
It's also good to remember that just as your mouth is always producing saliva, your lactating breasts are always producing milk and will never really be "empty." You may see a slowing of milk flow when you're pumping, but you're just a moment away from another let-down and more milk. Since it's all supply and demand, the more often you remove mik from your breasts, the more milk your body will prduce. If you pump a lot, your body may respond as if it's trying to feed a whole daycare full of babies an you could set yourself up for chronic engorgement. Sooo, unless you have a specific reason for pumping (are you preparing to go back to work?) I suggest pumping less often and keeping your baby at your breast more. I you're struggling with an ineffective latch at the breast, you must get some help in person, either from a La Leche League Leader (free) or an IBCLC certified lactation consultant (often covered by insurance). Breastfeeding is much easier than breastmilk-feeding.
Breastmilk does change in consistency throughout a feeding, however, so current advice is to allow baby to finish the first breast first, instead of switching after an arbitrary amount of time has passed. This allows Baby to receive more of the creamy, high-fat hindmilk that comes after the initial let-down of thin, high-water, high-protein foremilk. Some (not all) moms report seeing pieces of seed-like particles in their breastfed baby's stool--this is digested fat and can help reassure you Baby is getting enough fat. Mothers are also encouraged to "watch your baby, not the clock," for signs of satisfaction.
It's also good to remember sucking is a reflex for babies. Just because Baby will take more milk from a bottle doesn't necessaily mean he wasn't satisfied--he will continue to swallow if liquid is in his mouth. Also, sucking is soothing and it's a way to reconnect with mom, so non-nutritive sucking at the breast is healthy--Baby can get some extra milk and use calories learning and growing instead of complaining.
Your milk supply sounds great to me. A full milk supply (and this is considered a generous amount for a newborn)for a newborn in the NICU whose mom is EXCLUSIVELY pumping to bring in her milk supply is *about* a Big Gulp--32 ounces per 24-hour cycle (no such thing as days and nights anymore, you know). You are fortunately NOT in that situation, so any additional milk you are pumping is great. But if your baby seems restles or unsatisfed, it could be a call for more snuggles and nursing for comfort, or it could be that your baby is nursing for the foremilk and then you are pumping out the hindmilk. The hindmilk is what will keep your baby satisfed longer. (But human milk is such a perfect food it is usually digested within 90 minutes--plus, a newborn's stomach is only the size of a shooter marble, so frequent feedings make sense and are normal.)Some babies do what's called "cluster feeding," which mean they nurse a whole bunch of times in a short period to prepare for a slightly longer sleep period. It's normal and healthy.
Watching baby's urine and stool output is the most reliable way to determine if he's getting enough. If he has 5 to 6 really wet paper diapers and at least 1 or 2 stools (the size of a U.S. quarter or larger) inn a 24-hour period, you're doing fine. If not, consult with a LLL Leader or IBCLC certified lactation consultant. (Most pediatricians have little lactaion training.)
There are some new guidelines to freezing and storing milk, if that's what you need to do. You can find the details at www.llli.org, or ask your local Leader for the new milk storage tear sheet. But, again, there's no rule that says breastfeeding moms have to pump at all. Make sure you are eating well and resting enough and enjoying your baby and your other children so you're not using up all your (precious, limited) energy going crazy with pumping.
Your local La Leche League group will have lots of books to borrow for free that may be helpful to you, such as "Nursing Mother, Working Mother," and my all-time favorite, "The Baby Book" by Dr. William and Martha Sears. Your preschooler will also be welcome at a LLL meeting, so no need to juggle her to someone else unless you want to.
Good for you for working this hard! Things will settle down soon. Hang in there and keep us posted! Best wishes!