Wednesday, June 25, 2014

The Pumping Mom: My advice

I realize this topic is a little random and probably doesn't apply to most of my readers (I know you're out there because I see the hits). I've been wanting to write this post for a while though. I had a hard time getting going with breastfeeding (probably another post in and of itself) and then when I finally felt confident, it was time to think about going back to work. Pumping at work felt overwhelming. I want to offer support to other women but I also want to remember my own advice for when baby number 2 comes along.

If you are anything like me, the thought of leaving your baby when you head back to work is scary. I cried and cried the night before I was supposed to go back to work. I was able to take 12 full weeks for maternity leave. I loved it and I just couldn't imagine how I was going to leave my sweet little baby for so many hours at a time. My schedule at the time only required me working three days a week but it was for long hours. While my shifts were only 12 hours, I had to be away for 14 hours and that's if I actually got to leave on time.

I had so many fears and so many questions about going back to work. How many times would I need to pump? How long would I need to pump? What if it was too busy and I missed a session? How was I going to eat my lunch and pump at the same time? How was I going to store all of my milk? How would I clean my pump parts in between sessions? How much milk do I leave for Owen? How many bottles would Owen need during the day? What about my milk supply?

Spoiler alert: We were fine. More than fine. There were a few bumps along the way. However, I was able to breastfeed Owen and pump for an entire year. I'm so thankful for that. I learned a lot in that year and overcame obstacles. Breastfeeding doesn't always come easy and when you add pumping to the mix, well, it can be overwhelming. Here is what I learned.

Establish a support system
I cannot stress this point enough. Patrick was definitely my main cheerleader but I should also give shout outs to my sister, my friend Laurie (who was right there with me with her little newborn), my mom, and the countless other nurse friends who had gone before me that were willing to offer their tips, advice, and encouragement.

Do some research before baby arrives and be sure to share this information with the person who is going to be supporting you the most. I gave Patrick a packet of information on the benefits of breastfeeding before Owen was born. I believe the knowledge he gained from that helped him cheer me on because he knew the importance and health benefits of breast milk.

Grab a book on the subject of breastfeeding that includes information about pumping. I bought The Essential Guide to Breastfeeding by Marianne Neifert. This book was part of my support system too. It was a helpful book to have around and I used it as a quick reference to answer questions several times.

Get the right supplies.
You need a breast pump. It needs to be a double electric and it needs to be reliable. There are a ton of different brands out there. Medela seems to be the leading company and is used in most hospitals. However, there are other options. Unfortunately, a lot of the good pumps are expensive when bought new, but keep in mind that it doesn't have to be new. See if you can find a friend who has one. Maybe you can just barrow one. I've even heard that some hospitals allow you to rent a pump. When my first pump (a playtex double electric) began acting up and randomly not turning on, I bought a medela from a lady off of Craigslist for $50. Medela doesn't actually recommend sharing, but I read up on it beforehand and felt that it was safe to use as long as I used my own parts. She had used it with two children and said it had never given her problems. I used my own pump parts and bottles that I received while I was in the hospital. Recently, I've heard that some insurances will cover the cost of a breastpump. I've even heard that WIC is now on board to help out women by giving out pumps to those lower income families who have decided to breastfeed.

You will need bottles to pump into. Most breastpumps come with bottles, but consider how much volume you will be putting out when you are away from your baby. I actually chose to carry 3 medella bottles (8oz) with me to work and I pumped into them. I would pump into the same two bottles for my first two pumping sessions of the day. I researched and found that this was okay to do as long as the volume you are adding does not exceed the cold volume that is there. Luckily, most women produce more in the morning and less and less as the day goes on and that was true for me. Pumping into the same bottles was never a problem. The third bottle was there to help me get through the final pumping session of the day without overflowing the other two.

You will need bottles for your baby to drink from during the day. By the time I went back to work, Owen was feeding about 7 times during the hours that I was going to be gone. However, I decided to stick with six Avent bottles (9oz). It meant that whoever was keeping him had to be sure and wash at least one bottle, but that didn't seem to be a big deal. My main motivation was to prevent excess. I mean, he can only drink out of one bottle at a time.

You will need freezer bags and they need to be designed for breastmilk. I bought the target brand and they worked great. Buy whatever brand you would like. Be sure to label milk with the date it was pumped and then stick it at the back of the line so that the older milk gets used first. Also, avoid freezing large amounts in one bag. The bag may hold 8oz but it's better to freeze in small quantities of 3-5oz to avoid waste.

If you are going to be in a time crunch and needing to pump while you eat or while you make phone calls, then you will love having a hands free pumping bra. I've actually heard that smaller chested women can sometimes get away without them by simply using their regular nursing bra but I'm pretty sure that wouldn't have worked for me. The hands free bra was great because once I got going, I could focus on other things like eating or I could just simply close my eyes and relax for a couple minutes.

There are many options for cleaning pump parts between pumping sessions. They make wipes (they aren't cheap), you can use soap and water after every use, but I found that the sterilizer steam bags were the bomb. Each bag can be used 20 times. I would steam my parts, drain the water, and then leave them in that plastic bag until the next pump session. Prior to discovering the bags I had been hand washing my parts after every use but it was time consuming. The steam bags were very convenient. 

Build up a freezer stash
Honestly, I wish I had started my freezer stash way sooner. I think I was about 4 weeks into my leave before I even thought about it. Don't do this! Start as soon as you can. The key is to pump a little extra after a few feedings. Once again, most women have more in the morning. Take advantage of that engorgement and pump it out. Not only will you feel better, but you will soon have a little stash going.

I began by pumping after the first two feedings of the day. I should have kept that schedule as long as possible, but I just didn't know any better. I got tired of it and dropped to pumping after the first feeding of the day only. Each pumping session should last anywhere from 10-15 minutes.

Pump right after you feed your baby. Don't wait one or two hours. You won't get much the first few days you do this because your baby has just nursed, but eventually your body will respond to the demand that you are placing. That's how it works. Demand and then supply. 

Prepare your baby for the transition
Obviously, the first day you go back to work shouldn't be the first day your baby gets introduced to a bottle. I think the sooner the better. Sure, you can give baby a couple of weeks (we actually had to give Owen a bottle after only a few days due to his jaundice), but I would start to offer it occasionally after that. Maybe just one feeding a week. By eight weeks I decided that it was time to get more serious about the bottle because Owen was still choking a lot on them. I decided that I would try to have Owen take one feeding a day from a bottle. Maybe that was excessive, but it made me feel better. I also tried to allow as many different people as possible feed the bottle to him. If we were out to dinner with friends then I would ask for a volunteer. It wasn't hard to find takers.

The interesting thing about giving Owen a bottle once a day is that I became more familiar with how much milk my body was producing at different times of the day. Up until that point I had only ever pumped in the morning hours. I would get a ton of milk. The first time I pumped after returning home from dinner where we gave Owen a bottle, I was shocked that I only pumped out 4oz. Well, it turns out that was completely normal for me during that time of the day. I soon learned that I could easily pump 8oz in the morning but maybe only 3oz at night. This turned out to be helpful information when I went back to work because I better understood how to prepare the bottles for the caregivers (more volume in the morning, less at night).

Prepare yourself for the transition.
Know why it is going to be important for you to continue breastfeeding even after returning to work. I say this because it will help you when you have your bad days. Because you will probably have a bad day or two. You might just be so tired when you get home that you forget to put that breast milk you worked hard to pump that day away in the fridge. You might just wake up in the morning and melt into a puddle of tears over it. In that moment, you will need love and support. You will also need to remember why you are doing it in the first place and why you aren't going to give up. Arm yourself with knowledge.

Prepare yourself for the transition back to work by knowing what it will be like to pump at your job. Does your employer offer time for pump breaks. Most do. Will there be a space for you to pump other than the bathroom? Knowing when are where you will pump ahead of time will ease your mind.

Know your numbers.
Before you return to work, count the number of times your baby typically nurses in a day. Subtract the number of feedings that you will be available to feed your baby and you have the number of times you should pump while you are at work. If your baby is still feeding all over the place, then go with every three hours. Be sure that you never allow your breasts to get overly full while you are away from your baby. Overly full breasts begin to send signals to your brain to stop producing as much milk. 

Take the milk you pumped from the day and go ahead and divide it up into bottles in the fridge. For example, I usually pumped 16-18 oz of milk when I was away from Owen. I knew that Owen would need 5 bottles when I was away from him but that the first one of the day would be what I pumped right before leaving for work. I would pump out about 8oz before leaving for work and leave that fresh milk in a bottle on the nightstand for Patrick. Then I would take the milk from the day before and divide it into the 4 remaining bottles for the day. I would put on average 4oz in each bottle. Keep in mind that most newborns take 3oz per feeding and that they are going to take their largest amount of volume during the first couple of feedings for the day. On the days that I had pumped more than 16oz while at work, I put the extra in the bottle that Owen would take following his morning bottle (the one from the nightstand). I ordered the bottles in the fridge so that everyone would know to grab the one in the front first and work their way back.

Don't stress.
Stress can decrease your milk supply so don't do it. Ha! Easier said than done. One of my friends from work actually had a pretty great idea that helped calm her nerves and kept her from worrying. She said that she purchased one small can of baby formula for emergencies and that she kept it in a hidden place in the house. She didn't tell the caregiver about it, but it was her insurance. She said that it was just in case she ever got a frantic phone call about being out of milk. Knowing that the formula was there in her home gave her peace. I thought it was a pretty genius idea. I think it's important to keep in mind that formula isn't poison. It's more important to feed your baby.

I kept formula in my pantry the whole time I was at work. I think we used a total of 3 cans during Owen's first year of life before we weaned and transitioned to whole milk. It's not the end of the world if you have to give your baby a little formula every now and then. You may never need to give any but don't let your pride, your ego, or your goals get in the way of feeding your child. Remember that some women choose only to formula feed or only have that option and guess what? Their babies do fine. I guarantee that if we lined up a group of fourth graders, you would have no idea which ones breastfed, which ones got formula, and which ones got a mixture of both. It will all be okay in the end.

If you are anything like me, you will have a love/hate relationship with pumping. I wanted to burn the thing by the time I was reaching the year mark. It's just felt so unnatural and made me feel like a cow instead of a mom. However, it allowed me to continue breastfeeding even after returning to work and so I was thankful to have it. Just hang in there and don't give up. Before you know it, cuddling your sweet little one against your chest will be a distant memory you cherish.

1 comment:

  1. Thank you for this! You are so good at being informative and supportive! Thanks for the advice!