Pumping Breastmilk and What You Need To Know

By Amy Peterson, IBCLC

This article made possible by the generous support of Earth Mama Angel Baby.

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Not every mom needs to pump. When baby is with mom for feedings and transferring milk effectively, there is no need to pump. But there are times when pumping breastmilk is important:

  •      Baby needs more milk (a supplement for one or more feeds)
  •      Mom wants to increase her supply
  •      Mom and baby are apart for feedings, such as when mom is at work or school
  •      Mom wants to have someone else participate in feedings
  •      Anytime mom will miss a feeding

In these circumstances, using a breast pump helps maintain or increase the milk supply for future feedings, and the pumped milk offers the perfect food for baby. This article touches on choosing between the different types of breast pumps, general pumping guidelines, and tips for increasing milk supply if necessary.

When possible, choose a pump that meets your unique situation. If you’ll only miss a feed or two each week, a manual pump or single electric is plenty. If you need to pump for several feedings a day, a high quality, double electric pump is a better choice.  If your baby is hospitalized or you need to dedicate time to increasing your supply, a hospital grade/rental pump is the best choice.

You can get a breast pump from many different places: box stores (Babies ‘R Us, Target, WalMart, etc.), online, a friend, thrift store, or possibly through your insurance company. Buying a used breast pump or borrowing a pump is usually not recommended. Most brands are considered single user items. These pumps do not control for the transfer of bacteria or germs between the pump motor and the milk, putting the baby’s health at risk. If you know the pump brand has a closed system, you could consider purchasing a new collection kit with tubing. Even so, you may not know if the pump is working less effectively than when purchased new, potentially putting your supply at risk.

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It is also important to note that not all women respond well to pumps and not all pumps work equally well for every lactating individual. This is why we have options. There are various contributing aspects that may impact how well a pump performs such as flange size, suction strength, type of suction, etc. If a pump is not working well for you it is possible that another would. Some breasts prefer one pump over another and some breasts prefer manual expression.

Most breast pumps have two settings. One button controls the vacuum, and the other button controls how fast the pump cycles (sucks). These settings let you fine tune the pump to mimic your baby’s suction and rhythm. For maximum milk production, use the highest comfortable suction. Use a fast cycling rate until your milk flows, then adjust to your comfort level; this mimics how your baby sucks before and after a let-down. A few brands of breast pumps have a built in feature that begins with fast cycling and adjusts slower. Some moms find they have better milk flow when they reset the button and continue with fast cycling.

Here are some general pumping guidelines to get you started:

  •      Pump for any feeding you will miss. Your milk supply is based on supply and demand, and pumping for each missed feeding tells your body to keep producing milk during that time.
  •      Pump the amount of milk your baby needs.  For example, if your baby takes 3 ounces of milk, pump 3 ounces total (1 ½ ounces from each breast).  If you pump what you need in 4 minutes—you can stop pumping.
  •      Pump between feedings to build a bottle. You can combine the milk from several pumping sessions to make a larger bottle of milk.
  •      Pump at night or in the early morning hours when your supply is highest.
  •      A gentle breast massage routine, called hands-on pumping, has been proven effective in increasing the amount of milk a mom can pump. Check it out here.

For moms who are not able to pump enough milk and who want to increase their supply, there are additional pumping tips:

  •      Pump until your milk stops flowing, and then pump two more minutes. This limited extra pumping is enough to tell your breasts to make more.
  •      Pump more often. Leave your pump set up (where your toddler can’t reach it!). Pump for 5-10 minutes once or twice an hour.
  •      Use the hands-on pumping technique listed here and above.
  •      Know that pumping alone may not increase your milk supply. Work with a breastfeeding helper who is knowledgeable about other targeted methods to boost supply.
  •      While you work on increasing your milk supply, feed your baby. You can combine your breastmilk with donor milk or formula to be sure your baby is getting enough. Some moms choose to feed breastmilk separate from formula to avoid wasting any breastmilk if baby doesn’t finish the bottle. As long as your guestimate is cautious, it is safe to mix; the milks will mix in baby’s belly anyway.

While pumping is an important aspect for many families in reaching their breastfeeding goals, how much is pumped is not a reliable sign of milk production. As with most areas of parenting, take your cues from your baby. When baby is growing well and reaching milestones within range then how much you pump doesn’t need to be a concern. If you see signs of dehydration or poor weight gain, speak with your child’s healthcare provider.

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Happy pumping mamas! You’ve totally got this and we’ve teamed up with Earth Mama Angel Baby to support you in your pumping journey with a giveaway of Earth Mama Angel Baby’s Milk-to-Go kit for Leakies in the USA. A $40 retail value, this kit includes:

One pair of Booby Tubes® (one pair) for cold or warm therapeutic use, 1 box of Organic Milkmaid Tea (16 tea bags) a fragrant comforting blend that supports healthy breast milk production, safe Natural Nipple Butter (1 fl. oz.), Happy Mama Body Wash (1.67 fl. oz.), one Eco-friendly Reusable Insulated Bag, and a tasty recipe for Organic Milkmaid French Vanilla Chai.

Use the widget below to be entered!

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a Rafflecopter giveaway

Amy Peterson is a mom of 4, IBCLC, Early Intervention coordinator, and retired LLL Leader. She works alongside a speech-language pathologist, and together they co-authored Balancing Breast and Bottle: Reaching Your Breastfeeding Goals. They have also written a series of tear-of sheets available through Noodle Soup: Introducing a bottle to your full-term breastfed baby, Pumping for your breastfed baby, Pacifiers and the breastfed baby, and Bottle pacing for the young breastfed baby. Amy’s passion is helping others find fulfillment and confidence in parenting, regardless of feeding method. Visit Amy’s website at breastandbottlefeeding.com.

 

 

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My Journey As A First Time Mom; a #MyStoryMatters Leaky Share

by Kelly Warner

guest post, leaky to leaky

Meet Samuel. This is my rainbow baby, who we welcomed with joy in January, 2014. After struggling with infertility for 5 years, my doctor in Houston told me it was unlikely that we would ever conceive. When we moved to St. Louis we started seeing a fertility specialist, who discovered a few factors that were either keeping us from getting pregnant or not allowing us to sustain pregnancy (an underactive thyroid, being a carrier for MTHFR and either not absorbing folic acid well or clotting after conceiving, and low progesterone). Once we addressed those issues we got pregnant right away, which was so encouraging after having our arms ache to hold a child for years. Unfortunately, we miscarried at 9 weeks and would later miscarry a second time at 6 weeks.   We were in a very dark place but continued to trust God with our fertility. A few months after our second miscarriage we found out we were pregnant again. 40 weeks later, after a snowstorm and before another one shut down the city for a week, our sweet Samuel Bennett was born!

I was so focused on maintaining a healthy pregnancy and having a natural birth that, admittedly, I didn’t educate myself on breastfeeding. Our Bradley Method instructor encouraged me to attend LLL meetings while pregnant to meet other like-minded moms, but I didn’t make it a priority to go. I knew that I wanted to breastfeed for a minimum of 12 months and had hoped that I would be able to make it for 2 years, but I figured I would have the baby first and then it would just naturally come to me. You know, because so far my story has been so natural and easy that it makes sense that I would just figure it out.

We had a beautiful natural birth and our nurses were great about immediately putting Samuel on my breast and delaying all newborn procedures until we had time to bond. He didn’t latch right away but found comfort sleeping on my chest. (In his defense, he did have a pretty long and intense birth that included 4 hours of pushing, his cord wrapped around his neck twice, and the threat of a C-section before I pushed so hard I broke my tailbone and his head came out before the doctor was even suited up to catch him). I kept trying to get him to latch and had just about every lactation consultant and nurse helping too. We were adamant about not using bottles, sugar water, or formula, so when he started showing signs of dehydration, we all panicked. The LC informed me that the combination of my flat nipples and large breasts were making it difficult for Samuel to latch and she recommended we use a breast shield. I was a nervous first time mom, who just wanted her baby to eat, so I took her at her word and began using the shield. I have since come to learn that there are absolutely medical situations that warrant the use of a shield . . . but mine was not one of them. Samuel began “latching” and getting colostrum, but it was so frustrating, painful, and messy for me. Worried that I would give up with breastfeeding, the LC convinced me to rent a breast pump to take home, pump my colostrum, and feed with bottles until my milk came in. Although she unnecessarily encouraged me to use a shield, I have to give her credit for pushing breastfeeding. She showed me how to use the pump and was shocked when I pumped 2 ounces of colostrum in a few minutes. At the time I was super confused why she was all giddy (and felt the need to show my liquid gold to everyone working in the maternity ward) but have come to learn that colostrum is not typically measured in ounces. That gave me hope that I was going to be able to feed my baby – it was just a matter of figuring out how.

My milk came in a few days after we got home from the hospital and my already large breasts became so engorged I didn’t know what to do with them! Seriously, they practically had their own zip code (38-K)! I had a serious oversupply problem and a fast letdown that Samuel did not find nearly as amusing as my husband and I. He’d pull off the breast and get super-soaked in the face or just grimace as a stream of milk shot halfway across the room. I guess when you’re an exhausted new mom you find the humor in anything, because everything else is just so, so hard!

We continued to use the nipple shield but struggled. I can’t tell you how many times I wanted to quit. Thankfully, my husband knew, deep down, I didn’t really want to quit and I just needed to be encouraged to continue. He was up at every diaper change and night feeding with me, sitting at my feet, praying for me. I remember one time in particular: It was 2am and I was exhausted from nursing Samuel around the clock during a growth spurt. My husband and I got up to feed him and I burst into tears when Samuel latched and I felt the “60-second sizzle.” I said I didn’t want to mess with the shield anymore and that I just wanted to feed my baby. He comforted me in that moment and said he had read that night feeding was a good time to try to wean off the shield. So, figuring it couldn’t get any worse, we took off the shield, and together, we re-latched Samuel. I’m talking, all 4 of our hands were trying to hamburger my nipple so Samuel could latch! There were more tears (by me) and more words of encouragement (from the hubs), and finally Samuel latched! This was such a small thing but felt like such a big breastfeeding victory!

I continued to pump out a few ounces before EVERY feeding to soften my breast tissue so he could latch better. It was really annoying to be tethered to my pump and time-consuming to have to constantly be cleaning out pump parts (and during the winter, which made my hands crack and bleed), but it was worth it to be off the shield and begin having a successful nursing relationship with my son. Plus, it allowed me to build up a good stash of breast milk that I donated to my friend to give to her adopted newborn.

By the time Samuel was 6 months old my supply had finally regulated. It was so freeing to be able to feed on demand and not have to pump first. Samuel was healthy and happy and in the 50th percentile for his weight, and an added bonus was that he was a really good sleeper! Shortly after he turned 7 months old, however, he started waking up multiple times at night to nurse. We brushed it off and assumed he was just teething or going through a growth spurt, but it continued for weeks. I called my pediatrician and asked her why she thought his sleeping pattern changed suddenly. We ruled out ear infections, viruses, the Bubonic Plague, and continued to be dumbfounded . . . until my ped asked if it was possible that I was pregnant. I probably offended her for laughing so loud on the phone, but, come on! Me? Pregnant? I mean, sure, it was a possibility I could be pregnant, but I was exclusively breastfeeding, had not introduced solids, and remember how it took the stars aligning for me to have a healthy pregnancy with Samuel? I hung up the phone, dug out an expired pregnancy test from the Dollar Store, and took the test . . . and then proceeded to take another 3 before I believed my eyes! I told my husband and he didn’t believe me, so he went to the pharmacy and bought the most expensive digital pregnancy test . . . which told us the same thing the 4 tests prior did, only in words instead of hieroglyphics. I. Was. Pregnant!

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Once the initial shock settled we were thrilled for our news, but clearly my milk supply had already begun to decrease. Ahhhh the irony! My ped suggested starting a supply-boosting supplement that was safe while pregnant, but cautioned that it was likely we would need to supplement with donor milk or formula. Having just donated all of my pumped milk to my friend for her adopted baby, we were forced to supplement with formula. We chose the only organic formula that we can buy locally and hoped that it would be palatable. Only, Samuel wouldn’t take it. Clueless about what to do, I emailed Jessica from The Leaky Boob for advice and was so humbled that she took the time to answer me. She encouraged me to get a Supplemental Nursing System (SNS) to keep stimulating my breasts to produce milk while getting Samuel the supplementation he needed. He had lost so much weight he dropped to the 5th percentile, so we were ready to try just about anything. All I can say is using an SNS is like trying to juggle flaming arrows while blindfolded! I feel it apropos to high five any mom that has successfully nursed with an SNS. First off, that thing is impossible to set up alone (thankfully my husband is really supportive of me breastfeeding). Secondly, the tape that is supposed to keep the tube in place is worthless! Thirdly, my son was so offended that I was trying to sneak that tiny plastic tube in with his latch. Needless to say, we gave up.

After giving up on the SNS we tried to introduce a bottle. By this time Samuel was close to 9 months and had only had a bottle when I pumped my colostrum the first few days of his life. If he was offended about the SNS tube, he was not having the bottle either. We must’ve bought one of every brand of bottle on the market only to find out he would rather starve. We tried syringes, medicine droppers, spoon-feeding, sippy cups, open cups and this kid was not impressed. The only thing that he took a liking to was a straw – and not a sippy cup with a straw because that’s far too juvenile for a 9 month old – a straw that you, a grown adult, would get at a restaurant. He’d sip on the formula throughout the day but never really had a “feeding” like he would with breastmilk. We sneaked it in smoothies, made popsicles, and just about anything to get that kid to drink milk.

Keep in mind I’m still pregnant through this . . . I’m tired, hormonal, my nipples are sore, and I’m nauseous! I lost 10 pounds from throwing up and not being able to eat food while pregnant and still nursing Samuel. Those days were ROUGH! I kept telling myself that, “This, too, shall pass.”

We found our rhythm and made the most of our cuddles and nursing sessions until Samuel started throwing fits when I offered him the breast at nap-time or bed when he was 13 months. After a few days of us both crying at every feeding, I assumed he was no longer interested in nursing and wanting to wean. I stopped offering it and we just, kinda moved on. Looking back, I honestly believe he was having a nursing strike from being frustrated from having to work so hard to get any breastmilk.

In May we welcomed our daughter, Felicity Claire, into the world. Once his sister was born he started showing interest in nursing but it was as if he had forgotten how it all worked. He constantly talked about my “ba-ba’s” and wanted to touch them for his sister’s first month of life. 4 months later, he asks for milk at bedtime and smells and touches my breasts asking for more. It breaks my heart that I likely cut our nursing relationship short, but I am glad we were able to overcome so much and still make it 13 months.

guest post, leaky to leaky

So far, Felicity nurses like a champ and I feel so much better prepared this time around. While I wouldn’t wish my struggles with breastfeeding on anyone, I am glad I had to persevere through them. Not only did it show me how much support I have, but it highlighted how important a good support system is for breastfeeding. I hope that other moms find support to help them reach their breastfeeding goals and that my story encourages them in their journey.

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guest post, leaky to leakyKelly is a mother of two from St. Louis, Missouri, who lived a good chunk of her adult life in Houston, Texas.  She and her hunk of a husband struggled with infertility for 5 years and had multiple miscarriages before having their first child in 2014.  Prior to starting a family, she taught 7th grade life science at a college preparatory charter school for low-income, minority students in Houston.  When she’s not nursing her 5 month old or telling her 21 month old to stop throwing balls at his sissy’s head, Kelly enjoys hanging out with her husband, binge-watching Gilmore Girls, and writing music.  Despite many struggles with breastfeeding, Kelly nursed her son for 13 months; 6 of those while pregnant with her daughter.  In addition to being passionate about breastfeeding, Kelly loves baby wearing, cloth diapering, staying up to date on car seat safety, and having grandiose dreams of being a midwife someday. In the meantime she’ll stick to chasing her sports-nut toddler around the neighborhood and hoping that she remembers to put her boob away before answering the front door.  

 

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