Thursday, March 31, 2016

exclusive pumping (there's more than one way to give your baby breast milk)

Let me give you a little insight into Meredith's and my adventure in breast feeding. For several reasons all including a lot of TMI, we both were so frustrated we cried nearly every time we tried it.

Turned out, my insurance through work was awesome about breast pump coverage. They covered either: 1) any manual pump at 100%; or 2) any electric pump up to $300. You could get a more expensive one, you just had to pay the difference. First step was to call the insurance company and let them know that you are pregnant and want a breast pump for your offspring. They give you a list of durable medical equipment providers they work with. You have to call and find out who has breast pumps and from there, it is honestly really easy. The representative at the DME company gathers your insurance information to determine what you're eligible for and asks you to have your doctor's office fax a prescription for the pump to them. I just sent an email to my doctor with the rep's name and phone/fax numbers. They took care of that bit. The rep called me back once everything was squared away and we talked about which pump I wanted. Which, by the way, I chose the Medela Pump In Style Advanced. It is a double electric pump that I highly recommend. My insurance required that I wait until my third trimester to have the pump shipped, so that was no big deal. Now after talking to several friends with different insurance coverage, I know that my work has excellent coverage for this which I am extremely grateful for. They sent me the pump exactly when they said they would and that was that.

Now. I tried to breast feed my baby before my milk came in and had such a hard time that I ended up supplementing her with formula for about a week and a half. I think I did have colostrum in there, but for the TMI reasons, she couldn't get it out. I was not interested in starving my kid, so I supplemented until my milk came in and my supply caught up to her. My advice if anyone has this issue is to take it easy on how much formula you give. Remember how truly tiny their stomachs are that first couple weeks and try to 1) nurse on both sides before you supplement (to remind your body to make milk); and 2) give only a small amount of formula. Like a half ounce to an ounce at a time if that. Tiny stomachs, remember? Size of a cherry. Here's the thing. They will drink more if you give it to them. They don't need it. Small amount every 1.5 hours or so at first. Your body only makes about one teaspoon of colostrum per breast at a time anyway. Coincidentally, this is the size of your newborn's stomach. So, my doc told me that if you get started over filling their little bellies, they will get used to that over-full feeling and what you give them from the breast won't feel satisfying to them. So that's my early breast feeding deal. It was frustrating.

When my milk came in, I was very happy to pull out that breast pump. The key to exclusive pumping long term (so I hear, I've only been at it for 7.5 weeks) is to pump as often as your baby eats. So I started out every two hours. Yes it's a lot. But you're on maternity leave and your brand new baby sleeps a lot. I held her in my lap while I pumped. Sometimes I bottle fed her while I pumped. It can be done. I would pump 8-10 times a day until your supply is established. Right now I'm pumping 5-6 times a day because I'm producing more than she eats and I'm trying to not have too obscene of a freezer stash. Currently got 480 ounces in the freezer. Too much. I pump about 35 ounces daily. I will add a pump or two a day to produce more when she catches up or if my supply drops too much! I do wake up once during the night to pump mostly for comfort.

Supplies I like:

  1. My Medela pump. I will probably get this one again for my next baby.
  2. Lansinoh brand milk storage bags. They are only a touch more expensive than the store brand bags and they are more durable and will lie flat for freezing and efficient storage.
  3. Medela storage bottles. I don't feed her from them, even though they come with nipples, because she swallows so much air with them. It gave her awful, painful gas. We use Dr. Brown's bottles which are vented (and quite cost friendly of all the vented bottles!), and it is worth noting that the standard neck bottles fit the breast pump, so you could pump directly into them if you wanted.
  4. Antibacterial wipes (Johnson & Johnson or Wet Ones) to wipe down parts in between pump sessions. I only wash parts once a day. Ain't nobody got time for that. 
  5. Medela disposable nursing pads. Because I leak. It's gross. I'm in the market for reusable/washable ones. I'll do a review on those if I ever buy any. 
  6. Make-your-own pump bra. Ok, so I need a quick way to strip down and pump for work. You must get a hands-free pump bra of some kind if you're double pumping. Which I recommend highly. I used an old bra that still fit and cut slits about where my nipples are. So I can put the breast shield in there and the bra holds them in place. I wear a nursing bra over it, so when it's time to pump, I pull up my shirt, un clip the nursing bra and put in the shields. No changing clothes. I do not recommend the Medela easy expressions pumping bra. I have big tits (it's a strapless number) and it did not hold them in place. You also have to strip down to put it on. Unable to layer if you have giant boobs like mine. Just make your own. Really.
Other tips: have a water bottle and a snack if you want it where your pumping. You will be so thirsty. And probably very hungry. Lube the inside of the breast shield. That plastic rubs so bad. I got a little blister once. Use coconut or olive oil (food grade and safe if it gets in the breast milk) and rub a little bit on the inside of the shield where it bends to suck your nipples into that little tube. You're welcome. 

Not getting a lot out on the pump? Check your breast shield size. Your entire nipple and part of your areola should be sucked up into the shield when the pump is on. Not too much. If it hurts, your shield is probably too small. If it's not getting good suction, the shield is probably to big. Try a couple sizes on and see what you think. Next, check your pump. Good pump? Don't buy a cheap-o one and expect to EP. Impossible. You need a high quality double electric. Mine retails for $270. Worth every penny. Also, most non-hospital grade pumps are only made to last for one baby (or multiples of course, because the double electric pumps mimic feeding twins anyway). You really need a new one for each pregnancy. To increase your milk supply, you can do the herbal stuff (I never did), or you can eat certain foods thought to increase supply (I eat organic oat granola and yogurt every day), or there are pumping techniques to increase supply. I recommend "power pumping" which there are tons of Pinterest articles on, so I won't detail it here. It works though.

There are a lot of reasons to exclusively pump. You know most of mine from the first part of this post. Also, if you are going back to work, you give your baby breast milk without worrying about nipple confusion or whether they'll take a bottle at all. You don't have to buy the "just like the breast" expensive bottles. Maybe you had a preemie who couldn't breast feed, but really needed that breast milk to be his or her healthiest. Etcetera. Maybe you just wanted to do it this way. Anyway, it's working for me and mine so far, so we'll continue as long as possible! Up to 1-2 years. I'm not crazy.

Here's a milk drunk picture of my baby:
This was about a month ago.
She was just a couple weeks old here!

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