On Pumps and Pumping

January 17, 2013

When I was pregnant with Phoebe is 1995 I took a birthing class and a breastfeeding class. In week six of the birthing class the teacher brought in a guest – a woman who rents breast pumps. The businesswoman made it clear that if a person was to be breastfeeding she would need a good quality pump.

Phoebe and I struggled for a few days but got the hang of nursing and all was well. The pediatricians were impressed with her weight gain and were nearly shocked I was exclusively breastfeeding. Looming in the back of my mind was that little voice of the woman “you need a breast pump, you need a breast pump.”

After about four weeks I found a local pharmacy that rented pumps and plopped down my $212.32 for a two-month rental with all of the supplies. I brought it home and it sat on the kitchen table.  Rob came home that evening and saw the new appliance in the kitchen and said, I see you got the pump.

Day after day, Phoebe and I developed our routine. We both loved nursing and she grew so beautifully. Rob loved watching her nurse and saw how happy she was. When I thought she was nursing too much he is the one who pointed out how happy we both were at these moments.

About two weeks after I rent the contraption I realize I have spent this money and I had better use the thing. Phoebe lay asleep on the bed off the kitchen and I watched her I set up the machine and began to pump. It was fascinating to watch my milk flow out of my breasts into the bottles. After about ten or fifteen minutes I had collected about three quarters of an ounce. I placed it in the refrigerator so Rob could feed it to her in the next day or so. After all, shouldn’t I let him get involved in this parenting adventure.  Why should I be the only one to bond with our little girl?

That night when Rob came through the door beaming as usual to see us at the end of the day. Just as he arrived home a thunderstorm rattled our little house. The lights flashed off and on and off.  The electricity was out.   My mind went directly to the fridge where my precious liquid gold sat on a wire shelf. Rob, the electricity! My milk! You must feed it to her now before it goes bad! I ran to the kitchen ran the bottle under hot water and handed it to Rob with a hungry wiggly Phoebe in his arms. She started to root on his chest. He placed the bottle in her mouth she looked in his trusted eyes as if to say: What the hell are you doing?  I stared at them and my breasts began to tingle. They struggled, both looking betrayed.

Give me that bottle, I said. I unscrewed the nipple and pour the milk down the drain. Let me hold her. I latched her on and we all melted into the normal little family we knew. Is it okay if I don’t pump? I asked Rob. Of course, I never asked you to. I don’t need to feed her to feel connected. 

The next day Phoebe and I drove to the pharmacy and returned the pump and she never had a bottle.

It is important to know that Phoebe and I were rarely separated in the first year of her life. Well, in her case we were rarely separated for the first few years of her life.

Chloe, my second baby also never had a bottle.

Finn, my third baby was born slightly early and had a severe tongue-tie and lost a full pound by his third day of life.  On day six I rented a pump and for 24 hours I pumped my left breast and fed him the milk. In all, he had about three bottles. When he was about nine months old I left him for a few hours and left behind some milk. Rob said he through it across the room and he didn’t really need it.

That is my story about bottles and breast pumps.

Now I want to address the general population.

For many women a pump is an important tool to continue breastfeeding. Just as my story was unique to my situation, so it is for all moms. In 1995 there were not on-line mothers groups. The moms I met were face to face and the conversations about feedings were that – conversations, two- or three-way discussions. These days moms go to their on-line community and read posts. In many ways these forums are great but they can also be scary and mis-informative.

A recent trend I notice is that moms believe if they do not start pumping right away they will not get enough milk. Another trend is that it is important to have a freezer full of milk. All of this work puts so much pressure on new moms and takes away from the time spent face to face with her baby. It also throws off the balance of her milk supply.

Why do you need to pump?

There are different scenarios where a mom really should pump.

If a mom is directed by her doctor to supplement her baby then this mom should use a hospital grade pump to express her milk. This is so that she has a supplement for her baby and it also will help to establish her milk supply.

If a mom and baby are separated it is important for the mom to pump her milk to again establish her milk supply and/or prevent engorgement.

These days many women work outside of the home. In this case pumping her milk assures she has milk to feed her baby while they are apart.  If the mom is one to three days ahead of her supply she can keep her milk in the refrigerator. There really is no need to have a freezer full of milk.  The idea is to nurse your baby when you are with him and to pump when you are separated.

Some moms would like to have a stash of milk so that she can leave her baby in the care of someone else occasionally. In these situations it is truly fine to keep a bottle or two a week in the mix.

For some moms it truly is nearly impossible to pump while at work. Pumping at home after feedings is one way to save milk for this time. Other moms find they use either donor milk or formula as a supplement. If a mom is not 100% breastfeeding it does not mean she is not breastfeeding. There seems to be this idea that breastfeeding is an all or nothing proposition. It is not. When you are with your baby you nurse your baby.

Some moms like to include her partner or other family member with the feedings. Many moms find this helpful while others prefer help with other aspects of her mothering this new baby. A couple of things to keep in mind: be sure it does not complicate the feedings and not feeding a baby does not preclude bonding.

What kinds of pumps are there?

There are many pumps on the market. It seems everyone wants to get in the game. As a new parent it is important to watch out for marketing. New parents are one of the targeted markets.

Read reviews, real reviews, not just a couple of posts on forums. And watch for paid advertising. Not all pumps are created equal. Just because a pump costs more than others, it does not mean it works better or even as well.

If you need to pump in the early weeks it is important to rent a hospital grade pump.

If you have an established supply and you are working outside of the home on a regular basis you may need a rental pump or a good quality double electric pump.

Look at the size of the motor. Are you paying for technology? Or quality?

If you just need the occasional bottle often a smaller pump or a hand pump can work well. And do not forget your hand. Learning to hand express is a great gift. You do not need to rely on electricity or batteries. Hand expression is something all moms should know how to do.

Here is a quick tutorial:

You take the pads of your thumb and middle finger and place them just on the inner edge of your areola.

You put pressure as though you are going to touch your rib cage.

Then, imagine there is ink on your thumb – you roll your thumb towards your nipple as though you would make a thumbprint – not a smudge.

Repeat.

If you do not have milk flowing you can massage your breast toward the nipple.

You repeat until you have expressed  enough milk for your particular needs of the moment.

The best place to practice is in the shower. Sometimes you will find a “sweet spot” where you get a nice continuous flow.

When should one pump?

If breastfeeding is going well there is no need to pump right away. Allow time for you and your baby master this art. Let your baby and your body flow into a nice equilibrium. You can wait several weeks to introduce a pump and expressed milk.

If there are hiccups in your situation pumping may be indicated.

When to pump varies from person to person. There is no one size fits all prescription.  If you are not sure contact an International Board Certified Lactation Consultant (IBCLC) or a La Leche League Leader.

Infant feeding can be complicated or it can be smooth. It is important to find your way. Feel free to share it on your forums but please, please put a disclaimer that this is your unique experience.

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