To Pump or Not To Pump
July 26, 2017
This is a question many new parents are faced with. People do not realize the amount of information thrown at new and expecting parents until they are expecting and new parents themselves.
One of the big decisions parents have to make is how they are going to feed their baby. It seems like most Americans consider breastfeeding. There are many obstacles that interfere with breastfeeding – that is a post for another day but let’s talk pumping milk.
I recall when I was pregnant with my first baby I took a breastfeeding class. I knew I wanted to breastfeed but did not have many role models so I listened intently on how to breastfeed. I remember the instructor talked about pumping and how it is best to rent a pump – I am not sure I remember much more. When Phoebe was born I struggled with how to get her latched and how often to feed her and I had a striped scab across one of my nipples and a hickey on the other from her latching onto the areola. I remember in a fit of frustration telling Rob WE NEED TO RENT A PUMP! NOW!
It took a few days for us to figure out how and where to rent a pump – this was 1995! Phoebe and I found our rhythm – she found my nipple I found how to listen to her cues. The pump arrived and I stared at it.
For three and a half weeks. We rented it for four weeks. I knew I needed to use it before returning it and having spent over $80 renting and buying parts. I put the shields on my breasts and was impressed that milk came out of my breasts.
Later that night Rob came home from work. This was summer and there had been a storm. The electricity was out. Phoebe started to root around. “You have to give her this bottle! Now! My milk is going to go bad and we do not have a refrigerator and it is 99 degrees!”
Rob grabbed the bottle and tried to feed our screaming baby. I walked out of the room. My breasts began to tingle and leak. Rob was sweating, Phoebe screamed louder and louder. Her head spinning like Linda Blair in the Exorcist. I started to cry. I think Rob was crying, too.
“Give me the baby.” I latched her on and we both chilled out.
“What do I do with this?’ asked Rob.
“Pour it down the drain,” I told him.
It turns out I did not need to pump. The company I was working for went out of business so I became a full time mom.
I asked Rob if he felt he needed to feed Phoebe to bond. He laughed and told me he felt bonded with here.
And eventually I became a La Leche League Leader and then a Lactation Consultant (IBCLC).
As someone who has been in the breastfeeding business for two decades I have seen different trends. With the Affordable Care Act offering up pumps to expecting parents and with social media there is a big pumping culture. And there is so much information shared that it can all be confusing.
If your baby latches on, you feel comfortable and your baby is gaining weight there is no need to pump.
Conversely, I have seen women who were told not to pump for two weeks or for one month or whatever someone told them was a rule. Or no one told them to pump while their baby is being supplemented with formula. In some of these cases this compromises their milk supply. The bottom line is that the baby must be fed. But if your baby is being supplemented and you want your body to make milk then it is important to pump. Milk is made by removing milk form the breasts – this can be with a baby who has a good latch, by hand expressing or by using a good breast pump.
Let’s now talk pumps. Pumps are not all created equally and not everyone responds to pumps the same. I have worked with people who pump using their hands – hand expressing – here is a cool video:
There are hospital grade pumps, electric single user pumps , and hand pumps.
When should you pump?
- If your baby is separated from you
- If your baby is not gaining enough weight
- If your baby causing you so much pain you cannot tolerate nursing
- If your baby takes a bottle
- If you are donating milk
- If you are working away from your baby
There is no need to fill your freezer! Pumping is not an Olympic sport!
How many people compare their milk stash to those they see on Instagram?!
You really only need enough milk to feed your baby.
If you want to pump that is cool but if you do not want to pump and do not need to then don’t pump.
People can bond with a baby without a bottle. If you want your baby to have a bottle of breastmilk, then pump.
Each situation is unique and blanket statements do not help new parents. For help call an IBCLC (International Board Certified Lactation Consultant) Find a Lactation Consultant or a La Leche League Leader.La Leche League International
Uniforms and Fairy Dust
January 30, 2015
Why do new parents seem so guarded or opinionated or defensive? Well, much of it is that they are protecting their new family.
Another thing I have noticed is that parents feel they have to subscribe to a specific style. In the years since I first became a new mom – over nineteen years ago, I have noticed that so much around parenting is trademarked. I believe that is all about marketing. I have written about how poor parents are the biggest target of marketing these days.
I remember when it was time to start feeding Phoebe solid food a mom at a La Leche League meeting suggested baby led weaning. This made sense to me – let her take food off the table – I would bite off a tiny piece of apple and let her chew it, I would continue to nurse her. Eventually I became a La Leche League Leader. A couple of years back at a meeting I was leading for toddlers a mom mentioned baby led weaning and I was thrilled to hear this concept being embraced until I heard about all the “rules around it. Rules? There is a book! Wow. I thought it was about being instinctive with a few guidelines about what foods to give and which foods to avoid so that they would not choke.
I also noticed how people would comment on how attached Phoebe and I were. Of course, I am her mom, we are together (the company I worked for closed while I was on maternity leave and I was a full time mom then.) Then I learned there is an organization called Attachment Parenting – which I love! But I hear moms asking, “Is it is AP to . . . “ Or “does it go against AP if I . . .”
Then there are the breast feeders and the bottle feeders and the co-sleepers and the baby never comes into my bed, and there are “Never let the baby cry” and the Cry It Outs.
I belong to way too many groups on Facebook and I hear so many new moms asking permission to go outside of the rules of whichever category they have chosen to join. I hear arguments about how you cannot do this or you should do that.
Titles: Tiger Mom, Hippie Mom, Crunchy Mom, Stay At Home Mom, Working Mom
Does one need only belong to one “club?” Does anyone only do things exactly as planned out in a book? Do breastfeeding moms never give their babies a bottle? Do most parents have their kids in their bed at least some of the time? Do the families that make their own baby food sometimes use a jar or sometimes eat convenient food? Do the touchy feely moms yell? Does the Tiger mom cuddle? Does the home-schooling mom want to send her kid away to boarding school? Does the mom with the most awesome and fulfilling career want to quit her job and stay home?
If you asked these questions to these parents you would get a resounding YES from time to time.
It seems like a new mom has to wear armor to defend herself and her choices. She has to seek permission to care for her baby. Whatever happened to instincts? Have we cultured intuition away by writing books and coining phrases and categorizing everything and everyone?
Maybe the extended family has done things differently so a new mom feels she needs to defend her choices. Perhaps she is faced with criticism and needs to wear a uniform.
Whatever it is I wish I could hug all new moms and blow some instinct like fairy dust at them and let them take it in, take in their babies. I want them to clear out the noise so they can hear. So they can hear that voice inside them that tells them: this is your baby, your child, do not strive to fit in, strive to find love, strive to find the wonder in your little person, strive to grow along with them.
In the meantime I will interject my thoughts in those groups when I have it in me to do so. I imagine fairy dust with each click of the keyboard.
Sweet Sleep and the Sleep Experts
November 19, 2014
This morning I attended a panel discussion of the Children’s Health Council at Cornell Weill Medical College on New York City’s upper east side. The topic was Tots to Teens: Sleep and Your Child.
The panelists were Vikash K. Modi, M.D., FAAP, Haviva Veler, M.D. and Mary J. Ward, Ph.D.
The topics they addressed are the things I discuss with my clients: routine, rhythm and consistency for good sleep hygiene. The topic of co-sleeping was mentioned but was never actually addressed during the panel discussion. It was great to hear these panelists discuss normal sleep behavior and when medical conditions get in the way.
Then they talked about the importance of letting babies learn to sleep on their own. They even encouraged Cry It Out. What was especially compelling was the fact that the two moms on the panel confessed their own discomfort with letting their own babies Cry It Out. I was relieved to hear this because it confirmed I was listening to real people with real life experience. But I wonder why. Why they have expectations that others should “do as they say, not as they do?”
They discussed the problems of electronics and irregular schedules. They discussed how light disrupts the excretion of melatonin.
They never discussed diet. They touched on allergies, mostly airborne allergies causing inflamed adenoids and obstructing airways. But they did not discuss what and how babies are fed. I wonder if they considered this in their research.
They talked about sleep associations like music, blankets and parents. They insist these “objects” need to not be there when the baby falls asleep or they will need these associations when they wake in the middle of the night. They did not discuss breastmilk or the melatonin levels that change throughout the day to help babies to sleep more. They discussed circadian rhythms.
I learned the two factors that determine the need for sleep are 1)circadian rhythms and 2)how much time has elapsed between sleep sessions.
During the Question & Answer period there were many parents asking about their own children’s sleep issues. Luckily I got a chance to ask my question. Into the microphone, I spoke, “I am a Private Practice Lactation Consultant and one of my favorite things to show new families is how to SAFELY lay down and nurse their babies and to know how to SAFELY fall asleep if that were to happen. Why then when families pass into the borders of the United States do their bodies suddenly become dangerous?”
Dr. Ward admitted that she may be biased toward Western philosophy and mentioned a study that showed most parents do not like sleeping with their babies or children.
It made me wonder if the participants in that study answered that they don’t like it because they are conditioned to think it is bad? Are they conditioned culturally to think that babies are not supposed to cross the border of the marriage bed? Maybe I am reading too much into it. Maybe my personal bias towards wanting more sleep and wanting to breastfeed comfortably colors my thoughts on this controversy.
Gerald M. Laughlin, M.D. suggested that in this country the mattresses on adult beds as so soft as to cause suffocation as opposed to the hard mattresses in Asia where co-sleeping is the norm. I am not an anthropologist but I do sit on a lot of beds and very few I have examined are soft enough to cause a risk for babies.
Dr. Veler stated that there is research that states that there is an increase in SIDS when sleeping with parents. I told her I have research that negates that untruth.
I brought along two copies of Sweet Sleep – Nightime and Naptime Strategies for the Breastfeeding Family, the new book by Diane Wiessinger, Diana West, Linda J. Smith and Teresa Pitman published by La Leche League International. This book debunks many myths around sleep. The authors really went through many studies with a fine tooth comb and proved that in specific circumstances co-sleeping is the safest for babies.
They talk about the Safe Sleep Seven. For this to work a mom needs to be:
1) a non-smoker
2) sober
3) breastfeeding
the baby needs to be:
4) full-term and healthy
5) kept on his back when he is not nursing
6) unswaddled, in a onesie or light pajamas
and they both need to be
7) on a safe surface.
This is nearly a five-hundred-page book so if you are really interested I recommend you check it out – many of those pages notes with citation of studies and research.
I gave one to Dr. Veler and the other to Dr. Loughlin.
It is my hope that these doctors will really look at them, take in the research and consider their words when they are asking parents to do what goes against their instincts.
I did take away some good information about my own older children. I learned how sleep works. My knowledge of the technology interfering with sleep is a real thing. I learned that it is absolutely normal for my thirteen year old to not want to wake up early in the morning.
I also learned that by trusting my instincts and paying attention to my children’s sleep I know what works against them getting good sleep and what helps. As babies we all slept better together. I did not mind being their sleep association “object.” It reminds me of the time when Phoebe was a toddler and she was holding onto her little red Elmo and another mom asked me, “Is Elmo her security object?” I was stunned then I realized what she was asking. “No.” I replied. “Well, what is,” she needed to know. “Um.” A beat, then “I am,” I beamed.
My Review of Breastmilk – the movie
May 16, 2014
I have seen the documentary Breastmilk twice.
The first time around I was happy to see the diversity of the subjects, the inclusion of gay families and the normalization of milk sharing.
I came away knowing that Dana Ben-Ari is a true documentarian in that the viewer is brought into the scenes unobtrusively. We observed real life situations and outcomes.
The second time around I was sitting next to woman who nursed her child a decade earlier. She squirmed in her seat and whispered to me, “If I had seen this before having my son I would’ve been afraid because it seems so hard to nurse.”
Certain elements were left out that I believe only a seasoned eye would catch. Missing from the film: physicians trained to support breastfeeding, pre-natal education, support for the mom and baby and extended work leave. Were with these elements missing from the film because they are missing in real life?
There were a handful of subjects followed from pregnancy through the first birthday of the baby. In the end only one of those babies was nursing.
The moms who experienced premature weaning talked extensively about how was “really okay”, that “the doctors were right”, they “had their baby’s health in their best interest” and “thanked goodness that their baby was healthy.” What I saw behind those words was grief, defeat and lots of justification for their unplanned weaning.
The producers, Ricki Lake and Abby Epstein, say the outcomes of the subjects of their film align statistically in the United States with breastfeeding rates.
I believe documentaries are made not only to show real life but to affect a change or to educate or to inform.
There were experts talking about the cultural anthropological aspects of breast-feeding in the Western world but there was no real information on how to make breast-feeding easier or even pointing out what got in the way. We did see a bit on how our culture gets in the way: the boyfriend who not wanting to be patient as his baby nursed, the nurse not wanting to be patient as the parents wanted to baby to self attach, the moms who had to go to work and could not keep up making milk. Once again women, these new mothers, are at the mercy of the system, a system that does not support women or children.
In my documentary I would show women all of the world breastfeeding. I would show statistics on breastfeeding rates in different countries. I would show how birth practices impact breastfeeding, how working outside of the home impacts breastfeeding, how education and lack of education affect breastfeeding.
But I am not a filmmaker. I am a lactation consultant, a La Leche League Leader, a mom, a friend. I am working in the field daily to support mothers and babies one by one.
The longer I work in this field the more obstacles I see. What do you think? How do you see breastfeeding? Do you see it as easy? Do you see it as a privilege? Do you see it as impossible? How does a baby see breastfeeding? What if we asked babies? Would that change our outcomes? Would that change our culture?
Women Words & Transitions
March 8, 2014
I am a group person. Let me just put that out there right up front. You may find it hard to believe but I was a very shy child. Not until fourth grade when I cracked a joke and most of the class laughed did I feel any level of confidence. Until that moment I was a loner, hiding behind Mama’s legs then using my baby sister as a shield.
In sixth grade Mama took us to Ala-teen, a support group for teenagers with alcoholic loved ones. I joined the theatre. When I moved to New York I joined a Buddhist cult – for only a day and half but I still joined! When I became a mom I joined La Leche League. When I wanted to lose weight I joined Weight Watchers. I lead various breastfeeding support groups. I belong to the B & N 5 – a writing group.
Last spring I was talking to my friend Amy, she and her husband own a fantastic café in the East Village , ciao for now. Amy and I often talk about parenting – we both have three children. I whined a bit about Phoebe graduating high school and starting her freshman year of college. We both welled up with tears lamenting the passing of time. I mentioned my changing body, peri-menopause, aging, all the changes we women experience. “We need a support group for that!” we nearly sang in unison. Amy immediately offered up her café as a spot for our group. I let the idea simmer for a couple of days. I had also mentioned to the B & N 5 that I wanted to teach a writing class. An idea gelled. Writing Through Transitions! I search the web and found a woman on the west coast had written an e-book and was doing workshops by that name, so much for original ideas.
I bought and read her book. It was good but she is a therapist and her approach was different.
My background is more in peer-to-peer support. My new group would be for women, we would talk and write about all of these changes, these transitions. I have creative strategies for managing the group and divining memories from the past while being able to express oneself and to be heard. A few of us gathered last fall to workshop the idea at ciao for now. I saw what worked and what I needed to change. So now, beginning March 20 we launch the official Women Words & Transitions workshop at Lila Wellness.
If you are a woman of any age in or around New York City I hope you will consider joining me in this creative, self-exploration journey. You need not be a writer just a woman. I can help you explore the many changes in your body, mind, relationships and more.
I plan to offer weekend long workshops for those who cannot commit to weekly meetings. Let me know if you are interested!
Mother Anger
July 1, 2013
We openly talk about being angry at our teenagers, our mothers and our partners but how many of us openly admit to being angry at our babies?
I recall late on night, or was it early one morning? This was in the summer of 1995. New to parenthood, Rob and I were trying to figure out how to integrate a new baby into our lives. Phoebe kept waking and crying. We were still at that point of reading books and not our baby.
The newborn cries impaled my body and I understood the story that my mother repeated often about the eighteen-hour drive up I95 from North Carolina to Massachusetts when I was a six-weeks old. She described a constant bloodcurdling cry and openly said she wanted to throw me out the window. I now knew that feeling, that longing to dispose of ones precious newborn.
Just as I was trying to figure out how to quit my job as Phoebe’s mom, Rob threw the sheets off himself and I thought he was going to hurdle her into the neighbor’s house. I immediately shifted gears into protective mama bear. I scooped Phoebe into my arms and put her to my breast for the millionth time that day and I wept.
How could I be so angry at my sweet baby girl? Didn’t I love her? Hadn’t I signed onto this job? Did I really want to give her back?
A few days later I attended at La Leche League Meeting. Lucta, the Leader, was a transplant from South Carolina. I loved listening to her deep drawl. I loved how everything that flowed from her mouth was like reading a Fannie Flagg novel. She was funny, self-deprecating, maudlin and full of wisdom.
A mother of five, Lucta spoke of how her vanity saved her first born child. When she wanted to hit him or throw him out of the window she would walk outside onto the sidewalk and hold him out for all to see.
“Ah was vain. I would never do somethin’ regretful in front of anyone,” she proclaimed. “Mah vanity saved that poor child.”
And then she said it, out loud. “Ah was angry.”
The guilt I had about my feelings of anger at Phoebe began to fade with her words. Then she said it was normal to mourn your old life. Normal. I was normal.
I have learned to respect those words in my life.
Grief is real and it is a process. Once you have a baby, one chapter of your life is closed, forever. No matter how much you love motherhood you have lost the innocence of childlessness.
One brave mother brought it up at my support group the other day. She said out loud that she gets angry at her adorable baby. Relief permeated the room. Acknowledgement that it is normal to have all different feelings as a new parent is priceless.
It is taboo to talk about anger towards a baby. New parents suppress these feelings because we romanticize babies and new parenthood.
Parenthood is wonderful – some of the time. Parenthood is challenging – some of the time. As long as you do not actually throw your baby out the window or into the neighbors yard you are pretty normal.
One game I have played with myself when I am either out with my three children or if I am feeling on the edge of losing my mother cool is, I pretend I am the subject of a documentary. I pretend that I am being filmed and I want to set a good example. Silly? Yes, but this little game has gotten me through hard moments in my mothering.
Love your baby. Remember, you have a relationship with this little person. Do you ever get angry at your best friend or your spouse? And so you ever just have the best time ever with these people? It is the same with your child.
And, if you ever feel like you want to act on your anger let your vanity step in. Go out and stand on the sidewalk with your baby.
My Review of the Lecture: Our Bodies, Our Nature: Breastfeeding & Maternal Ideology in the mid-20th Century America
January 19, 2013
On Thursday evening January 17, 2013 I attended a lecture at the New York Academy of Medicine. The title was Our Bodies, Our Nature: Breastfeeding & Maternal Ideology in mid-20th Century America.
This was presented by Jessica Martucci, PhD. She is an historian and gender studies professor. This lecture was from her research on the history of breastfeeding and environmental contaminants. She is also writing a book called Back to the Breast: Natural Motherhood and Breastfeeding in the 20th Century.
Breastfeeding research always interests me. What piqued my interest in attending this lecture was Ms. Martucci’s seeming attack on La Leche League. The descirption on the announcement has this quote:
“In 1972, the international breastfeeding support organization La Leche League published a pamphlet titled “DDT and Mother’s Milk,” which addressed the problem of tainted breast milk. “Many mothers have wondered whether they should discontinue nursing their babies,” they wrote, adding “The answer is ‘No.'” As much as the League wished the issue of DDT and other toxins in milk would just go away, environmental contaminants have been a persistent issue in scienitific and popular discussions of breastfeeding.”
Now perhaps I was wrong. I went to the lecture with an open mind.
The presentation was interesting. She paralleled the resurgence of breastfeeding with the contamination of the environment. She also discussed her concept of Natural Mothering. She somewhat spoke on it’s impact on feminism.
She pointed out two environmental researchers who had been breastfeeding while doing research on environmental contaminants and had their own milk tested. Glenda Daniel made the decision to discontinue breastfeeding her daughter sometime around 1980. She then discussed Florence Williams, a science writer, who in 2005 wrote an article for the New York Times titled Toxic Milk. Ms. Williams decided to continue to breastfeed her daughter despite the environmental contaminants. She wanted to know why these two women made different decisions with nearly the same data. I found two big missings in this parallel. One big missing was Sandra Steingraber, the ecologist and author, who also continued to breastfeed her children knowing the environmental impact.
The other big missing in my opinion is that we know much more about human milk than we did thirty years ago. Perhaps Ms. Daniel did not understand what she was giving to her daughter in terms of immunity and long term protection from diabetes, cancers, obesity while she was breastfeeding her.
She also chose to show examples of prominent women in the natural motherhood movement who had breastfeeding failure. She highlighted the experience of Eleanor Agnew from her book Back From The Land. Ms. Agnew had two terrible bouts of mastitis and discontinued breastfeeding.
Ms. Martucci seemd to have a subtle, but palpable dislike for La Leche League and breastfeeding. I could not call her on it for it’s subtlety nor would it be my place. She referred to the organization as The League.
This was not the forum to ask her about her personal life. I wanted to know if she is a mother, if so, did she breastfeed? I wanted to know if she was breastfed herself. I wanted to know what her birth experience was like.
My big question during the Q & A was “How many babies have died as a result of being nursed from polluted breasts?” While Ms. Martucci said that data has not been collected the was a resounding “None” from the audience.
The great thing about the evening was that the audience was peppered with physicians and scientists who spoke of the importance of breastfeeding despite the environment.
The big take home was that we need to act to clean up our polluted world.
To Pump or Not to Pump
March 25, 2012
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 as 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 Rob came through the door beaming as usual to see us at the end of the day. He was followed by a thunderstorm that 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 poured 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 most heavily 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.
Bye Bye Breast Burka
March 23, 2011
Some of you have seen this but it bears showing from time to time: 
Katherine, a new mom, called me to discuss her milk supply. She was concerned with keeping up the demand of her baby. Then she asked me other breastfeeding questions. She was not sure how to nurse Sadie outside of her house. She thought it was because she needed her “special pillow.” The truth is she doesn’t know how because few women really breastfeed in public anymore. There was an orangutan at a zoo in Boston. The zookeepers mated her and she became pregnant. Ms. Orangutan had been raised in captivity. She had not lived among sister orangutans so she did not know what to do with her baby when he was born – the baby orangutan died. The second time around the zookeepers asked volunteers from the local chapter of La Leche League to nurse their babies in front of the primate. When the second baby was born the primate placed her baby in her arms backwards but with some guidance from the staff quickly learned to feed and care for her baby. This is how we learn. We observe the behavior of others. When I was a pregnant with my first baby I had met a few breastfeeding mothers along the way including my sister-in-law. I took a breastfeeding class to learn as much as I could before my baby arrived. When Phoebe was born she was placed in my arms and we nursed for the first time for about twenty minutes. And then we nursed – a lot. I felt awkward. I fumbled to unlatch my nursing bras, some of which were too big, some of which were too tight and one that broke. I bought dowdy nursing clothes. I wore button shirts. I still felt awkward. Phoebe was born on a hot summer day. I am a gregarious person. I am best chatting with a group. As a new mother I felt isolated. I hungered for company That summer we had a few social events – a wedding, an engagement party – “showing off our baby” weekends. I noticed that wherever I went the host always had a “nice air conditioned room with a comfy chair” for me to go and nurse Phoebe. And Phoebe nursed all the time. I was even isolated in my socialization. Sandra, my brother’s wife had recommended attending a La Leche League meeting. The meetings had been a great resource for her as a new mom. I found the meetings helpful but even more important were the lunch dates after the meetings. Phoebe and I joined other nursing moms monthly at the Thruway Diner. We always sat at the big round table in the center of the bustling eatery. Six to ten moms and their babies smack in the middle of business suits, ties, skirts and silk blouses. This is where I learned to nurse out and about with confidence. I watched the moms with older babies. I saw unspoken communication between them. I saw how a baby might start to wiggle a bit and like Houdini the mom had unhooked her bra, lifted her shirt and latched the baby in seconds flat. It looked effortless and it also looked like there was a baby in her arms – no breasts hanging out, no cover ups – simply a babe in arms. I wanted to be like them. I wanted to feel that assured. I wanted to look that smooth and at ease. As I expressed my envy at their mastery they all assured me that they too had been awkward. They encouraged me to nurse Phoebe in front of a mirror and I did. I grew confident in my ability to nurse Phoebe whenever she needed. At the next social gathering Phoebe started rooting and I said to Rob, “I am going to nurse her here.” He put his arm around me and kept talking. From there I declined offers for the “air conditioned room with a comfy chair.” I eventually became a La Leche League leader and then lactation consultant. I gave birth to two more children. I nursed them all over the place: the bus, the subway, Saks, Barnes & Noble, fancy restaurants, diners. Usually no one except other mother’s knew I was nursing. I was not hiding behind anything just nursing my babies. When my youngest child, Finn, was about 6 months old I was at the pediatrician’s office for a well check up. In the waiting area were two new moms discussing a new product they had just discovered – “The Hooter Hider” one of them said in an embarrassed giggle. Then I started seeing breastfeeding covers everywhere. This was the antithesis of the Thruway Diner experience. A baby begins to fuss, the mother searches her bag for the cover, the baby fusses more, the mother opens the cover, ties it around her, by now the baby is wailing, the mom fumbles with the cover and the baby, the baby kicks about, perhaps not wishing to be under a tent. Now everyone knows what is going on under the fabric. How challenging this makes everything. Breastfeeding by its very nature is designed to be simple. We have complicated it. We have made it shameful and difficult. Like the orangutan new moms today have no real life positive breastfeeding images. Courtney, another new mom, asked me a question about nursing in public. I asked her, “ Do you have any friends who are breastfeeding?” “Yes,” she replied. “So go hang out with them, learn from them,” I offered. “They use a cover or expressed milk in a bottle.” she answered. “Go to the thruway diner!!!” I want to scream. But that was another time, another place. I walk down the street and look into the windows of Victoria’s Secret, American Apparel and Abercrombie + Fitch – this is our provocative world yet we must put a tent around us to feed our babies? We flaunt our breasts to sell products. Breasts are sexy – until they become functional. Then we hide them. A few years ago I could spot a breastfeeding mom because I had a keen eye and I had been there. Nowadays anyone can tell a breastfeeding mom – she is the one hiding behind the overpriced piece of calico. 
mamamilkandme 