Thursday, December 27, 2012

Pumping and Driving

Yesterday was a LONG car ride. We got stuck in bad snowy/icy weather in states that do not know how to handle it: Pennsylvania, Maryland (all ten miles), and West Virginia.

It turned a 4.5 hour car ride to an 8 hour one. When we got home, my family from OH (who'd made the trip the day before in the same amount of time, which is good time for the trip) was here in Virginia with us. My mom asked me how we did on the car ride, "Did you have to go the whole time without pumping?!?"

I said no, and realized that we could have been in a very challenging situation, had I not started using the battery pack with my PISA (Medela Pump in Style Advanced). There had been a couple trips to my husband's home that I did not pump the entire way (and instead, hand expressed), and was pretty full when we got there.

Because I decided to start using the battery pack (and the PISA, while I normally use my symphony when stationed in one place) I survived the trip without much stress in the pumping area. But stress in other areas--baby pooping and puking at the same time, changing baby in the car, dealing with fussy baby, being thirsty and hungry.

Do you worry about the people passing you seeing you  pumping? I just have a loose shirt on with a hands free bustier and don't worry about it. The only bad thing is the seats tilt your pelvis back, so I have to intentionally lean forward so I don't get milk. It's also difficult to hand express in the car because of that angle. I drip milk down my belly.

I decided to purchase an outlet adapter for our car so that I can use the Symphony pump in the car, because the suction is different-- less powerful.

I'll have it for the next trip--it arrived after we left.

Got a crying baby to attend to.

Pump on!

Monday, December 24, 2012

Cloth Diaper helpful information!

I just found some GREAT links to working with cloth diapers!

This one is a trouble shooting diagram for when you have stinky diapers, and the other is on how to strip cloth diapers!

We've been using cloth diapers since little N was about a month old. Recently they started really stinking in the diaper pail so I started to look up different things to help with the smell.

Here's a diagram from this link about trouble shooting.

And here's a link about stripping diapers. The most helpful I've found this far.
Most sites have some suggestions about stripping and then they ask people. there were far too many opinions and I found this one to be the most helpful.

THey talk about how to do the simplest strip (with just hot water and lots of rinses) and then what to do if that doesn't work for you.


Friday, December 21, 2012

How much suction?

When you are pumping, the beginning two minutes (or so) engages your nipple and areola to let your milk down. This is done by quick, low suction.

Then your pump switches to deeper, longer sucks, pulling your nipple and areola deeper into the flange. This is the suction it maintains until you turn off your pump.

Your pump has a standard suction for both of those, and you have the option of turning it up or down to your needs. The question is? How strong of suction should your pump be giving you.

I read on one website that the suction stimulating the letdown reflex is the equivalent of a sleeping baby sucking, which means that to have your "active baby sucking" you really need to turn it up. This website endorsed the idea that you should put the suction as high as you can stand it.

I've also read that you should let it be and not get too much suction going on because you could give your self nipple trauma.

The lactation consultant I worked with through WIC said to turn it up as high as you can stand it.

Well, if you are like me, you are relatively sore during pumping sessions (this is partially due to thrush, which I'm working on) . so I draw the line with my suction. On the Medela Symphony, I usually turn it up three degrees of suction after the initial let down. There have been times that I've pushed it (and myself) to maximum but I usually cannot stand that much suction.

Gotta go. Crying baby.  

Thursday, December 20, 2012

how long to pump?

As a rule of thumb (where ever that phrase came from),
you should pump 15-20 minutes each time. 
I just can't get over how ridiculous the ads for hands free pumping bustiers are. 


I also read that in order to stimulate your milk supply,
you should pump five minutes after your milk stops flowing. 

"I wish I could wear my pump ALL day, I love it so!" It's like they think the pump is their baby in these pictures!

Now I have yet to figure out if that means when your let down stops, or if you actually have to wait until the occasional drops quit altogether. I think that it's somewhere in-between, and for me personally, with the sore nipples that I have been fighting since day one, I usually don't stay on the pump for more than 25-30 minutes. When I start reducing pumps, though, that will need to change.

You should pump the same amount of time every day.


"Oh my goodness! You should totally try this!"

Here's my example. I pump nine-ish times a day for twenty minutes. That's 180 minutes (that's three freaking hours, I know!) So when I start reducing pumping sessions, I will still need to maintain 180 minutes. So for
8 pumping sessions: 22.5 minutes ( think I'll pump for 23 minutes. nbd)
7 pumping sessions: 26 minutes
6 pumping sessions: 30 minutes
5 pumping sessions: 36 minutes
4 pumping sessions: 45 minutes
3 pumping sessions: 1 hour

(remember not to reduce more than one pump per month!)

I doubt that I will get down to 3 for fear of losing my milk supply. I might not even do four. I'm shooting for a year of pumping as much as I can, and then I might still pump --maybe do the 3 a day to get what I can for Miss N so she can enjoy my benefits as long as possible.

I hope this helps!


Wednesday, December 19, 2012

How many pumps per day? (ppd)

Well, it depends on how old your baby is, how long you have been pumping already, how large your supply is, and depending on that, if you are ok with supplementing with formula towards the end of your goal time to pump breast milk for your child.

From the get-go, it is extremely important to pump as often as your child eats. Yes, that means every two hours or more. This is to simulate when your baby would actually nurse. If you have a hectic schedule, or another child (or children), then you should shoot for the minimum number of times, listed below. Your body produces the hormone prolactin (get it--lact-- as in lactate) to stimulate lactation during the first twelve or so weeks of your baby's life, so to engage and establish your supply, it is vitally important to pump

8-12 times a day (for the first 12 weeks).

I shoot for 9, and it's easy to do when you have developed a routine. I organize everything I do around when little N eats and when I pump. Not nap time (and the reason for that is that if I need to go somewhere and tis' nap time, I put her in my Ergo and she conks out. But we can talk about nap time later)

I've read many women who have no problem with pumping seven times, or six times a day and producing more than enough breast milk for their babies. They are very blessed with a good milk supply-- and some of that may be because of having a great start with pumping.

When I started, it was two weeks after my daughter was born and had been nibbling on my nipple for two weeks breastfeeding, so I really had to work to get my supply back to where it is now (supplementing only one bottle of formula a day). If this is you, it is super important to pump at least the minimum of times per day. 

If you are the mom with gallons of breast milk in the deep freezer, consider Human Milk for Human Babies and donate to a mom (willing) to use your extra milk. 

how much some women get
I get about half this much in the fridge in the morning. It dwindles to nothing around five pm


(side note: if you are donating, provide how old your baby was at the time you pumped the milk, because milk composition changes as babies get older. They specify milk between birth to 2 months, 2-6 months, 6-12 months, and 12 months +)

One other important thing about pumping is your middle of the night pumping. Between the hours of 1am and 5am, there is an increase of prolactin produced by your pituitary gland. Pumping at least once at night time is important, because you want to hone in on that prolactin increase to help stimulate and maintain your milk supply. This pumping session is one of the most important ones to keep for as long as you can, even if your little one sleeps through the night. 

Don't we all look this happy when we're pumping!? hah hah NO.
After 12 weeks or so (or so meaning you shouldn't just drop three pumping sessions on week 12-day 1, because the hormonal effect changes slowly.), you can drop one pump. I've read that the best way to do it is to drop one pumping session a month (see reason below), until you are at the number of pumps or (more importantly) the number of ounces you would like to maintain. 

As you drop pumps, it will take a month to notice any drop in your supply. There will be a drop. You may lose a half an ounce from your day's pumpings, or you may lose 2 oz. Knowing this, it's important to make a good decision in mind about how much formula you are willing to supplement (again, if this is an issue for you).

Many women settle down at 5 or 6 pumps per day comfortably. Some may settle at four, but that it on the verge of weaning. You know your needs (needs to get out of the house and away from that darn pump), your baby's needs (how much milk they need, how much formula you are willing to give them), and other extraneous factors--other children, your husband is tired of that machine, pain from pumping.

My daughter reaches twelve weeks this Friday. And honestly, I'm fearful of dropping a pumping session, but I know that it might give me more sleep, and more patience. I've started to come to peace with the formula she has to eat (it does help her sleep longer. :P) But I also know that as I drop pumps, and I lose ounces, there will be more formula and less breast milk. I'm not at peace with that yet.





Tuesday, December 18, 2012

Pumping and the holidays

So with a new baby brings much joy at the holidays! And awkwardness, if you aren't sure how to come out of the closet with your pump! Not saying you need to do it in the gathering roomwith all your uncles and cousins, but for goodness sake, don't wait to come home to pump!

courtesy of http://mommymcblog.files.wordpress.com/2012/11/christmas-tree1.jpg

I learned at Thanksgiving that because family get togethers often last five hours on my husband's side, it's ok for me to bring (aka lug--it's HEAVY!) my pump and trimmings along to relieve my breasts and feed the baby.

When we stay at my in-law's house, I have a separate room to pump in. I get all my stuff set up nad there is a clock for me to watch how long I pump, and a comfortable chair to sit in.

When you have your space--and make sure you can have it-- make sure it's private, and quiet--your baby will probably want to take a nap while you are over at your relative's house nad it's a good idea for it to be a bedroom. To find this location, if you are attending a meal, ask the lady of the hosue. She will direct you to the most appropriate place (any one who has been a mom knows the need for privacy to nurse or feed, both for you and for your baby.)

This is a good time to remember that big family get togethers will most likely be overstimulating for your little one.  Make sure you find that quiet room before this happens and you ahve a screaming baby. (speaking from experience here).

When you pack your pump bag, don't forget all your trimmings--breast pads if you need them, oil if you want to have a comfier pumping session, lanolin or whatever you put on your breasts post pumping, lids (very important unless it's going straight into the bottle), and of course, the bottles.

Another tip before traveling. Either make sure your membranes are new/working well, or bring an extra set! It's no fun sitting down for your middle of the night pumping session and the suction just won't kick in because your membranes bit the dust.

If you are a mom who pumps extra, don't forget those bags! If you are me, don't pack the bags hoping your supply will magically increase. Depressing.

Enjoy the holiday season! Because you are nursing, you can eat more (not exponentially more though, especially if you are working off the baby weight). Make sure you take a walk in the winter wonderland to escape from the confines of the pump, and to promote happy holidayish I-refuse-to-gain-weight-this-season thoughts!

little blog chain called Liebster Award



Shout out to Bethany as my main distraction from working on my list of post ideas for this blog, and instead getting to talk a little about myself. I'm not gonna continue this because I have zero connections, but it's good for you to know who I am.



Eleven things about me...
1. I graduated from college in three years, and declared my major after the first one.
2. My family is Mennonite and my parents are pastors.
3. My husband and I have an eleven week old baby girl.
4. I can't wait to get pregnant again and have another baby, but we're waiting until I get my weight to a manageable place.
5. I tried to make homemade chocolate chips yesterday. It was a half fail--the sugar separated from the oil.
6. I love bright colors. Grey is my enemy.
7. When I was in high school, I was voted most likely to stay in Streeetsboro... which is why I'm in Virginia now.
8. I'm a musician-- I play the piano and sing, and my baby can sleep through it all!
9. I can make a fanastic dinner out of almost nothing. 
10. I'm pumping right now. It's my excuse to get on the computer.
11. My favorite fruit is a cantaloupe!
Questions as requested by Bethany.
1. What is your greatest fear?
My greatest fear is the death of my child or my husband. Grief would be intense, God would get me through it, but pain is scary.

2. What is your biggest accomplishment?
My biggest accomplishment was graduating from college, and having a natural childbirht. :)

3. What is your favorite thing to cook (recipe included please)
I love making these cocoa brownies! And these lactation cookies comes second.

4.What is your guilty pleasure?
chocolate chips (thus why I tried to make them)

5. Who is someone you lost touch with and miss?
A friend from high school who I was close to.

6. Who is someone you need to forgive?
 My professor.

7.What color is your underwear?
red. It's cinco de mayo underwear. I know, TMI. :)

8. Who is your favorite person in the world?
Husband! 

9.What do you do too much?
Check facebook. My husband would say I pump too much. but I pump just the right amount! (try for 9  or 10 times a day)

10. Boxers or Briefs? (if you say briefs your a loser)
Boxers. Because they don't look ridiculous if I wear them too!
11. Plain or Peanut?
Peanut! Go for the chocolate peanut butter!

Making sure you have the right flange size

Being a pumper is hard work!

It is not comfortable  at all to be hooked up to a pump 15-20 minutes a day for 8 to 12 times a day. It inhibits flexibility, getting out of the house, soothing your baby (although if you have a hands free bustier, you can diaper, feed, play with your baby, and blog while you are pumping (guess what I'm doing right now), and taking care of other things (like other children, eating a snack, getting water to drink).
Pumpin' Pals flanges. I want to try these1 I've heard wondrous things about them!

But what can be even more uncomfortable is when you get a blister from your nipple/areola rubbing against the side of your flange. FOr this reason, I recommend oiling up your flanges before pumping--it's almost pain free, and you can just be left with irritation of having to be still when you want to go for a run.

Because pumping is so uncomfortable already, it is vitally important that you are wearing the right sized flange. One size (especially the standard that comes with your pump) does NOT fit all. I started with the medela 24 mm, and when I got the WIC Symphony pump moved up to the 27mm and it increased my supply a lot--all that milk finally getting out!! After my pumping consultation with the lactation consultant at WIC, she commented that I had rather wide nipples ---i.e. large-- and I had to purchase the size larger 30mm. There are also smaller and larger sizes, custom sizes and each brand of pump runs different mm flanges. I came across a diagram with information about being sized for flanges.

http://www.medela.com/IW/en/breastfeeding/good-to-know/right-size-of-breastshield.html

This website shows what the incorrect flange size will do with your breast.

Using foods and herbs to boost milk supply

A couple weeks in with exclusively pumping, I still wasn't meeting all of my daughter's needs with breast milk. This was incredibly frustrating for me because I didn't want anything to do with formula and every time I made a bottle with it I felt like a failure because I couldn't make enough.

So I decided to see if I could use herbs to increase my supply.



I started with fenugreek. It's well known as an herb to help stimulate more breast milk, especially if it is combined with nursing/pumping often. And it makes your sweat and urine smell like maple syrup. sweet. It originates from India and is a popular spice in many dishes. The seed is where the good stuff is. From what I read, it is important to get organic fenugreek because it is good quality.

I think the fenugreek actually made a difference. I took it for ten days-- three capsules, three times a day. I was keeping track of my production at that point, and I was making between 20 and 26 oz per day, which was still about a bottle (4oz) short of what my baby required of me. But it didn't make a huge difference.

When I quit using it, my supply maintained itself.

From my research online, many women experience great increases from using herbs, specifically fenugreek. And many experience little or no effect (one could say that it is a placebo effect, and maybe that's what I had).

My second round of herbs was after a consultation with the WIC lactation consultant. She encouraged me to do a couple different things to attempt to increase my milk supply--power pumping, skin to skin contact, breast massage and compression before and during pumping, hand expression after pumping, and to get more milk plus (www.motherlove.com) to help with the supply.

More milk plus is a mixture of herbs, including fenugreek, blessed thistle, fennel, and nettle herb.

If you purchase more milk plus, be aware the taste is no walk in a park. It's an herbal tincture in alcohol. It is very bitter. What makes it harder for some to take is that the manufacturers suggest for optimal use, consume no more than 1-2oz of liquid for fifteen minutes before or after use. Luckily there are capsule forms of the same mixture if you cannot handle bad tasting things.

I used this one mL, four times a day, and it also didn't make much of a difference. I maintained my milk supply. I ran out of it quickly, and then did not continue use.



My last hoorah, which was slightly wimpy and not truly effortful, was with brewer's yeast, in the form of lactation cookies. I bought a nice can of brewer's yeast from our local supermarket, and added six tablespoons of it to my lactation cookie recipe (found here). And ate a large amount of cookies (in fact, most of them, and gained weight this week (ugh postpartum weight loss) and still didn't see a great supply increase. THe cookies were wonderful, healthy and wholesome (I used honey instead of sugar and they have oatmeal and flax in them, as well as whole wheat flour).

The cool thing with the left over brewer's yeast is that is has a great amount of protein and is absolutely FULL of vitamin B and amino acids. So it's super good for you! I will continue using it in my diet to promote health (and get good protein not from meat or animal products!)

Other goods that are supposed galactogues are oatmeal and flax, and I've read great things about barley (but haven't tried any of them). I've also read about goat's rue, and that's one herb I'm a bit more skiddish about.

Overall, there were only a few things that helped--one was pumping more often, and the other using the right sized flanges. But I am not everyone, and many different herbs have been very successful for some women. Here is a very helpful article on increasing milk supply: http://www.breastfeedingbasics.com/articles/increasing-your-milk-supply

How about you? Have you had success with herbs? Which ones? How about goat's rue? What have you read on it/experienced with it?

The Beginning

I never meant to exclusively pump for my daughter.

We were going to breastfeed, and breastfeed a LONG time. That was on my list of things i wanted to do, along with babywearing, attachment parenting, co-sleeping (another thing that didn't work out), cloth diapering, natural childbirth, water birth, no induction, and birth at a birth center (this would have been homebirth if we didn't live in the basement of our landlady).

That's what we started with. Little N (well, hardly little, born at 9lb 3oz) was breastfeeding and we were using a nipple shield because my nipples were flat and she couldn't grab them.

But it was painful! SOO bad. And my nipples were peeling layers of skin after every feeding, coming out of the nipple shield misshapen and very sore and sensitive. And they were so sore though I would slather lanolin on them religiously after every nursing. Those first two weeks, i was in a perpetual flash--breasts exposed to the air in hopes that they would heal.

Then at N's (and my) two week appointment, she was still under birthweight, at 8lb 8oz, and our midwife was concerned. She said N wasn't nursing efficiently. She took one look at my nipples and said we should take a break. Pump for a bit and heal up, and get some help. My husband, N, and I went to a Le Leche League meeting that night, with our hungry screaming baby and pump in tow. The leader was helpful, attempting to latch her screaming mouth on my still flat nipple, and then said it was ok to give her formula. Your goal is to feed the baby. So my husband was off to the supermarket to get some formula and a bottle. Two things we thought we'd never need.

N also had a pediatric chiropractor look at her. He said she had tension in her neck, jaw, and diaphragm, and also saw a lip tie and a posterior tongue tie. We were desperate, exhausted, and into her belly the formula did go.

And I started pumping. I had a Medela Pump in Style, 24 mm flanges, and a couple bottles. We'd give her the ounce and a half I got, from I pumping every two hours, and I thought I'd have to quit then and there.

Thankfully, a week later, a lactation consultant from WIC (contacted by the LLL Leader for me) called and offered to drop by with a WIC symphony for me to borrow. She said it would help me increase my supply as opposed to the pump in style, which would only maintain my supply.



And the pumping began.

As I write this post, I have been pumping for nine weeks.