Tips on Pumping

Yes, I know: strange coming from me, who hated pumping (then again who doesn’t) and stopped breastfeeding when Georgia was 9 months old. But I’ve found myself in the odd position of helping others who’ve struggled with pumping and low supply a lot recently, even though I myself tried everything and had pretty spotty success. So I decided to write it all down, in case you can benefit, too.

At least I had a constant companion in Tasha to cheer me up.

I’m certainly not encouraging anyone to skip breastfeeding. By all means, do it and pray for an easy time — I want that for you. But let me be the one to explicitly tell you: it IS possible to try everything the lactation consultant, pediatrician and mom blogs tell you, and still not make it to a year (or longer) nursing. I don’t know who set that deadline, but I can’t tell you the hours of undue stress it caused me (and my husband) when I felt I was “falling short.” And trying isn’t just OK, it’s downright heroic. Because you grew a child in your body, and you are continuing to give it life today, whether that’s with breast milk or formula.

Nursing 24/7 and having the doctor tell you your baby isn’t growing: I’m not sure there’s a worse feeling.

Formula, though not ideal when compared to Mother Nature, is quite literally life-saving for some babies. I’m aware of all the things people don’t like about it, and I am definitely troubled by statistics showing that only 16% of women nationwide are able to continue exclusively breastfeeding by the time their babies are 6 months old. But I think the solution will come via national change at the policy level, when this country decides to support all mothers’ and  babies’ health by providing high-quality prenatal, postnatal & pediatric care (plus lactation consultants and dual-phase, double electric breast pumps), at least 6 months of paid maternity leave for all parents, and access to high-quality, affordable child care. It’s shameful that one’s race, finances or address have anything to do with breastfeeding outcomes, but this chart has the latest data and it’s pretty damning:

Personally? As a mom to a baby labelled with “failure to thrive” just two weeks home from the hospital, I feel like a freakin’ champion to have lasted 9 months. I know breast is best, but I won’t apologize to everyone I meet for not being able to “EBF” (exclusively breast feed, for those of you with better things to do than follow internet mom jargon). My breastfeeding experience is not the totality of who I am as a woman. Plus, where does this debate leave adoptive parents? Or gay dads? I could go on. But I won’t; I’ll just cut to the chase and give you my tips.

Tools of the trade

First, you’ll need (ahem) a pump. Call your insurance to see what Obamacare will provide to you for free, then order it from an approved vendor. Or, ditch that route and do what I did — get the one you want on Amazon. In my case, that was a hands-free, double electric, hospital quality pump from Medela (affiliate link). I used and loved the Freestyle, but the Pump In Style is another great option (key difference is that the Freestyle clips to your clothing so you can walk around, whereas the Pump In Style is built into a tote that you carry and sit with. Both have multiple speeds and shield sizes and are relatively quiet and fast).

Second, you’ll need a hands-free breastpump bra. I tried and returned a lot of these. Thanks to friends, I finally settled on this one by Simple Wishes. Women of literally any size can wear this thing, because it’s so adjustable, which helps as your boobs change size gradually; it’s also extremely easy to put on and to fit the pump flanges into, and the seal is really secure.

For a basic introduction to setting up and using a breast pump, check out this step-by-step video by FitPregnancy.

Some other things that help:

• Extra bottles. I got another set of the Medela bottles that came with my pump, so it wouldn’t be as problematic if I left full bottles at work or clean bottles at home accidentally, but they are small. So you may have to transfer the milk to a larger bottles for feedings, or get extras in a bigger size if your supply is really high and you fill these really quickly (alas, not my personal case, but I suppose I have other talents). You can also use special freezer bags if you’re pumping enough to put some away for later. These store flat and can be marked by date so you don’t let them expire, and are great if you travel for work or go away for the weekend. Most day cares will take either bottles or bags, as long as they’re clearly labelled.
• Bigger nipples as baby gets older. You can get faster flowing nipples for the Medela bottles (or whatever brand your pump requires) so that your baby doesn’t get frustrated trying to drink from a tiny newborn opening. This helped Georgia a lot. We couldn’t seem to overcome nipple collapse, however, because Medela bottles (as well as Dr. Brown’s) share a nipple design that just didn’t work for her (and in my opinion, looks nothing like an actual boob!) To work around this, I only used breast milk straight from the Medela bottles at bedtime, when she wasn’t as ravenous and thus didn’t drink so forcefully, which caused the nipples to flatten or cave into the bottle.
• At least one ice pack. My pump came with a reusable cooler pack and a contoured ice pack (meaning it could fit in between four round bottles) but it couldn’t hurt to have a spare in case you lose or forget it. There was a point, before I realized I just wasn’t going to be one of those women who could pump enough to replace three 8-oz. bottles during the workday, that I considered getting a mini fridge or an extra freezer for our basement, since the fridges we have at home and at work are pretty tiny.
• Cleaning supplies. You can use any number of products to clean your pump in a hurry, but I always found that it performed best when I took everything apart and washed it with good old fashioned warm water. Then you just dry it with some paper towels and pack it up for next time. Other options: wipes and steam bags. I had access to a microwave and a sink near my pumping room at work, so I tried all three methods.
• A nursing cover. This comes in handy if you have to share a nursing room with someone else at work, or pump in your own cubicle/office discreetly, or in the car. It’s good to have on hand if you’re headed to a meeting or conference where you don’t know what pumping accommodations can be made (it never hurts to call ahead). I have one by Bebe Au Lait but I’ve heard good things about Udder Covers as well.
• You might also find hand sanitizer, extra makeup for touchups, spare napkins for spills, and nursing tea plus a mug to be helpful items to keep around. I also found that breastfeeding made me really thirsty with very dry skin and lips, so I stashed lip balm, hand cream and bottled water in my diaper bag and pumping tote.

Getting set up at work

I was very fortunate. My company set up a privacy room for nursing mothers to use two years ago, and then expanded it when we had a bit of a baby boom. With a solid computer terminal, a full-length mirror, a rocking chair, fridge and plenty of locked cabinet storage, it had essentially everything you needed to pump while working or resting. The only thing it lacks is a private sink to wash the pump parts, but with a bathroom and kitchen down the hall, those resources were in close proximity. What companies are obligated to provide varies by state and workplace size, but it can never hurt to ask for more. That’s how we got an improved setup at my place!

I was also lucky that my workplace offers nursing mothers extra breaks or unbilled time in the day during which to pump, which is crucial to being successful at breastfeeding, no matter how much supplementing you’re doing at home. The main challenges I encountered? Rescheduling meetings around my pumping time, without extending my workday beyond 9 to 5; people texting me questions while I was pumping, so as not to “bother me” by phone; having to eat lunch while pumping because I had no other time to fit it in; eating and drinking enough before pumping so my supply didn’t drop; and keeping the stress of work problems at bay so they wouldn’t affect my letdown or my yield. While the pumping room was awesome, fitting in the actual pumping in a workplace that values long hours, no lunch breaks and tight deadlines was beyond tense.

What to wear

At home, this was easy: leggings or a stretchy skirt plus a nursing tank top. Drop the front panel, attach pump, and go! At work, this was harder to figure out. Some days, I simply made a nursing camisole my base layer under a blazer, sweater or cardigan, and then took off the top item to pump; other days, I wore a dress that unzipped in the back instead of going over my head, and that was equally comfortable. It turns out that dresses make great wardrobe staples for busy mornings with crazy toddlers, too, since you don’t have to think about matching separates. Thus, I continue to build my professional wardrobe around them, and hardly ever wear pants anymore at all. I found it helpful to keep a pashmina or other soft scarf in my office in case it got cool in the nursing room at work.

Taking care of you

Not getting adequate sleep (ha, HA!), drinking too much caffeine and too little water, stress, and exhaustion can all drastically reduce your supply. Same goes for waiting too long to eat lunch, or not eating the right things. Sound like anyone else’s typical day at work with a newborn at home?? Right. Do the best you can not to guzzle an XL coffee or engage in a tense discussion with your boss before pumping, and block out enough time for the full phase of expression on your pump to get what you need (for me, this was the full 30 minute cycle just to get 2-3 ounces per side, so the whole affair took a solid hour after setting up the pump, disrobing, cleaning the pump in another room, rearranging myself and storing the milk). If you have to pump more than once per day, which is very possible, then I suggest doing one when you first get in and another in the late afternoon so you’ve eaten a meal before each session and you don’t go so long between nursing that you get engorged on the way home. Other moms I know had better luck pumping at home while they were getting ready for work, or just before bed, in addition to once during the workday. It all depends on your supply and your baby’s appetite!

Eating right

Good foods to eat: oatmeal, soup, lactation cookies (seriously!), granola bars, good fats like nuts, olives and avocados, and cold-water fish rich in DHA such as salmon, shrimp, catfish and crab. Fenugreek is a supplement that several lactation consultants suggested I take to boost my supply. Keep a reusable water bottle at work wherever you pump, so you can’t forget to fill it every time. As a general rule, have healthy snacks on you at all times. And keep taking your prenatal vitamin.

Bad foods to eat: salad, unless topped with any of the foods mentioned above to round out the meal; too much alcohol, which enters your breast milk and can affect your let down; excessive caffeine, in the form of coffee, tea or energy drinks; any soda; and anything that may irritate your baby via the bottle, such as garlic, beans, onions, peppers and broccoli, all of which can cause gas and fussiness. The last thing you want to do is pump all that milk and have baby refuse it (been there — Thai takeout, we cannot be friends until baby is weaned).

Here are two helpful charts to help you meal plan while pumping:

Overcoming hurdles

You know, I wish that all women were as supportive as some of my friends and family. At one point, when I really felt like a failure for all of this nursing business not going the way I had planned (so what else is new with babies), Mark just turned to me and said “where are you feeling all this pressure from? It’s not me. It’s not our parents. It isn’t even Georgia’s doctor. So what is it?” And I didn’t know what to tell him, except that I spent my entire pregnancy being indoctrinated that breast is best so intensely that I never even considered the possibility it wouldn’t turn out to be so simple. I know I was lucky to give birth at a hospital that didn’t give formula in the nursery after birth, and that made so many lactation consultants available in the first few days. That coaching was invaluable. If you’re running into problems with nursing, pumping, or both, I would highly encourage you to reach back out to your OB, or your child’s pediatrician — that’s who connected me with my local LCs, when Georgia was a few weeks old and we were really struggling — or search online using the International Lactation Consultant Association’s web tool. Insurance is obligated to cover these services now. And, please, never hesitate to reach out to me directly. When I confessed how much trouble I was having nursing over social media, loads of women reached out….but what killed me was how many said I could never tell anyone  about it, because they had lied to their own families and friends about supplementing!

This madness has got to stop. Surely there are better things women can be doing than judging one another for this crap. Do you know what’s actually important? This.

Now on to a few reasons you might pump (other than to make bottles). Even after I stopped pumping at work, I used my Freestyle to “pump and dump” after I’d had migraines that required medication Georgia couldn’t safely ingest through my milk. Because I continued to nurse her before and after work and on the weekends, I had to pump off any contaminated milk that resulted from taking my migraine medication. The same would go for having drank too much alcohol (generally one glass of wine or beer is considered safe while nursing) or for any other non-nursing-safe meds. Of course, you could also keep a simple hand pump around for times like these.

You might also want to pump just to “take the edge off” when your baby first sleeps a good long stretch at night, until your body gets used to going 6+ hours without nursing. Within a couple days, your body should regulate, just like it will as you gradually wean (whenever that happens). I’ll never forget pumping for 10 minutes while blow-drying my hair on the way out the door just to make sure I wouldn’t leak during the opening night of my husband’s show last fall. The things we do.

If all else fails

I practiced pumping between feedings in the weeks before I returned to work, so I’d get used to it, and so my supply would ramp up. I pumped twice a day when I got back to work full time. My supply fell bit by bit every month until eventually, no matter how many times I pumped or what I ate and drank, I was only getting an ounce or two total — and my baby was drinking three (!!) 8-ounce bottles while I was away. So, I made the decision to stop pumping when she was 6 months old, right after we went to Florida, and then two months later she started to refuse nursing at the two remaining times I offered every day (6:30 a.m. and 6:30 p.m.) I continued to offer her the breast until it became clear, between 8 and 9 months, that we were done. Apart from nursing her for comfort when she had two bouts of the flu at the end of May, that’s been that.

Do I miss it? Not really. She’s not an infant anymore, and by 9 months she was standing, crawling and investigating her world, not cuddling up to me for hour-long feedings. Also, I got my body back. The last pregnancy pounds dropped off, I had freedom to go running early or take yoga late, and I didn’t physically “belong” to someone else anymore. I could reconnect with the greater world again. No more rushing home to do bedtime or risk my milk drying up, or going into work late on those days Georgia decided she really missed me and needed an extra-long nursing session in the morning, or hiding in someone’s bedroom during a cookout or family gathering. Nor do I miss having to craft my outfits around half-undressing at lunch to put on a pumping bra in a cold office every weekday.

But, not knowing whether or not we’ll have more kids, I am sad that I may never again have the lovely feeling of nursing a tiny baby to sleep, or of smelling that musky scent they get after eating, or have a tiny hand reach up to stroke my cheek when it’s just the two of us in the wee hours. Those things are really, really, profoundly special, and I’m blessed that I got to experience them at all.

My boobs shrank back to their previous size (sigh) and I’ve packed away all my nursing tanks. There are days I can’t believe it’s over, and then there are days when I trip over my pump — still sitting in my office at work — and wonder how the heck I did that for so long. And I know so many with babies Georgia’s age who are still going! It’s an individual journey, ladies, and no two experiences are the same. If I have another baby, I guess I will see how it goes for me next time… for now, I’m simply enjoying my perfect, beautiful, precious joy-filled miracle of a baby.

‘Later ta-tas, it’s been real.

Psst: If you love data and can’t get enough breastfeeding stats, you can read the CDC’s full 2014 Breastfeeding Report Card right here. Other great web resources for pumping and nursing in general are KellyMom.com and La Leche League. Special thanks to the staff at Beth Israel Deaconess Medical Center and Melrose-Wakefield Hospital for critical coaching, literature and support. And, of course, my friends who sent supportive Facebook messages, texted advice, drove me to lactation consultant appointments with a screaming, hungry newborn in back, or recruited me into local breastfeeding support groups. It’s mind-blowing that some women have to go this alone, and I am thankful every day that I don’t.