Thursday, March 22, 2012

Pumping Revisited

I have been promising for several weeks to do a follow-up post to pumping with all of the nifty tips and tricks I've learned from girlfriends, lactation consultants and doctors.  I realize this will be a boring post for all of you who do not have children slash are not pumping, but I hope it will be helpful for those of you who do pump or may pump at some point in the future.

One thing I will say about pumps is this: if you think you're going to pump, it may be expensive, but get a good one.  The ones in the hospital are awesome and make my pump at home seem like it is straight out of the stone ages, but obviously hospital-grade pumps are not an affordable option for the masses.  I myself have the Medela Freestyle Hands-Free pump, courtesy of my girlfriend Lindsey, and I love it (well, as much as you can love a pump).  However, I have heard that really you can make any of them hands-free if you get the hands-free bra.  I can't remember whether I mentioned this before, but my friend Jen recommended the Simple Wishes Hands-Free Breastpump Bra and it has literally changed my life - on the expensive side but well worth it, in my opinion.  If you're not pumping as often or don't want to splurge, I also have one from Target that worked just fine (until I discovered the miracle of the Simple Wishes bra).  :-)

Anyway, so now to the good stuff.  I got tons of great comments after the last post I wrote on this, and have since spoken to several lactation consultants, my doctor and Lilly's pediatrician, so I thought I'd put together a list of things I learned in hopes that it will be helpful to others:
  • CLEANING:  As mentioned in a previous post (which I'm too lazy to find and link to), I was annoyed at all of the cleaning that has to happen - both with bottles and pump parts.  I was cleaning my parts after every use, which was a TOTAL pain.  My solution to this was to buy more pump parts and bottles - which is still, in my opinion, a good idea, especially if you pump a lot, because it means you don't have to deal with cleaning them right away when you need a new set.  However, several girlfriends and Lilly's pediatrician recommended something that I wasn't aware of that changed my life.  After you pump, just rinse the pump parts and store them in the refrigerator until the next pumping session.  You can do this 5-6 times before cleaning them/using a new set.  Genius, right?  Truly the difference this has made is incredible - it has saved me so much time (and probably water, too).  I typically do this and use one set of parts for a whole day before switching to a new set and cleaning them.  Another suggestion was to use the Medela Quick Clean breastpump wipes, which I have also done - I find them to be particularly helpful if I've pumped in the car, so I keep them in Lilly's diaper bag.
  • PUMPING PHASES: This tidbit came from L's pediatrician and was a serious game-changer.  Turns out I had been using my pump incorrectly.  Last time we went in, I was telling her how I was pumping and getting exactly what Lilly was eating, which was fine but I was worried about how to increase my supply when she wants more, or just to have for stockpiling.  Turns out there are 2 phases on your breastpump: the stimulation phase and the expression phase (you can read a little about them here).  When you first turn on the pump, it is automatically in the stimulation phase for the first two minutes - the pulls are quicker/closer together to stimulate the milk flow.  This mimics what a baby does when he/she is on your breast. After 2 minutes, the pump automatically goes into the expression phase, which simulates a slower, deeper suck.  The pump will stay in the expression phase for the duration of the pumping session unless you change it.  The good doctor told me that I should be manually putting the pump back into the stimulation phase when my milk slows or stops in order to trigger more let-downs.  This is exactly what a baby does when he/she is on your breast and the milk slows - their sucking becomes faster and lighter again to get the milk to let down again.  It makes perfect sense, right?  I was just letting the pump do it's own thing, staying in the expression phase for an entire session.  The pediatrician told me that when Moms do this, they normally notice a 40-60% increase in their supply right away.  She was not lying.  At one point over the past week, right after I implemented this (like within a day or two), I was 15 bottles ahead of Lilly (angels singing), which has helped me to start stockpiling again.  I've started keeping four bottles ahead of her in our refrigerator and freezing any excess.  Woohoo!  The pediatrician said that you should go back to stimulation phase 5-8 times in a 20-minute pumping session, depending on your letdowns. 
  • PUMPING TIME:  The pediatrician and lactation consultants also told me that I should never pump for less than 20 minutes, and that the length of time pumped is not as important as emptying the breast.  They explained to me, and it makes perfect sense, that if you aren't completely draining the breast when you pump, your body thinks that you don't need that excess milk and is therefore reducing your milk supply.  This is probably why I was getting exactly what Lilly was eating - I was basing my pumping sessions on time and just doing 20 minutes total every time I pumped.  What I have learned about my body is that I have approximately 23894723974 letdowns, and I have to pump for a much longer period of time in order to completely drain my breast - normally 35 or 40 minutes.  This is a HUGE pain right now, because Lilly is eating so frequently, so I am having to make sure I pump every 3-4 hours (normally more like 4, and I'm so far ahead right now that sometimes it's 5 or more), but I think when she starts eating more, less often it will be a lot easier on me.
  • INCREASING SUPPLY:  There are several ways to do this.
    • The pediatrician told me that in order to keep up during a growth spurt, I should pump every 2.5 hours.  I wanted to ask her if she'd ever had an infant.  Lilly is so much more awake these days and therefore demands a lot more attention, so it's hard to even pump every 4 when I have her by myself, much less every 2.5.  BUT, I have found that if I can pump more often consistently, my supply increase is drastic.  She also told me that I should increase the frequency of pumping (i.e., every 2.5-3 hours if I normally pump every 4) for 48 hours straight in order to see an increase that sticks around, and I have also found that to be true.
    • Herbal supplements.  Fenugreek was the one that she recommended to me and that I've been taking.  She said that the instructions say to take one tablet three times per day, but she recommends three tablets three times per day.  Between the Fenugreek and the correct mode/length of time/etc. on my pump, I have seen a HUGE increase in my supply.  I also have girlfriends who have recommended Mothers Milk - I think you put it in tea?  Or maybe it is a tea, I'm not sure - and have said it helped them as well.
I think that may be all of the important things I wanted to touch on.  In a typical day, I try to pump every 4 hours, because Lilly is still eating every 3 hours during the day.  At night, she normally falls asleep between 9-10 and we've recently implemented a dream feed 2 hours after she eats (but prior to 11:30 p.m. because anything after that is apparently considered a night feeding and not a dream feed - tomayto, tomahto), which is normally between 10:00 and 11:00 pm.  After the dream feed, she's been sleeping until 4:00 or 4:30, waking up to eat, and then going back down until 8:00 or 8:30 (And then going back down again until 11:00.  Sooooooo sleepy!).  Because I'm ahead and feeling a little more confident about my supply, I have not been pumping during the overnight feeding.  My last pumping session of the night is normally somewhere between 9:00 and 11:00, depending on when I pumped last, and then I have not been pumping again until she gets back up at 8:00 am.  The result is that I have to pump a little longer to make sure I'm completely empty, but I've been getting between 16-20 oz so I haven't noticed my supply decreasing thus far - if it does, I will go back to pumping after I feed her overnight.  This also works well because when she starts making noise, I get up and come downstairs and throw her bottle in the warmer and start to pump, and then Dan takes her for the first feeding of the day, so she eats and then falls back asleep and I can pump in peace.

Gosh, I know I always say it but these posts always get so long!  I hope this one has been helpful to some, and at the very least informative to others for future reference.  :-)  In closing, I would like to show you what happens when you spend a week at your parents house and your child is spoiled rotten by her grandparents and aunts and is held 24 hours/day, and as a result insists on being held while you're pumping which is difficult:
Notice the pump wires coming out every which way - and you can thank me later for not getting a nipple shot, ha!  She stayed like that for about 15 minutes and then finally fell asleep so I could finish pumping without her in my lap.  I did let her fuss for a few minutes to see whether she was serious before putting her in my lap - sometimes she's a total faker - and had I not JUST sat down to pump I probably would have just tried to fend her off with the paci until I finished.  At least she's cute and snuggly, yes? 

Sarah

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