Saturday, June 25, 2016

Weekend Chats: Confessions of a Former Exclusive Pumper

Exclusive pumping is something near and dear to my heart since I did it for a year with my older son, Kellen. 

What does it mean to exclusively pump? When a mother exclusively pumps she is pumping breast milk with an electric or manual pump to feed her baby by bottle and not her breast. The next question many may naturally wonder is, why?  There are many reasons and really they are only important to the mother because none are more important another. Some mothers struggle to get their baby to feed at breast due to latch or other anatomical issues with baby or mom, some are not able to put baby to breast due to medical conditions (commonly in the NICU with a premie or unable to handle a feeding), and some prefer pumping and bottle feeding. These are just a few scenarios, but are the more common reasons a mother/family might opt to pump over feed from the breast. In this post, I will refer to a baby put to breast as nipple fed and a baby whose mother is pumping as bottle fed s times. I will never classify the nipple fed baby as breastfed and infer that the other is not. In my opinion, the mother is breastfeeding in both of these scenarios, but the delivery system is different. I find it insulting to ever infer that a pumping mother is not breastfeeding her child. 

As I previously stated, I pumped milk for Kellen for a year. It was a choice I made after his NICU stay and feeling particularity helpless. It is amazing to me how different the NICU in the short period of time between Kellen and Rowan. In 2013, I shared a note on my pumping journey with Kellen after he turned 1 on Facebook and will share it here with you (it is a little long):

I want to start off by say that I am going to talk about my preferences and beliefs in this story.  I in no way wish to offend anyone who decided to take a different path with their family.   You are not any less or more of a parent than I am because we made different choices.   Also, I am going to talk about breasts, babies, nipples and breast milk- consider yourself warned.  I wanted to share this because it has been such a big part of my life and I haven’t really put it into writing till now.

These are my opinions, my experiences, my beliefs, my values and my family’s journey.

Before my boy was born I knew that I would breast feed. It is the best for baby. Hands down.  You can make arguments either way, but when the chips are down it gives baby the best start in life…. After I read the back of a formula can it makes me cringe to see Kellen get anything but breast milk.  I think breast feeding is beautiful and milk is made just for my baby by me.

My son Kellen was born on 12/11/12 at Bellin Hospital at 42 weeks 2 days. My husband Ron and my Doula & friend Emily were by my side.  The birth went great, but the following day we were told Kellen had pneumonia and was admitted to the NICU for treatment.  

I was discharged on 12/13/12 and Ron and I went immediately to pick up my Madela PISA breast pump (free- thank you insurance!). 

Ron and I really liked Bellin and felt very comfortable with the nurses and the staff.  We had gotten to know them and I was able to pump and nurse him within the NICU.  I was also asked if he could be given some formula since I was not always there to feed.  I consented to this but was troubled because I wanted Kellen to primarily get breast milk. Problems came when Kellen (the little stinker) kept pulling out his IV.  Ron and I received a call from Dr. Rock (Kellen’s NICU Doctor) at 12:30 am on 12/13/12 informing us that Kellen was being moved to St. Vincent Hospital. 

At this time Ron was already back at work and I made the trip to St. Vincent Hospital early the next morning.  Kellen was alone in a room and looked so small. The first nurse we met will stay with me forever.  She looked kind, but her demeanor changed when I asked to nurse my baby. She acted as if I was an imposition.  I asked for a more comfortable chair like I had seen in other NICU rooms. She told me they did not have a chair and gestured for me to use a tall computer chair.  Kellen was 10 lb 4 oz when he was born….needless to say I say on a boppy for a little while after he was born and a tall computer chair was not going to work for me.   I was feeling defeated already.  I thought to myself, “you are strong you need to make this work…no failing!”.   The final straw came when I tried to find the bathroom.  Apparently, there is not one close to the NICU… was on the other side of the hall way…  I remember walking down the hallway crying because I felt so alone (and at the start of a post birth UTI…yay).  When I came back my mom was had come to be with me (she was there every day- thank goodness).   I tried to nurse Kellen again and he would not latch. I asked to speak with the LC on staff and the nurse told me that he could just be given formula and implied that I was starving him.  I consented and allowed him to be given formula.  Shortly after the LC came and gave me a nipple shield.  She showed me how to use it, but did not offer very much help to me with our latch issues.  It was also at that time that the nurse mentioned that Kellen may have to stay for 10 days…..Excuse me?  Dr. Rock was not in the NICU and my mom and I went to grab something to eat.  At lunch I made a list of questions and concerns.  After the nurse's comment practically accusing me of starving my baby because I wanted to breast feed I was done with their shit.  Fuck you, I wanted to say, and bring my baby home.  However, being a lawyer’s daughter I decided to use a different approach.  When returning to the NICU I was pleased to see Dr. Rock.  I discussed with him what the nurse had said about the formula and Kellen’s stay.  I was diplomatic, but I wasn’t about to take anyone’s crap anymore.  It was my baby and my show to run.

After our discussion, a comfortable chair was placed in Kellen’s room and I did not see that nurse the rest of Kellen’s stay.

The remainder of the NICU stay was a combination of running to the hospital, sleeping and pumping.  I remember being at my family Christmas, in my parents room, pumping.  It was the beginning of a very long journey.  My family was kind enough to come to the hospital to visit Kellen since he was not able to attend the festivities.

Kellen was discharged on 12/16/12 at 6 pm.  Ron and I were banging down the door to get him out and never look back.  As we left I said goodbye to the other families whose babies were not coming home soon. I still think about them and hope this holiday season everyone is home, healthy and happy.  We even got home in time for the Packer Game.

Over the next few weeks we struggled with latching. I tried the nipple shield and went back to the LC twice.  I was pumping the entire time and bottle feeding as well.

There came a time when Kellen was about a month old that I decided that I was going to pump.  My mom said to me, “what is your goal? If it is breast milk you are getting him breast milk”.  She was right.  At that was when I made the decision to pump exclusively for Kellen.  I figured that since I had to back to work anyways it would work well for Ron and I and help with feeding responsibilities.  I thought hard about goals for how long I wanted to pump.  I decided that my first goal was 6 months and my long term would be a year.  At the time I remember thinking…it’s just a year…little did I know.

In the beginning, I supplemented with a few formula bottles here and there.  Kellen was a big baby and my supply had to catch up with his demand.  It was not until later that I learned about donor milk as an option…. 

Anyone who says breastfeeding and/or pumping are easy is lying or has no other responsibilities besides their child.  I could have bought stock in bread pads in the early months because my body was all over the place. I truly learned what the word letdown meant and it was all over my tank top when I would wake up in the morning.  In addition to the leaking I needed to pump every three hours not only to build my supply but to make sure my boobs did not explode (I know they wouldn’t have, but it seemed like it).   When you first start pumping, like breast feeding, it hurts! I quickly learned that lanolin was my best friend. My world was rather swampy…..  From 1 month -3 months I was pumping for 20 minutes 7 times a day.  To put into practical terms, the time I was pumping would be the same if I drove to Madison, WI every day.  That, along with work and other responsibilities- even to a girls weekend, was taxing.   By the end of 3 months I was pumping about 30 oz a day.  
4 months came a challenge, a family trip to Key West, FL, while exclusively pumping.  I knew that I had a battery pack and an adaptor for my pump so pumping in the car or at the airport was completely doable.  Ron and I pack bottles, pumping part, water free cleaning (these are awesome for work!) cloths, ice packs, breast pads and lanolin.  Getting there was a challenge….I practically dove into our rental car to pump after the flight.  We made it! The week followed me pumping about 5 times a day and resulted in some supply issues when we returned home.   When we returned home I ate a tone of lactation cooking and more milk supplements. Thankfully I was able to get my supply back up.

5-6 months in was where I felt myself start to want to give up.  I developed thrush on my left side.   I have never felt pain like I did with thrush. It felt like someone was stabbing me in the chest and kept me up at night in tears.  I said something to my doctor at Kellen’s 6 month appointment and she gave me a cream to try. Thankfully it worked and the pain went away.

Pumping, sorry if it is TMI…you were forewarned, beats the hell out of your nipples.  After the thrush stopped, I started to develop blisters.  I tried changing the size of my pump parts, but it did not seem to help.  I had two in my left side and one on my right.  When they finally popped it was horribly painful (toe curling deep breathing painful).  I remember sitting in the living room pumping milk that looked like pepto because I was cracking and bleeding because of the blisters.  I sat and cried and my poor husband tried to find a way he could help me.   After struggling with the blisters, the thrush returned.  After the thrush left, the blisters returned.  I almost quit. I almost walked away because it was so much to deal with.  I felt alone and drained.  I wasn’t technically a breast feeder and wasn’t comfortable reaching out on the group Facebook page.  I was tired of having my life revolve around a pump and I was tired of the pain. I just wanted to go to sleep, I just wanted to have a glass of wine and not worry about timing in order to have another and I wanted to be able to be spontaneous again.  I have since heard from other EP mom’s of their struggles to fit in with breast feeding and formula.

At about 7 months, I reached out to my doula and friend, Emily and my good friend Kayla.  I don’t think they know, but they saved me from quitting.  Kayla’s son was born a few weeks after Kellen and we love getting the boys together.  I could also talk with her about my struggles because she understood.  Emily pushed me to complete my goals. She knew how important this was to me and even found me a Facebook group of other EP moms.  Ron also gave me so much encouragement. He never failed to tell me how proud he was (or tell anyone else).   I had hit pumping rock bottom….I cried each time I had to pump because it hurt and I wanted to have my life back.  After talking with my friends it gave me a shot back to my goals. I could do this.   At this point I was pumping 6 times a day and making about 45 oz.

By month 9 my thrush had gone away and blisters had healed. I think this is when things got better for me. I was making about 40 oz a day and pumping 5 times a day.  My supply had dropped slightly, but it was ok.
Around month 10 my supply dropped dramatically when my period returned.  I dropped from 40 oz to 30 oz within a few weeks and I could not make it jump…it just kept dropping.  After talking with Emily and with Ron I decided to seek out a donor.

The first person I went to was my friend Kayla. I knew that she had extra and had donated in the past.  Being the wonderful person she is she donated about 250 oz to Kellen.  I continued to trudge along pumping, but my supply kept sinking. Thankfully Kellen was taking solids and his needs were not as great.  I started to consider the weaning process since I was getting close to 12 months.

At 11 months I was pumping 3-4 times a day and getting 20-22 oz.  After cutting to 3 pumps a day I tanked again and was circling around 10 oz a day.  Thankfully, Kayla was looking to donate and Kellen received another 100 oz. 

Month 12.  I made it….. Kellen has been transitioning to dairy over the past few weeks with his breast milk and has been doing great.   I am writing this on the eve of his first birthday with tears in my eyes remembering how hard my family worked to make this goal.   It feels bittersweet to put away my pump.  It had become such a big part of my life I have to re-learn how to live without pumping multiple times a day. 

I think about how much those words from that nurse in the NICU changed how I decided I was going be for my child. I was going to fight for what I wanted and what I thought was best.  Emily and I went to a tree lighting a few weeks ago and were talking about breast feeding and pumping.  I think I am a harder person from this experience, but I think I have learned so much about myself.   I truly learned what it is to advocate for you.  I learned how important a natural approach is to me. I learned that with the right planning I can could still do on vacation, girls weekends, nights out, camping and weddings!  I learned that surrounding yourself with support is important.  I learned that the off-handed comments people make, while annoying, about breast feeding/ pumping are because they do not know better.

I will never be able to thank Emily for her support.  She is a rock to me and I will never have another child without her by my side.  I will never be able to truly thank Kayla  for sharing her milk and friendship with Kellen.  Kayla gave Kellen 350 oz of milk! 

My family was so supportive to me. They never acted as if it was an imposition to them and always supported Ron and I. 

To Ron, you are the best person I could have asked for to support me. Thank you for not getting grossed out, annoyed or mad because I always got to sit in the recliner to pump.  You never doubted me and you never gave up. Thank you for making this as important to you as it was to me.

People told me I was crazy and that I couldn’t do it, but I did it. Since December 2012, I have done almost 2,200 pumps. At 20 minutes that is 733 hours and, if calculated to days, about 31 days.

It was worth every second.

  Anyone out there who wants to breast feed or pump, do it because you will never regret it.   It is the hardest thing I have ever done, but one of the best.

So that was 2 1/2 years ago. I read it now and it makes me cry because I wish I could tell the woman who wrote that post that it was going to be better next time and to thank her for doing the things she did because she allowed the person I am now to learn so much. I wish I could explain the NICU to her and why certain things were done because after a longer stay with Rowan I learned so much more (I would also assure her that Dr. Rock would be there again because he is an exceptional doctor). I feel like I sound so angry in that note and maybe I was.  I wrote about how I was a harder person, but I am not sure that is true anymore. I think in 2013, I was still reeling from everything and think what I became was a smarter and more compassionate person. I really leaned to appreciate the medical field and the professionals in it- there are very few like the one I encountered out there. I learned to be part of a team the next time around- that experience taught me how to be a better mom, a better advocate, and better patient. 

As you read above, I had a schedule for my pumping and I think that is one of the more common questions I hear from people interested in pumping exclusively is how you create a schedule. From what I have learned is that the beginning is the most important and to get up and do the middle of the night pump even thought it is a giant pain in the butt! You will be saved months of worrying about your supply by working to boost it in the first few months versus trying to boost your supply when coming up a little short. The first 12 weeks are the best time to build a supply, but it can still be done after that but takes a bit more work and who likes to get up in the middle of the night after baby has started to let you sleep!?  My point is- put in the work in the beginning and you will be happy you did. Aside from the middle of the night pump what does the schedule look like for an pumping mom? A good rule of thumb, for me, was 3-4 hours while supply building (7-10 times a day). This will change some days because  life happens, but it is important not to make a habit of spaced pumping in the beginning. Once you develop your supply spacing the pumps or dropping a few will not create big problems, but this can vary from person to person. 

So what do you need to pump? First you need a pump and since the passage of the Affordable Care Act it should be covered by your insurance. Before you have your baby call your insurance company to get a list of their providers and many times it is as simple as ordering online and the company will bill your insurance. 

I used the Madela Pump In-Style exclusively pump and what I use to pump in between feedings with Rowan:
I have the different accessories shown above, but had 2 additional sets of breast shields and a bunch of extra bottles in the 5 oz and 8 oz sizes. If you are and exclusive pumper you may want to have extra membranes and tubing because your pump may have a bit more wear and tear because of the frequent use.  I have not tried other pump brands, but can say that my Madela was good to go after tubing and membrane changes when I started pumping with Kellen. I did order a new one as well and keep one at work since it was free for me to order one. The cooler was a big draw for me as a pumper because it was nice to have the ability to keep the milk cold if I was pumping away from home (which happened often).  The pump bag is nice as well because I often needed to bring multiple bottles with me. Another accessory that is not shown is lanolin- but stock in that.....seriously. Another helpful accessory is the water free wipes to clean the pump if you do not have immediate access to soap and water. If you are a part-time pumper many of these things you will have to pump when you are away from baby, but maybe not the larger quantities. I also recommend getting the car adapter and the battery pack for the traveling or when you forget to grab your plug off the wall! 

Another area to touch on is supply. As a former EP mom I know how obsessive the numbers game can get with pumping- any EPers do a spreadsheet *raises hand*.... Will I make enough today? Can I freeze some? How often is baby eating and how much do I need before I can leave for X number of hours? Exclusive pumping is not for the weak of heart my friends. Supply issues are sticky because there are many reasons for supply issues to become problems. Many time supply issues are rooted in the mom not pumping enough. Pumping is a big commitment and if you aren't doing it, especially in the beginning, your body does not know to keep increasing milk production. Another big supply reducing culprit is getting enough liquids and calories. I am sorry, but 3 weeks postpartum is not time to go on a diet to loose all the baby weight if you are breastfeeding. I do not mean that you should go hogwild, but your body needs the calories. Your body also needs liquids, lots of liquids. The amount you should drink is different from person to person, but my daily water goal was/is 100 oz. There are other ways to increase supply with baked lactation goods, teas and essential oils, but a calorie and water boost does the trick many times. Supply issues with pumping moms can trigger stress (big for me with Kellen) and that can also impact milk production.... the worst part for me was my stress from supply impacted my supply....sigh.  If you are having these issues bounce some ideas other breastfeeding moms and there is always lots of good advice out there. If you do not have any friends breastfeeding turning to the local breastfeeding Facebook groups is another good option. 

What about the bad times? If you decide to EP there will be hard times like what I described above. Really hard times. Lancing a blister off my nipple was not the highlight of my life that is for sure and at the time I almost quit. Looking back I am so happy I didn't and have gotten blisters since then with Rowan and have been able to take it in stride much easier than with Kellen. My only words of wisdom are to keep truckin' without guilt as best you can. It is really easy to feel guilted  or to have someone try to guilt you when you are pumping. One story that sticks out to me was when I was about 10 months into my pumping journey with Kellen. I was a member of a local breastfeeding mom's group on Facebook and a girl posted a photo of a mom pumping while bottle feeding her baby. The poster said, "this makes me so sad and it is lazy". She got he ass, rightfully, handed to her by the pumping moms in the group. However, it really hurt me when I actually sat and thought about the judgement she had passed. She did not know the woman's story in the picture, assumed it was because the woman was somehow lazy, and didn't even consider that is was a viable choice. I consider myself lucky because I only ran into a handful of people like that and the majority of people in my life were very supportive. I stated before that I find it insulting to ever infer that a pumping mother is not breastfeeding her child and that interaction was what really spurred my opinion about that to be as passionate as I am about it. I truly feel that it is no one's job to marginalize and judge another mother who chooses to have a different type of breastfeeding relationship with her child. I have learned how to brush off people like that, but it is something that took me a long time, but now I could really care less what another person thinks when it comes to feeding my baby. 

There were some funny times as well! Dragging my pump through security at the airport, pumping in the parking lot before a Packer game, and spilling the (empty) bottles and killing Ron's car battery while pumping when we went camping! 

I also have so many bittersweet feelings about exclusively pumping. It certainly has it's perks and well as it's pits. One perk is that you are not always the feeder and Kellen was very laid back about who fed him. Another perk was that I got to get away a little more often and have time to myself or with Ron and I. I was also able to rely on a feeding schedule and longer times in between feedings. I think it is important to explained that there were great advantages to it, but it did come with additional work of pumping and planning.  Currently, I am breastfeeding Rowan and pump about 3-4 times a day depending on my schedule or what milk I need for daycare. I am blessed this time to have a great supply due to more aggressive pumping while Rowan was in the NICU and pumping after because of some of the issues I outlined in my breastfeeding post NICU post (I almost went back to exclusive pumping again). I think I probably pump more often that an average breastfeeding mom due to some of Rowan's issues and frankly out of habit from being a former exclusive pumper- old habits die hard.  A perk of this great supply was that I was able to donate milk to a mom who uses donor milk for her son. I used donor milk with Kellen and it was on my breastfeeding bucket list to donate if I was able. I was so excited that my body gave me the opportunity to payback what was given.

To summarize, exclusive pumping is hard work. You are a breastfeeding mom and do not let anyone tell you otherwise. You are giving your child the best nourishment you possible can. If you are pumping and want to be feeding at breast do not be afraid to try again with the next baby or, if you are able, when the baby is older because you will learn so much from this experience. If it is your personal preference to pump- you go girl and get pumping. 

If you want to talk with me about pumping I am all ears and it is a topic I enjoy discussing (I know I am a giant weirdo). E-mail me at or leave a comment below. 

Next week I am diving into another side of pumping:  Breastfeeding, Pumping, and Working- The Juggle. 

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