Can't Breast Feed? How to Pump Exclusively
Many mothers have breastfeeding in their plans, but some find out it is not as easy as expected. This can be due to pain, a medical problem for the mother, or a medical problem for the newborn. This can be a heartbreaking revelation, one which I know first-hand.
If you are unable to breast feed and are like me, you may feel like a failure, because you wanted it so badly. After all, this is a natural process that should be smooth sailing, right? Maybe you are physically able, but it is out of your control. If your child is unable to nurse or is in NICU and your only option is to pump, I can imagine this being heartbreaking as well.
For me, it was chronic skin yeast overgrowth that made breastfeeding my children the most painful, burning feeling I have ever endured in my life. I tried exhaustively to nurse all 3 of my children. I read books, researched online, spoke to other moms, talked to my doctor, disccussed it with the pediatricians, and visited 2 different dermatologists. No matter what I tried, I failed, and I cried a lot.
Regardless of your situation, as long as you can produce milk, there is good news. Pumping exclusively is a viable option that can give your baby nutrition second to none. The bonding experience of nursing will not be there, but you can make up for that in many other ways. All you need is a good pump and some dedication, but if I can do it, you can too.
To Rent, or To Buy?
There are many types of pumps on the market today. Manual/hand pumps, single electric pumps, and inexpensive double pumps are good for occasional or emergency use, but are not meant for pumping full-time. In order to successfully pump all of the milk your baby needs, you will either need to rent a hospital-grade double pump, or purchase a good double pump from your local baby supply store or online retailer.
If you are considering renting a hospital grade double electric pump and can afford the monthly fees, this is a good option. Hospital breast pump rental fees vary, but average about $50 per month. Two common brands of hospital grade pumps that hospitals rent are Ameda or Medela. These are expensive to buy, as they cost anywhere from $1,000 - $2,500. These work very well, and the hospital will provide you with brand new tubing and parts that only you will use, usually referred to as a "personal accessory kit". The pump itself is reusable because it does not come in contact with you or your milk.
Commonly available hospital-grade rental pumps include the Medela Lactina, the Medela Symphony, the Ameda Elite, the Ameda Platinum, and the Hygeia EnDeare. Medela, Ameda and Hygeia are very well respected brand names and have a reputation of quality. I have used the Medela Lactina and the Ameda Elite and had great success with both. Ameda, Medela, and Hygeia personal accessory kits are interchangeable as well, as the same diameter tubing is used, and the tubing is the part that attaches your accessory kit to the pump. If you need replacement parts in an emergency, Medela parts are easy to find at stores like Wal-Mart, Target, and Babies R Us.
The downside to these hospital-grade pumps is the portability. If you are using them for a short period of time such as during your hospital stay or during a short maternity leave, this is not much of a problem. However, when pumping exclusively long-term, it is critical to have a pump that is easy to grab and take everywhere with you. These hospital-grade pumps are larger, require an electric outlet, and are much less portable overall.
Besides portability, consider the total cost difference over the course of the amount of time you want to pump. For example, if you plan to pump for only 6 - 12 weeks until you return to work, renting a hospital-grade pump will be a small total expense and makes a lot of sense. However, if you plan to pump for 6 months, 1 year, or more, you will spend more in the long run to rent a hospital pump than buying your own personal double pump.
If you choose to buy a personal breast pump for full-time pumping, you can expect to spend between $250 and $350 for one that will meet your needs and help you maintain supply. In my experience, the good quality personal pumps on the market today work just as well as the hospital grade pumps. Not only are they a better deal in the long run, but they are much easier to take everywhere with you, which is going to be very important to someone who plans to pump full-time after getting back to life as usual.
Which Personal Pump is Best?
There are many brands of personal double electric pumps available today. Many of them are fast and convenient for occasional use when supplementing breastfeeding with pumping. However, if you plan to pump exclusively long term, I would recommend investing in one of the following 3 pumps:
These pumps will last, offer superior portability, and are work-horses. They all operate on an electric outlet when at home, but have available backup batteries, auto adapters, and manual pumping attachments for those times when an outlet is not available or you experience a power outage. They all come with convenient and discrete totes and cold storage to keep your milk cold for up to 12 hours. These pumps are easy to take anywhere you go.
I've used less expensive pumps and have literally burned up the motors because the pumps I was using were not made for long-term, full-time use. Using pumps meant for occasional use will not save you money in the long run because you will likely have to replace them at some point. However, you can save a little money on any of the 3 recommended pumps above by buying them without the convenient totes and using something you already own.
How To Build and Maintain Your Milk Supply with a Pump
Breast feeding your baby directly is the best way to build and maintain your milk supply, but when you don't have that option, you can do it successfully with a good breast pump such as one of those recommended above. However, regardless of what pump you get, you will need to follow some additional advice in order to be successful. Based on my extensive experience with pumping exclusively, I recommend following the guidelines below.
Frequency is one of the most important factors to building and increasing milk supply. When your milk initially comes in, your body will be paying attention to queues like frequency. Initially, a newborn feeds frequently, and in small quantities. This is nature's way of building your milk supply. When pumping, the same trick works, except we have the ability to go even farther by pumping excess to refrigerate or freeze so that when our babies are ready to increase their feeding volume, we will be prepared.
When building a supply from scratch, it is important to pump both breasts every 2 hours for 10 - 20 minutes, which is the same advice a nursing mother might receive for feeding on each side. Once you are confident that your body has adjusted to this rhythm and you are getting more milk than you need at the 2 hour intervals, you can move this to every 3 hours, and then every 4. I recommend at least a week between these time changes to be sure not to confuse your body and throw off your supply. After 2 - 3 months when you know your body and are confident in your supply, you can eliminate the nighttime sessions (more is explained about this below in Timing).
Please note that any time you increase the time between pumpings, your breasts will become engorged between pumpings for a day or two, but will adjust. For example, if you change from pumping every 3 hours to pumping every 4 hours, your breasts will become full after 3 hours even though you will not pump for another hour. As long as you are OK with committing to the new schedule, this is nothing to worry about, as your breasts will soon adjust to your new schedule and not become full until the 4th hour. However, be sure that you are OK with this new 4-hour schedule, because once your body adjusts, it will be very difficult to convince your body to go backwards and return to a 3-hour schedule (see Weaning below for more info on this).
An easy way to keep up with the rhythm schedule is to pump as often as your baby feeds. Newborns are normally on a consistent schedule for several months, so you might want to feed the baby, and then pump immediately after, or have your partner feed the baby while you pump. This will make it easier for you to keep up with the schedule and make sure you don't miss pumping sessions. This is the method I always follow while I am home on maternity leave, as I can plan my day around the baby's feeding times. However, when I become more active away from home and return to work, I choose the timing of my pumping sessions so that they fit better into my schedule.
Our bodies have internal alarm clocks, and our mammary glands are apparently very aware of these clocks. One of the major keys to maintaining your milk supply is timing. Pumping at the same times each day will allow us to train our bodies to produce milk at the times that we are going to extract it. When these times arrive, our bodies will know it's time, and it will prepare the milk that we need. If we pump at an unexpected time, it is likely that the full amount of milk we intend to pump will not be available. It may seem strange, but our bodies really do become confused about when it is and isn't supposed to provide milk. If we pump at the same times every day, our bodies will become very predictable and give us assurance that we can consistently pump the milk that our babies need.
In order to maintain a full supply of milk through pumping alone, I do not recommend ever increasing the frequency between all of your pumping sessions to greater than 4 hours, with one exception. To keep your sanity, you can eliminate night pumping sessions once your regular sessions are 6 hours apart for at least 1 week. I typically eliminate my night sessions when my babies begin sleeping through the night, which has ranged from 6 weeks to 3 months for my children. By that time I knew my body and my supply was well established and consistent.
Once your supply is well established, the number of hours are between each pumping session becomes less important than keeping the specific times of those sessions consistent. In other words, it is important to pump at the same exact times every day. Once I am confident in my supply, my long-term, consistent pumping schedule is as follows:
- 6:00 AM
- 10:00 AM
- 2:00 PM
- 6:00 PM
- 10:00 PM
As you can see, I eventually eliminate my 2:00 AM night pumping session and pump a total of 5 times per day, at the same times every day. With this adjustment, I go 8 hours without pumping for one stretch every night, but pump consistently every 4 hours during the day. I have been able to successfully maintain my supply with this schedule, and even freeze 50% - 100% more milk than my babies consume.
I have tried combining the 10:00 AM and 2:00 PM sessions into one 12:00 PM session because this was easier to do at work, but this attempt proved nearly fatal to my supply. My overall production was lower, and I was forced to supplement with my frozen supply. I was never able to successfully change my 4-session schedule back to a 5-session schedule, and gradually lost my supply until I was no longer able to pump. Please keep this example in mind as a reminder of why frequency and consistency are so important.
A very good way to increase your milk supply is to continue pumping after you have emptied your breasts. If you consistently do this, your body will eventually catch on to your plan and start producing more milk. Even when I am not trying to increase my supply, I try to pump for 5 minutes after emptying as a way to safeguard my current supply and not give my body the opportunity to decrease supply.
Relaxation is Key
I cannot stress enough how important relaxation is to succeeding with all of the steps above. If you are stressed about something, trying to hurry, or have someone waiting on you for a meeting, you will have difficulty expressing milk, even if your breasts are full. One of the most distracting things you can do is to keep checking your bottles and counting ounces. This will also hurt your production. If you are able to relax during the same session, you can easily overflow your bottles. Without reading this tip online about 11 years ago when I had my first child, I would never have been able to exclusively pump so successfully.
I recommend saving your favorite magazines, books, and TV shows on DVR for your pumping sessions. Even when pumping at the office, it is essential that you give yourself permission to take his time to relax and read something that you enjoy. Relaxing and taking your mind completely off of the fact that you are pumping will allow your milk to flow freely.
Once your supply is established, I recommend purchasing inexpensive 8 ounce baby bottles to attach in place of the 5 ounce collection bottles that come with your pump. This will give you peace of mind that you will not overflow your bottles without realizing it and make a big mess (been there, done that). Not having to worry about overflowing will help you relax and pump more milk.
I also recommend purchasing a stylish nursing cover like the ones below. There are many brands available, and you can even find them custom made on Etsy at great prices. You will thank me when you end up having to pump in your car, at a relative's house, or in the nursing room at the mall. These covers allow you to see exactly what is going on with your pumping session, but you will feel comfortable, secure, stylish, and in complete privacy.
Freeze, Freeze, Freeze!
When my babies started sleeping through the night, they consumed a maximum of 24 - 26 total ounces of breast milk per day. Once my supply was established, I was pumping approximately 32 ounces per day, and gradually increased that to 60 ounces per day! Since I was producing more than my babies consumed, I was able to freeze quite a bit of milk.
I purchased a chest freezer on sale from Home Depot for around $250 and filled it to the rim with breast milk, along with our regular freezer. When I weaned myself from pumping, my babies were then able to continue drinking my frozen breast milk for at least 3 additional months. Freezing this much milk in collection bottles is too costly and bulky, as is using the bags that require clips. I tried all brands of breast milk storage bags until I found one that I absolutely love. I recommend the Lansinoh storage bags below, as they are sturdy, great quality, freezable, easy to use, and freeze flat, maximizing space.
When I get ready to wean and discontinue pumping, I generally adjust my pumping schedule to allow 6 hours between all sessions. Doing this steadily decreases my supply, so this is why I do not recommend stretching regular pumping sessions longer than 4 hours if you intend to continue pumping exclusively. I only recommend this if you are weaning off of pumping altogether.
Once my body adjusted to the 6-hour schedule, I'd increase an hour at a time until my supply was depleted. It is up to you how quickly or gradually you decide to wean, and you can make that choice depending on the amount of discomfort you experience as your body adjusts. Personally, I never had any pain while weaning, as my body knew what I was doing, and gradually decreased supply until it simply went away. However, if you try to stop abruptly, your breasts will become engorged and will cause discomfort for a few days until your body reabsorbs the milk it already produced.
You Can Do It!
I know that pumping exclusively can be done, because I've done it - 3 times. I will not sugar coat the fact that it takes drive, determination, and a little money to invest in a good pump. But if you have all of those things, you have what it takes to succeed. If you need advice or encouragement, please contact me by commenting on this article, and I will do everything I can to help you succeed. If I can do it, you can do it!