Pumping and Milk Supply

I planned to breast-feed RJ, but we had trouble getting her to latch, so within a couple of days after she was born she had formula for the first time. We needed to buy some time so she wouldn’t starve while we learned how to latch. But a mother’s milk supply is directly related to how much milk her baby draws out of the breasts and since RJ wasn’t taking any milk at all from my breasts I had to enter into the world of the breast pump to stop my milk from drying up.

If your pumping goal is to work towards syncing your boobs with your baby’s appetite the ideal thing is to pump every time the baby feeds. Then at the next feed you can give baby whatever milk you’ve pumped through a finger feed, supplemental nursing system or bottle (and if you are not producing very much milk you can supplement with formula).

I wasn’t producing very much milk until four days postpartum. My milk came in with a vengeance and I was engorged all the way to my collarbones. Then RJ couldn’t latch on my nipples because my breasts were like rocks. I pumped furiously for a few days to relieve the pressure.

But…. I MADE A MISTAKE.

This is the reason why I wanted to write this post.

I pumped on the HIGHEST SUCTION SETTING of the pump. I thought it would get the milk out faster and make my pumping more efficient. I found out later that it is better to pump with the lowest suction that will work to draw out the milk. What happened for me was that I overstimulated my breasts, which increased my milk production… so my breasts stayed engorged for longer, and baby’s latching problems were exacerbated.

This simple mistake led me into an overproduction of milk, so when RJ tried to feed, the milk came out too forcefully and she would start to choke.

This story does end well though. I started pumping on a lower setting, my breasts became less swollen, RJ and I learned how to latch and breast-feed without any paraphernalia. One day, I sat on a bench in Ikea and fed RJ from my breasts. It was fast, convenient and discreet. We’d made it.

Guest Post: Breast feeding Challenges

Today I’m posting a guest post written by my friend Alicia. Her breast-feeding story is an incredible tale of challenge and perseverance.

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My thoughts on breastfeeding before my son was born was that breast feeding was the obvious choice because it was free, convenient, and let me develop a quick bond with my baby. I thought it was something you just had to choose to do and it would happen; that people who chose not to were just being vain about damaging their precious boobs or cared more about sleeping or some other silly reason. I even went so far as to purchase only a single manual pump because “I won’t even need to pump like, ever”.  Looking back on this, I’m embarrassed about just how ignorant and uneducated in the matter I was.

I’ve since discovered that breast feeding can go one of two ways:  The best possible scenario being that baby latches on well from the start and there are no issues to speak of. The second being a hellish uphill battle where you end up in a lot of pain, both physical and emotional. My situation was of course the second.

Useful Breastfeeding Supplies

Indispensible:

Baby D-Drops: All breastfed babies need a vitamin D supplement. There are a few different kinds of liquid vitamin D, but this is the easiest to administer because it’s only 1 drop. You can drop it on your nipple while baby feeds, or on a pacifier if she’ll suck for 30 seconds, or on a finger that she’ll suck (tip: put your finger on the hard palate in the front roof of her mouth to stimulate her sucking reflex). We started by giving it to her on a finger but now that I’m more coordinated I sometimes give it on the nipple.

Really Great to Have:

Nursing pillow: I spent $70 on mine and it isn’t that great. But using normal pillows adds more frustration to an already often frustrating process. They are always slipping around. If I could have a do-over, I’d try this pillow because it has all the features I wish mine had (firmness, secures to the body).

Nipple Ointment: Usually pure lanolin, sometimes you see them with other ingredients. Keep in mind that the baby will ingest whatever it is, and lanolin is completely benign. Don’t know about the other ingredients. I had a prescription nipple ointment (called Viaderm) they gave me in the hospital because my nipples cracked which contained a steroid and an antifungal (thrush on the nipple can be a cause of pain during nursing). It was awesome but it took me six weeks to wean myself off of it (pun intended!) because I was afraid of the pain coming back. I think nipple pain is par for the course, but if it’s going to stop you from nursing, ask your Dr. for the good stuff. Otherwise try the lanolin and hope for the best. Tip: Another thing I’ve done is hand expressed a drop of milk and rubbed it into the nipple. Breast milk is moisturizing and anti-microbial, and you don’t have to remember to carry a tube of cream around with you. Plus it’s free.

Nursing Bras: I heard recommendations that you buy these in the eighth month of pregnancy because that’s approximately the size your breastfeeding breasts will be. I ignored this advice and then found myself at the maternity store 6 days postpartum, trying on bras and trying VERY hard not to leak milk onto the store bras as I tried them on (because stimulating your nipples stimulates milk flow ESPECIALLY in the beginning). My mom thought nursing bras were unnecessary because you could just buy a normal bra and pull it up. But that would deform your bra, plus there is a concern with underwire and plugged ducts. So I recommend a wire-free nursing bra… or six. I prefer one that exposes a lot of the boob when unclipped. This is my favourite bra. I also have this one and the opening is too small for ease-of-use so I never use it.

I wear a bra all day and night, and change it once every 24 hours because they always seem to get a bit of milk on them that starts to smell sour. I never used to be a woman who slept in bras but this brings me to the next (almost) essential piece of equipment…

Breast Pads: I went through two boxes of disposable pads that I received as gifts before I bought my own reusable pads. I think I have eight pairs? I could probably use more. My breasts leaked a lot in the beginning (hence the sleeping in bras). They still leak, especially if I am feeding on one side, the other side will leak. There is actually an interesting product for this that allows you to collect the leaking milk. I thought about getting it but since I have a breast pump it seemed like a slow way of collecting milk, plus you’d have to figure out what kind of sterilizing regime you’d use for a slow collection method like this.

Breast Pump: When I was pregnant a family friend (who is a nurse at the children’s emergency department) told me to feed my baby formula for the first few days and pump like crazy to get my milk supply in. I ignored her advice and it took 4-5 days to get my milk supply in. In the meantime, baby was jaundiced and not eating well, and we did end up giving her formula out of necessity, although the whole medical establishment is so anti-formula that it felt very drastic. It took me two weeks to get breastfeeding established. We used all sorts of interventions until we got it down. In short, my pump got a lot of use for 2 weeks, and now I used it about once a week when I want to leave a bottle so I can go out and miss a feed. But in hindsight, formula is not poison, and it would be a lot cheaper to give baby an occasional bottle of formula rather than buy a breast pump.

In terms of choosing a breast pump though, I bought the Medela Freestyle which is like the Cadillac of breast pumps. It also happens to be the same one that my public health nurse chose for herself. So you know it’s good. It’s really good. She also mentioned to me that her health plan covered the cost of her pump. So that’s something worth looking into. You can also rent breast pumps, which might be a good option. Then you could rent for a month, freeze a bunch of milk, and be good to go. Or seriously, just give an occasional bottle of formula and save yourself the hassle.

Bottles: Unless you plan to never miss a feed, bottles are a good thing to own. I’ve heard it recommended that you go out and choose ones with nipples that resemble your own nipples. Also, if you are breastfeeding it’s recommended that you use slow-flow bottle nipples.

Sterilizing Bags: Only if you have a pump and/or bottles. These things are amazing.

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For some women, breastfeeding is easy. For many, including myself, it’s very difficult before it gets easy. Even if it’s easy, it’s still something that happens 8-10 times per day. So your breastfeeding equipment will get a lot of use. And when you’re cringing at the cost of buying 6 new bras, just calculate the cost of formula. It’s expensive, and breast milk is free. Good luck!