If I knew then...Shopping/Registry Changes - Jana

While it is becoming increasingly common to choose EPing before giving birth, most EPers "end up" pumping after other plans go awry. We asked our pumping moms to take a look back and consider how they would re-write their registry/pre-baby shopping list now that they've ended up EPing.

If I knew that I would be EPing with my daughter I would have purchased a pump before she was born and also had a rental hospital pump ready to go. I also would have purchased more bottles. We only had a few because we didn't expect to use them. Even though I had received a nursing cover as a gift to use while nursing, I was able to use this as my pumping cover! With our next babe, I will definitely plan to have a hospital grade pump ready in the event that we need it. It was so stressful when nursing was just not working and we didn't have a plan in place. I would suggest any expecting mom to have a breast feeding plan and back-up plan. Have phone numbers of lactation consultants, La Leche League, or any other breastfeeding resources. Make a plan for if you need to express milk; this might include watching a video on how to hand express while you're waiting for your pump to arrive. I never expected to have problems with nursing and I know that we would have had a lot less stress had I created back-up plan prior to our daughter's birth.

Places We've Pumped - Janna

The strangest place I've pumped is in the car while I was driving. My sister and I wanted to go shopping and it was time for me to pump, so I put on my nursing cover, hooked up the pump and started driving. It was a little strange, but it worked! I became a pretty experienced car pumper when I needed to pump every 2 hours. Once I was in the back seat with my husband driving and I actually fell asleep. It was great! When I woke up the pump had turned off and I was done. Too bad it was time to pump again :-( The scariest place I have had to pump is at work. I just never felt comfortable pumping at work. I shared an office with another woman and she didn't mind if I pumped at my desk with a cover on. One time we forgot to lock the door and a guy that we worked with walked in. Akward!! From that point on I always double checked to make sure the door was locked.

Costs of EPing - Janna

We've asked several of our pumping moms to add up their expenses and explain how much they've spent EPing. You can read all of the cost breakdowns posted to date by searching the cost label. Here's Janna's breakdown:


Cost of EPing

1.) Hospital Grade Rental Pump - $8 per month
2.) Lactation Consultant Fees (included pump instruction) - $200 per visit x 2
3.) Medela Freestyle - ~$380
5.) Medela Symphony Kit - ~$20
6.) Bottles - ~$100
7.) Breast Milk Storage Bags - $30
8.) Time: 2-6 hours per day pumping - priceless!
9.) Hands Free Bra - ~$30
10.) Bottle Brush - $5
11.) Nursing Pads - ~$20
12.) Deep Freezer for breast milk storage (used) - $100
13.) Medela Spare Parts - $12
14.) Medela Membranes - $8
15.) Lanolin (several tubes) - ~$20

I think that's it!! I probably spent more than necessary, but again, we didn't expect to be EPing and had no plan so we just did everything trial by error which ended up being very expensive.

Which bottles and nipples? - Janna

We went through a lot of different types of bottles before we found the right one. When I first started pumping, I was still trying to nurse, so we picked bottles that were supposed to be compatible with nursing. We first used the Medela bottles with the wide base nipples. We actually used the small 2.5 oz Medela storage tubes with the nipple attached at first. These worked great when our daughter was only eating ~2 oz per feeding and her stuck wasn't that strong. I always hoped that we would be able to transition to nursing, so we put up with these bottles for quite a while even as she started taking a lot more milk. While the bottles were convenient because I could pump directly into them, the nipple always collapsed and our daughter was having a lot of spit-up and gas.

Some other bottles that we tried in the mean time were The First Years Breastflow bottles and Adiri Natural Nurser. I did not like the Breastflow bottles because we seemed to lose a lot of milk in the nipple parts which was incredibly disappointing when I wasn't pumping very much in the beginning. Our daughter was never able to latch onto the Adiri Natural Nurser; I think it was too much like a breast and by the time we had tried this bottle she had developed a pretty severe aversion.

When my daughter was about 2 months old it was pretty evident that nursing was not going to work out and that I would be EPing to provide her with breast milk. At that point, we decided to switch to a bottle that we thought would minimize spit-up and gas regardless of whether it was "compatible with nursing" or not. We ended up purchasing Dr. Brown's bottles because our neighbor had used them and swore by them. Although there are a lot of part to wash, I have to admit that I really like these bottles. Our daughter was able to eat a whole extra ounce at each feeding immediately after switching to these bottles. I think it was because she wasn't filling up on air!! Additionally, she had a lot less spit-up, burping, and gas.

These bottles were also great because I could pump directly into them. I have head that the Advent bottles are good and a bit cheaper, but I was swayed by the ability to pump directly into the Dr. Browns bottles.

Schedule & Equipment - Janna

I have been exclusively pumping (EPing) since my daughter was 3 days old. You can read about how I came to that decision in my first post here. For the first three months I tried to pump at least 8-10 times per day. I didn’t worry about the spacing as much as making sure that I got the correct number of pumps in per day. I tried to space them as evenly as possible and not go more than 4 hours between pumps. I ended up dropping the middle of the night pump when my daughter was just over a month old because I just couldn’t do it anymore. I would stay up really late and pump around 11pm and wake up about 6am to pump. I would usually be really uncomfortable and engorged, but I felt like I needed this extra sleep to function as I was continuing to feed my daughter throughout the night as well. As long as I continued to maintain 8 pumps per day, I didn’t see any decrease in my milk output. When my daughter was just over two months old I started experimenting with dropping pumps. My goal was to get down to 4 pumps per day by the time I returned to work, so I needed to taper. I basically just dropped 1 pump per day each week and re-spaced my pumps as evenly as possible throughout the day. I was finally beginning to feel like exclusive pumping would be possible long term and amazingly, I did not experience any drop in my milk supply as I dropped pumps. In fact, my supply increased when I returned to work when my daughter was 3 months old!

When I initially started pumping at home I used a Madela Symphony to build my supply. From what I have read, a hospital pump is absolutely essential to building your milk supply if your baby is not nursing. When I first started pumping I was not making a lot of milk (about 12-16 ounces per day). I had to work really hard to build my supply. I found the most useful techniques were to pump for at least 30 minutes (if you baby is not nursing at all), using heat packs, and breast massage. Also a hands free bra is absolutely essential! Once I made these changes to my pumping regimen, I saw a drastic increase in the amount of milk I was able to pump. I bought a Madela Freestyle so that I could pump on the go (in the car!) and to use when I returned to work. The portable pump allowed me a lot of freedom that I didn’t have with the hospital pump.

On the days that I work, I pump at 5am, 10am and 3pm at work, and right before I go to bed (usually about 10pm). I like to sleep in on the weekends (if my daughter will let me!), so my first pump is usually about 7:30 am and then I pump again around 12pm, 5pm, and before bed. I started out with 30 minute pumping sessions, but recently I have gone down to 20-25 minutes. I did see a slight drop in my milk supply, but I’m still making plenty to meet my daughter’s needs. I also developed mastitis about 2 weeks ago which may have contributed to the decrease in my supply as well. As a side note, mastitis is extremely painful and takes quite a while to recover from. Take good care of your nipples if you are EPing! I had not been using lanolin on a regular basis and developed sores and cracks which I think may have been the cause of my mastitis. I now put lanolin on my nipples before I pump to help reduce the friction. I have heard that some moms use olive oil and that works well too.

If you aren’t able to pump enough milk to meet your baby’s needs, she is still going to benefit greatly from whatever amount you can provide. Feel good about what you are able to accomplish and try not to compare yourself to other moms. Take EPing as far as you want to go and try not to feel guilty if/when you decide to give it up. EPing is a lot of work and is a huge time commitment. Please know that you’re not alone. There are a lot of moms who end up in this same situation and choose to pump exclusively. It is one of the many options to feed your baby. If you can make it through the first 3 months it truly does get easier!!

Here are some of my favorite internet resources that I found to be instrumental to my pumping success.

http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

http://newborns.stanford.edu/Breastfeeding/HandExpression.html

http://www.kellymom.com/bf/supply/maintainsupply-pump.html

http://www.mother-2-mother.com/ExclusivePumping.htm

Janna - an Introduction

I always knew that I would breastfeed my children. It was the one thing that I was absolutely certain about motherhood. However, my certainty faltered when my daughter was born in February of 2011.

In order to maximize my chances for breastfeeding success, I chose to deliver naturally at a birth center. I took a breastfeeding class, read breastfeeding books, and watched breastfeeding videos. My daughter was immediately placed on my chest after she was born and put to my breast. We were able to snuggle without interruption for her first hour of life, but after the first hour she still had not latched. Unfortunately, I suffered a third degree tear during childbirth that required medical attention. At only two hours old, we packed my daughter up in the car and drove to the hospital. When we were finally able to attempt breastfeeding again, my daughter was too sleepy to rouse. We opted to go home the morning that she was born. In retrospect, we should have stayed at the hospital and maybe we could have benefited from some lactation support, but at the time I didn’t know that anything was wrong.

No amount of reading could have prepared me for the challenges we were about to face over the next several weeks. After we arrived home from the hospital we continued to attempt to breastfeed without success. I immediately called a lactation consultant to come to our home to assist us. She was able to get our daughter to latch, but not well. Each time the lactation consultant tried to get her to latch, she would force my daughter onto my breast. We continued to attempt breastfeeding with little to no success. I was able to hand express some colostrom to feed her while we continued to work on breastfeeding. On my daughters 3^rd day of life, we knew that things were going terribly wrong. She had been screaming all night because she was hungry and unable to latch to my breast. We had tried every hour throughout the night and in the morning she was so upset there was no way that we were going to be able to get her to latch. She was jaundiced and had stopped having stools. Her urine frequency had decreased and there were uric acid crystals in her diaper. We were scared. My husband was minutes away from running out the door to buy formula. I called the lactation support services at the hospital and they sent me a Madela Symphony pump out that afternoon. We also called the lactation consultant we had been working with so that she could come to our house to help our daughter latch and show me how to use the pump.

Having no success with latching that afternoon, I started pumping and feeding my daughter expressed milk. At first we tried using the SNS with a nipple shield, but it was way too cumbersome to keep up long term; we only used the SNS for about a week. Additionally, she wasn’t latching all that well to the nipple shield, just to the tip, so we didn’t feel this system was getting us any closer to breastfeeding. We tried finger feeding for a while, but there is only so long you can keep up with the circus of breastfeeding devices before giving up and switching to a bottle. By this point, with all the interventions we had tried, my daughter had developed a severe breast aversion. At one point I couldn’t even take my top off around her because if she saw my breast she would start screaming. Any time I would put her near my breast she would scream. I was heartbroken. I felt like a failure. All I wanted to do was to feed my baby in the most natural way possible and I felt like she was rejecting me. It was really hard not to take the breast refusal personally. I spent a lot of time crying while pumping.

Over the course of our breastfeeding struggles, we saw a total of 4 lactation consultants and a physical therapist (for craniosacral therapy). Even though we had a lot of professional assistance and personal determination we were unable to get breastfeeding to work. I decided that in order to provide my daughter with the best nutrition possible I needed to focus on pumping. When I gave up on nursing, I actually started making more milk. At first I was really ashamed and embarrassed. I was very self conscious about bottle feeding my daughter in public. I also felt very isolated because I would pump alone in the nursery. I felt very disconnected; I was spending 4-5 hours per day pumping away from my daughter. I felt like I was missing out on a lot of opportunities to bond with her. I was lucky to have a huge amount of support from my husband and family. Without their encouragement I don’t think that I could have continued.