We have all heard the mantra “Breast is Best!” For some of us breastfeeding never gets off the ground, or we lose supply, or we think we have to give up when we go back to work.
My husband and I had a work trip to Australia planned when she was only 4 months old. I had already been pumping some for the supplementing, but now I really got down to business to build up a supply for her while we were away for 10 days. Pumping is not fun. It takes up time you could be sleeping, eating or showering. I never got as much from pumping as I got from nursing (and I know because I was at the nursing clinic measuring exactly how many teaspoons little nugget was sucking out). After I had a sizable stash in the freezer I started to worry about keeping up my supply while we were away. Bless my saint of a husband for stopping every 2-3 hours to let my pump, for letting me freeze the pumped milk and for bringing a cooler bag to haul home 15 lbs of frozen breastmilk! (Don’t ask about airport security.. those poor men are scarred). I took two pumps with us (yes.. two. On a flight that charged us per pound for luggage). I had a hospital grade pump, which I highly recommend for at-home pumping, and I had a portable pump that I carried all over Melbourne (and half of New Zealand). I also had a video of my little one’s specific nursing noises to help with my letdown. I asked a LOT of questions of the lactation specialists, my mom and other friends who nursed.
We made it past 2 years old before Rowan fully weaned, but I had questions all along the way. Luckily, I have a friend who has been very willing to share advice with me about pumping, nursing in general, and “extended nursing” (basically, the internet knows nothing about nursing past the age of 1 year). When she voiced an idea on Facebook last week about wanting to share FAQ’s she gets about pumping I jumped at the chance to share them here. She has 4 beautiful children and is a WEALTH of information. Thank you Serena for your giving spirit!
First, about me: I have four kids, ranging from 11 years old down to 11 months old. All of them were exclusively breastfed for their first six months and no one has weaned before 2.5 years old. I also work full time. My schedule has varied for each kid, but for the third one I was working ten hours days with a long commute and was thus away from home about 13 hours per day. Needless to say, I am now very familiar with pumping. And over the years, I have heard a number of things from other women that have made me want to write up a post of responses to common concerns or questions about pumping (and maybe a little about breastfeeding in general). My hope is that women can access information like this when they are in the moment or even before the give birth; many times I hear comments about why people stopped nursing/pumping when it’s too late. I haven’t really asked people for their reasons why they stopped nursing or pumping, but somehow people feel the need to share when they see my rinsing my pump parts in the break room. So let’s use the experience of others to better support those currently in the thick of it.
“I didn’t get anything out when I tried pumping so I must not be making any milk.”
I’m not sure about the experience of other women on this, but I know that for myself, it always takes my breasts a while to get accustomed to the pump again. Nursing may be going fine (I usually start pumping when the baby is about three weeks old, so my milk supply is already in) but somehow my breasts don’t like the pump. They balk. They rebel. But I persist, and eventually they give in and start producing for the pump. I don’t think that pumps were really made to match how babies stimulate production, and I think that it’s a little unnatural for breasts to use the pump—perhaps this is why pumps never do as good a job as the baby at maintaining supply.
The other thing that may be going on is that you may have a slow letdown. I’m going to talk about the Medela Pump in Style because that’s what I’m most familiar with. When you first turn this pump on, the sucking cycle is fast in order to stimulate letdown. It is in letdown-stimulation mode for about two minutes and then automatically switches to slow-suck. If you haven’t gotten a letdown when it switches to slow-suck, press the button again. If you go into slow-suck before you have a letdown, you won’t get much milk out, if any at all. Hit that button again and see if the second go round helps you get a let down. I find my let down is particularly slow if I’m cold or stressed. Also, if ever you get the sense that the milk has stopped flowing but you haven’t really pumped what you’ve got, hit the button again. Get another let down. You can do this multiple times in any given pumping session, if needed.
Get the last bit out
Your breasts are never really “empty,” they produce milk continually. But when you’re pumping, try to be thorough. You may find it helpful to stimulate a second (or third) letdown. Breast compressions can also help. I don’t know what the typical method is for small-breasted women, but I shove my fist into my side-boob while pumping. Yes, I just said that. I think of those side glands as my “hidden” mammary glands and find that if I don’t give them a good shove they won’t empty properly and I’ll end up with blocked ducts. In the early days of nursing, I also do these sorts of compressions while the baby nurses, otherwise I get this odd partial-engorgement.
“How strong do I need to set the suction?”
My advice is to set it just below pain-level. I turn the strength up to where it becomes uncomfortable, and then turn it down to just below that.
“I got the same daily ounce total whether I pumped twice or three times, so I started only pumping twice.”
This is a recipe for reducing your supply. Three smaller sessions will do a better job maintaining your supply than two larger sessions.
“I couldn’t pump anymore, so I had to wean the baby.”
My own mother told me this, trying to explain why she weaned me at nine months (this was back in the day when she was considered a crazy hippie for nursing me even that long… or at all. So huge props to her for that and for the wonderful work that she has done supporting nursing women through her entire career.) I’ve heard this from a number of other working women since then. My goal when nursing my babies is to make it to two years. When I have had people ask me “How long are you going to nurse her?” I ignore the implied “Isn’t she a bit old to be nursing?” and just give my completely honest answer: “I plan to nurse for at least two years; anything after than is just bonus.” However, I stop pumping around a year (to be more specific, I typically drop to pumping just once a day on my lunch break at a year and continue that for another couple of months). Just because you’re not pumping during the day doesn’t mean you have to stop nursing entirely. Nurse when you get home. Nurse at night. Nurse on weekends. Now, if you tried to do this with a wee babe, I suspect your supply would dwindle. But for an older child that is on solids, it’s pretty workable. Especially after a year.
“I stopped feeling full so I stopped pumping as much.”
It’s pretty normal to stop feeling full when the baby gets older. Some women never feel “full”! Don’t wait until you feel full to pump. Letting your breasts get full signals your body to produce less milk. If you’re getting full, you’re probably not pumping often enough (unless you have oversupply and are trying to get your supply to let up a bit).
Related to this, I have had women tell me they stopped nursing because they stopped feeling full, they felt their baby was sucking and “not getting anything.” These women often tell me that this happened around a big growth spurt. Around the time of a big growth spurt, the baby will need to nurse a ton when you are more empty in order to stimulate you to produce more. In order to increase your supply, you need to nurse when you’re “on empty.”
Embrace the night-nursing
Night nursing does wonders for keeping your supply up. I make exactly zero efforts to “night wean” because, as I always say, “The more I nurse at night, the less I have to pump during the day.”
“How much should I pump each day?”
Make sure you are pumping out at least as much as the baby is taking in each day. Don’t run a deficit. If you have a freezer stash from when you were on maternity leave, you shouldn’t be digging into that regularly. So each day, I get a report from whoever is watching the baby on how much he took down. I count my own number of ounces produced that day. If I’m short, I’ll pump another time at work before driving home, or pump an additional time at home. There have been times (especially when I’ve had a commute over an hour each way) when I would get to work a little early in order to pump before my first client of the day, then again at my morning break, then again at lunch, again at afternoon break, and then again at the end of the day before heading home. As the kid gets older and starts on solids, I can reduce the number of sessions per day, as long as I’m still keeping up with demand.
And yes, I’m writing this while pumping.
-Brynn again! The above picture I found on the Willow Pump website. I paid out of pocket to rent the hospital grade pump for more than 6 months, and I purchased my Medela Pump in Style rather than jump through hoops for the insurance company. I think I would have paid any amount of money for THIS breast pump. I can’t tell you how many times I cried over spilled milk trying to wrangle my clothing, the battery pack, the milk bottles and tubes while working.