Bessie's Dance

I have accumulated some tips and tricks for making pumping as successful as possible, which I have shared with other moms and discovered are not as commonly known as I might have thought. Most of them I got from my Doula and friend, Nancy, who is a wealth of useful information. She's also the one who told me that for pink eye I can put breastmilk in baby's eye - I thought that was nuts but then my pediatrician told me the same thing, and it helped. So I felt bad for ever doubting her. But I digress.

This is a long post, so I'll summarize the steps at the bottom.

Here is a description of one pumping session. I'll do my whole work day schedule another time. Note that all the usual disclaimers apply - I am NOT a lactation consultant or educator, I do NOT know what will work best for any individual mom, and I will NOT be held responsible for any ill effects from employing these techniques (although they're all pretty mild, hard to imagine what they would be). YOU are the momma, you know best what works for you and your little bundle of joy, and you are woman enough to make that decision without my help. This is just a description of what worked for me, which I share in the hopes that it will help other moms too.

The key to getting good results when pumping is to RELAX. The pump does not get as much as the baby by a long shot, and if you are all tense, it ain't gonna happen. So this means relaxing before you start and distraction while it's running. So I always pump at the computer, although in front of the TV would work. I have pumped at like 3:30 in the morning a couple times, so I read a book, which is less likely to make me unable to fall back asleep than the shiny glowing screen.

So. First step is to wash my hands. Then get all the gear together and make sure I'm going to be comfortable. So obviously that's Bessie the Breastpump, clean parts for same, and my boobs. A glass of water is totally key, as all breastfeeding moms will recall. I often also have a snack handy, or some tea, or whatever I'm noshing on at that moment. I also make sure my office door is locked and the curtains are closed, or that I've got a blanket nearby (home) in case I get chilly.

Next I take a moment to breathe. It helps me to look at my hands, palms up, and take a few slow, deep breaths. I'm not someone who can meditate with my eyes closed - it doesn't ground me, it just sets my brain free to race around at an even more manic pace. But looking at my hands works well for me - sort of reminds me, "I'm here, now." And deep breathing, of course, as we little yoginis are all wont to do. This may totally not work for you, so if it doesn't, try something else - perhaps a prayer, or give yourself a little one minute neck rub. Just keep it positive. "Thank you Lord for the amazing gift of the ability to nourish my adorable child," as opposed to, "Please let me get more milk this time or I'll just cry." Again, relaxing is key.

Then I get all set up. I keep a fleece jacket on my chair at work, so if I wore something that really needs to be removed for pumping, I can just slip into that to keep warm. Once the girls are free of their fabric housing, I do a little breast massage. This is also a Nancy tip, although I think I also read it in one of my books. So I gently place my fingers on the breasts below the nipples and do little circles. Then outside of the nipples, then inside, then above. Gently enough to be comfortable, firmly enough to stimulate the milk ducts. If I'm lucky enough to have slept through the night and be pumping before nursing Kiddo, then I am somewhat engorged and massage even more gently. I have to reach across with opposite arm, one side at a time, for a couple of the positions. I make sure to make the circles slow (it's a massage, not a sports rub-down) and count that I do at least eight per position - twelve is better.

Next is lube (yet another Nancy tip!). Pumping on dry skin is very uncomfortable. I am using Motherlove Diaper rash and Thrush ointment, but I have also used Nipple Butter or just water. I think the water is hardest to get where you want it and doesn't have the staying power of a lubricant. Plain olive oil might work too. Lanolin doesn't work as well, is harder to get off the pump parts, and is a no-no if you are combatting thrush. The amount can be a little tricky - enough to make the skin slip easily in and out of the breastshields, but not too much or the shields will slip around too easily and the nipple won't stay centered. You can wipe some off with a tissue if needed.

I use a hands-free pumping band, and if you are pumping more than occasionally, I highly recommend one. The one I like best is the "Made by Moms Pumping Band," but there may be other good ones out there. I think La Leche League or someone makes a "pumping bra," which might be good. I tried a pumping "bustier," which was crap. Since it had no straps, there was almost nothing but faith to hold up the apparatus. So I ended up using one hand to hold up the bustier, so it was more of a "one hand pumping bustier." Getting the nipple shields set up well with the pumping band took some practice. One trick is to press them gently into the breast as you are placing them, and see if the nipple points straight into the tube. I used to use a mirror, that helps too. And then it's time to hook up the rest of the pump to the nipple shields and start the pump. I watch the first few cycles to make sure I have the nipples placed well in the shields, and often have to make some sort of adjustment. It's worth the hassle of re-placing the shields a few times to make sure you've got a good placement.

Okay, now I'm pumping! This is the point at which it might help to look at a picture of the baby, or listen to baby's cry. I got my husband to email me an mp3 of Kiddo crying when I first got back to work, to help with let down. (Remember when you learned that your boobs could hear, because whenever the baby cried your milk let down?) But after a few moments of adoring, I find it best to get back to work, or read email, or something totally unrelated. The best way to get frustrated with pumping breastmilk is to sit and watch the pump bottles and fret over each drop that does or doesn't appear. I set a timer for ten minutes and don't look (or almost don't look) again until it goes off.

When the timer goes off, I look to see if milk is still coming out. I usually gently massage the breasts to see if there's more waiting to come out. I don't think this is officially endorsed by the lactation types, or that one is supposed to do breast compression rather than what I do, which is gently stroke from chest towards nipple. So I'm not recommending that - for all I know I'm doing something detrimental (seems unlikely?) but that's what I do and it helps. If I get more than a drop or two, I set the timer for maybe three more minutes and then do it again. When I don't get any more or only a drop or two, I let the pump go two or three more minutes and then I'm done. At any rate I rarely go over 20 minutes and it's usually more like 15.

After I'm done, the first priority is to secure the milk. I've spilled milk after pumping, and it's heartbreaking. So I take the band and shields off, and set the pump going with just the tubes attached to dry them out, and then move straight to securing the milk. I use milk storage bags at work, and sometimes at home, although sometimes I just combine the milk into one of the bottles (if I'm lucky enough to get more than four ounces I'll use both) and put a sticky note with the date on it and stick it in the fridge. If I'm using the bags, I test to be sure I've gotten it sealed sightly by gently squeezing the bag to see if air or milk comes out the top. I got breastmilk all over my desk this way once (and only once!). But better that then the shared work fridge!

One is probably supposed to wash out the pump parts with hot water and soap after each usage. When I'm pumping at work, I just rinse out with water, shake them out a bit, and put them loose in the top of my pump bag on a paper towel to air dry. This results in needing to dry them out a little with a tissue before the next session, but less than if I try to get them all the way dry with a paper towel right after washing them. I am not advocating just rinsing - this is a decision you'll have to make for yourself. I also boil my pump parts after each day of use, but that's a topic for another post.

So there you have it!

As promised, here's a summary of the steps above:
Wash hands
Collect equipment, water, snacks, etc.
(Wash hands again if you did anything funky like butter your toast while collecting equipment)
RELAX
Massage
Lube
Attach pump, turn on, correct placement if necessary
Relax again, adore baby as inspiration for let down
Distraction!
Check if done yet
Pump a few minutes past "dry"
Secure milk
Clean up

One follow up note - I used to worry a lot about not pumping too close to when Kiddo might want to nurse again. This made pumping an even bigger logistical nightmare. Then a lactation consultant assured me that, since the baby is so much more effective at extracting milk than the pump, one's breasts really only need a quick break after pumping before nursing. By the time all the milk storage and cleanup is done, I've gone to the bathroom, and refilled my water glass, the girls are ready to go. Kiddo is wise to this now and sometimes complains that the milk doesn't come out as fast as at 4 in the morning when I'm engorged and haven't nursed or pumped in hours. But he does get enough to fill his tummy. Switching back and forth a bit can help too.

Happy pumping ladies!!!

Bessie at the Office

Bessie is a Medela Pump-in-Style electric dual breast pump. That's right people - I named my breast pump. After a cow. Not just any cow, mind you, but my colleague's best cow when she was growing up. Okay, fine, I named the breast pump and THEN she told me about the cow. But anyway, I think it is a very fitting name for her. Plus it's just easier at work - "I gotta go see Bessie," or "That Bessie is such a slave driver." Instead of, "I can't, I have to pump now" or "Yes, really, four times during the work day."

It took a lot longer than I thought it would to figure out the whole pumping at work thing. I've gotten pretty efficient at it, and it still takes me a half hour round trip, just over half of which is the actual pumping time. I use a hands-free pumping band, which I hope to review soon on this blog, so I can be on the computer while I'm waiting for Bessie and the girls to work their magic.

I've gotten a feel for what times of day I'm going to need to pump - there is some wiggle room of course but to get all the sessions done with enough time in between to rest there isn't as much flexibility as one might like. So when someone asks in the hall, "can you talk about that at 2?" I can say, "Unless you only need 15 minutes, better make it 3."

The law provides (I think... should check that) that employers must let you pump every three hours, but I find I need to do more like every 2.5 hours. Otherwise I can't get in four, and I go too long on the way home and/or supply decreases. I'm lucky - I have my own office, with a door, and can just sit at my desk to pump, not hide in the file room or oust someone else from their work space. I read (somewhere on some forum I'm no longer on) about a mom in the Air Force (I think - maybe Navy?) who is a pilot. She was pumping in the bathroom on her plane (a feat in itself) to get supply for her baby while she's flying. So if she can do that, I should woman up and do my job in my cushy office and not complain.

A friend told me about an acquaintance who actually pumps on her commute home. That seems sort of brilliant, except for the part where I'm sitting in the car doing all the set up in the parking lot of my workplace. I have gotten pretty good at pumping in the car but I don't love it and it takes enough extra set-up to remain modest (read: not get arrested or gawked at) that I don't actually think it would save me that much time. Plus then of course I'll get stuck in a traffic jam and not be able to take off the pump and shields, and of course I could safely turn off the pump while I'm driving, but something tells me trying to store breastmilk and put my bra back together while barreling down the 210 at 70 mph is just not a sound decision. Perhaps this other mom's commute is just the right length - anyway, my hat is off to her, but it ain't for me. Although to be fair I've pumped in my car three times now and no one has even walked by at an inconvenient moment.

My co-workers recognize the sound Bessie makes over the phone - I think I freaked one of them out with it - I thought he wouldn't be able to hear her, but he said, "what's that sound?" and I said, "I'm sorry, is that too weird? I could call you back..." He graciously finished the conversation but I suspect I was the subject of much sports bar mocking later that week.

So lately I've really been struggling with the whole working while breastfeeding thing. I'm struggling to feel like I'm doing well at work, I'm struggling to have enough breastmilk at home for my baby, and I'm struggling to remember that we really do need the money and I really shouldn't just quit. It would be much more responsible to let my husband get a job first and then quit, or at least go part time for a while to give him a chance to look. Right?