I’m due in late January with my first baby. I’ve had an easy pregnancy (knock on wood) and am planning to continue working until I go into labor and then return to work after my 12 weeks of maternity leave. I would love to exclusively breastfeed, but I also do not want to be tied to my baby all the time. I have a pump, but how do you get started? And when should I start? I want to hopefully get my supply to a point that I can freeze milk so that I can do crazy reckless things like leave my baby with Grandma for a night, but I just have no idea how to do it. Do you have any helpful tips or pointers or things you wish you’d known? Can you help, Boob-Master?
Okay, before I type another word, please promise me that sometime in the next month, BEFORE the baby arrives, you’ll find a local lactation consultant. Ask your friends or your OB/midwife, or even your future pediatrician’s office for a recommendation. If you can’t seem to get a specific “oh I used this woman and she was wonderful” recommendation from anybody, call La Leche League and get some names and do some interviews. You’ll want somebody with a good bedside manner, a breastfeeding philosophy similar to your own, and someone who — on the off chance that you run into trouble — is not going to be completely insane about supplementing and/or other nursing aids.
(My first LC spent the first 15 minutes of our visit bitching about formula in the hospital bags, likening it to “sending a crack baby’s mother home with drugs,” riiiiiight before she put Noah on the scale and realized how much weight he’d lost and that he actually NEEDED that formula in order to escape being rehospitalized. And then she wondered why I sat there sobbing for the rest of the appointment. And then probably wondered why I made my next appointment with SOMEBODY ELSE.)
My initial LC experience aside, I will testify to the skies that a good LC is essential, and not even just for first-time mothers. My LC’s office was a great resource for low-cost breastfeeding supplies: everything from pillows to gel pads to prescriptions for the absolutely essential All Purpose Nipple Ointment (APNO) and for helping me spot potential problems (think thrush or mastitis) before they turned into bigger problems. And my LC was a wonderful all-around postpartum resource for me, who would give me the encouragement and pep talks I so desperately needed AND give me permission to like, go out for dinner and a movie and leave the newborn with a grandparent, because she was a big believer that even exclusively nursing moms Need A Damn Break. And after struggling with supply problems the first time around, she came up with a plan ahead of time to start amping my supply up from the day Ezra was born. And it worked! Oh lands, did it ever work.
The pump, incidentally, was a big part of that plan. (Along with teas and herbal supplements.) So I admit I personally never had the experience of pumping just for daycare and nights out, at least not initially. My dreams of breastfeeding Noah exclusively were dashed long before my maternity leave was up, because I simply couldn’t pump very much milk at all, nor did it seem to be “enough” to keep my supply steady and level once I was back at work and using it instead of actually nursing all those hours.
I had a much more successful relationship with the pump the second time around and was eventually able to store and freeze plenty of extra milk while nursing exclusively at home, but the way I got there was unique to my situation. I pumped for 10 extra minutes after EVERY FEEDING from like, the DAY I BROUGHT EZRA HOME. I basically tricked my newly postpartum body into thinking I had twins, so it upped my supply accordingly. This is…well, probably not what you’ll need to do, without known or suspected supply problems. Again: a lactation consultant will be able to tell you everything that you need to know about pumping, for you and your boobs and your baby and your schedule and your wishes. Breastfeeding and pumping are not really one-size-fits-all with a set of established rules that work for everybody. Go get yourself a customized plan.
If I HAVE to commit to typing out some general tips I learned, well, here goes:
You can really start pumping any time. It’s best to feed the baby first, then add on five to 10 minutes on the pump immediately post-feeding. That way you aren’t denying the baby any of that essential milk while your body is still figuring out how much to make. HOWEVER, this approach can lead to oversupply problems, if you start before your body has regulated itself. Or it can help with undersupply, like it did for me! Ohhhh, good lord, I KNOW. Again: a good LC will help take the guesswork out of the “when to start” and “how often” question.
No matter WHEN you start or how often you pump, don’t expect to necessarily be stockpiling ounces and ounces of milk right from the start. And don’t assume that just because you can only pump an ounce and a half in 20 minutes means that’s all your poor baby is getting during a 20 minute nursing session. I cannot stress this enough: Your baby is way, way more efficient at getting milk out than the pump.
Pumping takes practice. So there’s this thing called “letdown.” It’s a…kind of a reflex, I guess, where your body realizes the baby wants milk and suddenly WHOOSH, you feel your boobs tingle maybe even swell a bit and you realize WHOA, there is milk there and the milk is ready and baby needs to EAT. NOW. It can be triggered by simple timing, the sound of your baby’s cry or the feeling of his breath on your chest or even just the smell of his head or clothing. The letdown makes it easier for your baby to get milk, and it also makes it easier for express milk via the pump. But since it’s a hormonal, mental thing, you may realize that you put the pump to your boobs and…nothing. Very little milk, and the slightly unsettling realization that you feel like a damn dairy cow. So you have to figure out ways to trigger the letdown (unless you’re pumping post-actual feeding). Some women use a photo of their baby or visualization techniques. I had the most success with smelling Ezra’s clothing or blankets, but also found that turning on a sink faucet worked pretty well too.
(God, just typing that triggered a phantom letdown feeling. BOOBS ARE WEIRD.)
And lastly, since you mentioned you already bought your pump: Don’t open it yet. Don’t even take the shrink-wrapped or bagged-up parts out of the box to examine them. You may not ever actually use that pump. While the plastic manual/hand pumps and double-electric pumps sold at the baby stores seem like a totally essential item that YOU MUST BUY BEFORE BABY IS BORN OR ELSE ALL IS LOST, the fact is that they simply don’t end up working for a decent-sized segment of the breastfeeding population. Both times, I needed to rent a hospital-grade pump for the first few months in order to actually, you know, GET MILK OUT OF MY BOOBS. Eventually, with Ezra, I was able to return the rental and downgrade to the popular Medela Pump-in-Style. (Never with Noah, though. I ALWAYS needed the heavy-duty pump that went up to 11, so to speak.)
The Pump-in-Style is a GREAT pump for working moms with healthy, established supplies…but seriously, it’s expensive and should probably only be purchased once you KNOW for a fact that you are headed back to work with a healthy, established supply and not before. I registered for a pump when I was pregnant with Noah and multiple people warned me not to bother, and to simply request a rental at the hospital, but I didn’t listen, because BABY THINGS! I NEED TO BUY ALL THE BABY THINGS! Yeah. I totally should have listened, because I never, ever used whatever pricey Avent pump thing I initially ended up with.
Anyway, that’s probably all the general pumping advice I can offer without getting (even more) uselessly specific to my specific experiences. And I probably could have saved us all a LOT of time by just beginning and ending with the lactation consultant bit. So just go back and re-read that first paragraph and go find yourself a bona fide Boob Expert to guide you through the Incredibly Natural Process Of Breastfeeding That Women Have Been Doing For Centuries But For Some Reason It’s A Lot More Complicated Now Than Back When We Were All Just On The Fields & Tundra Or Whatever.
If there is a question you would like answered by Amalah on the Advice Smackdown, please submit it to email@example.com.