What to Expect the First Year (40 page)
Read What to Expect the First Year Online
Authors: Heidi Murkoff
Whenever you pump (and no matter what type of pump you're using), there are basic prep steps you'll need to take to ensure an easy and safe pumping session:
⢠Time it right. Choose a time of day when your breasts are ordinarily full. If you're pumping because you're away from your baby and missing feedings, try to pump at the same times you would normally feed, about once every 3 hours. If you're home and want to stock the freezer with breast milk for emergencies or relief bottles, pump 1 hour after baby's first morning feeding, since you're likely to have more milk earlier in the day. (Late afternoon or early evening, when your milk supply is likely to be at its lowest thanks to exhaustion and end-of-the-day stress, is often an unproductive time to pump.) Or pump from one breast while nursing your baby from the other oneâthe natural let-down action your body produces for your suckling baby will help stimulate milk flow in the pumped breast as well. (But wait until you're skilled at both nursing and expressing, since this can be a tricky maneuver for a newbie.) Still got extra milk after a feed? Pump whatever baby didn't finish and save it for later.
⢠Wash up. Wash your hands and make sure that all your pumping equipment is clean. Washing the pump parts immediately after each use in hot, soapy water will make the job of keeping it clean easier. Dishwashers can work well, too. If you use your pump away from home, carry along a bottle brush, bottle wash, and paper towels for washup.
⢠Set the scene. Choose a quiet, comfortable environment for pumping, where you won't be interrupted by phones or doorbells and where you'll have some privacy. Cozy up in a chair that allows you to relax in relative comfort. At work, a private office, an unoccupied meeting room, or a designated nursing room can serve as your pumping headquarters. An office restroom is definitely not ideal, and in fact, federal law requires employers in companies with more than 50 employees to provide a private place other than the bathroom for pumping. If you're at home, wait until baby's naptime or when your little one is otherwise occupiedâin a swing or infant seatâso you can concentrate on pumping (unless you're pumping while nursing).
⢠Chill out. The more relaxed you are, the more productive a pumper you'll be. So try to chill out for a few minutes firstâvisualize, use meditation or another relaxation technique, listen to music or a white noise app, or do whatever you find helps you unwind.
⢠Hydrate. Have some water before you get started pumping.
⢠Encourage let-down. Think about your baby, look at baby's photo, and/or picture yourself nursing, to help stimulate let-down. If you're home, giving baby a quick cuddle just before you start pumping could do the trickâor you can pump while your baby sits beside you in an infant seat or swing. If you're using a hands-free pump, you can even try holding your baby while you pumpâthough many babies won't be too happy about being so near and yet so far from their source of food. Applying hot soaks to your nipples and breasts for 5 or 10 minutes (clearly not so practical at work), taking a hot shower (ditto), doing breast massage, or leaning over and shaking your breasts are other ways of enhancing let-down. A convenient alternative at home or at work: hot/cold packsâpacks that you can chill in the freezer before using when you want them soothingly cold or that you can microwave for a few seconds when you want them warm (as in when you want to encourage let-down).
Simply put, pumping shouldn't hurt. If it does, make sure you're pumping correctly, not going over recommended pumping time limits, and that you're treating any soreness or cracking (or other sources of pain, such as infection) you might be having.
Check, check, check to all threeâand you're still finding pumping physically painful? The problem may lie with the pump itself (in which case, it might be time for a switch, if that's financially feasible), but it's more likely to be a matter of a too-small (or less often, too large) flange size, a very common problem that's easily fixed. If the flange is the right size, your nipple will move freely in the flange tunnel during pumping, and not much of the areola will be drawn into the tube with the nipple. Check your flange in action next time you pumpâand when in doubt, try sizing up or down to see if pumping becomes less of a pain (at least, physically).
No matter what method of expressing you choose, you may find it difficult to extract much milk the first few times. Consider those initial pumping sessions to be practiceâyour goal should be to figure out how to use the pump, not necessarily to score large quantities of milk. Milk probably won't be flowing in copious amounts during early sessions anyway, for two reasons: First, you're not producing that much milk yet if your baby is still less than a month or two old. Second, a pump (especially as wielded by a novice pumper) is much less effective in extracting milk than a baby is. But with perseverance (and practice, practice, practice), you'll become a pro pumper in no time.
Though the basic principle of expressing milk is the same no matter how you go about it (stimulation and compression of the areola draws milk from the ducts out through the nipples), there are subtle differences in techniques.
Expressing milk by hand.
To begin, place your hand on one breast, with your thumb and forefingers opposite each other around the edge of the areola. Press your hand in toward your chest, gently pressing thumb and forefinger together while pulling forward slightly. (Don't let your fingers slip onto the nipple.) Repeat rhythmically to start milk flowing, rotating your hand position to get to all milk ducts. Repeat with the other breast, massaging in between expressions as needed. Repeat with the first breast, then do the second again.
If you want to collect the milk expressed, use a clean wide-topped cup under the breast you're working on. You can collect whatever drips from the other breast by placing a breast shell over it inside your bra. Collected milk should be poured into bottles or storage bags and refrigerated as soon as possible (
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Expressing milk with a manual pump.
Follow the directions for the pump you're using. You might find moistening the outer edge of the flange with water or breast milk will ensure good suction, but it's not a necessary step. The flange should surround the nipple and areola, with all of the nipple and part of the areola in it. Use quick, short pulses at the start of the pumping session to closely imitate baby's sucking action. Once let-down occurs, you can switch to long, steady strokes. If you want to use a hand pump on one breast while nursing your baby on the other, prop the baby at your breast on a pillow (being sure he or she can't tumble off your lap). You can also use a manual pump to get breasts primed for electric pumping, though that means double the equipment and more work for you, so no need unless you find you have a very hard time getting started with the electric pump.
Expressing milk with an electric pump.
Follow the directions for the pump you are usingâdouble pumping is ideal because it saves time and increases milk volume. If you find it helps, you can moisten the outer edge of the flange with water or breast milk to ensure good suction. Start out on the minimum suction and increase it as the milk begins to flow, if necessary. If your nipples are sore, keep the pump at the lower setting. You might find you get more milk from one breast than the other. That's normal, because each breast functions independently of the other.
If you're not double pumping, the breast not being pumped will start getting into the action ahead of time ⦠and likely leak accordingly. To avoid a mess, make sure the breast that's being ignored is well packed with breast pads (especially if you'll be going back to your desk after pumping), or take advantage of every drop of milk and collect whatever leaks in a bottle, a clean cup, or a breast shell.
Many pumps come with containers that can be used as storage and feeding bottles, and others allow you to use a standard feeding bottle to collect the milk. Hoping to build up a freezer stash? Special breast milk storage bags are convenient for freezing milk and are less likely to break than disposable bottle liners, which are made of thinner plastic. Some pumps allow you to collect the expressed milk directly into the storage bags, so you can skip the extra step of transferring the milk from bottle to bag before storingâand the risk of spilling any drops of that precious fluid. If you will be transferring, be sure to wash any containers or bottles used for milk collection in hot soapy water or a dishwasher after you're finished transferring the milk from the collection containers to the storage containers.
Keep expressed milk fresh and safe with these storage guidelines:
⢠Refrigerate expressed milk as soon as you can. If that's not possible, breast milk will stay fresh at room temperature (but away from radiators, sun, or other sources of heat) for as long as 6 hours and in an insulated cooler bag (with ice packs) for up to 24 hours.
⢠Store breast milk for up to 4 days (96 hours) in the back of the refrigerator where temperatures are coolest (though ideally, it's best to use the milk within 2 to 3 days). If you're planning to freeze it, first chill for 30 minutes in the refrigerator, then freeze.
⢠Breast milk will stay fresh in the freezer for anywhere from a week or 2 in a single-door refrigerator to about 3 months in a two-door frost-free model that keeps foods frozen solid, to 6 months in a freezer that maintains a 0°F temperature.
⢠Freeze milk in small quantities, 3 to 4 ounces at a time, to minimize waste and allow for easier thawing.
⢠To thaw breast milk, shake the bottle or bag under lukewarm tap water; then use within 30 minutes. Or thaw in the refrigerator and use within 24 hours. Do not thaw in a microwave oven, on the top of the stove, or at room temperatureâand do not refreeze.
⢠When your baby has finished a feed, throw out any breast milk that's left in the bottle. Also toss any milk that has been stored for longer than recommended times.
Fill breast milk storage containers or bags for the freezer only three-fourths full to allow for expansion, and label with the date (always use the oldest milk first).
Determined to feed your baby mama's milk but circumstances (say, problems with latching) have made breastfeeding a struggle, or even impossible? There's still a way to give baby the best from the breast: exclusive pumping. It's definitely tougher on moms than nursing is (babies are usually more efficient at extracting mama's milk from the source than a pump is), but pumping all your little one's meals is doable, if you're dogged about it. Here are some tips to keep in mind if you decide to exclusively pump:
⢠Get a good double pump. Since you'll be spending a lot of one-on-one time with your pump, you'll want one that's efficientâand that works two by two. Doubling up when pumping with a double electric pump will cut back on the time you spend pumping and will actually pump up your milk output.
⢠Pump often. Pump as often as baby would be eating (every 2 to 3 hours in the early months) to make sure your supply of breast milk becomes established. That includes pumping at least once or twice during the night.
⢠Pump long enough. To make sure you're stimulating your breasts enough to continue producing milk (and increasing the amount of milk they produce), be sure to pump for around 15 to 20 minutes (that's per breast if you're not double pumping) or until the milk stops dripping at each pumping session (which could be longer than 20 minutes for some moms). Don't exceed the recommended time limit in hopes of scoring more milkâchances are you'll only score sore nipples.
⢠Don't drop pumps until your supply's pumped up. It could take anywhere from 6 to 12 weeks until your milk supply is well established. Once it is, you can start dropping some pumping sessions, but if you find your milk supply diminishing, increase pumping frequency until you're back where you want it to be.
⢠Record ⦠or not. Some experts suggest moms record how much milk they're pumping per session. Others recognize that keeping a record (or spreadsheet) is time consuming and can add to the worry. If you're struggling with a low supply, for instance, recording your output will only stress you out, and possibly decrease your supply. Do what works for you.
⢠Supplement if needed. Sure, your goal is to feed your baby breast milk only, but if your supply is too low, if you're too pooped to pump enough, or if you decide for any other reason that you just can't commit to exclusive pumping anymore, don't feel guilty. Feed your little one with as much breast milk as you can and supplement with formula to fill in as needed (you can even mix breast milk and formula in the same bottle). Remember, every drop of breast milk counts!
It's normal for breast milk to be bluish or yellowish in color. Sometimes it'll even look clearâand that's probably because you've expressed only the foremilk (the hindmilk will usually look thicker and creamier). So if your pumped milk looks thin and watery, it could be because you're not pumping long enoughâor the bags or bottles you're pumping into aren't big enoughâto get the hindmilk. Expressed milk will also sometimes separate into milk and cream. This, too, is normal. Just swirl gently to mix before feeding (try not to shake, because that could cause a breakdown of some of the milk's valuable components).
“Breaking” Baby
“I know it's a cliché, but I really am afraid of breaking the babyâhe seems so tiny and fragile.”