Thursday, February 25, 2010

All About EPing

Having been a "mum" for nearly a year, there are so many great experiences I'd love to share. But for the next little while on this blog I'd like to spend some time sharing some experiences related to the choices we've made in raising Mia. These are by no means absolutes, as you'll see, but rather the choices we've made and why we've made them. I've had lots of questions along the way about why we do one thing or another, or wanting more details on how or why we chose a certain path. So I thought this forum would be a good place to share what I've learned.

Let me share with you some truths I have learned along the way regarding "Exclusively Pumping":

One truth: Breastfeeding is considered the most natural way to feed your baby, but sometimes for a new mom and brand new baby, it can feel anything but natural. There is certainly a learning curve to nursing, which can take time (generally up to 6 weeks, sometimes more/less) to master and feel comfortable with it for mom and baby.

Another truth: Learning to do something that is generally not talked about, but highly recommended, can be very isolating. The way I learned to feed Mia is something very, very personal to my heart and so it is with trepidation that I proceed to share our story, but I share it so that others may know and have it as an aid/help to them should they or someone else ever find themselves in a similar situation.

A third truth: I'm going to be talking about breasts, breast pumps, and breastmilk. This may make the casual observer squeamish, and if you find yourself in that boat, you may want to pass this post. On the other hand though, what I'm going to be talking about is perfectly natural and a fact of life as bajillions of babies have been breastfed for thousands of years. Many Americans are unfortunately uncomfortable talking about these things because the female body and breasts are so often associated with sexuality thanks to our society and pop culture, but God did indeed make them for another purpose (aside from sexuality): functionality and sustaining human life! Kind of neat when you think about it, and perhaps that will help reframe your mind if you are having weirdness thinking about these things. Or just think about a cow pumping milk. That'll always tone it down for ya ;)

Without further adieu...

As alluded to (and one of these days perhaps I will post a more complete birth story – detailed enough for the curious reader, but discreet enough to avoid too much graphic detail!), Mia was born 3 days early, in a free-standing birth center, a bit on the small side. Due to her small gestational size, we had to transfer to a children’s hospital --not a women’s hospital-- so she could be seen for evaluation. I was not able to successfully nurse Mia before we made the transfer. For a successful nursing relationship, it is suggested you put the baby to your chest and try to nurse as soon as possible after delivery, which we did try. While she had a great sucking reflex on Greg’s pinky finger, we were not able to latch on before we went to the hospital, which was just 5-6hrs after Mia’s birth. Even the first night we were in the hospital, Mia was given glucose water via a syringe until the next morning, when she was given her first (and one of only few) bottles of formula. The hospital staff wheeled in a breast pump for me and thus I began my first of many pumping sessions.

Being in the children’s hospital was different than being in a women’s center, where ob/gyns, ob/gyn nurses, and lactation consultants may abound. I was instead surrounded by nurses and doctors most commonly used to dealing with children and usually not day-old newborns. For whatever reason, there was a policy that LCs could not work in the children’s hospital. However, I was very blessed and had friends at the hospital who tried to round up as much lactation help as possible, finding nurses who had nursed, phone numbers for LCs, literature, etc. My doula came in one night to help us, as I had only been able to feed Mia via pumping and bottle feeding, and determined I needed a nipple shield. Heard of these? Well, the nipple shield helped Mia to actually nurse (yay!) but our nursing sessions were not sufficient enough to feed her adequately, not to mention it was still quite painful. So, back to the pump I would go to try to round up some more milk to fill her little tummy.

My goal was to exclusively nurse. I knew it was great nutritionally for Mia and myself and would be a convenient way to feed her, among dozens of other benefits. However, I was finding increasing difficulty in my new surroundings to nurse her with the support I needed. I was not at home, in a comfy place with lots of peace and quiet. I couldn’t see an LC, and I couldn't just take Mia out of the hospital to see an LC before she was discharged and given the "all-clear". Nurses and doctors bombarded me and techs walked into our room at any moment, which is sort of embarrassing if you have a pump plugged in and are looking like a cow. It was all very disorienting.

To make matters worse, after being in the hospital for a week and having some nursing sessions followed up by the pump and a bottle, I went home with the beginnings of mastitis. I proceeded to get mastitis two more times over the next two months, the next round beginning immediately after finishing antibiotic #1. Mastitis is a breast infection, which has flu-like symptoms like fever, red inflammation, engorgement, etc. The best way to treat mastitis is to empty out your breast (and nursing is more effective than pumping in this arena), drink lots of fluids and lots of rest. Aside from the fluids, two of those things I was not able to achieve. Rest? Nursing? Neither of those were happening very well with a newborn's schedule.

Add another week with occasionally trying to nurse but mostly pump, and a blood clot began to present itself in my leg. For me, talk about total physical and mental debilitation. I do not think I have ever been as discouraged in my life as I had been at that time. My number one concern was bulking up Mia, but nursing alone was not sufficient. I’d think she’d be done because she’d fall asleep while nursing, but 30 minutes later she’d wake up crying and I’d have to pump anyway while we gave her a bottle that was in the fridge. It was a never-ending depressing cycle and I dreaded each nursing session.

For whatever reason, I was not very comfortable discussing this with anybody. It was probably the baby blues. I think I was afraid people wouldn’t understand, be unsupportive, or judge me for not solely nursing my child. I guess I had encountered some people who have very strong opinions about these things and it was messing with my mind. I, of course, talked to Greg about it, my doula, the midwives, Juline, and maybe a few friends who I knew had experienced nursing difficulties. Talking to my doula helped relieve some pressure. She reminded me that there are women who only nurse certain times of the day, and formula feed the rest, or pump while they are away from the baby. For some reason I had not realized it does not have to be all or nothing. She suggested trying to nurse during the day, and pump at night as pumping was faster than actual nursing. I tried that suggestion until the blood clot pain worsened, and I felt that pumping only was easier and less tiresome on my body than trying to nurse. When I went into the hospital myself for mastitis #2, high fever and pulse, and the blood clot at 3 weeks postpartum, I was thankful for the bottles of breastmilk I had saved up from pumping in the freezer and refrigerator. I was still able to feed Mia without being physically present.

Lots of milk! (and some OJ)

Fast forward a few weeks. Thanks to some fact acting anticoagulants I started feeling better from the blood clot and from mastitis (lots of drugs, loads of sleep - thanks Mom!, and lots of immune boosters helped there), but I was still working on the emotional side of my brain trying to round up the courage to try nursing again. It had been a week or so since Mia had last nursed. I was still pumping around the clock (just like I would have been nursing around the clock) and Mia was gaining weight, and I was losing weight (one of the benefits of lactation!) But, after the emotional and physical rollercoaster we had gone through in just one month, I still wasn’t ready for it. I was beating myself up in my head for not trying, but I had lots of questions and situations I wasn’t sure if I was ready to face.

In the months to come, I did try a handful of times to nurse Mia. There were times when I thought maybe she was latching on, but, as it turned out, she eventually refused nursing and went through fits if I tried. This can happen if a baby gets used to a bottle and its faster flow. After 4ish months with scattered bouts of trying, I officially gave up and surrendered myself to be an “Exclusive Pumper.”

When I finally found more confidence to discuss this with more people (the confidence came as I found easier ways to pump, increase my milk supply without pumping 24/7, and finding an exclusive pumpers group online), many remarked that they were surprised I had not just given into formula. I do not know why I did not do that either. I think there is something ingrained in my brain—perhaps a very stubborn streak—that said I did not want to try that. I also felt like I owed it to Mia and myself. Thus far, I had been able to maintain an adequate milk supply without having to take supplements and was able to provide Mia with more than a day’s worth of milk every day. I kind of felt like if God blessed me with this much milk, I should use it!

You would think that if I was so stubborn, then why didn’t I persist in nursing? And perhaps we will never know the answer to the question, but I do know that when I decided to just pump, I did feel a significant weight pulled off my shoulders and a lot of relief. I look back at the last 10 months and am grateful we have come this far and am excited that there are only 2 months left in my year-long journey of pumping and have more determination, knowledge, sympathy, expertise and compassion for nursing/pumping/formula-feeding mothers.

And here I will explain HOW I did it.

In order to exclusively pump, there are a few things you will need in your arsenal of tools:

  1. A really good breastpump. Double electric pumps are the best, and I recommend Medela Pump in Style Advanced. Ameda Purely Yours and Lansinoh's double electric are also highly rated. You can buy, borrow, or rent. I've been particularly blessed by my gracious SIL, who loaned me the Medela PISA from day one. I don't think she realized quite how much use I'd get out of it, but Mia & I thank you!
  2. Extra sets of bottles, pump parts, so you don't have to wash everything every single time.
  3. A good support team. Your husband, family members, friends, etc., can make or break your willingness and ability to hold on.
  4. A hands-free pumping bra. Just google it. It looks ridiculous, but trust me, it makes it so much easier!
What I did/learned:
  • I pumped following Mia's feeding schedule, which meant pumping every 2-3 hrs for at least 10 mins each time. 20 mins/session is what is recommended, but I didn't know that at first, so I just pumped until I thought I was empty. Pumping every 2-3 hrs means pumping 8-12 times a day including overnight. This is crucial to building up and maintaining your milk supply.
  • Milk supply is based on supply & demand and your hormones for the first 12 weeks/3 months postpartum. After that, your milk supply is pretty much established and should be sustained based on the demand. I, however, was still learning the ropes here and gradually reduced my number of pumps/day from 10x to 4x by the end of 2 months (before the recommended time). I was creating enough milk that I did not need to pump each time Mia actually ate, and was able to go longer between pumping sessions. This was very nice, however, I have learned that not all women are able to do this. Some need to continue pumping around the clock the first three months or sometimes longer to maintain an adequate supply. When I did drop down to 4 pumping sessions a day, I was pumping first thing in the morning for 20 minutes, around the lunch hour for 20 minutes, around the dinner hour for 20 minutes and before bed for 20 minutes. So a total of 60 minutes/day plus a few minutes to set up and breakdown everything. In this area, I have been very blessed, although I struggled with the occasional dip in supply after 6 months.
  • There were some nights when I was too tired to feed Mia a bottle and then pump afterward and Greg helped me on occasion by giving Mia the bottle while I pumped. This made a big difference and was super helpful. I have to give a shoutout to my husband here because I know not every new dad would be willing to do that when they have to get up for work in the morning.

One of Mia's first feedings; Greg's first foray into his infamous "Daddy Daycare"
  • You need to find the right size of pump parts for you. Not all women are created equal and so the standard size for the flange may not be the right fit for you. Your pump's manufacturer may have more info on their website. I'm moving on here lest I say too much. Oh wait, that already happened. ;)

There are lots of other things I learned as I went along but that's the gist of it. It's not an easy road but it's well worth it, I believe, if you have the time, energy, and will to keep doing it.

There have been a lot of conveniences to pumping such as anyone else being able to feed Mia (like Greg, grandparents, aunts/uncles, friends, etc.) and being able to feed Mia pretty much anywhere, etc. It's also so nice that Mia has been able to hold the bottle on her own for a couple of months now!

A few cons to pumping are that you cannot really pump discreetly just anywhere like you might be able to when you nurse (it's easier to disguise a baby under a nursing wrap than a pump!) and it's simply just less equipment to lug around, which requires more upkeep. Not to mention, most moms who continue to nurse talk about the amazing bond they feel with their child from nursing. I nursed for such a short period of time under stressful circumstances that I'm not sure I ever felt that bond, so I don't know what I'm missing out on, but it sounds really special. I guess I'm just really bonded to my pump. :P But to answer that concern, I do feel very bonded with Mia despite the pumping. In my mind, we both overcame big hurdles in the last year together. She's learning from me and I from her.

And in regards to what I think I'll do Lord Willing with another child, I hope to be able to nurse. Now that I've been through this, I have a different perspective on what it takes to nurse. I know there can be challenges, but I feel like I can face another challenge in this area with more confidence and determination than I previously had, and if things do not work out the way I want them to, I hope I will not beat myself up the same way I did with Mia. I will also seek out more support instead of withdrawing to myself, whether it's from friends/family members, or LCs or my doula. If I am to be successful at it I will need to open up about it and reach out. It really was all-consuming for quite some time, and I'd rather enjoy the newborn days (the moments of them for which I'm awake!) rather than feel guilty for not putting a baby to the boob. In an ideal world, I'd have a baby whom I primarily nursed, and pumped for on occasion, when necessary. Most moms like having the flexibility to be able to do both (nurse & bottle-feed), so that in the occasion where they are separated from their baby, they can still take a bottle and take care of their hunger needs. However, some babies are one way or the other, it's either all nursing and no bottle or all bottle and no nursing. But whatever boat I find myself in, I hope I've grown enough as a person to realize that while feeding and taking care of my baby is very important, it's not a do or die matter (for me). As a friend once told me, happy mom = happy baby, and it's not just nature, but also nurture!

So, there you have it. Just another day in the life of an EP'er. And you thought I was gonna talk about Eden Prairie, my beloved hometown, & its feeding style. Don't worry Rose, that post is on the docket as well.

What has been your experience? Do you know any "EPers" or women who have taken a different path feeding? Questions/Comments/Concerns? :P


Juline said...

Thanks for sharing this wonderful story, Megan! What an encouragement you can be to other mothers who find themselves in this same (or at least similar) situation. The one thing I've learned about birth and newborns is that every story is different. You have to adapt and you did it marvelously! You discovered what worked for Mia and for you during all the crazy things that happened after her birth. And the outcome? Happy Mom = Happy, Healthy Baby! I love you, thanks again for sharing.


Amy said...

This story is SO similar to mine...not able to nurse right after birth, 4 week hospital stay for the babies, complications due to prematurity including weak suck and general inability to suck/swallow/breath at the same time, mastitis, physical exhaustion due to being at the hospital all the time, etc... Pumping around the clock was the hardest thing I've ever done (mostly because of the circumstances), but it was one of the only things I could do for Eli and Landon, so I forged on (with the support of an incredible husband). I pumped exclusively for 6 months and I definitely understand the unnatural attachment to the Medela Pump In Style! I love this post and I'm totally impressed that you're still going strong after 10 months!


Rose said...

so honored i got a shoutout and thanks for the advice and wisdom that i will hopefully someday use!

Aubree said...

LOVE LOVE LOVE this post! I can't tell you how much I appreciate it! Like you said, a lot of new mothers, myself included, can feel insecure not only in regards to the best way to feed your baby, but also how others will react to your decision. I've been breastfeeding, pumping and occasionally supplementing with formula when I don't have enough breastmilk to feed him with immediatly after pumping. Its worked out well for me, because with Colt being a musician, and us having weird hours, sometimes its more convenient to give him a bottle of breastmilk. I never felt like I HAD to choose one feeding method, and now I'm glad I didn't because he's so easy going. He predominantly breastfeeds, but he usually takes one bottle per day, whether it be pumped breastmilk or formula. This post is so great because it really made me and I'm sure other new mothers as well, feel like whatever decision they made is the right one for them and their baby, and not to feel bad about it! Keep these informative posts coming! :)

The Cain Family said...

THANK YOU for posting this. I've been pumping for a week and half now and it's working great, i think?!?! My goal was to pump and give Ila Kate breast milk for the first 2 months but after reading this post my goal is now changing to "as long as I possibly can!" I want to pick your brain more, sometime soon hopefully! Thank you for posting this, it's a defnite inspiration!

Megan said...

Kara - whatever you can give her will be great! It's tough work but there are a lot of benefits. We'll talk more again soon, I'd love to hear your story.