Breast Pumping Advice

I love giving advice.  I’m not talking about in the patient care setting- I find that to be different.  When I’m discussing, say, birth control options with a patient, it’s more about counseling.  I review the different methods, pros and cons, and ultimately based on the woman’s preferences, she chooses what’s best for her.

I’m talking about straight up giving advice.  You just had a baby?  Oh boy, do I have a ton of advice to give you!  When it comes to baby advice, there is no shortage of it for new parents.  The thing is, every baby is different, so not all advice applies to all babies and parents.

So I’m gonna try to stick to advice that I think is generally helpful to most new parents.  Today, I’m going to share my experience with breast milk pumping.

Luckily, my supply was good early on and WZW didn’t have any issues, so I was able to breastfeed exclusively.  Even then, it wasn’t easy- my nipples were sore for the first few weeks, and then finally they started to get used to the multiple daily and nightly beatdown.

We started giving WZW a bottle of my pumped milk at 4 weeks to get him used to the bottle.  A lot of babies are particular about brands of bottles, or just won’t take a bottle, period, after getting used to the boob.  But my kid had no issues- he was just happy to get fed.  We gave him a bottle every other day, then realized that since he didn’t have any issues taking a bottle, we might as well conserve my frozen milk.  So we spaced it out.

He was generally satisfied with one breast, so I’d pump on the opposite side while he was feeding.  With a baby that doesn’t exactly stay calm and still during his feeds, that wasn’t always easy.  I looked into bras that I could simultaneously pump and breastfeed with.  I came across some that clipped like a regular nursing bra, but had a layer underneath to hold the pump.

Then I came across the Rumina bra, and it is seriously the best thing ever!  I wasted money buying other nursing bras, because now it’s the only one I wear.

RuminaRumina with flanges

I love it because it’s comfortable like a sports bra (wireless), and I can wear it all day even at work.  When it’s time to pump, I can just lift my shirt and stick the flanges in the bra.  It’s available on Amazon or the Rumina website, and best of all it’s $34.  That’s half the price of some of the other simultaneous pumping/nursing bras I found.

They have two versions, the Classic Crossover and Relaxed Crossover.  I haven’t been able to tell the difference, but then again my boobs never got that big even with lactation.  Unlike most women, I wore my usual bra size throughout my pregnancy- 36A (though I’m probably really 36AA).  Even with postpartum engorgement, I only got to like a 36B.  So I can’t speak to the support for women with larger breasts, but I love the design of the Rumina bras.

I had previously gotten the Simple Wishes Hands Free Pumping Bra, but found that it was extra effort to have to put it on.  Plus, the holes are too small to fit the pump flanges in from the outside, so you have to place them before putting on the bra.  Way too much effort when you’re in a rush to quickly pump at work.

Simple Wishes

In November, as WZW’s feeds started to space out to every 4 hours, I realized I could no longer feed one breast and wait till his next feed to empty the other breast.  So with every feed, I was feeding him on one side as I pumped on the other.  It was a lot of work, but I ended up amassing a good amount of milk.

IMG_1473

After a month of that, and seeing how much I had, I got pump fatigue and decided it was too much.  It was a lot of work to be dealing with a fussy baby trying to feed, and pumping simultaneously.  And it was extra work to have to wash the pumping accessories at night.  So I switched to feeding him from both breasts until I went back to work and needed to pump.

Alas, now that I’m back to work and pumping twice during the day, my supply has gone down, so I often don’t pump as much milk as he is consuming during the day.  So even though the picture above looks like a ton of milk, my husband defrosts a significant amount each week.  My pumping at work replaces most of it, but not all.  Hopefully I won’t ever run out completely, as it would be nice to stick to breastmilk and not need formula.

The first pump I bought was the Limerick PJ’s Bliss, based on an article my husband found regarding breast pumps, which referenced this article from The NightLight which ranked it #1:

http://thenightlight.com/best-breast-pump/

PJ's Bliss

The biggest difference and advantage of this pump is that it has silicone instead of plastic flanges.  I find that the comfort is similar, but the silicone adheres to my skin better.  So that means the flanges stay in place better as I’m dealing with a fussy baby or typing at work.  Between the silicone flanges and the Rumina bra, I was able to simultaneously pump and breastfeed.  I probably wouldn’t have been able to do so if I started with plastic flanges.

When I realized that it would be a lot of extra hassle to have to take my pump and accessories to and from work daily, I decided to get a second pump, and went for the Spectra pump, which is ranked #2 and I’d heard about from my colleagues who had just had a baby.  Spectra makes the S1 (blue) and S2 (pink), and the difference is that the S1 has a rechargeable battery pack.  Since the PJ’s Bliss didn’t come with one, I got the S1.  But the PJ’s Bliss does have a battery pack option that you can purchase for $80.

Spectra

After using both the PJ’s Bliss and the Spectra, here is my breakdown of their pros and cons:

As I mentioned, the PJ’s Bliss has the silicone flanges which are great.  It’s also lighter in weight than the Spectra, and more compact in size for transporting.  When you purchase it, it comes with a little backpack as well as a small cooler pack which fits 4 bottles and comes with 3 ice packs that fit in the slots in the cooler pack.  I love the tiny cooler- it’s so small, just the right size for the milk.  The PJ’s Bliss has two bottle holders that easily attach on either side of the main unit, and hold the bottles securely.

The biggest con of the PJ’s Bliss is that it’s louder.  I can speak to patients on the phone while I’m pumping with it at work, but I’m sure they can hear it, so I tend to avoid doing so.  Other cons include the price- at $257, it’s more expensive than the Spectra, and if you want the rechargeable battery pack then that’s another $80.  The Spectra S1 is currently selling on Amazon without any accessories for $158.  For me, the cost of the PJ’s Bliss was similar to the Medela Pump in Style Advanced, which friends who had their babies several years ago told me was the go-to pump.  For me, given how frequently I’d be pumping, it was worth the investment.

The way the filter and tubing are designed, if you lean forward too much when the pump is active and there is a lot of milk in the bottles, the fluid will go into the tubing and to the filter.  This doesn’t happen that easily, but once I forgot and leaned over to pick something up on the ground.  Whoops.  Once the filter is wet, it must be replaced.  One extra filter is included, but additional cost $15.  If the flange is attached to the bottle and there isn’t much milk in it, it will fall over.

The main advantage of the Spectra is that it’s quieter.  The pump mechanism is a little different.  Unlike the PJ’s Bliss which goes suck, suck, suck, this has a more vibration-like quality to the pumping, with multiple quick tiny pumps per suck.  Also, the pumps are significantly cheaper, even to get the S1 which has the rechargeable battery.  It is really helpful to have the rechargeable option just in case.  I used it when I had a work all-day meeting at a hotel, and as I suspected finding an outlet wasn’t as easy.

The design prevents fluid from getting in the tubing.  I haven’t needed to do it myself, but I’ve heard you can use Medela supplies with the Spectra.  This is convenient because you can more easily find them at Babies R Us and the like in a pinch, as opposed to waiting for things to ship.  The Spectra also has a built-in nightlight.

The downsides of the Spectra include that the plastic flanges don’t stay on as well as the PJ’s Bliss silicone ones.  One has to lean forward to catch the milk.  I’ve heard about angled flanges to help avoid this issue, but I’m not sure if they’re compatible in size with the Spectra.

The one spot for holding a bottle isn’t a secure holder like with the PJ’s Bliss.  It’s a space that’s wider than the bottle, so although the Spectra bottles don’t tip over as easily, you can easily knock over a bottle if it’s in this Spectra resting space.  And there’s only one, so what do you do with the other bottle?

Although the Spectra looks newer and fancier, the round shape is ultimately more bulky and the unit is heavier.  At least the S1 is.  I’m not sure if the S2 is lighter.

The pumps are different in their adjustment function, which I don’t think makes a difference.   The PJ’s Bliss has two dials, one for frequency and one for strength of suction.  The Spectra is digital, so you just press the buttons to go up or down on frequency or strength.  Both pumps are clear in letting you know how long you’ve been pumping.  The PJ’s Bliss tells you how many minutes you’re at, while the Spectra has a digital timer so it tells you to the second (which is not necessary).  I haven’t noticed a difference with either pump yielding more milk.

For me, bottom line is that I like the PJ’s Bliss better, so that’s the one I keep at work.  I have the Spectra for when I need to pump sometimes at home or elsewhere.

I have a friend who has used 4 different pumps- she rented an Ameda hospital grade pump for a couple months (not sure if Platinum or Elite), borrowed the Medela Pump in Style Advanced from a friend, used the Medela Symphony at work where it was present in their pumping rooms, and purchased the Spectra.  From most liked to least liked, she ranked them #1 Ameda, #2 Spectra, #3 Medela Symphony, and #4 Medela Pump in Style Advanced.

One last piece of related advice- I got the Nuk breast milk storage bags based on a compelling Amazon review.  Someone posted a review saying something along the lines of being a researcher, and for whatever reason she needed to ship her breastmilk, so she tried all the different brands, and these held up the best.  I haven’t had a problem with them, either.

Happy holidays!

 

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First Week Down

Mommy survived her first week back at work, and Daddy survived his first week with WZW 24/7!  High fives all around!  Turns out December was a good time for me to head back to work, since the patient load was more manageable.  Sure, I had some busy days that were just like old times, but it wasn’t every day.

I’m lucky that my work has given me one less patient each morning and afternoon so that I have time to pump.  I realized that it’s easier to have an entire pump and supplies at work so that I don’t have to worry about taking things back and forth from home.  Which means no risk of forgetting things at home.  So I have a second pump and accessories, drying rack, dish soap, dish sponge & brushes, and breast milk storage bags.  I’ll discuss my choice of pumps in my next post.

It’s a little tough during a busy day to squeeze in the pumping, but it’s not terrible.  The issue is that due to time constraints I will sometimes just pump for 10 minutes instead of 15 or 20 when I have more time.  I’ve already noticed that due to the pumping instead of breastfeeding, my supply is decreasing.

The challenge more so is that WZW is still not on a regular feeding schedule.  It would be great if I could feed him in the morning before I leave, but that doesn’t always happen.  And at night, the challenge is that I want to breastfeed to keep my supply going, but I also need enough sleep to function at work.  I don’t exactly have the kind of job where I can half-ass it.  So I’m improvising as I go, trying to breastfeed in the evenings and in the morning when timing works out.  In the middle of the night, if I wake up with my breasts feeling full and uncomfortable, I’ll get up and pump.  Last night, I went to bed early, then had my husband wake me when it was time to feed him, and then went back to bed.

I also don’t want to go too long between feedings/pumping and get mastitis again.  I started noticing a little redness, and thought NO!! Not again!  So I breastfed that night instead of pumping and thank goodness it went away.

Since I still have a similar routine at work, it’s easy to notice differences like how much hungrier I am now.  I made the mistake of not snacking during my pumping session one afternoon, and I started feeling really hypoglycemic later in the middle of seeing a patient.  Now I never skip a snack.

Even then, I’m still hungry all the time.  Case in point- the other day, I had a normal-sized lunch.  Then I had some Paleo bread as a snack during my pumping session.  Even then, I was still hungry and ended up eating a Kind bar before my last patient.  Then a second bar as I was finishing up charting.  On my drive home, I was STILL hungry so I ate a bag of plantain chips.  I breastfed as soon as I got home, and then I proceeded to scarf down a full dinner at 7 pm.

I’m also thirsty all the time.  One of the lactation consultants told me while I was still in the hospital to drink lots of water.  She herself noticed a difference in her milk supply on days she was busy and didn’t drink as much.  Well that hasn’t been a problem.  Unlike during pregnancy when regular water was often unpalatable, now I feel like I have an unquenchable thirst.  I am constantly drinking water.

During the pumping or breastfeeding itself, I have a weird drained sensation that makes me feel like I need to drink water and snack.  So much for trying to get back to my pre-pregnancy weight.  You’d think with all the extra calories burned by breastfeeding that it would be like the equivalent of working out daily (which I don’t have the energy nor time for these days).  But since I’m so hungry, I end up eating enough to make up for it and then some.  Hence I’ve remained stable at about 10 lbs. over my pre-pregnancy weight.  I wonder if my body wants me to be in that range right now, given how hungry I am all the time.

Everyone asks if I miss my son.  Of course I do, but as I suspected it hasn’t been extremely hard for me emotionally.  One of my coworkers once told me she looked forward to coming back to work after maternity leave.  She got tired of the baby care.  While I can’t say I’m at that extreme, I do relate.  The 24/7 baby care is really tiring and repetitive.  In contrast, I now get more sleep than I used to and I’m back into my old routine.

I have to say that it’s gratifying to realize that I enjoy my job.  Even though we’d all rather spend time with our kids than be at work, it’s rewarding to see familiar patients again, and help new patients.  It’s great to have a job that I find fulfilling, where I don’t dread being at, and away from my son.  Sure, I have busy days that stress me out and make me hate life in that moment, but it took being on maternity leave to confirm that I’m still very happy with my career choice.

Having my husband at home also makes it easy since I have zero worry about WZW’s care.  When he goes back to work, we’ll have a nanny two days per week.  We had a trial session this week with her, and as we suspected, WZW had major “stranger danger.”  He had done it over Thanksgiving at my parents’ place.  Even though he was fine two days before, on Thanksgiving he suddenly cried when anyone besides me and my husband held him.

Our poor nanny did well handling his incessant crying upon being with her.  Eventually he calmed down.  As tough as it is when he gets so upset, there is also an element of relief for me and my husband.  It’s reassuring to see that WZW does differentiate us from others; that we’re not just his servants who feed him and provide warm comforting bodies.

And now, back to my weekend.  Nowadays, they won’t be as restful- gonna breastfeed all weekend to try to keep my milk supply going.

Heading Back to Work

It’s been 13 weeks since I delivered WZW, which means it’s time for me to return to work.  Today is my last day of maternity leave, and the anxiety is building.

I do have flexibility with maternity leave with my job, and many of my colleagues have taken more time off postpartum.  I’m sure leave varies in different states, but here in California, we receive a minimum of 6 weeks postpartum after a vaginal delivery, 8 weeks after a Cesarean section.  Those who qualify can receive an additional 6 weeks of infant bonding (aka Paid Family Leave).  This can be taken concurrently or staggered anytime in the year after the baby is born (or after an adoption).  I decided to request 13 weeks off from my due date, so that in case I didn’t deliver until 41 weeks, I’d have at least 12 weeks off postpartum with the 6 + 6 weeks of leave as above.

Part of the reason I decided not to take more time off like some of my colleagues is that December tends to slow down.  With the holiday season, I think people get busy and are less likely to make appointments.  Also with the holiday days off, I have built-in days when the office is closed, and would only work if I’m assigned hospital duty.

I feel fortunate to be able to take this time off, since some of my patients don’t qualify for Paid Family Leave and have to return to work after just 6 or 8 weeks.  Between the breastfeeding/pumping and the babies waking up so frequently at night, that must be such a challenge.  Particularly without much help at home.  I definitely would have a hard time focusing at work.  And many workplaces, despite California law, are not supportive of or set up well for pumping breast milk, so many women stop when they return to work.

I’m also very lucky to have a husband who can take additional time off now that I’m going back to work.  He returned to work one month postpartum, but now started the second part of his paternity leave and will be off for a month and a half.  That makes the transition so much easier.

In fact, since he will be helping with nighttime duty, I will actually be getting more sleep.  Part of me is looking forward to that.  The months of baby care by day and frequent interruptions of sleep at night do take their toll.  Of course, my sleep still won’t be like it was pre-WZW.  Our Baby 411 book has a funny line, talking about how even when children get older, they still wake up for various reasons: The concept of “sleeping through the night” is only a fuzzy and abstract concept that exists for childless couples.

I like to think that even though I will miss WZW, I won’t get overly emotional.  One co-worker of mine said she used to cry at lunch in her office at first.  I’m hoping that knowing he’s in the best hands possible with my husband will be a huge relief.  Plus, I’m going to have necessary pumping sessions between patients- one in the morning and one in the afternoon.  The logistics of juggling the patients and dealing with the pumping might be a little tough, but at least it gives me time when I can take a look at pictures and videos my husband texts me.

I think what will be the hardest is missing WZW’s new developments.  They grow so fast and quickly develop new skills, so I will miss seeing many of those for the first time.

For now, he’s not on a regular schedule with sleep or feedings, so I’m realizing that the logistics of feeding him and pumping will be a challenge.  As much as I would like to breastfeed him before I leave for work, his timing may not match up.  And even though I’d love to sleep a full night, my breasts beg to differ and will need me to pump.  So I will have to figure all of this out and see what works.

Some of my colleagues completely check out during maternity leave.  My philosophy was that it’s not vacation.  Inevitably, during such a long hiatus, things change at work.  It’s impossible for me to keep up with it all, but I did try to at least check my work emails regularly to keep up with things.  There will still be some hiccups as I return and have to deal with new changes, but I’m keeping my fingers crossed that the initial days won’t be too busy and I can handle it ok.

We shall see!  Those who have been through it before me have said it is tough at first, but then it just becomes the new normal.