Pumpin Ain't Easy

Most moms eventually return to work and with the sad 12 week leave (or less) that most of us are entitled to in the US, if you plan on breastfeeding for the recommended first year of life you're going to need a pump.

There are tons of blog posts, books, forums and websites dedicated to giving moms tips on how to combine breastfeeding with work. Make sure you buy a good double electric pump! Always keep extra storage bags and pump parts at work! Here's how to talk to your boss about setting up a space for you to pump! These bottles are best for breastfed babies and don't forget the slow flow nipples! Wow, pumping at work is now protected by law! And on and on and on.

What is implied in these blog posts and message boards and websites is that if you do it right and have all the accoutrements, that you can totally work full time outside of the home and continue to breastfeed your baby. I'm here to tell you that is a lie. Even under the best conditions, with a supportive boss and co-workers, a door that locked on my own office, hell, even being the boss myself! and owning top of the line breast pumps and even renting a hospital grade pump..... I couldn't pump successfully.

This lie that breast pumps quickly, easily and efficiently put milk into bottles is so pervasive that every mom asks for a pump on her baby registry and everyone assumes she will use it so her husband/partner/mom can give the baby a bottle. Many women who find the idea of breastfeeding icky say they'll just pump and give the baby breast milk in a bottle.

Thirty minutes of hard work pumping BOTH breasts

Let me let you in on a secret: pumps don't magically suck out all of the milk from your breasts. YOU have to actually have a letdown for the pump to extract the milk. And many women simply cannot letdown for a machine the way they can for their own sweet baby. This means that you can have a full milk supply and not pump enough for your baby. It also means your supply will diminish over time because you are not removing enough milk, but in the meantime you can suffer from plugged ducts and mastitis until your supply regulates. No pump is as efficient as your baby but for some women the pump is practically worthless.

And before you say, "You should hand express!" let me stop you and say I cannot for the life of me figure out how hand expression works. I've watched all the videos and I've never been able to get more than a few drops out that way.

How did we get here? How did we get to a place where everyone assumes pumping is easy and of course they will be able to maintain a full supply when they return to work? Almost every woman I know has really struggled to maintain breastfeeding while working and the main reason is they couldn't pump at work what their baby needed at daycare. Some did OK until the infamous "six month slump" but many, like me, found their supplies dwindled down to nothing in mere weeks.

With Miles I barely made it two months before he was almost exclusively getting formula at daycare. Thankfully I was able to take advantage of my employer's generous 6 month leave so he was nearly nine months old and so in love with breastfeeding that my boobs still made enough milk to nurse in the morning and before bed. He was sleeping through the night but got a bottle or two of formula a day in addition to solid foods and nursing a few times on the weekends. It wasn't ideal and I was annoyed but he went on to nurse for 3 years and overall I think he got mostly mama milk for the first year and I'm OK with how things turned out.

But Aminah isn't even four months old and I have no freezer stash and we are already having to supplement. She is nowhere near sleeping through the night and we haven't started solids. My supply is slowing down and I can easily see her being fully formula fed by 6 months. That is NOT OK with me. It's actually beyond fucked up. I do not want my baby getting formula when, if she were with me there'd be no need for it. I make plenty of milk for her and she's happy and healthy. I don't want to have to get up in the middle of the night to fix bottles, I don't want to jeopardize her health with formula at such a young age and I don't want her rejecting the breast for the bottle, even if I could pump enough for her which I can't.

If she ends up being a formula fed baby I won't feel guilty but I will feel angry. Who decided that we should be fighting for the right to pump at work instead of fighting for paid maternity leave? And who keeps perpetuating the myth that every woman can pump and provide milk for her baby? You can do everything "right" and still end up failing. And THAT'S what truly sucks.

The Relief Bottle

When my son was born, I was lucky that my husband was able to take a few weeks off to be with us. Because he is also a teacher, after his leave was up it was winter break, so he was home for an additional two weeks. In that time, my son and I were working out our breastfeeding difficulties and finally settling into some semblance of a routine. I was getting used to my new reality, which of course involved getting up several times a night to breastfeed. My son slept in his bassinet at first, so it was only a matter of reaching over and picking him up but he would scream bloody murder when I went to change his diaper and I'd have to nurse him back down to sleep again. Shortly after he made his way into our bed and at that point I barely had to do anything but unhook my bra. He seemed to seek out and find my nipple on his own and I eventually was able to sleep through most of his feedings.

But after the new year when my husband was back at work, I did start to feel resentful at times that as I sat up breastfeeding or carried the baby to his room for a diaper change, my husband was snoring away, totally oblivious. I just wanted a stretch of uninterrupted sleep and it seemed really unfair that I had to take 100% responsibility for all of the feedings. I had read about moms pumping a bottle so that their partners could share in the feeding duties and it seemed like a great idea. I had a pump, I'd just put a 4 oz bottle of breastmilk on ice in our bedroom and when the baby woke up, I'd happily hand him off to Daddy and roll over and go back to sleep for another three hours. Score!

Except....not so much. I had to practically kick my husband awake and I couldn't fall back to sleep so I was up for the entire feeding anyway. Then it took quite a bit of jiggling/walking to get Miles back to sleep after, and I was awake through all of that too. In the morning I was engorged. After a couple more nights of this, I had a plugged milk duct and I was through. The relief bottle was more of a hindrance than a help.

I'm always surprised when moms say this arrangement worked for them. Obviously if it works for you, then yay and keep at it. But this idea that pumping a bottle so dad can take over a nightfeed never seems to come with the caveat that it can lead to other problems. And the advice to pump a bottle so dad can share in the feedings never seems to come with any advice on how to do this while still managing your milk supply.

So what say you? Yay or nay on the relief bottle?
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New Advocacy Group Forms to Protect Nursing in Public

Here is a clip from a breastfeeding advocate, featured on a local morning show, talking about a mother's right to nurse in public. (if you're reading this in a feed reader, you may have to click to the post to see the embedded video).




Advocacy Group: Mothers Have Right To Expose Milk-Engorged Breasts In Public

OK, fine, this clip is from the funny folks at The Onion. But it appears they used a real breastfeeding mom, I swear I saw actual milk being expressed at the end there! So what do you think, funny or did they take it too far?


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Target's Idea of Breastfeeding Marketing

I have a love/hate relationship with Target. I hate they let their employees harass nursing mothers in their stores and don't do anything about it. But I love that they sell cute clothes for toddler boys for ridiculously cheap prices. But then I hate that every time you buy a baby item from them, they print a coupon for formula on the back of the receipt. But I've also always given them props for this:

Yes, at Target, the aisle that sells breastfeeding supplies is the "Natural Feeding" section. I've always sort of loved that, a lot. But when I was poking around the Natural Feeding section this weekend, I saw a new display that gave me some serious pause.

A new display advertising several different breast pumps and their various accessories was accompanied with the above sign that reads "Natural Feeding, get started in 3 (baby) steps." OK, so according to Target, how does one get ready to feed naturally?

Step 1 is to select the right pump. For feeding naturally you need a breast pump? Thanks for letting me know, Target! Who'd have thought you needed equipment to feed naturally? Not only does Target think you need a double electric pump (which is thankfully and inexplicably DISCREET) but you should probably buy a manual pump to supplement your primary pump as well.

Step 2 is to choose my accessories. And no, accessories doesn't mean anything like a nursing pillow or a glider or even a sling. No, Target wants you to buy a converter kit so you can use your pump with multiple types of bottles and different containers for your breast milk. And while you're at it, you should buy special wipes so that you can totally wipe up your breasts both before and after you nurse your baby because obviously having a mouth on your boob, even your own baby's mouth, is like, so gross.

And finally, take care of yourselves, ladies! Breastfeeding really HURTS so you'll need creams, gel pads and cooling packs for your sore, aching nipples. You'll also leak, which is SO embarrassing, so be sure to buy some breast pads to conceal that.

That's all Target had to offer. Nothing about how to actually enjoy your baby or breastfeeding. In fact, the baby seemed to be totally removed from the entire equation. So what's going on here? Why such emphasis on pumping, rather than the act of breastfeeding a baby? I understand that Target is a store and has a lot of product to move, but they do sell items to nurture the natural breastfeeding relationship. This is very similar to the marketing that has cropped up at Babies R Us, where Medela sponsors breastfeeding classes whose description begins "Ready, Set, Pump!"

So is it any surprise that a recent article in Time magazine states that more and more women are choosing to exclusively pump in order to provide breast milk for their babies, instead of actually breastfeeding? I know it's a complicated issue, but for the life of me I don't understand choosing this route. One of the biggest benefits to breastfeeding is not having to fool with sterilizing and preparing bottles. Breastfeeding makes life easier because you just latch the baby on and go about your business. The few times I tried to pump while taking care of my newborn were a complete and total disaster. If I had tried to do that every few hours in order to maintain a milk supply, I'd have given up on breastfeeding with a quickness. I know that some moms have no choice in the matter because the baby cannot or will not latch. I am talking about making the decision to not offer your baby the breast and instead pump around the clock to offer breast milk in a bottle.

There was an interesting discussion of this trend on the Motherwear Blog. The fact that it seems some moms are choosing pumping because they don't want to have to nurse in public is distressing and sad. But are moms also being influenced by this message, that pumping provides the benefits of breastfeeding without having to deal with any of the stuff that might be uncomfortable or weird at first? Or are the pump manufacturers and stores just noticing the trend and responding accordingly? Is feeding your baby breast milk in a bottle breastfeeding?

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What breast pump does Kimora use?

A lot of people have been finding my blog lately in search of the breast pump that Kimora Lee uses on the new season of her show, "Life in the Fab Lane." Kimora is pumping with the Medela Pump In Style Advanced, which can be purchased at your local chain baby store. This is definitely a pump that comes highly recommended, but there are other great double electric pumps out there, including the Ameda Purely Yours and the Hygeia EnJoye.

Other Uses for Breast Pumps

Have you ever stopped to consider any other uses for your breast pump? I mean, after you fork over hundreds of dollars for a quality pump, you may feel like you got your money’s worth if you were able to provide that liquid gold for your baby for a full year (or more!) But perhaps you ladies who are more, um, frugal, wish that you could’ve found yet another use for your pump. If you’re both cheap and lazy, you’ll love what the guys at Evil Mad Scientist came up with…..a cocktail robot that makes mixed drinks. Hot!

Apparently there are people all over this great country of ours who spend lots of time creating Barbots, AKA robot bartenders. There was even a festival celebrating these cocktail robots in San Francisco last night.

This beauty was created using an Evenflo double electric pump and is capable of making cocktails with up to three ingredients. According to its inventor, it was tricky finding a pump that could quickly move liquids, but was also safe to use with food. Enter the breast pump! He says:

"If there's one consumer group that I can expect to be more picky than me when it comes to food safety it's new mothers, so these pumps-- designed to move food grade fluids without contamination-- aren't actually a crazy thing to consider. They are cleanable, don't use much power, and are inexpensive. Amazon sells a pair of these "Evenflo Comfort Select Performance" units for $45. (Try as I might, I could not find a three-pack anywhere.)"

And for those of you intellectuals who are into science and engineering, here’s what your breast pump looks like on the inside.

By the way, the guy behind Evil Mad Scientist used this baby to create a White Russian. I won’t ask where he got the milk.



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History of pumping in New Yorker

Remember my post the other day highlighting a journal article on the history of breastfeeding? Well, the New Yorker has a new article up entitled "Baby Food," which details the politics of pumping. Writer Jill Lepore argues that the history of breastfeeding is inextricably connected to the social and political climes of any given era. Back in the day, if you were poor, you breastfed and if you weren't, you either had someone else do it (wet nurse) or you could afford to pay for formula after the turn of the century.
But in the new millennium we've added an extra conundrum. Lepore says ours is the age of the breast pump and that the stark difference between being able to nurse your baby and being able to provide breast milk after you've returned to work by pumping cannot be overstated. She raises an excellent point that I think we as lactivists need to argue for: more and better maternity leave, less encouragement of breast pumps, pump breaks and lactation rooms.


I mean, really, which would you rather do? Is this just another area where feminism has let us down? As Lepore argues,

Pumps put milk into bottles, even though many of breast-feeding’s benefits to the baby, and all of its social and emotional benefits, come not from the liquid itself but from the smiling and cuddling (stuff that people who aren’t breast-feeding can give babies, too). Breast-feeding involves cradling your baby; pumping involves cupping plastic shields on your breasts and watching your nipples squirt milk down a tube. But this truth isn’t just rarely overstated; it’s rarely stated at all...No one seems especially worried about women whose risk assessment looks like this: “Should I take three twenty-minute pumping ‘breaks’ during my workday, or use formula and get home to my baby an hour earlier?”

It seems like once again breastfeeding is linked to a class structure. You have to be educated and well-read to truly understand and believe in the benefits of breastfeeding, but you can't continue to breastfeed once you return to work unless you can afford an expensive pump and have the "luxury" of a place in which to use it. Who is benefiting from this in the end? It doesn't seem to be moms and babies.

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Pumping & Working: Essentials to making it work

One of my good friends will be returning to work in a week and will be pumping for her 4-month-old daughter. I told her I would make her a list of items and tips she'll need to make working and pumping easier. Below is my list, but please feel free to add anything I may have overlooked.

• A good double electric breast pump. It goes without saying that if you want to keep your supply up, you'll need a quality pump. Most lactation consultants recommend the Medela Pump in Style and the Ameda Purely Yours. If your supply starts to dip, you can consider renting a hospital-grade pump. I am also hearing really good things about the new Medela Freestyle, a hands-free pump.
  
• Pictures and videos of your baby, clothes your baby has worn, your baby's blanket. All of these items can help elicit your let-down reflex. If you have a cell phone that takes videos and pictures, make sure you have some photos or vids of your baby nursing that you can play while you pump.
  
• Burp cloths. My son never spits up so I have a ton of these things in his linen closet and never had a use for them until I returned to work and began pumping. These will save your clothing. Breast milk does stain (I learned this lesson the hard way by ruining two pairs of pants) so be sure to put the cloths in your lap before you pump. When you remove your breasts from the horns, some milk may drip down into your lap so use the cloths to catch it. You can also them to wipe up any milk that spills on the table/desk where you're pumping.
• Speaking of horns (or flanges or breast shield....same thing!), it's smart to invest in an extra set. That way, you don't have to wash pump parts at work. Since breast milk is sterile, you can store the horns from your morning pump session in a fridge at work or even in a plastic ziplock bag until you're ready for your lunch time pump. Then you can use the extra set for your afternoon pumping session(s).
• Make sure the horns are also the correct size! Check out how the right fit should look here.
  
• Extra accessories. Keep them on hand, both at work and at home. I can't tell you how many times I've forgotten to pack one little tiny part that then makes it impossible to use the pump. The white part that aids in suction is the membrane and the yellow piece it clips onto on a Medela pump is the valve. On an Ameda pump, the white piece is the valve. Medela accessories can be purchased at Target and Babies R Us, but Ameda parts can only be found online, so stock up before returning to work. You'll also need to replace the valves and membranes every 6 to 8 weeks to ensure the integrity of your pump and your output. If you notice you are pumping less, sometimes just replacing these parts can get you back on track.
  
• Extra collection bottles/milk storage bags, just in case. You never know how much milk you're going to get in a given day.
• A cooling pack. If you don't have access to a fridge, you can keep your milk cool enough with a freezer pack. Even though I have a fridge, I prefer to keep my milk with me at all times.
• A fun magazine, book, or web site to read. Many moms, myself included, find that "bottle watching" really wrecks your output. If I concentrate and worry about how much milk I am getting, I inevitably get less than if I surf the internet or read Us Weekly.
• Learn how to go hands-free. If you can't splurge on a Freestyle, you can purchase a bra especially made for pumping moms, like the Easy Expressions. You can also rig up any regular old nursing bra to be hands-free with a couple of rubber bands.
  
• Pump at least 3 times a day. Ideally you should pump for every missed feeding, but if you can't, 3 times is in a typical 8-hour work day should be enough. If you get busy, squeeze in a 5 minute pump. Some pumping is better than none!
  
• Herbs. Fenugreek works wonders for boosting milk supply, as does goat's rue. You can purchase them at a health food store, or try a tincture like Mother Love's More Milk Plus.
  
• Determination and a good attitude. Working and pumping is tough, but worth all of the effort to give your baby the best..your milk! It helps to think of pumping as a way to connect with your baby even when you're apart. You will definitely run into issues at one time or another but don't let them prevent you from continuing your nursing relationship with your baby. If you find pumping becomes too difficult, always remember that some breast milk is better than none and nursing doesn't have to be an all or nothing proposition! Your body will make enough milk for you to feed your baby when you're together and you can give her formula at day care if it makes your life easier and preserves your sanity.

For more tips and information on the many common concerns working and pumping moms face, check out the following:

Work and Pump site

Pumping & Relactating Moms forum

Breast milk calculator

Nursing Mother, Working Mother

Optimizing Milk Supply when Returing to Work or School

101 Reasons to breastfeed your baby, when you need some inspiration and encouragement

Ameda Breast Pump on sale

For those of you who are in the market for a new breast pump, you can take $25 off the purchase of any Ameda pump at HappyMothers.com with the coupon code AMEDA25DOLLARS. This deal on the highly-rated Ameda is good until 9/30!