Tag: breastfeeding

Exclusive Pumping: 4 Months Down the Road (and How Goat’s Rue Worked for Me!)

Awhile back, I shared my story of exclusive pumping and the struggles that came with that and postpartum depression. I was just re-reading that post when I decided it was time for an update.

I’m now over four months postpartum, and I’m happy to say I’m still successfully pumping exclusively. One note on that: our pediatrician has stocked us up with formula at every doctor’s visit, so we mix bottles about 3:1 breast milk:formula to help build up a freezer stash.

In the beginning, I pumped 7-8 times per day to mimic my son’s feeding schedule. This signals to the body that you’re feeding a newborn, and that signal helps you make enough milk. If you read my last post, you know I was producing barely enough to cover the amount he was eating per day. After trying all of the many recommended things to boost my supply, someone recommended Goat’s Rue.

I had never heard of it, but I was willing to try just about anything. From what I’d read, most women develop new milk ducts during pregnancy. That’s why your breasts get bigger–often a size or two larger than pre-pregnancy. For me, that never happened. I didn’t think anything of it, but I later learned that might be why I wasn’t producing very much; I just didn’t have enough ducts. Goat’s Rue is an all-natural herbal supplement that actually helps you grow new ducts. Crazy as it sounds, it’s even used by farmers to get cows to produce more milk. I was intrigued, so I ordered the Mommy Knows Best brand on Amazon:

Within just a few days of starting the supplement, I noticed a slight increase in supply. I mean, it wasn’t enough to get excited, but it was enough to think it was working. About a week in, my supply had increased measurably! Before I started taking Goat’s Rue, I was producing somewhere in the ballpark of 24 ounces per day. With the Goat’s Rue, my daily production went up to 30-34 ounces per day (sometimes even 36-38). I was thrilled! I was finally able to start getting a good freezer stash going.

I continued the supplement until it was gone (I had purchased a month’s worth), and then I didn’t know what to expect. Did I need to keep taking it to keep the supply up? Was my supply now “established” and therefore steady? By this point, I was 10 weeks postpartum. In theory, your supply is established at about 12 weeks. That means when you get to 12 weeks postpartum, you should be able to cut back on the number of pumping sessions per day and still yield the same amount.

I was still pumping 7-8 times per day (I pumped whenever he ate since I was still able to be home with him all day), 25-30 minutes per session. Now I know that sounds like A LOT, and believe me, it is! I was so worried about losing my supply, though, that I felt I had to tell my body to keep producing.

When we got to 12 weeks postpartum, I decided to experiment a bit with dropping pumps. I dropped down to six pumps per day (still 25-30 minutes per session) for about two weeks. My supply stayed the same, so that was a good sign. Then, when I was pretty sure I wasn’t losing supply, I dropped to five pumps per day (now going a full 30 minutes each session). Again, a couple of weeks later, my supply was still the same. Then came the big experiment–dropping to four pumps per day (still 30 minutes each session). I’m happy to say my supply still maintained! By this point, I was up to 32-36 ounces per 24-hour period.

Then I got a bit greedy and decided to try three pumps per day. After several days, my supply not only dipped a little but continued to fall. After five days of three pumps per day, I had dropped to about 28 ounces per day. That was two days ago. That’s when I decided three wasn’t going to work for me.

They say every pumping mom has a “magic number,” a perfect number of pumps per day where the output is its highest. For some women, they even produce more at this number than they did when they were pumping one more session. For me, my “magic number” is evidently four and not three. Ha! Live and learn.

A few days ago, I went back to my schedule of four pumps per day. So far, my output has not increased. I’ve gotten 28-29 ounces per day over the last several days. My understanding (and hope!) is that it can take 5-7 days to see your output return when adding the pump back in. I ordered another bottle of Goat’s Rue, and my husband offered to make some yummy lactation cookies. Fingers are crossed!

With my first son, I failed as an exclusive pumper. Maybe you read that story already. When I decided to pump exclusively with my second, then, I really wanted it to work. I did a ton of research–reading any forum or article I could find. I joined an awesome Facebook group, and I was determined to be successful. Looking back now on my first go-round, I know I did literally everything wrong.

With my first exclusive pumping journey, I didn’t pump often enough or long enough. I didn’t drink enough fluids. I didn’t eat the right things. I know now why it didn’t work. You’ll find tons of info out there to help you be successful should you choose the exclusive pumping route. If you want a few tips from a successful exclusive pumper, read on:

goatsrue

Get the right equipment.

The Pump: Breastfeeding moms who want to pump between feeds don’t need a great pump. If you’re pumping exclusively, though, the more basic, inexpensive pumps won’t hold up to that much use. Get a hospital-grade double pump. I have a Spectra S1 and love it though now I wish I’d gotten the S2. They’re the same, except the S2 has a rechargeable battery. I have a pumping station set up at home, so that’s not a big deal, but it would certainly come in handy when I’m away from home. I ended up buying a car adapter to pump on the road, and I just have to be aware of outlet locations when I’m pumping somewhere else. Cordless would be nice.

Hands-Free Bras: If you’re holding the flanges, you won’t get anything else done. As I mentioned before, I pumped and fed my little man at the same time (and still do when our schedules jive), so I needed my hands free. Invest in a few good hands-free pumping bras, so you don’t have to hold the darn things. I have this one, made by Rumina.

Get the Right Size Flanges: Your pump will come with some standard size flanges, and they very likely won’t be the right size for you. If you’re using flanges that are too big or too small, your output will be lower, and you’ll get sore. The right size is key. You’ll find lots of pictures online to show you what the right size looks like, and ya know what? They didn’t help me at all. What did help me was to actually measure!

  1. Pump for about five minutes (your nipples will continue to swell as you pump, so it’s important to measure at the right time).
  2. Turn off your pump, and remove flanges.
  3. Use a tape measure to measure the diameter of each nipple (they may be different sizes) in mm.
  4. Be sure to measure just the nipple and not the areola.
  5. Use flanges that are 3-5 mm larger than your nipple diameter. Again, you may need different sizes for each side.
  6. Note your size may change over time also. I recommend re-measuring monthly to ensure you’re still using the right size.

Note: your pump brand very well may not have the actual size you need, but that doesn’t mean it doesn’t exist. NeneSupply has tons of size options for lots of different pumps. I just searched on Amazon for my pump brand (Spectra) and the size I needed and found a compatible part.

Replace your membranes monthly.

Regardless of which pump brand you’re using, the membranes (aka duckbill valves) should be replaced monthly if you’re an exclusive pumper. Over time, these little parts will wear and stretch, and that will decrease suction. I use the NeneSupply brand with my Spectra, and they work great (and are far cheaper than the Spectra originals). Side note: as I mentioned above, NeneSupply is a great brand for “after-market” parts and accessories for your pump. Check out everything they have.

Don’t wash pump parts every time.

Pump parts only need to be washed once a day. If you’re washing every time (especially in the beginning when you’re pumping 7+ times per day), you’ll get tired of it by day two. You don’t even need to rinse them. In between sessions, toss the parts (I leave mine assembled) into a container or bag, and store them in the fridge. Wash them in hot, soapy water once per day. The necessity of sterilizing is debated, but I sterilize mine a few times per week if for no other reason than to get the milk fat out of the hard-to-reach places. Just boil the parts for five minutes, and allow them to air dry.

Understand letdown mode vs. expression mode.

With my first son, I had a Medela pump. When you first turn the Medela pump on, by default it starts in letdown mode. This mode is fast and is designed to trigger the letdown reflex, so your milk starts flowing. Once the milk is flowing, you switch to expression mode. This mode is slower to help express the milk out. Well the Spectra starts the opposite way, and I had no idea! The Spectra by default starts in expression mode, so you have to manually switch it to letdown mode to begin (that’s the button with the three wavy lines on it). Then, when your milk is flowing, you switch back.

It’s absolutely possible to get multiple letdowns (and thus more milk) per session. When your milk flow slows to drips in the expression mode, switch back to letdown mode for a couple of minutes. Then go back to expression mode. Switching back and forth will trigger more letdowns increasing your output per session.

Use your hands while you pump.

Remember how I said you’ll want your hands free while you pump? Some of that is to allow you to do “hands-on pumping.” Once you get into expression mode, use your hands to squeeze and massage your breasts. This will help get the milk moving and flowing. Move your hands around a bit to ensure you get all sides and up toward your collar bone and arm pits.

Faster and stronger isn’t better.

Pumps (especially hospital-grade pumps) will go pretty darn high for suction and speed. A common misconception is that faster and stronger suction will yield more milk. While I suppose that could be true for some women, it was absolutely not true for me. I produce more on slower speed settings and lower vacuum.

In letdown mode, I use 70/2. That means my pump sucks 70 times (or cycles) per minute, vacuum level 2 (out of 5 in letdown mode). When I go to expression mode, I use 38/4: 38 cycles per minute (ranges from 38-55), vacuum level 4 (out of 12). If I try to go higher on either number, it gets uncomfortable, and my milk flow slows. It’s important to experiment with the many different settings to find the right levels for you. It absolutely should not hurt or even be uncomfortable. If it is, turn it down.

Exclusive Pumping Struggles and Postpartum Depression & Anxiety

If you read my previous post about my first son being raised mostly on formula, you know I’ve struggled with breastfeeding. (Read it here if you’re interested in hearing my story.) When my second son was born (now just over five weeks ago), my success wasn’t much better. This time, he didn’t go into the NICU, but I still had trouble with latching.

I gotta start by saying, the first 24 hours were pretty awesome. His latch didn’t hurt, he seemed to be getting something, and he was overall pretty darn content for a newborn. Sadly, it took a downhill turn not long after. That second night in the hospital was a struggle.

Exclusive Pumping Struggles.png

It was about 2 a.m. when I woke up to him crying in his bassinet. I quickly scooped him up and prepared myself to start feeding him, but this time was different. Regardless of the hold we tried, it was painfully uncomfortable for me. Plus, he would latch for just a few seconds before screaming again–like nothing was coming out.

I finally did get him to latch (mostly pain-free), and then he kept working at it for 40 minutes! Yes, 40 minutes!! At the 40-minute mark (and really, way sooner), I couldn’t handle it anymore, so I made him stop. The instant I removed him, he was screaming again. I absolutely couldn’t take letting him latch again, and I was about in tears from the pain and frustration.

I sat there for a minute or two not sure what to do. Finally, I pushed my call button. When the friendly voice asked me how she could help, I asked for formula. My nurse quickly came to the rescue with a 2-ounce bottle of formula in hand. She got it ready for him and handed it to me. When I gave it to him, and he happily gobbled it down, I felt myself sigh with relief. He was eating, he was happy, and I wasn’t in pain.

For the rest of our hospital stay, we gave formula. By that point, frankly my nipples couldn’t handle even trying anymore, so I gave myself a much-needed break. The nurses were awesome and stocked us up on formula before we left. They also gave me tons of info about meeting with lactation consultants to help with his latch and/or to help with pumping should I choose to go the exclusive pumping route again.

When we discharged and got home, the first thing I did was pump. That initial pump didn’t yield much, so feedings were primarily formula mixed with what I was getting. The good news was pumping didn’t hurt.

After a day of just pumping, we tried breastfeeding again. I was immediately in pain, and it wasn’t long before the tears came–from me! I immediately felt like a failure. This is what moms are made for–feeding their babies. I had heard and read so many times about how you just have to grin and bear it for the first few weeks and it gets better. I had also heard and read (equally as many times) that if you’re doing it right, it shouldn’t hurt. So there I was…was I doing it wrong? Did I just need to buck up and deal with it?

No matter the answers to those questions, I knew I couldn’t do it. My husband quickly swooped in and took our son. He had a bottle ready for him. He told me I was doing great and all I could do was try. He told me not to cry and that he would feed him. He told me how proud he was of me. Have I told you all how INCREDIBLY AWESOME my husband is? Have I told him? Note to self: tell him more often.

So here we were, back to this idea of exclusively pumping. What does that mean? It’s exactly what it sounds like. You don’t breastfeed, but your baby gets breast milk because you’re pumping ALL. THE. TIME. It feels like it anyhow.

Most moms who struggle with breastfeeding are led to believe their only option is formula, but that isn’t true. If you’re able (and willing) to do it, there’s a mysterious third option called exclusive pumping. Ideally, you pump as much as your baby feeds. So if your baby is eating every two hours around the clock, that means you’re also pumping every two hours around the clock to mimic that. That’s what tells your body to keep making milk.

Of course, that’s all in theory. My understanding (I obviously have no personal experience) is that a baby is far better at emptying your breast than a pump. If the pump isn’t fully emptying your breast, your body might not make enough or might not produce as quickly. So far, that’s been my experience. While I feel like my breasts do get fully emptied with the pump (they’re soft and free of lumps when I’m done), I don’t feel like I’m producing as much as I need to.

A couple weeks ago, I downloaded an app to start keeping track. I record when and how much the little man eats, and I record when and how much I yield pumping. For the first few days, I was making about 3-4 ounces more than he was eating daily. I was able to freeze some, so that’s a good feeling (especially since I stopped producing with my first son at six weeks). Over the last week or so, though, my production has been–at best–exactly the same as he’s eating. Often times, I’ve had days with lower output than what he was eating.

Before I even noticed the production dip, I started the common recommendations:

  • Eat and drink enough. If you’re not getting enough calories and/or drinking enough fluids, your body won’t be able to produce enough milk. Most folks recommend eating at least 1800 calories per day and consuming at least half your body weight in ounces of water per day. Admittedly, I’ve struggled with both. With a two-year-old, a newborn, and a pumping schedule, it’s hard to get in enough food. And, I hate water. I do not like it one bit. I try to drink lots of other fluids to compensate.
  • Take Fenugreek. Fenugreek is an herbal supplement that is supposed to boost your production. Most people say you should take 2-4 capsules three times a day. I’m up to three capsules three times a day, and I’ve yet to notice a change.
  • Make lactation cookies! Remember that incredibly awesome husband I told you about? Well he loves to bake, and he baked these awesome cookies we found on Pinterest. Let me just say they’re delicious, and I was happily scarfing down 3 or 4 or more a day! Did they make a difference? Again, I didn’t notice one.
  • Last resort: prescriptions. When nothing seemed to be helping, I asked my doctor for a prescription for Reglan. My understanding is that Reglan is actually prescribed for acid reflux but has a side effect of boosting the hormone in your body responsible for milk production. I’ve been taking it about a week and haven’t noticed a difference. **Also: one of the side effects is depression, and let me tell you–that kicked in over the last couple days! Like a new mom isn’t already riding an emotional roller coaster! Last night, I started to have panic attacks (I suffer from anxiety, so I know what these are like) seemingly out of the blue. I’ve decided to discontinue taking it.

So now here I am…producing less than the little man is eating, struggling with postpartum depression and anxiety, and feeling overwhelmed. Thank God for my awesome neighbor!

Yesterday, in the midst of a near-breakdown, I called her and asked for help. She quickly came over and helped take care of our little guy so I could pump in peace. Bonus, she also has some excess breast milk in her freezer and brought some over for us (she also gave us some a few weeks ago).

Moral of the story: don’t be afraid to ask for help! As a general rule, I’m terrible at it. But, I knew I’d reached a point where I needed another person to help me.

Fed is Best

When our first son was born (he’s now 2.5), he went into the NICU right away. I had a bit of a fever during delivery, so they took him as a precaution. The downfall was they did formula and pacifiers right away. As an adopted kid, I had no problems with formula since I was raised on it, but I wanted to try breastfeeding. We weren’t able to get much skin-to-skin time, and he was so far away in the NICU!

Needless to say, when I did try to breastfeed, we didn’t have much luck. By that point, he was used to a free-flowing bottle, and I of course didn’t offer that. He had a hard time latching well, and I’m a huge wimp, so it was super painful. I know–it gets better, right? But I’m such a wimp that I simply couldn’t take it. I had decided to pump exclusively instead. That way, he would still get breast milk, but I didn’t have to be in pain.

We ended up having to mix formula and breast milk for the first few days, but when my supply came in after several days, it went well. Everything was great until POOF–week 6 came, and I just stopped producing. Looking back, I did nothing right. I wasn’t pumping often enough, I didn’t drink enough fluids, and I didn’t try any of the helpful supplements. From then on, we mixed what little I had stashed away in the freezer with formula, and it wasn’t long before we switched completely to formula.

Again, let me say: I have NO problem with formula, but dang it’s expensive! When he got to 11 months old, I purchased my last tub of formula. I remember coming home and posting an excited update on Facebook: “We just won the lottery. I bought our last tub of formula!” All jokes aside, I was ready to save the money and start switching to cow’s milk.

Rewind to my followup with my OB at six weeks. By the time we went to that appointment, I’d stopped producing for several days. When she asked how pumping was going, I told her I was done. She told me I should’ve said something sooner; there was a prescription she could’ve given me. Who knew?! Obviously, I didn’t. Well shoot.

Looking back, I have absolutely no regrets. Our son is perfectly healthy, and formula is not the poison some people might lead you to believe. Do I think breast is best? No. I think fed is best. Breast milk is ideal, yes, but formula is great too. And if you’re getting through each day, taking care of yourself and your little one, and feeding that little creation you just cooked up inside you, you’re doing great!

Fed is Best