Exclusive Pumping - Lake in the Hills,IL

M.:

I have moms in my practice who exclusively pump/ there is a "new" book out by a mom who exclusively pumped and I belive that she has a web site as well. I will get this information for you later today if you want.

I would be happy to talk with you.

P., RLC, IBCLC
Pres. Lactation Support Group, Inc
www.lactationsupportgroup.com
P.

Congratulations on your new bundle of joy! What an exciting time in your life! As a mom of 2 and a postpartum nurse, I can tell you that pumping out 3 oz already at day 5 is AWESOME! Unfortunately, there's no set amount as to what your baby should be eating. The only sure way to tell if they are getting enough is to keep track of their diapers. Your baby should have 6-8 WET diapers a day (not including stool).

I'm sorry you had such a hard time breastfeeding. I can tell you that there's nothing wrong with using the nipple shield. I had flat nipples and used the shield for 2 weeks - WAY past the time the lactation consultant told me to use it. So if you really want to breastfeed, go ahead and continue using the nipple shield - if it's the only way you can get him to latch on, by all means, use it! Slowly but surely my nipples "cooperated" and I no longer needed the shields. I tell all my patients the same thing, it takes about 2 weeks to really get the breastfeeding thing down (for moms new to breastfeeding). So please don't be discouraged! And just because he's only on for 4-5 minutes, doesn't mean he's not getting enough. Maybe your milk comes in that quickly and all he needs is that small amount of time to get a good feeding. Both my kids were on the breast for about 4-5 minutes and then were satisfied. I could tell they were getting enough because of the amount of wet diapers and the increase in weight. Not only that, but when I pumped, I would get about 2-3 oz. on each side in 4-5 minutes. So I figured, hey, they should be getting about that when they're at breast, right? You can use the nipple shields to start off with and once he gets a good latch on and pulls your nipple out, you can remove the nipple shield and let him re-latch on your nipple. Like I said, don't be discouraged. . .

Pumping is work too. It takes committment to do it - just like breastfeeding. Pumping every 3 hours should be enough to feed your little one, especially since you're already getting 3 oz. out! But if you notice that your little one needs more, then go ahead and pump every 2 hours (even through the night) - just for about 24-48 hours to increase your milk supply.

As for the pacifier thing, I know a lot of people are really opposed to it. My daughter used it until she was 1 year and we let me 2 mo. old have it too. I had no trouble taking it away from my daughter. My opinion is this, it's easier to take away the pacifier than it is to take fingers away (for those thumb suckers). Besides, if giving him the pacifier quiets him down, then I'm ok with it and both my kids did fine - no nipple confusion. But it's entirely up to you as to pacifier or no pacifier. It just helped us on some very sleepless nights.

Ok, I'm sorry I wrote a book, but I hope this helps you! If you have any more questions, feel free to e-mail me!

M.,

I had a very similar experience to yours. My daughter was almost 3 weeks early and I have/had inverted nipples. I was given a niple shield after the first day since she wasn't latching on and eating at all. The second day she still wasn't all that interested with the shield. I think that when I left the hospital she had eaten twice for a total of five minutes. The lactation consultants were not overly helpful and one was simply mean spirited and made me feel like a terrible person.

After I got home my daughter started nursing better although still for only 5 minutes at a time on only one breast at a time. I started looking to books and online for information on what I might be doing wrong. That is wehn I read over and over again that I shouldn't use the shield and that it would affect my milk production. After a week of feeling like a terrible mother and worrying about getting my daughter off of the nipple shield, I finally got a hold of a wonderfully nice lactation consultant on the phone and she told me not to worry that that information is from when the shields were made of rubber years ago. Now that they are made of thin silicone they do not have any affect on your supply and that many women use them. I had been using the shield exclusively when we took my daughter in for her appointment at day 10 and she had not only gotten back to her birth weight but had gained another 10 ounces!

I used the shields for about 3 weeks and each day I would try a few times to get her to latch on without it. By the 4th week we were off the shield for good. She turns 11 weeks this Thursday and I am back at work so pumping and bottles during the day, but still nursing at night. I have to say, I enjoy the nursing much more than the pumping. And I know that when she nurses she is getting as much as she wants as often as she wants. I would say go back to nursing with the shield without any worries. But know that know matter what you are doing the best for your son.

D.

HI M.,

Congratulations first off!!! I have 2 boys myself. AND the two things that I can tell you about breast feeding having been in the EXACT SAME situation as you, except my son had to stay for 9 days in NICU is.... if the breast shield works to help aid and he won't take it any other way, then go for it. SECONDLY since you want to start pumping, here's the trick (from my experience)... Pump every 2 hours as much as you can. Then after 2 weeks, pump every 3-4 hours as much as you can. It's going to be tiring, it's going to be sore, and at times you are probably going to find yourself crying as your pumping because you are just tired of it, but keep it up and in 5 weeks, you'll have enough milk to breastfeed him directly. For example, when I first started the pump, I barely got an ounce. I was upset, but that's the last thing you can do, because stress doesn't give you as much milk. I drank LOTS of water and at the end of the 4 or 5 weeks, I was pumping 16 oz. total EACH session from both breasts. Then tried to feed my son and it worked. Everybody has their ways of making it work, so you will find yours. Don't worry!! It happens to the best of us..

Hello,

Sounds like you're doing great. Just wanted to add that the reason the LC was concerned about the shields is that they can affect your supply. They often prevent the baby from emptying the breast as efficiently. A good way to use them is to use them for the beginning of a feed and then take them off. Your nipples will most likely get "trained" as time goes on and you won't need them anymore.

Please find your local La Leche League (www.laleche.org). These ladies can help you! Babies from about 32 weeks have the sucking reflex, so they should be able to help you get him to breast and save you all that pumping and bottle washing time. Good luck, sounds like you a baby are doing just fine!

By the way, his tummy is now about the size of a marble, so you can feel safe that he is getting full if you are able to pump 3 oz. That's wonderful!

Congratulations on the new baby! Hang in there...I think 3 oz is good. I didn't start pumping until my son was a month old and that's about how much I got at that time. In the hospital however, I was told to pump every 2 hours to get my supply up. Maybe start with that, and then just pump after you feed your son. When you are breastfeeding your body knows how much to produce, so if you pump after you feed him, it will be similar to nursing him. This could get very exhausting though...so don't put too much pressure on yourself. Hang in there and good luck!

don't worry - we all start off like this. Even those of us who were not worried. It can be nerve wrecking at times for everyone. Hang in there - you're doing GREAT! I personally would try to just nurse him even if its just a little cause he'll eventually get a lot more than the pumping will get him. Try and see if it works. Best of luck!

First of all congratulations! Let me start off by telling you that I was in the same situation regarding the flat nipples. I too did not know it until I was trying to breast feed my 1st child. Don't worry about the amount that you are getting. I would pump every four hours and I would get about the same amount or less. I was also worried that that amount was not enough but it was. As he got older I was able to get more milk. At times I would have to pump every few hours in order to get more milk for him, but like I said before he had enough milk. The lactation consultants told me that in order to produce more milk I should pump more, that way the body would get cues to produce more milk. My son is now 20 months old and doing fine. Good luck.

I'm astounded! You're getting 3 oz each pumping session and you gave birth 5 days ago! I'm so jealous!!!! I think 5 days into it, I was maybe getting an ounce or less, but I did have to supplement!

I don't have much advice since my baby was a 4 lb 14 oz premie with a different appetite than a full term baby. But I was a 'pumping mother' & just had to say 'kudos' to you for getting that much milk so early. You should pump at least every 3 hours or less. (probably every 2 1/2 if you can in these early stages). I know that I read somewhere (probably in my book called "What to expect the first year") that there is a rule of thumb for how many oz per day a baby should consume based the the baby's weight. I think it was between 1.5 - 2 oz per pound of baby per day. I just can't remember right now. I'll write back if I remember. Good luck. You're doing great!

Chiming in a bit late.....

I too had inverted nipples. The LC at the hospital where I delivered gave me these things called "breast shells", which draw out the nipple. Medela makes them. You wear them any time you are NOT nursing. Anyway, after wearing these things for a week or so, I no longer had inverted nips, and I was able to stop wearing the shells! The breast shells are fairly cheap, so please consider them.

I successfully nursed my son for 3+ years. And, since I am a single mom, that also works full time, I pumped for him while I was at work. I hated pumping.....I always said that I "nursed a breast pump". Try to get your son nursing like a champ so that you can minimize your time at the pump. Nursing a baby is soooooooooooooooooooo nice. Nursing a breast pump?......not so much.

Regarding pacifiers. I was fairly clueless at the beginning, and I didn't know NOT to allow a paci. Well....maybe I just got lucky, but my son never had 1 nanosecond of nipple confusion. He used a paci for years, and he also was a very good nurser. Yeah, it was pretty rough in the beginning (he fell asleep at the breast, he'd get frustrated if he couldn't get a good latch, etc.), but I hung in there. It was so worth it.

A lady from LLL told me something that helped me thru some really hard nursing times. She said, "If you want to successfully nurse your baby, you will." And she was right.

Congratulations on the birth of your son!!!

D.

Congrats! And getting 3 oz at a time is fantastic! I was able to, with my first baby, get about 1-2 oz each pumping session until he was about 2-3 months old, and then the supply was great. Like the other mom said--supply and demand! Your baby won't be eating much each feeding for the first few weeks because his tummy is so small!

What my Dr told me, because I was concerned he wasn't getting enough, was that the only thing that would tell me was his demeanor, his weight gain, and his diapers. It sounds like the diapers are normal in your case, so just congratulate yourself on a job well done!

After he goes through a growth spurt and wants to eat about every 1/2 hour or so (or so it seems at the time)for about 24-48 hours, your supply will definitely go up! I got a lot of help from the delivery nurses at my hospital. Good luck!

Hi M.- Sorry to hear you had some issues with your delivery. I had pretty much the exact situation. If at all possible I would encourage you to keep trying to put your son to the breast. Pumping is a pain, and can be quite painful I found. I found that by just pumping I could not keep up with my daughters needs and ended up having to use formula. Also, you are pumping, feeding, pumping, feeding and it is exhausting. If you need to revisit your situation with another lactation consultant. I regret not breatstfeeding to this day.
Good Luck!

M. - you have such great information in the other posts from the other moms.

Some mentioned how important it is to pump every 2 to 3 hours initially to bring your milk in at first, and that really does include nighttimes. My son was born 6 1/2 weeks early and in the NICU for 3 weeks. I worked long and hard with the LC, even after he came home, to establish my milk supply and also to get him to breastfeed since premature baby boys sometimes just don't take to it as well as premature baby girls. I pump more than breast feed him now at 6 1/2 months because he became very interested in his surroundings around 4 months and we were really worried about him continuing to gain weight. He would take more from the bottle because he could look around the room then when he was eating. Since I knew I would be pumping when I went back to work, I just started to give him bottles of breastmilk at times and breastfeed at times when he would do a good nursing session. Some people I know hated pumping, because they would rather be having the personally connection during the feeding. I love the personal connection, but making sure my son got enough milk during the day to meet his nutritional needs and gain weight (while taking breastmilk and not formula) helped me deal with the disappointment that he was not getting it from me solely from breastfeeding.

My advice is to be very diligent about your pump schedule in the beginning. It is so important to establish a good supply early on, and then you should not have a supply problem. It sounds like you are off to a great start. My milk came in more slowly at first, but my the time he was eating from a bottle, I was producing 2 to 3 times the amount that he needed in a day. So as long as you are producing more or the same as what he is eating, don't worry. Don't skip pumping at night, your body is not ready for that yet. In the night time my LC said I could only go as long as every 4 hours from the beginning of my pumping and to only go that long for 2 pumps that night. So I pumped at 11pm, 3am and 7am. The rest of the day I pumped every 2 to 3 hours religiously. I pumped for 25 to 30 minutes to establish my supply and kept doing that until I started to have an oversupply problem when he was about 2 months old. At that point he could not handle my strong letdown so was getting frustrated when breastfeeding. Then I started regulating my milk to fit how much he would eat in a day. So if he at 3 ounces from a bottle, I would pump 3 ounces out after he ate. Another thing I did that cost us I think $20 a week was when I was establishing my supply I rented a hospital grade pump for the first month to make sure I completly established my supply while he in the hospital and only breastfeeding 1 time a day if we were lucky (he was bottle or tube fed the rest of the feedings). I started using my Medela Pump in Style 3 weeks into my pumping and kept the hospital grade pump one more week to make sure my supply did not go down when I switched pumps.

Stress does affect your supply, as does lack of sleep and not eating and drinking enough. It is hard to take care of yourself when you have to wake up to pump every 4 hours or breastfeed (if you are lucky enough for him to breastfeed from you at night). If you are worried about his getting enough, count the wet diapers (6 to 8 a day) and you can even do weight checks. We did weekly weight checks since our little one could not afford to loose any weight. If you feel you need to pump and give him the bottle with breastmilk because he eats more, do it. That is what we do and it has worked out great. Also that way I can see exactly how much he gets a day from the bottle and I do strict timing of when he is actually drinking during breastfeeding (not just taking a minute rest or cat-nap on the breast) and they helps monitor how much they are eating.

Don't freak about the pacifier. Our son had it and a bottle for his 3 week NICU visit before he came home and just decided one day when he was 2 1/2 months old that he did not want a pacifier. He refuses them to this day. But it did not hurt us at all with breastfeeding, and neither did him eating from a bottle. We did switch him to wide nipples for bottles the day he came home from the hospital though, since that is closer to your nipple. He goes back and forth happily now between bottle and breast and the great thing about that is, my husband can do some feedings at night while I get a bit more sleep! I would not advise skipping pumping or breastfeeding him (and letting your husband feed at night) until you have had your milk supply up and running for a good 3 to 4 months. I tried it too early and had to reestablish my supply. Babies don't usually sleep through the night until say 4 months if you are lucky (we were not) and 6 months more likely (but we still are not at 6 1/2 months) so your body doesn't know to keep up your supply if you skip pumps at night while he gets a bottle before then (that is at least in my experience, but a LC consultant may say that is even too early to start dropping out pumps at night). I have gallons of breastmilk stored in freezer now because I established such a good supply early on, so just be diligent and you should be fine.

Stick with it, you have a great start at 6 days out now! If you need any resources on where to get pumps or the name of a good LC, you can email me and I'll give you the resources I have.

Best of luck!
S.

Congratulations on the birth of your beautiful baby boy! I am also the mom of a beautiful boy and when he was born, he really didn't have any problems, except for the fact that my left nipple was flat. I wish that I had tried everything I could to get him to nurse from that side. As it was, he nursed almost exclusively from the right side. He is perfectly healthy and I never had any problem producing enough for him from just the one side. (supply and demand!) Anyway, when it came to the days when I needed to be away from him, I tried pumping, and I bought one of the really expensive ones, too. However, I could only get about 1 oz - sometimes 2 if I was lucky. I think there is somewhat of a hormonal response to nursing that provides much more milk, than if you were to just pump. I have heard that many moms nursed on one side and then pumped on the other so it would stimulate the let down better. I know that my sister had to play around with the controls to adjust speed and strength to get the optimal amount of milk pumped.

If you desire to have him nurse directly, know that he will get better at nursing as time goes on. He will develop neck and head strength that will help with the whole process. You should try different holds too. I found that my son, when he was just born, nursed best in the football hold. later he was able to do the cradle hold and also be able to nurse while we both were laying down (conducive for mom being able to rest/sleep while he nurses). So, that said, keep trying (if that's what you want).

Whatever you do, the best people to contact, that I have found, are the La Leche League leaders ( http://www.lalecheleague.org ). They are very supportive and will help you with any concerns you may have. If you don't find one at first that you "click" with, there are many others that you may contact. I have found the lactation consultants through the hospitals, although knowledgeable, are too quick to suggest supplementing with formula. Doctors (ob/gyn) are also very quick to suggest supplementing with formula. I understand the desire to nurse your child, and you are fully capable of doing so. Don't give up too quickly! Good luck!

I'm sooo sorry that the hospital didn't respect your wishes about a pacifier. I would have been screaming at them!

Anyways, if your son was "early" he might not have the sucking reflex quite right. Although it is quite normal for newborns to fall asleep quite often..making mom think that they aren't hungry. You pretty much have to try every method possible to keep them awake...tickling, using wet wash clothes, undressing them, changing their diaper. That will help them nurse longer.

As far as the nursing shield goes, use it until your kiddo is a strong nurser, then start to wean off of it. That's what I would do. I think the LC is dumb for saying that stuff. Do what you have to do to get your kiddo to keep nursing.

As far as pumping, unfortunately there could be a few issues with the pump that can help or hurt your supply....like your body may have already recognized that its not a baby getting the milk out...(also keep in mind that your son will be able to get milk out of your breast way more efficiently than the pump)...Also, remember that your milk has probably just coming in and trying to establish your supply. I think you should attempt another time with the nursing shields...I think that you are doing everything right, and that the lc is just misinformed. I believe when my twins were that age, they would nurse 5 minutes every 2 hours...then they after about a month, they would nurse every 10 minutes, then it got up to 15, then 20 then it stayed at 20 minutes for many months.
Now, at 15 months, they nurse for about 5 minutes, once during the day, and then at night before bed it is about 15/20 minutes.

M.,
You're doing great! One other resource that you might find helpful is the yahoo group "pumpmoms" http://health.groups.yahoo.com/group/PumpMoms/
Close to half the moms on this group are Exclusive Pumpers and they can give you amazing support.

They also have a number of surveys on the site and you'll be able to see most of the answers to your questions there as far as pumping frequency/amounts/etc. Good luck and congrats on your boy!

Congratulations!
You are doing splendidly for the first few days. I have 8 month old twins and I ended up pumping exclusively for 7 months. My babies were in the NICU for 2 weeks and my son just would not latch on. My daughter did but I couldn't feed a baby and pump at the same time.
If you do end up pumping exclusively - do not worry about supply. I had enough for my two. They had a bottle of formula each day but that was primarily to make sure that we could switch easily when the time came.
Pump every 3 hours or less. This is very important in the early stages to keep up supply. Don't give up if some sessions produce less. I would always produce a lot in the morning, but less in the night. Try to get as much sleep as you can, eat well, stay hydrated and relax. I was in tears the first couple of weeks because I worried that I would never produce enough for them. The best tip came from a pediatric resident - who was our neighbor - he said not to worry if I had to formula feed - that's what his mom and others did back in the '70s.
My son would scream at the nipple guard so I tried it only for a day. However, I do have a friend who used it for 3 months. Don't let the lactation consultant get to you - each baby and mom are unique and will find their own rhythms.
My hospital - Prentice - has a free lactation hotline and the consultants were very helpful. If you need help, try and find a different lactation consultant - mine were all very sympathetic and helpful.
Hang in there. The first few days are traumatic if the babies have to be in special care nurseries. You'll be surprised at how fast time flies and just how well you will manage.

First thing M. is to set yourself at ease. Mostly all mothers go through the same thing. When I had my baby boy a year ago I was literally on tears everyday. After we came home from the hospital- he wouldn't feed, and after I started pumping things got a little better (still I could only pump 2 oz maximum from both breasts initially). He was feeding for maybe 5 minutes at a time and just a little. He preferred the left breast only(became an issue to get him to drink from the other breast)(. I talked to my sis-in-law and she said she had no problem pumping 8oz. at a time (that got my crying as well). I thought my baby would die without any milk as I was hoping to only breast feed him, and I was against the pacifier. My mom would also give advice like- "you kids were never like this- I had no problems with you..!"

Things nevertheless got better.In the second month he stops accepting even an occassional bottle. I breastfed him till he was 11 months old, then we took a trip abroad, and when we came back, I started the cow's milk in a sippy cup.

I really don't know how I got through the first few months. The main thing is to "hang in there", and know that each stage is different from the one before. Also about accpeting advice- listen and read what you can, but you have to do what you think is right irrespective.

Also-about the nipple shield. When my mom gave birth to my older brother-her nipple was inverted, so the shield was the only way she could feed him, for a year.

Good luck!!

COngrats on your new baby boy. I am due any day now and am hoping to breast feed my little like I did the first one who is now almost 2 1/2. As for the volume of milk to be pumping I can not help you with that because I do not remember. But I am responding because my little girl was a month early and in the NICU for a few days where they would only give her my pumped milk and formula. So buy the time I was able to try and breastfeed her it was time for use to go home and my nipples were inverted so they gave me nipploe shields also with the warning they were just an aid also. Well the good news is I used them until she got to the point where she pulled them off herself and then would go back to nursing normal. I had no problems with supply and demand and nursed her until 10-11 months. And she was also in daycare and I pumped while working 8-10 hours a day.
Hope this helps because I was also afraid when they told me they were just an aid. I plan on using them with my new little one if I need them. One other thing is I really had no pain or discomfort that comes with breastfeeding due to her not being directly on the nipple and making them cracked and dry.

K.

M., I had the same "flat nipple problem". I too, pumped with my baby girl for the first 6 months(Then got prego with baby boy) The more you pump the more milk you will have. When you feel the burning feeling on your nips----pump!!! She took about 2-3 ounces every 2-3 hours but usually only 2 ounces. I would feed, burp, pump, store and then start all over. She was getting plenty as long as she was having dirty diapers and gaining weight. Try adding some more milk to the bottle and when he stops you'll know about how much he wants and how the different times a day may change his intake. Don't give up. I gave up with my son and only nursed/pumped for 6 weeks. It is so time consuming but stick to it for as long as you can.