Pumping Log

Everyday is a new day with its own stresses and joys. The more we can take time to enjoy each day, the less we are prone to worry and stress, the better it is for our overall health as well as our milk supply. The past few days I have been working in the neonatal intensive care unit at my hospital. It is my favorite place to work. I love coming alongside mommies and their new babies and helping them feed them in their most critical time. My job on the acute floors can sometimes be stressful. I am helping elderly patients and families make end-of-life decisions. I assess patients feeding skills and decide if the patients can still eat and the options they have for nutrition and hydration. This definitely impacts my milk supply. I always see more of my own milk when working in NICU. Of course when some of those hungry babies cry I can occasionally feel my mommy hormones stimulating my own letdown. Where is your happy place? Have you noticed certain aspects of your environment or work impacting your milk supply? Where do you find your peace when pumping? This really does make a big difference. Happy Pumping!!

I use whatever containers I have clean!! My pumping always decreases as the day goes on.

Pumping Log: pay no attention to the pump behind the curtain

In a previous blog I talked about my work pumping room. It has two chair separated by two curtains. I would say about 50% of the time I pump alone. It is a great time to FaceTime with my husband and see the baby to help my milk supply or a nice quiet rest to be able to write a blog. The other 50% of the time when I walk in there is the distinctive whirring of another breast pump.

Every pump and every brand has a very distinctive sound. Nine times out of 10 I know exactly who is behind that curtain based on the sound of their pump. Yesterday was no exception. Usually through the course of time and conversation, I get to know the other moms behind the curtain. I’ve pumped with nurses from every floor and unit, chaplains, administrative assistants, and students. We talk about everything related to our babies: their ages, their developmental milestones, and how much they’re sleeping at night. The biggest topic of discussion, though, always is milk supply.

Typically there is only ever one other mom in the pump room. However yesterday at least 4 other mothers tried to come in and pump at the same time. It was like the 405 at 8am! The entering mom’s knew it was me pumping from the quiet drone of my spectra pump. In trying to be effective, twice I left the in coming mother behind the curtain with me so I could clean up while she could set up. Both times we talked milk supply.

There’s such a weird pressure to “perform” in our culture. Even with pumping milk. We are told by “them” how much to feed our babies and if you don’t reach certain milk goals during certain months of development your baby is going to starve and fall off the growth curve. That it the whole point of this blog.

I want to normalize breastfeeding. I want to normalize milk supply and help reduce even a fraction of stress pumping mothers feel. Your baby is unique. Your story is unique. The amount and fat content of your milk is unique and specifically tailored to the individual needs of your baby. Remember breastmilk can vary from 13-35 calories per ounce! One mom I talked to yesterday could pump TWENTY OUNCES in one sitting first thing in the morning. I don’t think I’ve ever pumped more than 18 in a day across four pump sessions!! And yet my daughter is growing and healthy and following her 75 percentile growth curve.

We need to stop letting “them” tell us how much and how often our baby needs milk and listen to our individual babies. Let’s support each other and encourage each other in our unique breastfeeding stories. I hope if you get nothing else out of these blog posts it’s encouragement to keep going, stop worrying, and own your personal breastfeeding story. Happy Pumping!!

My entire day of pumping. Three 20 minute sessions during an 8 hour shift. A little over 9 ounces.

Product review

It finally came!! My Mrs. Patel’s mothers milk tea!!! I’ve used the grocery store brand but it didn’t really seem to have a big impact on my supply. In researching teas, I came across this brand. They’re Milk Water tea comes in two tasty flavors : herbal and Chai. The Chai has an amazing sweet taste and when I drink a cup consistently at night I do see an increase in milk the next morning. I just got the herbal blend and am so excited to try it!!! Check out the website here. Take note, the shipping is expensive, so if you have a friend or two who are also nursing it will help distribute the shipping costs.

 

Pumping Log: right vs left

Unfortunately breasts do not come with markers on them. When you are an exclusively breast-feeding mom you never really know how much your baby is getting. We teach in lactation to watch for the signs that tell you your baby is getting enough milk. You look at swallowing patterns, wet diapers, and the overall health and weight gain of your baby. When you are pumping mom though, we are meticulous in knowing how much milk comes out of our tatas. Have you ever actually stopped and looked at that milk? I’m sure you have. I’m sure you analyze every drop that comes out of your body. Did you know that the left and right breast can make different amounts of milk? One research study found that stereotypically moms always make more milk out of the right breast. Which is interesting in light of the fact that most women have a slightly larger left breast. (Click on text to read the research articles) It really goes to show that size does not matter for production. Size is related to fat in the breast tissue and not the actual glandular tissue that produces milk. I love breastfeeding. And I try really hard to rotate which side I start on when I’m breast-feeding my daughter. When I am at work or use a double pump to pump both of the girls at the same time. It has been always consistent for me. My right always make slightly more than my left. Usually not very much more, but enough to be noticeable. And science still doesn’t really know why!! Oh, our fascinating bodies!!! Happy Pumping!!!

Growth charts

Did you know that breast-fed babies and formula fed babies have different growth charts? Breast-fed babies tend to be leaner and gain weight at a slower rate than artificially fed babies. Make sure your pediatrician uses the correct growth chart when weighing and measuring your little one. Many a well meaning pediatrician has inadvertently recommended supplementation to exclusively breast-fed babies bexcuse they’re using the CDC growth chart which was standardized on formula fed babies. In 2006, the World Health Organization released revised growth charts that are representative of healthy breastfed babies throughout the world. Until our doctors are familiar with them, we need to keep ourselves informed so that doctors don’t undermine our confidence to breastfeed our babies.

Healthy breastfed infants tend to grow more rapidly than their formula-fed peers in the first 2-3 months of life and less rapidly from 3 to 12 months. All growth charts available before 2006 (which are still used by many health care providers in the US) included data from infants who were not exclusively breastfed for the first 6 months (includes infants fed artificial baby milk, AKA formula, and those starting solids before the recommended 6 months. The American Academy of Pediatrics revised their  guidelines on introducing solids for parents to wait until 6 months. A lot of. pediatricians will push to start solids at 4 months because they’re not current on the latest guidelines). Since many doctors are not aware of this difference in growth, they see the baby dropping in percentiles on the growth chart and often jump to the wrong conclusion that the baby is not growing adequately. At this point they often unnecessarily recommend that the mother supplement with formula or solids, and sometimes recommend that they stop breastfeeding altogether. This is often a cause of unneeded stress. Next time you’re at your peds office, ask which chart they’re using. For more information on growth charts, see kellymom.com

Pumping Log: back to normal.

Us pumping mamas tend to freak out about how much we pump. Can I get an amen?!? When our supply drops we freak the freaky freak out.  But what if we weren’t pumping. Would we actually notice any of these drops, or what our babies just happily do what they do and not even give us education that something has changed? Would we even have periods because we would be exclusively nursing And supply changeseould be a non issue? Yesterday I took my deep breaths and talked myself off the “I have no milk” ledge. Today my period is officially over. And low and behold my milk supply is back up. Remember, hormones do funny things to our bodies. Do what you can but don’t freak out over every little change. Stay the course. Love yourself. Love your body.

Pumping Log: One of those days

Is been one of those days. Let me tell you about it. I found a cockroach on my breast pumping bag this morning (I had it next to our 1920’s era fireplace where I was pumping last night). I lost my employee badge and can’t find it anywhere. I forgot my lunch on the counter. When I got to work I realized all my pump parts were sitting in the bottle drying rack at home. My stress was so high I pumped less than 3 ounces my first session (I was thankfully able to use the lactation room in the NICU) which only made me stress more. Then I remembered my own advice. Don’t partner with worry or stress. I have to actively choose joy and peace. I made myself a cup of mothers milk tea and a cup of oatmeal (at least those are always in my pumping bag) and took a deep breath. I made sure to eat a good lunch (I had a certificate for a free lunch in the hospital cafeteria) and treated myself to an ice cream for dessert. I’m already up to 3 ounces at my second pumping. Peace comes from within and not from external circumstances. Joy is a choice that needs to be embraced. Breathe in, breathe out. You’ve got this, mama.

Sometimes being a woman sucks

More specifically, having a period because you’re a woman sucks. Not only are there mood swings and cramps to deal with, there’s also my monthly dip in milk production. Time to make some lactation cookies with extra chocolate chips and a cup of Mrs. Patel’s Milk Water Chai Tea. At least my daughter hasn’t seemed to notice. I was with her the past four days on a mini vacation and she’s been more interested in eating off my plate than my chest. Today I went back to work and knew it would be a lower volume day. Although I always note thamy the milk I pump during my period is a little creamier and more fat sticks to the sides of the bottle. I hope showing these pictures encourages you that is OK to have high and low volume days and not get discouraged. Love your body. Love the process. Worry and stress don’t help anything. Keep eating healthy, drinking plenty of water, taking your prenatal vitamins and taking supplements as needed. Happy pumping!

 

Pumping Log: the pump room

I’m sure every workplace has their own unique style of pumping room. It is a place of sanctuary and safety for many nursing moms during the day. At the hospital where I work, we have an employee lactation room on the first floor. Inside are two somewhat comfortable chairs, each with its own table, two curtains to separate them, and a sink. We are actually very blessed to be in a baby friendly hospital  where they at least attempt to take care of their breast-feeding moms. I have read about pumping room horror stories, though, of “pump rooms” that are nothing more then broom closets or electrical rooms with folding chairs. The law states that all employers must provide a non-bathroom room for breast-feeding employees. But their definition of “non-bathroom” is occasionally taken liberally. The room in which you pump can definitely impact your milk output. If the room you are in makes you stressed, you will see a decrease in milk production. If you are in a calm environment and don’t feel rushed, your milk will have a higher chance of letting down. Do you whatever you need to do to make your pump room as comfortable as possible. Make sure to surround yourself with plenty of pictures of your baby and since it is your break, if you can FaceTime or Skype your baby.

My hospital’s employee lactation room

I do have a funny story about my work pump room. The tables are older and one of them had a broken table leg. The table looked like it was going to collapse at any second. I put in a complaint through the proper chains. I came in the next day and the table was gone. But the two chairs were facing each other with the table in the middle as if anyone pumping at the same time would have a pump off! I don’t Think the maintenance department quite understood the purpose of the room 🙂 with a quick phone call to HR we were able to get a second table and move the chairs back to the proper positions. What are your funny pump room stories? Feel free to share your pump room pictures.

Let’s have a pump off.

Happy pumping!

Make it a double

They say you can’t over feed a breast fed baby. They’re usually pretty good about taking what they need and stopping when they’re full. This is because of stomach and breast anatomy. Remember how sucking and milk flow rate at the breast are different than the bottle? This directly links to stomach anatomy.

There are two kinds of receptors in the stomach: density and stretch. Density receptors tell you how calorically dense or fat-rich your food is. It’s why at the Cheesecake Factory your belly starts to feel really full after about ten bites of Godiva chocolate Cheesecake but you can eat 3 bags of popcorn at the theater. Chocolate is much richer and calorically denser than popcorn. Stretch receptors tell you how full your stomach is from a volume perspective. Your stomach at rest is on average the size of your fist. That’s true throughout your entire life. But the stomach can stretch. Just like my stretchy pants at Thanksgiving. It can still only fill to a certain capacity. The only problem is, it takes approximately 20 minutes for your stretch receptors to tell your brain that the stomach had stretched to capacity. This is what I call the twenty minute phenomenon. You know, when a group of college boys order a pizza, they each eat a whole pizza in ten minutes and then twenty minutes later feel over full and sick. They as much as they could as fast as they could but paid for it in the twenty minute window. Exclusively breast fed babies don’t typically over eat because again, breast milk flow varies over a feeding. It starts slow, mommy goes into let down, then milk shows, mommy changes the baby to the other side, milk starts slow, mommy goes into let down, 15-20 minutes later the baby’s stomach tells the brain it’s full and the baby stops eating. Anatomy and physiology in perfect harmony.

Unfortunately bottle fed can be over fed. Bottles have these lovely ounce markers on them that tell us how much the baby needs to eat to be full. At every feeding my baby NEEDS to get a full 5 ounces of she will be hungry. She NEEDS to eat 24 ounces in a day or she will starve to death. And when baby stops eating at 3.5 ounces, I just jiggle the bottle or wait a few minutes and jiggle the bottle until baby takes that full feeding. Jiggle, wiggle, look at that she took the full feeding. Instead of listen to baby’s cuts that she’s full, we let the bottle dictate how much baby needs. And we wonder why formula feed babies have a significantly higher rate of obesity. Here’s the thing. Bottles are not the enemy. My daughter takes breast milk from a bottle five days a week while I’m at work. They are lovely devices that do an essential job. But we need to be mindful to not over feed our bottle fed babies.

Tips to not over feed a bottle fed baby (regardless of what’s in the bottle)

1. Always use a show flow nipple until 1 year of age. Slow flow most closely mimicks the flow at the breast. It also shows a baby down so the brain can keep up with the stomach (aka be mindful of those stretch receptors).

2. Watch your baby’s cues. Does he push the bottle away? Did he become sleepy? Do his hands and body relax? Does he release his iron grip on the nipple? These are signs he’s done. Over fed babies tend to spit up or vomit more because their tummies are at capacity. Don’t try to force in that last half an ounce. Respect your baby and stop feeding. Your baby will let you know if he’s still hungry.

3. In reality, babies only ever need 3-5 ounces of milk per feeding. In the first four to six months when your baby isn’t eating any solids, here’s a simple rule of thumb: Offer 2.5 ounces of formula per pound of body weight each day. For example, if your baby weighs 6 pounds, you’ll give her about 15 ounces of formula in a 24-hour period. Once a baby is six months of age and starting solid foods, offer the breast or bottle first (3-5 ounces), then offer well balanced, nutritious, solids. The solids will provide them the additional nutrition they need. (**Disclaimer : if your baby is not ready for solids at six months, that’s FINE. Your baby is ready to start solids when they can sit unsupported for a good amount of time, uses a pintcher grasp, and has the hand eye coordination of hand to mouth. If your baby is over six months and not taking solids, your baby may need additional milk per feeding.)

4. It is OK for volumes of feedings to be didn’t throughout the day. We take for granted that babies can know their bodies. They can tell us when they’re hungry and when they’re full. Sometimes I’m really hungry in the morning and I eat a Grand Slam breakfast. Other times I only want a piece of toast. It’s OK to have your baby eat a ton one meal and very little the next. Remember, there are no ounce markers on the breast. Exclusively breast fed babies do this all the time. And there’s no amount of nipple jigging that will get them to take more in a feeding.

Here’s the big take away: it’s OK to take the pressure off feeding, especially if your a working mom trying to keep up with pumping. As long as your baby is following their growth curve, making enough wet and dirty diapers, and happy, keep doing what you’re doing. If your baby is not getting enough nutrition, not gaining weight, or unhappy, please have your pediatrician write a referral to a pediatric clinic ASAP or give me a call and we can dialogue through a plan of action.

Happy feeding!!