Saturday, October 30, 2010

Exclusive Pumping

When Lana was born, I knew I wanted to breastfeed. I know that breastmilk is the best for the little ones - and while I'm not a "fanatic" about breastfeeding like some people I've met, I did want to give it as much effort as possible. I managed to have a very successful breastfeeding relationship with Lana, feeding her exclusively until she was about 15 months. She self weaned when I was about 3 months pregnant with Maddy. 

I always hoped during my pregnancy with Maddy that I would be able to breastfeed her as well. I was really hoping that she wouldn't have the cleft palate that many diastrophic babies have so that I would be able to feed her directly - but with her cleft palate along with the breathing issues that she's had, it will be unlikely that she will ever be able to directly breastfeed.

I have been pumping for Maddy since the day she was born - I figured that with her health complications, she had even greater benefit from having breastmilk rather than formula. Another benefit that I've just come to realise later is that it helps her to recognise me. Babies have a strong sense of smell and I'm sure that Maddy can identify me from the smell of the milk. Often when I'm holding her, she will turn her head in a similar way that breastfed babies do when they are wanting to be fed. I know she can smell the milk.

The doctors now allow me to put Maddy to the breast, and sometimes she seems interested and she seems as though she enjoys it - although she cannot latch on or get any great quantity of milk, only what I manually express for her. It's more for the experience than for an actual feed. 

I've been wanting to write a post for a while about my "exclusive pumping" experience for a while in the hopes that it may help someone else who wants/needs to exclusively pump for their little one. There are many reasons why someone would exclusively pump. Sometimes the baby is sick or premature and cannot be breastfed directly. Other times, a baby may have a cleft lip/palate that makes it difficult for them to latch and they will need to be bottlefed with a special teat. Other times, completely healthy babies cannot or will not latch for reasons unknown which can make breastfeeding difficult or impossible. Sometimes a baby can be a "lazy feeder" who does not get enough milk from breastfeeding and needs to be bottle fed (at least in part) since they are not gaining enough weight. And last of all, some women these days choose to pump for personal reasons - maybe they like the flexibility of having someone else being able to feed the baby, maybe they are returning to work, or maybe they have other reasons for not wanting to breastfeed.

When Maddy was two days old, I called a La Leche League leader here in Hong Kong and it was the best thing that I could have done in order to set myself up for long-term exclusive pumping. The main recommendations that she had were:
  • Pump no less than eight times a day for the first six weeks (elsewhere I've heard twelve weeks)
  • Pump until the breast is empty, and then another 5 minutes or so afterward in order to stimulate more milk production
  • Don't go for more than 5 hours between pumping sessions, including at night
At first, it was really hard work. I was pumping at 4:30am, 8:30am, 11am, 2pm, 5pm, 8pm, 10:30pm and midnight. During the first couple of weeks, each pumping session only yielded very small amounts - but the total amount was increasing each day. 
One thing that I am now thankful for is that I followed this strict regime for the first few weeks and that I always produced more than what Maddy needed because now, my milk supply is well established and I am not worried about not having enough milk for her. The hard work in the beginning really has paid off. 

When Maddy was about 4 weeks old, my supply was great and so I again talked with the LLL leader about dropping a pumping session. She said that most probably, I could afford to drop a pumping session or even two, but to drop one at a time and wait a week to see what the effect on my supply was. I went down to 7 times a day and my supply was still increasing. Then down to 6 a day and my supply was still increasing. I stayed at 6 pumps a day from around the time that Maddy was a bit over a month old until about two weeks ago and then dropped down to five. My supply seems to be unaffected by dropping that extra pumping session. I am still pumping over double what Maddy eats in a day. I'm happy to know that I could probably even in a month or so go down to four pumps a day and still be able to meet her needs long-term.

These days, I pump around 6:30am (only for 10 minutes to get me through the night), then again at 9am, 2pm, 6pm and 11pm. I found that for a "night pump", waking at 6-6:30am helps me to get the maximum amount of sleep. At that time, I'm not as tired as I was at 4:30 so it's not as painful to get up, but it's not too late for me to fall back asleep afterwards. I've pumped at 7-7:30am before but prefer to pump earlier since at that time, it's harder to get back to sleep. My next goal is to be able to drop the 6:30am pump altogether so that I can sleep completely through the night.

One of the best things that I have done is to print myself out a little "pumping diary" in which I write the date, the time and the amount that I pump. I have written the volume of every pumping session since Maddy was two days old in there. And while it really helps me to know where I am at, I am cautious not to freak out when there are variations from day to day. I have pumped for long enough to know that if on Monday, I get a lower than average volume, then most likely on Tuesday I will make up for it. Or vice versa. Instead  of making a big deal about the daily amounts, I think about the average of the past few days or the past week. I don't want to stress out unnecessarily. 

With pumping, I have found it difficult to go out for long periods of time since I usually need to pump during that time. Knowing that I have more milk than I need, however, allows me to go out with my hand pump and "pump and dump" while I'm out (ie, pump, measure the volume but then pour it down the sink). It's a shame to pump and dump, but I'm thankful that I have the oversupply that means that I have that option!! And since Hong Kong has no milk-bank, I am constantly dumping 50% of what I'm pumping. But I'd rather do that than to worry about whether I'll be able to have enough milk when Maddy is six months old and eating more.

Two of the things that I consider to be NECESSITIES for someone who is exclusively pumping are:
  1. A good, double electric pump. I have the Medela Pump in Style advanced. It is one of the most popular models for exclusive pumping and I highly recommend it! I hate having to pump when I'm out because then I need to use my Medela Harmony hand pump instead and while I think it's a great hand pump, it gets tiring pumping by hand, and it takes twice as long since you have to pump one side at a time.
  2. A hands-free pumping bra. Some exclusive pumpers will just take an old bra and cut holes in the front but I bought the Simple Wishes pumping bra. While it's an ugly thing and I would never wear it except for when I was actually pumping, it does a fantastic job of holding the bottles in the correct position and freeing the hands so that I can use pumping time to read or play Bejeweled on my iPod ;) I also find that when I am out and need to pump without it, I end up getting sore because there is a lot more rubbing from the pump. This is especially true when pumping by hand, but it is also occurs when using a double electric without the pumping bra. 
Long term, I would like to continue to pump for Maddy for as long as I possibly can since I know that it is the best (and cheapest!) food that I can give her. Now that I am pumping less frequently, it will be a lot more manageable when she comes home and I have to care for her and for Lana as well.  I'm sure that I will drop to four pumping sessions a day before she comes home, purely to free up a bit more time (each time I've dropped a pumping session, it is SO liberating!!). I don't know exactly how long I will pump for her, but ideally I'd like to make it to a year so I don't have to supplement with formula.

There is quite a bit of support online for people who exclusively pump. The two best resources that I've found are the Exclusive Pumpers Yahoo group (note, this group is only for people who are exclusively pumping because they need to rather than because they chose to) and the iVillage Exclusively Pumping forum.


  1. Nicole, I fell into the category of needing to pump exclusively because my two boys were unable to latch properly. I maintained a pump schedule similar to yours, that I made up as I went along, but I wish I'd thought to contact the La Leche League, as it seems like its been a helpful experience. I froze my milk, because of overproduction. In the end, I was able to pump up til 8-9 months and had enough stock frozen that it carried them beyond a year old. Although, if you move to Australia, I'm not sure how you'd go about getting it transported while remaining frozen, but its just a thought.

  2. Well to be honest, I don't have a big freezer stash, simply because I don't have a big freezer! I currently have three days worth of milk in the freezer and that's all that fits. Also, she takes 120mL in each bottle, but generally I try not to put in less than 150mL just so that there will always be too much, and even if they increase her feedings or spill some, there will be plenty for her. What she doesn't drink is poured down the sink.

    If/when we move back to Australia, I'd probably just use my frozen milk and start a new stash from scratch. If I had the freezer room, I'd love to build up a store of months worth of milk so I could stop pumping and continue to feed her breastmilk (I could probably pump for just six months but feed her for a year with my supply!!), but given our limited space, it's not really an option, unfortunately!!

    When she comes home, I'd like to give her mostly fresh milk rather than frozen anyway because it's meant to be better for them... Unfortunately though the hospital only accepts frozen milk so even though it's not my preference, that's what I need to do!!