Breastpumping (Not-So-)Basics

One of the things I’ve really become passionate about since giving birth is the amazing experience of breastfeeding. Now, I’m not here to debate people who have chosen to use formula for whatever reason (though I do think some education for the general population would be great – formula is not the same as breast milk – it’s the formula companies who have purported those beliefs and they’re frankly not true).  There are many reasons the World Health Organization recommends breastfeeding until 2 years of age; rather than explain in my own words, I’d encourage anyone wondering about the differences to read a few things.

As a sidenote… I’m not anti-formula (we used it briefly when Eleanor had problems with weight gain), I’m just pro-breast feeding. This is a high-guilt area for many mothers (along with choices of labor, going back to work, etc). If you understand the facts about formula and exercise your right to choose – great! I just get saddened by mothers who choose formula thinking there’s no difference. Let’s be better educated so we can stand behind our decisions. Here is a link with a considerable amount of clinical evidence: What should I know about Infant Formula?

Okay… off the soapbox.

Back to business… You’re here because you’re interested in breastfeeding your precious baby and know that pumping will be part of your plan. Here’s the honest truth: I hate pumping. It’s so impersonal (and weird – seriously, it’s a machine tugging on your  boobs… it’s strange) and definitely not the same as nursing your little one. But, for those of us who feel strongly about the benefits of breastfeeding, it’s a necessary evil when we return to work. So, here are the things I’d recommend as well as a few comments.

Also, you’ll find that many of the links below are to http://kellymom.com. You’ll find this is without a doubt the best breastfeeding resource site on the web. Go there first to answer any breastfeeding questions. She also has an excellent forum to meet other moms and ask questions. Use that resource!

As for additional reading, I love the series of books by Dr. Sears. I used “The Birth Book” to research and define my birth plan when we did natural labor with Eleanor (it’s a great resource for any mom having a vaginal birth though – I’d highly recommend it). I considered purchasing “The Breastfeeding Book” but read a ton of reviews on Amazon.com that suggested “The Baby Book” covered the material extensively while also providing a great amount of additional baby stuff. Note: kellymom.com has a list of recommended resources here.

Supplies:

Breastpump – I use the Medela Pump-In-Style Advance (Tote version) and love it. Yes, there are other options. This is a great heavy-duty model. It’s a double pump (which means it does both breasts at the same time) – not only is this convenient and faster, research has shown that when pumping with both breasts you’ll get more milk. Don’t spend the extra money to purchase the Freestyle hands-free model. Instead, buy the Simple Wishes bra that will attach to the pump as a much less expensive option (it comes in larger sizes if you need it, just do a search on Amazon). I’ve heard of moms using this option in the car! Given the rush to get to work and get in a pumping session before the day begins, I might actually try this soon!

Pump Accessories – This Medela link has a lot of stuff. The lactation consultant at the hospital gave me a set of breastshields and connectors to use with the pump in my hospital room… I didn’t realize how helpful this was until later! Keep everything they give you for a breastpump. You’ll get a set with your pump, but having 2 sets has made my life sooo much easier! I’m tempted to get a third but I know that would just allow me to be more lazy with washing things and I need to just get to it! 🙂

Bottles – I love the Tommee Tippee bottles. I did a ton of research before I decided on that brand and found more consistent reviews by breastfeeding mothers about these bottles. One negative is that (as of writing this post) these bottles aren’t available on Amazon at a competitive price (and not at all at Walmart/Target) so I did get them from my local Babies R Us store. This British company is new to the US, so they’re slowly creeping into the other stores. Keep your eyes open for common sales at Babies R Us like “buy one/get one 50% off” and the like, and save your 20% off coupons from that store! Below you’ll find a list of the Tommee Tippee supplies I purchased and use regularly.

  • 5 ounce bottles – Most babies will “max out” with a 5-ounce breastfeeding bottle. Remember, formula fed babies often get waaaay more formula, while exclusively breast fed (EBF) babies will rarely take more than 5oz per feeding. Certainly in the first few months the larger 9oz bottles will be way too big so if you decide to get those, wait till later. *There are some “value” boxes of bottles that are a better deal – I think you can get 3 or 6 to a box. I have about nine total bottles at home. Make sure you grab the boxes that come with the 0+ nipples, not the faster ones!
  • Storage Lids – These are great for covering bottles of breast milk. I don’t like putting the nipples on the bottles when I store milk in the fridge, but these caps allow me to cover and stack the bottles.
  • Breast Pump AdaptorI just saw this on their website and don’t have it myself, but this looks like a great way to pump directly into the TT bottles. I’ll probably see if I can find some of these – would allow for WAY less cleanup between pumping and preparing bottles.
  • We only purchased the “0+” nipples. Even those flow faster than the milk she gets when she breastfeeds! If you give your baby a faster bottle nipple they are more likely to get impatient at the breast. This is very important!! Even though we never gave Eleanor a faster flow bottle, we did experience some fussiness with her. This link on kellymom.com was very helpful.

Storage

Definitely check out the Tommee Tippee adapter for your breastpump. As I said above, I just saw it on their website for the first time and didn’t know it was out there. I’ll be getting two this week and trying them asap. However, there’s still other stuff you’ll need.

  • Lansinoh Storage Bags – these are the best bags! It was recommended through the comments on Amazon that you not store more than 4oz per bag to be sure they don’t split when freezing/defrosting. I tend to keep my bags 2-3oz at most to be safe. I did a lot of reading and found that the Medela bags have a much more problematic reputation. To be safe, I still put my Lansinoh bags inside a clean Ziploc when I put them in the fridge to thaw – at least that way I’d catch any spills! These are about $8 in stores so that Amazon link is a good deal ($12 for 3 boxes at the time of this post).
  • Medela 2oz bottles – These bottles are a great purchase. When you first start pumping, 2 ounces is a lot to get from each side, and these bottles will be the perfect size to catch your milk. One box of 12 will be more than enough unless you decide you want to freeze milk in these (bags are much easier/cheaper).
  • Medela 5oz bottles – These are what I use at work to catch my milk now that I’m pumping more (2-5 ounces per breast per pumping session). Unlike some of the other brands, these pour and store well.
  • *Note: The Medela nipples are terrible. Don’t use them! They’re so different from the breast they will cause issues with your baby’s latch. Some of these Medela products come with the nipples, but I just threw them out immediately b/c I knew I’d never use them!

Accessories

  • Lansinoh Breast Pads – You will leak. It is annoying. I tried other pads and didn’t like them (The Johnson & Johnson brand stuck to my tender nipples the first few weeks – not something you want to deal with, I promise. The Medela brand seemed flimsy and I didn’t like them either.). Buy these on Amazon through the Subscribe & Save Discount (more on that below) for the best deal. Eleanor is almost 5 months old and I think I’ve ordered this set of 4 boxes 3 times.
  • Medela Quick Clean Wipes – I think you can get a multi-pack of these cheaper on Amazon. These are great to clean your breastpump parts at work. Keep in mind, they’re NOT a substitute for sterilizing your parts at home! I usually pump, rinse the parts in hot water, then wipe with these (later, sterilize at home).
  • Microwave Steam Sterilizer – I used the bags from Medela (here, available at most stores) and would suggest that you grab a few of them for smaller items, but overall I prefer the TT steamer for my daily use.
  • Bottle Cleaner – this bottle cleaner (also available in blue) is the best, for sure. I tried other brands first before seeing this in the store, and find this cleans better and gets less gross than the ones with a sponge tip.
  • Drying Rack – This one seems to be way more expensive on Amazon (I think it was $8 at Babies R Us) but we’ve loved it. We’re lucky enough to have a large kitchen drawer (one of those deep ones) that I keep all my bottle supplies in – I have this drying rack in the drawer on a dish towel and put everything right on it to dry (I keep the drawer open for a few hours to let the moisture out). There are other great racks out there, we’ve just loved this one.
  • Dishwasher baskets – there are many different little baskets you can purchase to put your stuff in the dishwasher. We do this occasionally but I’m always quick to rinse out the bottles carefully (even though we use a very small amount of organic dishwashing detergent, I still sometimes end up with a bit of soap residue inside the bottles). Sometimes we put the nipples in the dishwasher but I always end up rewashing these by hand – they get cloudy in the dw and I prefer to make sure they’re not soapy at all by handwashing.

Every day I pack the following for work:
Breastpump – in the zipper compartment I keep the Simple Wishes handsfree bra, a nursing cover (even though I’m locked in a bathroom/classroom, I still cover up just in case!), the Medela Quick Clean Wipes, and the tubing used to connect to the pump (I sterilize this once a month so it can generally stay in my bag)
A cooler containing: ice pack, breast shields, connector parts, at least 3 small bottles that attach to my pump (the 5 oz Medela bottles are my preference)
A tote bag with my hot tea canteen and a mug (I talk about this below); I put the cooler in here.

Tips for Breastfeeding/Pumping…
1. Start pumping early! Take advantage of the lactation consultant in the hospital. Ask questions! Find out if you can contact them later if you have further questions. I had some serious issues by the end of the first week home (bad latch caused blistered nipples… awful) and reached out to a local LLLI (La Leche Leage International) member. She happened to be a pediatric nurse practitioner in my father-in-law’s pediatric practice so it was an easy fit. Ask around if you need help finding someone – they are a HUGE resource and they do that job because the care and want to help you. Shoot, email me and ask me a question. I won’t be able to answer everything but I can help steer you in the right direction!
2. Have reasonable expectations. The first few weeks/2 months you’ll only get an ounce or two out of each breast per pumping session. Keep in mind, that’s all your baby needs per feeding anyway! (There’s a great calculator on kellymom.com to figure out roughly how much she needs in each bottle: Milk Calculator) Be encouraged that this is a great amount and you’re doing the best thing for your child. Don’t expect big numbers now. If after 3 months you’re only getting this amount, start researching some ways to increase your supply. This is a great link: Milk Supply Questions and Answers
3. Pump in the morning.  Most mothers have more supply then. Nurse baby and pump about an hour later.
4. I keep a small bucket in one side of the kitchen sink where I toss all used breastpump parts/bottles as I go through them. Each evening I take 15-20 minutes to wash and sterilize everything and get my bag ready to go in the morning.
5. The first week I was back at work I got a decent amount of milk when pumping, but found that fluctuated a lot into the second week. Some tips… Drink a LOT of water. You’re attempting to make 25-30 ounces of milk each day to nourish your baby… that’s 30 extra ounces of water your body needs you to intake! Drink a lot! Keep a mug on your desk! I’m a huge water snob and bring gallons of distilled water to keep by my desk to refill my cup.
4. I have found two herbal teas that I love and that help increase my supply. Yogi Woman’s Nursing Support and Organic Mother’s Milk Tea are great. I find the Yogi tea is a bit more mild. I got one of those big camping canteens that holds 40oz of water. Each morning I fill the canteen with 4 teabags, 1 flavored tea bag (like peach or orange, to adjust the flavor), and a packet of Truvia. I add boiling water on my way out the door and remove the tea bags when I get to work. When I started doing this, within about 8-10 days I noticed a huge increase in my supply so I keep this up regularly.
5. Bring in photos or videos of your baby to look at while you pump. I used my smartphone for this and found that videos of her smiling or even crying would cause me to have additional letdown and greater pumping success. I even took a few videos of her nursing which helped (I was always careful they were stored in a different folder on my phone).
6. – We introduced a bottle to Eleanor around 4-5 weeks of age. Once a day (usually in the evening) Bronce would give her a bottle of expressed milk so she would get used to taking a bottle (I pumped while he gave the bottle). I’ve heard terrible stories of babies who absolutely refuse to take a bottle and wanted to make sure this didn’t happen to us. She’s been great with bottles ever since.
7. Don’t beat yourself up if you have to use some formula!! We had some issues with Eleanor’s weight gain and had to supplement along the way. There are ways to supplement without hurting your supply (so when you are able to stop the formula you can continue breastfeeding with no loss of milk). Do a ton of research as you approach this – again, kellymom.com has great resources. I’m grateful I’m EBF (exclusively breast feeding) now, but I’m also grateful that formula was available when we needed it. That being said, if I knew then what I knew now, I don’t think we would have needed to supplement with formula, but I think I could have pumped to monitor her intake.

Amazon Mom + Subscribe & Save
Additionally, there is a program on Amazon.com called Amazon Mom (also called “Subscribe and Save”). Basically, when you sign up for regular delivery of a product (like the tea, breast pads, or even diapers/wipes) at 1, 2, 3, or 6-month intervals you receive a significant discount! We’re eventually transitioning Eleanor to cloth diapers (the ones we have are too big for our petite baby girl!) but right now we’re still working with disposables. Compare prices and you’ll find that Amazon’s combination of discounts (Amazon Mom + Subscribe and Save) will beat any other online merchant. Plus, free 2-day delivery.
Hint: Even if you don’t want to commit to multiple deliveries, sign up, request the S&S discount, and then cancel the future orders once the first one arrives. You’ll always get an email reminder before they ship any future deliveries so there’s no risk there.

Whew.

I know this is overwhelming! These lists all come from months of experience with this choice. I wouldn’t change it for a second – I know I’m giving my daughter the best, most pure form of nourishment and I get to benefit from the experience with the amazing bond we’ve formed. It’s awesome knowing I’m able to comfort her in a way no other human can.

Embrace this decision. Surround yourself with people who support you. And when you find yourself nursing a baby in the Target dressing room or the backseat of your car in a Walmart parking lot, know that many other supermoms have gone before you and enjoyed those same inner moments of hilarity.

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