Breastfeeding & Pumping: A Practical Guide

https://www.popsugar.com/moms/How-Make-Tree-Life-Breastfeeding-Photo-42870000

I’ve been debating publicly talking about my experience with breastfeeding for a while now. After much thought, I decided to go for it because I myself found much comfort (and helpful information!) after I had my first baby through scouring the web. And by scouring the web, I mean at all hours of the day and night to try to make breastfeeding work, to see if what I was experiencing was normal or not, and to get over the guilt of not being able to breastfeed with my first daughter. I took what I learned the first time around and applied it to my second daughter. Somehow, through a combination of preparation and luck, breastfeeding turned out to be much smoother with #2.

I am not a certified lactation consultant or breastfeeding extraordinaire of any kind. I actually compiled most of the information below in an email for a friend who was about to have a baby. I figured if at least one person could benefit from a comprehensive guide to breastfeeding and pumping in one place, this post would be worth it. I’d be happy to accept comments and suggestions from your own experiences, too!

First and foremost: If you have trouble with BF and need to use formula, don’t stress or feel bad about this!!! At the end of the day, the goal is to give your baby nutrition, no matter what the form. I ended up quitting breastfeeding with my first daughter at 10 weeks due to developing a breast abscess (it sucked as much as you think). She went on formula weeks prior to this, and I was devastated. I felt like a failure, especially because I work in the medial field and knew that “breast is best.” But over time, I saw that she continued to grow, continued to be happy and healthy, and I stopped stressing out enough to actually enjoy my newborn. 
 

BEFORE DELIVERY

  • I went to a breastfeeding class which my hospital hosted prior to delivery. Though it was helpful and informative, I later felt like they pushed BF above formula to a fault. They should make it known that not all women will be successful at BF, and that using formula is ok.
  • LATCH!!! I learned more from YouTube about a proper latch than I did from any class. I highly recommend watching a video or two on YouTube about what a proper latch looks like because the latch is a HUGE factor in BF success! An improper latch can cause nipple trauma and subsequent infections, so if it looks like baby has not latched properly, pull baby off and try again. It can be frustrating at first, but trust me, you want the baby to learn the proper way to latch! Baby’s mouth should be wide and lips flanged out like a fish, and almost the entire areola should be in the baby’s mouth. Here’s a good video regarding latch.
  • A couple of weeks before your due date, I would apply Lanolin nipple cream 1-2 times per day to help prevent nipple damage once baby starts feeding.
  • Buy a few good nursing bras! You kind of have to estimate your size closer to your due date because the breasts will get bigger when your milk comes in.
  • Buy cloth nursing pads to wear inside the bra so the leaked milk doesn’t soak through to your shirt. These also come with a laundry bag to keep them together while washing/drying!

WHEN IT’S TIME TO START BREASTFEEDING

  • As soon as baby is born, and if possible, hold the baby on your bare chest (“skin-to-skin”). This will help regulate baby’s temperature and help with breastfeeding. Try to get baby to latch as early as possible!
  • Early on, you can never nurse too much. When in doubt, try to nurse baby. This will help stimulate your milk production too. The more you feed, the more milk you will produce. It also helps soothe baby.
  • Hydration is key!!! If you’re well hydrated, it helps with milk production. I drink 2-3 liters of water per day.
  • Use the lanolin nipple cream between feedings as needed to prevent cracking, etc.
  • I used these milk collection shells in the first 2 weeks or so because my nipples were very sore when they touched my bra or shirt. They helped a lot, and I eventually didn’t need them! Their main function is to collect leaking milk so none goes to waste (because breast milk is so precious!).
  • Massaging the breasts while pumping can help with getting more milk output.
  • The labor and delivery nurses who care for you after delivery are invaluable!!! Utilize their expertise! Also request the lactation consultant if your hospital offers this.

BABY POSITIONS FOR FEEDING

  • I found two positions to be most helpful at first: the Cradle Position and the Football Hold. I had more trouble with positioning baby on the left breast, and the “football hold” helped best on the left side. As baby became more skilled at nursing, the Side Lying Position came in handy when I also wanted to lie down!
  • As she got more skilled at nursing, I didn’t need the football hold anymore. Do what’s comfortable for you!
  • This video gives a basic sketch of each type of breastfeeding position. There are a ton of videos on YouTube to help with each type of position.
  • Consider using a breastfeeding pillow for comfort. You may be more comfortable without a pillow too. Two popular choices are the Boppy and the My Breast Friend.

BREASTFEEDING TROUBLESHOOTING

  • If you start to develop cracks, rubbing some breast milk on it will help it to heal. Remember that your breast  milk is chock-full of antibodies and nutrients!
  • You will need to nurse through the pain because you want to keep stimulating milk production.
  • If you feel painful lumps or redness, it could be be a clogged milk duct. The best thing to do is massage the area in a circular motion and then push from that area down toward the nipple to help dislodge the clog. Applying heat (heating pad, hot shower) helps during this process. Keep nursing as the action helps loosen the clog too.
  • If you develop fever or chills, call your doctor immediately! The way I knew something was wrong was when I felt a tender lemon-sized hard bump along with chills. It turned out to be an abscess. This is uncommon, but you should know about the signs!
  • Sleepy baby: When they’re newborns, babies are often very sleepy and won’t feed efficiently. Keep them awake during nursing by rubbing their palms or back, or tickling/tapping the bottoms of their feet. Undressing them also helps keep them awake since they are a little colder than they like! It can take upwards of 30 minutes per breast at first, but as they get more efficient it will take less time for feedings. Just aim to empty both breasts with each feeding (or nurse one side and pump the other if needed). Emptying the breast is crucial because the initial milk (fore milk) is less nutrient dense than the later hind milk.
  • Cold cabbage leaves can help with breast soreness (believe it or not)! Just stick a leaf in your bra.
  • Ibuprofen can help with soreness and inflammation especially if you have a clogged duct. Ask your doctor if it’s ok first, as there are many conditions in which people should avoid ibuprofen and other NSAIDs.

PUMPING

  • Find out which hospital-grade pumps your health insurance covers for free. Typically Medela and Spectra are covered. I currently use the Spectra S2 and love it.  My only complaint about it is the odd shape and large size. Medela is much more compact.
  • I would suggest pumping for a maximum of 15-20 minutes at a time. You probably will only get a few ounces total at first, but this should improve as you keep feeding and producing milk. If you are exclusively pumping, pump as often as you would nurse (every 2-3h) to stimulate milk. Also remember that no pump is as good as a suckling baby, so what you pump won’t equal how much the baby is actually drinking.
  • You don’t have to wash the pump parts each time you pump if you keep the parts in the fridge or in a small cooler! As long as the milk on the parts stays cold, it won’t spoil and you can reuse the parts for your next pumping session. At work, I use this wet-dry bag which I place in the fridge. I keep a small ice pack in it also in case I am out and about.
  • Get a good pump bag for work. I initially bought the cheapest kind on amazon – Dr. Brown’s. This bag is fine if you are not walking around/traveling a bunch. I had to walk quite a bit between hospitals each day, so this messenger bag style became far too heavy to lug around (especially in the Charleston summertime!) The Sarah Wells bags/backpacks are highly recommended and well-designed, but these were out of my budget. I ended up buying this bag which I love! Just be sure to get one that will fit your pump. Medela works in most of these bags, but the larger and oddly shaped Spectra is harder to find a bag for. Here’s a good review of pump bags.
  • You can add freshly expressed breast milk to refrigerated milk, but do NOT add freshly expressed milk to frozen milk. If you want to add expressed milk to a bag or bottle in the freezer, just let it get cold in the fridge first and then add it to the frozen milk. I store expressed milk in a NUK bag in 2-6 oz increments.
  • You can thaw breast milk in the fridge and then use it for 3-5 days.
  • Frozen milk is good for about 6 months in the freezer. Be sure to write the date and number of ounces on each bag!

TRAVELING

  • If pumping while traveling, TSA will let you bring breast milk on in quantities over the usual liquid limit. It’s best if the milk is frozen (in milk collection bags – I use NUK brand).
  • You can keep the milk in a cooler bag with ice or frozen ice packs as a carry-on.
  • Before getting to the hotel, ask them if you can store milk in their fridge/freezer before you get there! Most times they do allow this.
  • A breast pump is considered a medical device when traveling.
  • Some airports have nursing pods to sit in and breastfeed or pump! However, I recommend always bringing a nursing cover if you want privacy. Some nursing covers double as car seat canopies too.
BOTTLE FEEDING
  • I recommend glass or BPA-free plastic bottles. Most daycares will not allow glass bottles, so keep this in mind when buying bottles. I use Avent brand.
  • You may have to try a few different kinds of nipples depending on how your baby does. If baby does not initially seem to like a nipple (because none of them are as good as mom!), don’t give up right away. Keep trying with one kind of nipple, and you may find that baby will get used to it after a few tries.
  • If using formula, I found it easy to use the Dr. Brown formula mixing pitcher to mix 32 oz at a time. This keeps in the fridge for 24 hours.
  • Don’t shake breast milk. You’ll notice the fat will naturally separate from the water, so I would just gently heat it and swirl it to mix together before bottle feeding.
  • Place the bottle in a shallow bowl or cup filled with boiled water to heat. Check the temperature of the milk on your inner wrist before feeding baby.
  • Don’t microwave formula ever!

I hope this was helpful! If you have any questions, please feel free to comment!

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