Breastfeeding and pumping -- what is your strategy?

[rhymeswithfizz]

I'm a new mom -- yippee! Breastfeeding my 2 week old daughter Savannah is going great, thank goodness. So I have a Medela Pump-In-Style that I inherited from my very sweet sister in law, got the new parts, and am ready to start pumping! I will be going back to work but only 20 hours a week, most of it working from home, so I mostly want to pump to give dad a chance to participate in the feedings right now, and eventually build up a stash.

So now what??? Please tell me your strategy! When do you pump? For how long? What sort of "storage" methods do you use, for refrigeration and/or freezing?

What type of bottles/nipples do you like? The only one I have tried so far is a playtex, which she took willingly enough, but even the slow-flow nipple was much too fast for her. Any suggestions?

TIA!

[HelenD]

(First, you don't happen to post on horse boards too, do you? If it's the same RWF as at COTH and TTB, Hey! If not, ignore me and just know that there is another RWF out there in horse bbs land)

I'd think at 2 weeks old, she's a little young to start w/ the bottle. I'm not a lactation specialist, but I was told to wait until at least 4 weeks to offer a bottle. So, my first piece of advice would be to hold off on the bottle for another 2 weeks.

BUT...that doesn't mean you can't start pumping. My advice is to start by pumping in the morning, right after you feed her. The reason I suggest that is that the morning is typically when the hormones are highest and you have produced plenty of milk. That being said, you can pump any time you want or can. Just keep in mind that your baby gets WAY, WAY, WAY more milk then even the best pump could. Plus any stimulation you give your nipples, even if you don't get a lot (or even any) milk, is helping your body to produce more milk. That's right, the more you pump/feed, the more you will produce. That's why you don't want to pump in the middle of the night, no matter how engourged you get and desparate for relief.

I am back at work full time, but when I started, I started part time. I pumped at least 2x a day. I always pump in the morning and then again 3 hours after the last time I fed or pumped. (As a rule of thumb, I try not to go more then 3 hours between feeding/pumping during the day). I generally pump for about 15-20 minutes although some will say you can pump longer and get a second let down. I pump until I feel empty but not so long as to make my nipples sore.

I store my milk in Avent bottles purely because the lactation specialist I went to told me that Avent was the best for BF babies. So I went out and bought like a TON of Avent stuff. Well, dang if DD didn't hate Avent nipples. I ended up buying a whole bunch of different bottles to try and ended up w/ the Playtex naturals, which seem to work fine for her, but suck for me because of the stupid drop in bags and the fact that I can't store milk in them. But anyway, I like the Avent bottles for storing in the refridgerator. For the freezer, I use the Gerber freezer bags - and then I put 3 of those into a ziploc or whatever brand you like freezer bag to "make sure". (Also, date all the milk you freeze - trust me, buy a sharpie in your favorite color - you'll use it a ton) I follow the rule that my lactation specialist used; the rule of 3 (it's easy to remember BUT you will see lots of guidelines for EBM storage that are longer, but this seemed reasonable to me, so...FWIW, YMMV). That is, 3 hours out w/out refridgeration, 3 days in the refridgerator, and 3 months in the "normal" freezer (ie not a deep freeze, one where the door gets opened and closed normally).

I also found the slow flow nipples to be too fast for DD at 4 weeks; since your DD is still very young, you may need to wait a bit before ANY nipple works. As I mentioned, I tried Avent, Playtex (many different versions), Dr. Brown's, and Evenflo. DD settled on the Playtex naturals (the one w/ the clear nipple, not the yellow/brown one). Your daughter may have a preference of her own, so try a couple of different ones if you can. But I do like the Avent bottles for storing EBM in the refridgerator, FWIW.

I've found these particularly helpful websites, so you might want to check them out:

http://www.kellymom.com

in particular, http://www.kellymom.com/bf/index.html

(There is all kinds of GREAT information on this site, including weight to BM calculators, etc)

Also, http://www.breastfeeding.com/, in particular the archive section of their BB forum,

http://www.breastfeeding.com/cgi-bin/ultimatebb.cgi?ubb=forum;f=19

And this one that probably answers a lot of your questions,
http://www.breastfeeding.com/cgi-bin/ultimatebb.cgi?ubb=get_topic;f=19;t=000013

Anyway, sorry to ramble on, Good luck!

H.

[nitaghei]

Karen (stillplayswithbarbies) and Lori (momof3labs) are the best sources of info on this board. But:

I would strongly recommend not doing any bottles until your DD is at least 4-6 weeks old, to avoid nipple confusion, and to help establish your supply. A pump is not as efficient as your baby. Trust me - BTDT, though not by choice!

If you want to start building a stash, pump first thing in the morning, before nursing your little one. This is in addition to anormal nursing sessions. If you do a search on the archived threads, Lori (momof3labs) had some excellent advice on using a PIS. Maybe start out pumping for about 10 minutes? I had a Lactina, and my circumstances were a little different, so my input isn't that useful. At this stage, I wouldn't pump more than once a day - it's just too hard on your nipples.

The Gerber storage bags seem to work the best for freezing. I have an excess lipase problem, so I don't have a freezer stash. I've been using Medela bottles as well as the cheap Evenflo storage bottles (from Target) for storing in the refrigerator for the past almost 14 months without problems. I work full time, and the most I had was a total of 20-24 bottles (when I was pumping 3 times a day, and used 3 sets of horns/bottles). You really won't need as many as that. I think Karen ended up using the Pumpmate system.

DS had nipple confusion (NICU stay). We used NUK newborn nipples while we were working through this, on the advice of the LCs. Very slow flow - it worked for us. The advantage is that you can use these with the regular Medela/Gerber/Evenflo bottles - which is a cheaper alternative to Avent bottles/nipples - which are also popular for otherwise BF'd infants.

HTH, and I'm sure you'll get more answers!

Nita
mom to Neel 01/05/03
dog mom to a cocker and a PWD

[sntm]

ITA to hold off on introducing a bottle. Dad can participate in every other aspect of baby care -- and I think that in some cases, this has led to major supply issues down the road. Somewhere, that got popularized as an idea but I don't think everyone realizes the potential risks.

I think it is reasonable to start at around 4-6 weeks, and then you only need to offer a little bit (an ounce or two) a few times a week to keep her interested in a bottle. Save any major feeding for when you truly are gone (and then pump for every feeding she takes away from you).

Pumping in the morning worked best for me in the beginning. Except for my disastrous beginning, I always made tons of milk and responded well to my pump, so I usually pumped after a feeding, usually the first of the morning, when I was most full.

I store in Gerber milk freezer bags inside a rubbermaid container in a deep freeze (I've got a large stash and that keeps it the best). since you will be using yours intermittently, I would suggest that. You can rotate out the oldest milk. If you are giving her EBM more frequently, I would just put fresh milk into the bottles you plan to use to save $$$, and freeze the excess. Replace random feedings with frozen to keep your stash up to date.

Congrats on the beautiful baby and the great breastfeeding beginning!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03

[stillplayswithbarbies]

I agree about not starting a bottle until baby is about 5 weeks old, and not pumping until then. You don't want to mess up your supply.

I started pumping at 5 weeks, and pumped every morning before she woke up. I built up a nice freezer stash, which meant I didn't have the stressful worries when I did go back to work because I knew I had plenty of milk in the freezer.

I tried several things, but what I ended up with was the Pumpmate system. Although just this week, I have tried the Playtex pump and store system and love it! I will use it with the Pumpmate refills though because they are cheaper. (the playtex one only comes with 4 lids and I have 50 bottles stored)

At first I pumped 3 times a day, at home before work and twice at work. II started back at 4 months and I am gone from 7:30 AM to 6:30 PM, so that might be different for you. If I were going back at 6 weeks, I would start out pumping 4 times a day.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[ppshah]

In my experience if you wait until 4-5 weeks alot of babies won't take the bottle. We started bottles at 3 weeks and he took it okay- although he never really liked taking the bottle until 9 months when we weaned to formula. Of course every child is different.

I pumped once a day- gave DS about 2-3 oz and froze the rest. If you're willing you could pump more to build up your freezer supply- but to be honest I hated pumping. In the begining you supply is plentiful so I would definately start builing up the freezer supply.

We tried both the medela bags ( came with the pump ) and gerber bags for freezing BM and I like the gerber alot better. The medela only holds 5oz while the gerber holds 6oz. And the medela has twist ties which were annoying.

We used Avent bottles. & PIS Traveler backpack -which I loved! I use the backpack as an extra diaper bag now!

Congrats & Good luck with BF. I loved BF my baby and there were little bumps along the way but I'm glad I stayed with it. I wished we could have BF longer but we started to have supply issues at 9 months.

[rhymeswithfizz]

HelenD, boy it's a small world!!!! I am indeed the same RWF from COTH! I haven't been to the barn since the munchkin arrived, and I sure do miss my other taller, hairier kids. :) I have them both leased out right now so they are in good hands. Who are you over there? I gotta build up my horsey-mommy support group!



Many thanks to ALL for theideas and suggestions! So here's another question... i got some of the gerber storage bags, and they say they can be used with any disposable bottle type of system, which seems like it could be handy. But does that really work, or should i stick with the regular bottles?

Next question... do i really have to boil all these pump parts every day??? Surely there must be another way... dishwasher? Microwave? My very eager-to-please dog? ;)

[stillplayswithbarbies]

Every baby is indeed different. The reason that it is advised to wait until 5 weeks or so is that babies may begin to prefer the bottle to the breast (nipple confusion) and it could interfere with breastfeeding success if one starts too early. But on the other hand, if you wait until too late the baby might not accept the bottle at all.

5 weeks is a good compromise between those two issues for most babies.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[stillplayswithbarbies]

yes it really works to use the Gerber bags with disposable bottles. But it is easier to use the new Playtex pump and store system because they are drop-ins. (you don't have to deal with folding the bag back over the holder)

I only boiled once when I first got the pump. Unless your baby is a preemie or has health issues, you shouldn't need to sterilize every time.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[nitaghei]

After the initial sterlization, I just hand-washed or threw everything (bottles, horns etc) in the dishwasher. If you really want to sterlize once in a while - Medela makes these great microwave sterilization bags that are extermely easy to use. And much as I adore my dogs, no, using them to clean the pump parts is not advisable! :P

Nita
mom to Neel 01/05/03
dog mom to a cocker and a PWD

[californiamom]

Hi Karen,

Sorry this may be a dumb question but I am a new mommy. I just visited the Playtex website and didn't find a "pump and store" system. I found the "OneStep" system and "Drop-Ins bottle liners". Which one are you referring to? I am going back to work in 3 weeks and am working on building a freezer stash. I probably have about 100 oz in the freezer now... Do you think this is enough?

Ana

[stillplayswithbarbies]

Sorry, it is called the OneStep. I am away on a business trip and didn't have the box to look at. :)

100 ounces is a good stash to start back to work with. If you will be going on business trips, you may want more.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[HelenD]

Too funny! I'm HelenD over at COTH too, but I haven't been posting over there since about last August. Now mostly I check in at The Tack Room more the COTH - where I'm DoYaReallyCare. My horse boy is vacationing with others as well. I miss him, but don't think I can emotionally take the time from DD right now to give him the attention he deserves/demands. But I still can't wait until I have the time/energy to get back to riding!

Anyway, I never have had luck getting those stupid Gerber bags to work w/ ANY bottle system that says it works w/ disposable bags. So I just dump the milk out of them into a bottle or liner. I don't have a lot of patience for bottle systems/bags that end up dumping most of my EBM all over me. It takes too damn much effort to produce the stuff to let it go to waste!

I started out boiling everything every day. PFTTTTT. I now boil once every one or 2 weeks. I got the Avent Express Steamer instead of the Medela bags because I'm going to try to BF for a solid year and I'm back at work. I started out w/ the bags, but I needed to microwave 2 or 3 times in the bag per day, and that starts to get expensive! I figured out that the Avent Steamer paid for itself in a month as opposed to the Medela microwave bags.

Here's what I do, based on suggestion I got here and at www.breastfeeding.com where I asked essentially the same question you just did:

I have more then one pump set up. In fact, I just got 2 more, so I have a total of 4 Medela PIS pumping parts. This lets me go 2 days w/out cleaning/steaming if I have to. I pump 3x a day. The first one, I pump in the morning before work. I produce the most milk then, so I cap those bottles, and put them right into the refridgerator OR send it w/ DD to Daycare. I take another clean setup w/ me to work in the PIS. I pump around 10, and put the bottles with the connector piece into the cold part of the PIS. I wash w/ hot water and dry the horns. Then on the second pumping of the day, I take the cold bottles/connectors out, connect them to the clean horns and pump again. (I have an extra bottle or two in the PIS in case (ha) I pump more then 10oz in a day at work). When I get home, I transfer all the pumped milk into either bottles for the next day or storage bags to freeze. I try and feed my pumped milk as soon as possible after pumping, so generally I don't freeze anything until Friday afternoon. I then wash in hot soapy water all the parts/bottles (including the bottles DD used at DC) and then put them in the Avent Steamer. They get taken out to dry and then used again the next day if I need them. I usually have 2 loads of stuff for the steamer.

Also, I do use the dishwasher (we have one that has a "Sani-Cycle" which is supposed to sanitize) for bottles, bottle collars, pacifers, etc. I don't use if for nipples because I've found it leaves a residue. I will also use the dishwasher as an alternative to the steaming once in awhile for all the PIS parts (except the tubing).

Hope that answers your questions. Feel free to email me w/ any others!

Helen

[Jen in Chicago]

We later had issues where he refused the bottle, but at the beginning of week 2 we attempted a bottle of formula a day (the LC did not want me to pump yet.) On his 2 week birthday I had to leave him for periods for my bro's wedding, and he took a bottle. It was not easy, but he did it.

Our situation was unique b/c of my brother's wedding, but I would totally do it again. He did not always take the bottle well, but DH always gave it the old college try!

In the very beginning we used the ready to feed formula with the single use nipples (great for traveling to the wedding.) We moved to Avents which he soon rejected (bottle stike!) and eventually after trying most of Walmart's bottle he settled on the cheapest, Gerbers. I loved the Gerbers b/c they were cheap, I could pump into them, and they have one size fits all nipples which worked for us.

[wreckgirl1]

So, I didn't have a separate pumping session when I first started out. I pumped the side DD was not feeding from while she was feeding (obviously, I only fed her from one side per feeding...if you do both, then I probably wouldn't recommend it). This was nice at first because I didn't need to worry about letdown...I was already leaking out of that side anyway. After I got a little more used to the pump and figured out how to get letdown without DD there, then I could pump separately. Since handling the baby and the pump at the same time is a challenge, DH can help with that!

We started DD on bottles at two weeks (out of necessity - I had to go back to school). The first time we tried it, the Avent slow-flow was way too fast, too - milk went everywhere and DH seemed to think he was drowning her! This greatly disturbed DH, as he was going to have to feed her the next day while I was gone. But, miraculously, by the second feeding, she had figured it out. So I think this is just a practice issue. We didn't have nipple confusion issues, but that apparently can be a problem with introducing the bottle early.

Hope this helps.

Cynthia