Exclusive Pumping...some specific questions!

[megs4413]

So I EP'd for DS (cleft palate) for a couple months with limited success. I am bound and determined to give this the best shot I can, so I'm trying to do as much research/prep as possible, but I'm finding a lack of information out there. Does anyone have insight into these questions? TIA!

1. Should I *always* double pump? When nursing, you use one side and then the other, but with pumping, I always pumped both breasts every 2-3 hours. Was that wrong? What about in the first couple days before milk is in?

2. How many minutes after "emptying" should I continue to pump? I'm reading some people say 5, some say 1...I'm having a hard time imagining pumping dry boobs for another 5 minutes....seems like it will wear my nipples quite a bit more. Thoughts?

3. how much water will I need to be drinking? I'm starting to think I was nowhere near close to drinking the right amount of water and that might have been part of my supply problem. I'm drinking between 80 and 100 oz/day right now and that seems to only barely be enough. my doc has me on a high-sodium diet also to try to help me retain the water i'm drinking. if my water needs go UP with nursing....i mean, were you all seriously drinking more than 100oz/day?

4. are any of the products out there that supposedly boost milk production legit? there are so many now. with DS, I took fenugreek (and noticed no difference whatsoever beyond me smelling like syrup), reglan, ate tons of oatmeal/cookies and noticed nothing. Did you find anything helpful?

5. what bras???? I'm starting to think that my wearing of restrictive bras was part of my problem.....the ducts on the top of my breasts always produced better than the ones on the bottoms, though I could feel that those were full and struggling to empty. I hate looking saggy/gross in public, though. My breasts are enormous. I'm wearing a 42 E right now and it's too small. what can I do?

6. I had lots of trouble with cracked/bleeding nipples. I bought pumpin' pals flanges this time and they already seem like they will fit better (giant boobs). I didn't find lanolin particularly helpful last time. I am hearing a lot about olive oil instead, but I'm concerned that it adds calories/taste to the breastmilk. Any thoughts on that or other ideas for nipple care?

any and all other tips are appreciated. I'll be using a medela symphony double pump. I already have a hands free kit, but usually prefer using a sports bra with holes cut in it anyway. I've got pumping stations set up in two rooms so far and will have another one in the baby's room which we haven't even started yet. What else am I missing? TIA!

[Simon]

So I EP'd for DS (cleft palate) for a couple months with limited success. I am bound and determined to give this the best shot I can, so I'm trying to do as much research/prep as possible, but I'm finding a lack of information out there. Does anyone have insight into these questions? TIA!

1. Should I *always* double pump? When nursing, you use one side and then the other, but with pumping, I always pumped both breasts every 2-3 hours. Was that wrong? What about in the first couple days before milk is in?
I did NOT double pump after the first few weeks. I pumped to WOH for Ds1/Ds3 but I also EP'd for Ds2 for just shy of a year. I prefer to do breast compressions while pumping one side at a time. I felt this was very effective at emptying the milk fully. I also did not always use an electric pump. I had very, very good success using the Avent Manual, the Isis, because I was able to control the strength of the suction (based on how much I squeezed) and for me it worked better than the suction control on my double electric.
2. How many minutes after "emptying" should I continue to pump? I'm reading some people say 5, some say 1...I'm having a hard time imagining pumping dry boobs for another 5 minutes....seems like it will wear my nipples quite a bit more. Thoughts?
I did not pump after they were empty. From what I read to boost supply/keep it up, it is more effective to pump more often, than to pump after empty.

3. how much water will I need to be drinking? I'm starting to think I was nowhere near close to drinking the right amount of water and that might have been part of my supply problem. I'm drinking between 80 and 100 oz/day right now and that seems to only barely be enough. my doc has me on a high-sodium diet also to try to help me retain the water i'm drinking. if my water needs go UP with nursing....i mean, were you all seriously drinking more than 100oz/day?
I didn't drink nearly that much and I drank lots of things other than water (tea, juice, lemonade). I will say I noticed it helped my supply to drink more, but I don't think I topped 64oz/day.

4. are any of the products out there that supposedly boost milk production legit? there are so many now. with DS, I took fenugreek (and noticed no difference whatsoever beyond me smelling like syrup), reglan, ate tons of oatmeal/cookies and noticed nothing. Did you find anything helpful?
I didn't notice any help with Fenugreek either, but oatmeal and More Milk Tea both helped so long as I followed the tea brewing directions exactly and drank A LOT. Think 4-6 cups and about 18-36 hours later a noticeable boost in supply.

5. what bras???? I'm starting to think that my wearing of restrictive bras was part of my problem.....the ducts on the top of my breasts always produced better than the ones on the bottoms, though I could feel that those were full and struggling to empty. I hate looking saggy/gross in public, though. My breasts are enormous. I'm wearing a 42 E right now and it's too small. what can I do?
I think you might be right. I agree that wearing sports bras with my first Ds caused me some supply trouble, but he was born early and I didn't have anything or know any better. In the early weeks, I wore just nursing tanks or soft nursing bras while my size went up and down. later, I wore regular supportive bras, underwire often, and took them off to pump. I never did the handsfree pumping because I was always doing compressions.
6. I had lots of trouble with cracked/bleeding nipples. I bought pumpin' pals flanges this time and they already seem like they will fit better (giant boobs). I didn't find lanolin particularly helpful last time. I am hearing a lot about olive oil instead, but I'm concerned that it adds calories/taste to the breastmilk. Any thoughts on that or other ideas for nipple care?
I don't have any BTDT there. Sorry.
any and all other tips are appreciated. I'll be using a medela symphony double pump. I already have a hands free kit, but usually prefer using a sports bra with holes cut in it anyway. I've got pumping stations set up in two rooms so far and will have another one in the baby's room which we haven't even started yet. What else am I missing? TIA!
Do you have a manual around for use outside the home or in case the pump is forgotten (or the charger, etc). I had 3 sets of manual pumps (2 Isis and 1 Medela Harmony, loved the first detested the second). I kept one in each car and one at my office. That way I was never far from a pump. For me, supply really depended on pumping regularly so I used the manuals a lot out of the home once I was out of the house after the first few weeks.

Have you ever checked out the Yahoo EP group? I didn't find it until months into pumping for Ds2 but it was a treasure trove of information and I wish I'd found it sooner!

[BabyBearsMom]

I didn't exclusively pump, but I went back to work early so I pumped a lot:

1. Should I *always* double pump? When nursing, you use one side and then the other, but with pumping, I always pumped both breasts every 2-3 hours. Was that wrong? What about in the first couple days before milk is in? My LC said double pumping increased production which seemed to be true on the rare occasiont that I single pumped (I had a spare pump just in case). My LC said to pump whenever you would normally feed the baby, so I would think it would be all the more important to pump before the milk comes in to get it to come in just like a nusing baby would bring your milk in. Keep in mind you won't get much those first few days.

2. How many minutes after "emptying" should I continue to pump? I'm reading some people say 5, some say 1...I'm having a hard time imagining pumping dry boobs for another 5 minutes....seems like it will wear my nipples quite a bit more. Thoughts? I always did 2 minutes from the last drop of milk to make sure I was completely empty. If I was trying to increase supply (i.e. I was noticing a dip) I would do 5 minutes. The longer the suction, the longer your body thinks it needs to produce milk so it will produce more.

3. how much water will I need to be drinking? I'm starting to think I was nowhere near close to drinking the right amount of water and that might have been part of my supply problem. I'm drinking between 80 and 100 oz/day right now and that seems to only barely be enough. my doc has me on a high-sodium diet also to try to help me retain the water i'm drinking. if my water needs go UP with nursing....i mean, were you all seriously drinking more than 100oz/day? I drank a TON of water. I always drank a glass of water when I woke up in the morning. Then I had a 32oz jug which I usually filled 3 to 4 times during the day. Then I did another glass of water at dinner and another before bed. Plus I always drink while I am pumping/nursing. We used to use those big deer park 5 gallon jugs at our house. WHen I was nursing/pumping, we went through 7 per month.

4. are any of the products out there that supposedly boost milk production legit? there are so many now. with DS, I took fenugreek (and noticed no difference whatsoever beyond me smelling like syrup), reglan, ate tons of oatmeal/cookies and noticed nothing. Did you find anything helpful? I took fenugreek and it helped a lot. What dosage were you taking? I had to take a high dosage to get results. My LC helped me find the right dosage. Also, I used the Milkin' cookies with DD2 and they were delicious. One of the founders is a BBB mama and the cookies taste great and did seem to help a bit with production. They are pricey.

5. what bras???? I'm starting to think that my wearing of restrictive bras was part of my problem.....the ducts on the top of my breasts always produced better than the ones on the bottoms, though I could feel that those were full and struggling to empty. I hate looking saggy/gross in public, though. My breasts are enormous. I'm wearing a 42 E right now and it's too small. what can I do? I used nursing bras for easy access while nursing and pumping.

6. I had lots of trouble with cracked/bleeding nipples. I bought pumpin' pals flanges this time and they already seem like they will fit better (giant boobs). I didn't find lanolin particularly helpful last time. I am hearing a lot about olive oil instead, but I'm concerned that it adds calories/taste to the breastmilk. Any thoughts on that or other ideas for nipple care? I really liked nipple butter so much better than lanolin. But if you are having problems like that while pumping, you should make sure you have a proper fit on your flanges. A properly fitted flange should not cause nipple damage. I always put the nipple butter on after I pumped or nursed, not before so that the baby wasn't getting much anyway. I also like the soothies for sore nipples (little cold packs) they helped a lot.

[lizzywednesday]

I think having well-fitting flanges is the biggest tip (I did not fully EP, but started out as an EP mama) that I could give.

As for hydration, I was drinking at least 4-5 16-to-20 ounce bottles of water daily postpartum.

Another thing that helped me with production was to always have a photo of DD nearby while pumping. IDK if you'll be able to hold your new LO while pumping (I could never figure out those logistics, myself!) but that can also boost supply. Spending non-feed times doing skin-to-skin should also help, too, but IDK if you will be able to do that either.

Do you happen to know if the Symphony you'll be using has the "Preemie Plus" program set in it? I found that program was a HUGE help in getting supply going/established. I would often combine it with a full pump cycle to get the overnight pump session in.

And, yes, I did an overnight pump session. It scared the living snot out of DH the first time, but he got over it.

[calebsmama03]

First off I have to say I commend you for being so determined to pump for your little one! I did not EP but did pump at work for a year with my first and also took the training course to become an LC.

1. Double pumping always stimulates milk production better than single so whenever possible to double pump. The first few days are the most critical in establishing supply so pumping at least every 2 hours will certainly help, but those are the days you'll also be exhausted so just do what you can. The newer pumps should have cycles on them to help with simulating the natural suck pattern of a baby at the breast and tht is also helpful for establishing supply - a full session of short little "let-down" suck pattern isn't going to stimulate as much as the longer drawing suck pattern, KWIM? Also, much as it is a pain, definitely pump over night. The longest a new one should go w/o being at the breast is 4 hours in the first few weeks so I'd use that as a guideline for pumping.

2. I don't know that there is a hard and fast rule. Start out with a couple minutes and if it seems like your supply is not what you want then increase it. Again, the more stimilation in the early days the better.

3. Just drink a lot. Always keep water by your side. Sorry I dont have a specific answer on this one, but I doubt my intake was over 100 oz.

4. Fenugreek and mother's milk tea were helpful for me but for serious supply issues (like you might have with EP) the absolute best thing is domperidone. You can't get it in the USA but can fairly easily order it from other countries (NZ and Canada are most reliable). It is pricey but it works. If you google around a bit you'll also see that the reason it isn't available in the USA has nothing much to do with safety and everything to do with big pharma and the drug lobby. The safety issues that were presented were from critically ill patients receiving a huge IV bolus of the drug. It has a long safety record for breastfeeding women. Kellymom has good info on her site about dosing, as does Dr Jack Newman (and the LC he works with whose name is escaping me at the moment). They have info for moms who want to induce lactation for adopted babies and much of that might be helpful for you to read if you've not seen it? I have a friend who swore by brewers yeast as well. Also, depending how severe the cleft is, you may be able to let l/o do some non nutritive sucking which can do wonders for stimulating production- all those yummy skin to skin baby nuzzles. :)

5. I liked bravado body silk but I have the exact opposite size "issue" so am probably not much help there. Sorry! I also loved Coobie bras this time but again, not sure on size/support for larger breasts?

6. Honestly, olive oil is absolutely the best thing. It's close to natural sebum, low allergy potential, soothing, non sticky. It shouldn't add much, if any, flavor or calories to the milk but if you're worried about flavor you can go with "light" OO (as opposed to EVOO) since the flavor is less. Calories should be negligible if any but even so extra fat calories are never a bad thing for a newborn! ;) I've had many friends rave about various nipple butters and creams but, esp in the early NB days, I worry about the extra ingredients. Beeswax is in many and, like honey, can be risky for babies if contaminated with botulism toxin. There haven't been any adverse effects reported (that I'm aware of) but honestly I'd just start with OO and see if you need more. If you're pumping using good fitted flanges then you shouldn't have too many issues anyway. You can also use the OO proactively to help lessen friction on the flanges.

Good luck to you!

[schrocat]

I exclusively pumped for DS1 and DS2. I nursed DS3 for almost 3 years and am still nursing him into this pregnancy. About pumping, you need to drink alot of water and keep hydrated. I used to have about a liter by my side while pumping and drank while pumping. Make sure you take your calcium pills. I pumped both breasts for half an hour to an hour. Eventually I was able to cut pumping to just twice a day to get the daily required amount of milk for one child. About 20 ounces in the morning and another 20 ounces at night. I added more pumps in the day if more milk was needed.

The best thing I've found for boosting milk supply is fish and green papaya soup. I drank that religiously to increase milk supply. Also drinking malted drinks like milo and horlicks works. You can get those drinks at the British specialty grocery store.