Pregnancy, Prematurity and Pumping

First up — I was invited to do a guest post on the “Breastfeeding with Comfort and Joy” blog on my experience with pumping breastmilk for someone else’s baby. The post was inspired by this video, entitled “Prescription Milk,” which focuses primarily on the importance of babies — particularly premature babies — getting human milk for their nutrition.

It was so touching that the mother featured in the trailer chose to celebrate and memorialize her daughter’s brief life, by continuing to pump milk even after her own baby died, so that other babies might live.

My personal experience was that I had over-supply issues, so being able to pump extra was a blessing, instead of having to try to minimize my production. Some mothers may not be able to pump enough milk to feed their babies, but there isn’t enough donated milk to supply all the babies who need it. If you are currently pregnant or breastfeeding, or know someone who is, please look into becoming a milk donor through the Human Milk Banking Association of North America, your local hospital, some other organization, or (like I did) just giving a friend bottles or bags of milk. You have to be screened to make sure you aren’t carrying any diseases that may be transmissible through breastmilk, so get started on the process as soon as you can.

Pregnancy is the perfect time to start preparing yourself for breastfeeding. The best way to do that is to talk to women who have successfully breastfed, and watch women breastfeed. I emphasize, “successfully breastfed,” because so many women tell horror stories of how awful breastfeeding was, and how they ended up with sore, cracked, even bleeding nipples, or how they “tried to breastfeed, but I never could make enough milk,” or some other unsuccessful breastfeeding experience. You wouldn’t ask a poor man how to become a millionaire; you wouldn’t ask a teenager for tips on a successful marriage; and you definitely wouldn’t ask me for tips on how to run fast or throw a baseball. 😉 You would instead seek out someone who had been successful in whatever it is you were wanting to succeed. Likewise, don’t ask someone who had a horrible time breastfeeding for breastfeeding tips (even if the lactation person she saw at the hospital said she was doing everything right, or she is otherwise sure she did what she was supposed to do). Or if you do, don’t be surprised if you, too, have a horrible time breastfeeding! Instead, seek out those who had an easy time, who were successful, who had no pain, who nursed as long as they wanted to (and/or longer than they expected). If you don’t know anyone that fits that description, or feel awkward asking to watch them as they nurse their babies, don’t despair! There is a book filled with beautiful and intimate breastfeeding images, along with clear and simple text, to help you see what a good latch really looks like and how to achieve that.

Get the book now, while you’re still pregnant, read the text, study the pictures, take it with you to the hospital (or just keep it at your bed-side table if you’re having a home birth), and start breastfeeding off not just correctly but confidently. As World Breastfeeding Week draws to a close, let’s not just celebrate breastfeeding, but help support women as they breastfeed, and remove hindrances that would keep them from success.


Update — I just noticed that WP has added a “like” feature to posts — that’s cool! 🙂


5 Responses

  1. Hi!
    I stumbled across your blog, and I had a couple questions for you…

    My first baby was a preemie and didn’t have the ability to nurse, they said that she just wasn’t strong enough. I pumped and pumped and pumped, for over six weeks, but never got more then three oz out of each side. I know pumping isn’t as efficent as nursing, but a LC told me that since I had supply issues with number one, that I will with number two, because some women just aren’t made to breastfeed. Is that true? Is there anything I should be doing now @ 20weeks pregnant to prepare my supply? I’m reading and reading and researching because I so desperatly want to be sucessful at this and any tips and reccomendations you have would be great!

    • I am absolutely stunned at the disinformation and perpetuation of myths that this woman who is supposed to *support* breastfeeding has said. Yes, in rare, very rare instances, some women cannot breastfeed; however, the overwhelming majority of the women who believe they cannot breastfeed actually can breastfeed, but there are other reasons for their problems with breastfeeding.

      Let me start off by telling you about my friend, who had five babies and breastfed all of them. Even though she was able to exclusively breastfeed, at no point in her nursing “career” could she pump more than an ounce or two at a time. [And, no, she wasn’t starving her babies — they were plump and healthy, without formula or table food.] She didn’t get very much, even when she went from breastfeeding her infant almost exclusively to being gone from the baby for several days, and trying to pump.

      Pumps are just not as efficient “milk extractors” as babies are, for a start — there are a lot of hormonal things that contribute to a good milk supply, and “cuddling up” to a cold machine rather than your sweet baby can certainly affect how much milk you produce. Just read some articles or forums for working mothers who want to pump — there are all sorts of tips and tricks they suggest for triggering let-down, pumping enough milk, what to do with decreased supply, etc. If mothers who had their babies with them for several weeks or a few months, and had a sufficient supply while breastfeeding but then had significant trouble with a pump, you can see that may be even more difficult for women whose babies never nursed to get a large amount. Plus, some pumps are better than others; and some pumps work well for some women but not as well for other women.

      Additionally, I would think that the stress of having a preemie would be another difficulty you’d have to overcome. It is well known that stress can interfere with milk supply/production. In fact, I’ve known a couple of women whose milk actually dried up completely, due to the death of a parent; and another friend’s supply was greatly affected by her stressful separation and divorce.

      In my own experience, which I hope may be helpful for you, even though our circumstances are quite different, I experienced a huge difference in the amount of milk I could pump when I switched from a cheap pump to the very nice “deluxe” double pump that a friend let me borrow, when I pumped for my friend’s adoptive baby. Now, I had over-supply issues with both mine, but even then, I think I went from getting just a few ounces with the cheap pump to getting about double with the nicer one the next day.

      When I pumped, trying to increase my supply for the other baby, what I ended up doing was as follows: I nursed my baby in the morning, letting him nurse on one side while pumping on the other; then when he was done, I would pump both breasts until they were “empty,” and then pump for about 15 minutes more. As my supply increased, so did the time I spent pumping, so that towards the end, I was pumping 25 oz in one sitting, in addition to nursing my baby exclusively, but it took about an hour or perhaps more. I would also occasionally pump at other times, but it just ended up being easiest to do it in the morning, before the day got hectic.

      Is there anything you can do now to prepare your supply? Nothing that I know of, but I wouldn’t worry about it too much, because I’m fairly skeptical that the amount of milk you were able to pump was some sort of problem with *you*, but rather was just the natural outcome of your situation. Just because some women can pump a lot of milk even with a preemie baby doesn’t mean that there is a problem with you — it may be that they were just luckier, or had more support, or had a better pump, or were less affected by stress.

      There is something you can do now to help you breastfeed later, and that is to learn what is a good breastfeeding latch. You see, the main problem most women have that causes difficulty breastfeeding is that they have mostly seen babies being fed with bottles, and the ideal positioning for breastfeeding is quite a bit different. So, when women start to breastfeed their babies, they tend to hold their babies in a bottle-feeding position, which ends up causing all sorts of problems since the baby can’t latch effectively. This ends up putting a lot of stress on the mother’s breasts (particularly the nipples), which causes pain and can lead to cracked and bleeding nipples. Poor positioning can also end up causing problems with your supply, or with the baby’s ability to get milk, because he can’t get the best, deepest, fullest latch, and thereby empty the breast most effectively, which stimulates your breast to produce more milk and increase your supply. If you can be around women who are nursing successfully, and see how they’re holding their babies as they put them onto the breast, as well as after they’re already comfortably latched, you will be able to imitate that good latch more easily after the baby is born. If you feel shy or uncomfortable watching a woman breastfeed, or don’t have anybody around to watch, then you would do well to get the book I mentioned in the post, Breastfeeding with Comfort and Joy, because it is chock-full of beautiful and close images of babies breastfeeding and of good latches. You can look at these pictures as long as you need to, and even take the book with you to the hospital if you’d like, so that you can get breastfeeding started off right.

  2. I too had a preemie with my first. I never got much more than 3oz per side at any one pumping session-and that with a hospital grade pump. I luckily had good support staff and the nurses encouraged me to pump every 3 hours, round the clock to keep up my supply until my LO was strong enough to nurse. And his doctor told me early on that even if I had to supplement him, any breastmilk is better than none. Even after he started to nurse I would nurse him and then give him a bottle of pumped milk (since nursing would tire him before he was getting enough milk to gain weight) and then pump for 20 minutes with him in my lap. We kept that up for about 3 months until we were able to get by with just nursing. It was tough, but well worth it and I’m so glad I had people around me to encourage me during that time. Katie – I hope you have a great time breastfeeding this time.

    • Katie,

      Kathy has given excellent advice, but I would like to add my thoughts to address what I am “hearing” in your post.

      While it certainly would be beneficial for you to see breastfeeding in real life or in the images in my book (and I hope you do get the book — there is even a special running from now until midnight Eastern time, for 10% off if you enter wbw10 when you order), one thing that will be key for you is to work toward releasing the negativity surrounding the diagnosis you received with your first baby. Hearing positive stories like Debbie’s can certainly help.

      In my practice, I have witnessed hundreds of women successfully breastfeed, even after they had problems with supply (production) issues, including some who had been previously told that they just couldn’t breastfeed. One woman, I remember in particular, had gotten the “diagnosis” with her first baby as being one of those rare women who was biologically unable to provide enough breastmilk for her babies’ needs. I met her with her second baby. I worked with her positioning to allow her baby to have the best latch possible, and she saw significant improvement, but weeks later she still struggled with attaining her goal of breastfeeding her baby without the very real need for supplementing. Finally, we figured out that she felt “branded” by the past diagnosis, of her past “inability” to breastfeed. Once she was able to acknowledge it, grieve over it, and release it, things dramatically improved, and she went on to exclusively breastfeed her baby. I want to mention that she never was able to get significant amounts from her pump.

      In the course of my practice and my life, I have found that far too many doctors, and even lactation consultants and other health or breastfeeding “experts,” view the body as a machine, ignoring the mind-body connection. Rather than looking at the person as a whole being, they focus on biological causes (for instance, low milk supply necessarily being caused by “insufficient glandular tissue”) and are reassured by these labels. It is my goal to see the whole person, and see what may be affecting or causing this problem and avoid permanent labels despite how validating labels can be. Many times there is a physical problem — as Kathy mentioned, poor latch or positioning causing nursing difficulties for mother or baby, the pump not working well enough, stress interfering with supply — that can be corrected, but often there is not an inherent permanent “biological” problem.

      I do acknowledge that an unknown percentage of women cannot exclusively breastfeed for biological reasons including “insufficient glandular tissue” but I always like to limit such diagnoses to that time, that baby, that situation and in the context of the knowledge we have at the time.

      Do not give up hope; do not let yourself be labeled. Often people are afraid to give moms hope in situations like yours as there is this fear of failure and disappointment. I believe we know far too little about the resilience of breastfeeding to permanently diagnose or even suggest that any woman’s breasts are biologically unable to exclusively breastfeed future babies.


  3. Katie,

    OOPS. I responded to Debbie’s comment instead of yours. You can scroll down to see my comment that was meant for you.


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