#28: Moving to Exclusively Pumping

 Honestly, I didn't even open my pump, bottles, or warmer prior to needing them. No, I planned to exclusively feed Genevieve from my breast and then after a few months I probably would want a break and would begin pumping then to build a reserve. This was NOT how the process unfolded. The process of breastfeeding has been a humble reminder of why winging it can be useful (and freeing) when our intention doesn't fit our reality. Goals are great to establish, and grace is necessary to come to terms with the reality of your circumstances. 

Background: Breastfeeding with an Oversupply 
I developed mastitis my second week postpartum. Instead of waiting to pump in a few months, I needed to begin pumping immediately.  The night I was symptomatic with mastitis, we began reading the manuals to figure out the pump and warmer. Thank goodness for a friend who noticed I didn't register for bottles or a warmer and got them for me anyway. Andrew began sanitizing my pump parts and our bottles (I seriously love my Doctor Brown glass bottles). Sometimes (okay maybe more often that we'd like to admit) you don't know what you need until you need it. I was nursing G, but still needed to pump every two hours to get out the clog and for relief. It took me a while to learn the pump setting that worked for me and my flange size (word to the wise get a feel for the sizing and fit you need prior to baby to avoid pain and discomfort and to appropriately empty yourself--but do not pump while pregnant as it can induce labor). I did all of this learning while trying to temper a 104 degree temperature and between convulsive chills that made my entire body shake--clearly not ideal. 

Between my abundant supply of milk and Genevieve's lazier method to drinking, I learned I was pretty much incessantly at risk for mastitis. In fact, I actually nearly got it a second time a few weeks later (all the early signs were there) but I fortunately could avoid a second round of antibiotics (though my doctor prescribed them and I have them on hand if I need them). To give you an idea of what I contend with I will give a brief list of interventions I utilized in order to continue feeding Genevieve at the breast while managing my oversupply: 

• Only pump when absolutely necessary as to not create an even greater oversupply (this would mean if I fed G for 30-40 minutes, I would then also need to pump before or after feeds and do all the accompanying dishes while trying to keep baby occupied or do it before she was awake and ready to feed)
• Could not wear a handsfree bra to pump; I actually have to pump one breast at a time AND milk myself every time to adequately work the milk out (insert deep sigh and eye roll)
• Haakaa with epsom salt in the shower (usually every third shower) 
• Daily sunflower lecithin supplement (a life saver to aid in milk flow, it doesn't aid in supply) 
• Wearing Silverlette cups over nipples (these look absolutely obnoxious but I have issues if I try to get by only wearing reusable breast pads, though my nipples are in great shape and I don't need to use any creams, balms, or butters because of them) 
• Must not wear a normal bra (or if I do not for long) because I will develop clogs (I have like 4 sports bras I actually like)
• Must breastfeed with bra and top completely off because I will get soaked from dripping milk 
• Must feed with a haakaa on opposite breast or my letdown would soak me 
• Must feed with a nipple shield 
• Must avoid foods that promote milk supply 

There is no other way to say it, than to describe breastfeeding as a labor of love. There was one point in the first few weeks that Andrew looked at me and said "I don't know how moms work out of the home AND do all of this..." Truly, if I would be working, I do not believe I could have breastfed for as long as I did under these circumstances (or if I did I would certainly be a mama who battles chronic mastitis). Some may read this and say, "why put yourself through this?" But I can say, as taxing as this phase of breastfeeding was: I truly loved it. I did not expect to even like breastfeeding, let alone love it. I looked forward to the quality time and I can tell you I didn't feel the same attachment when giving her a bottle. Any personal strain or discomfort was minimized by the physical and emotional connection I felt during the activity. While we introduced a bottle during my bout with mastitis, we did not give her more than 1-2 bottles a day. I preferred to feed her from the breast over her receiving a bottle. Though Andrew was very happy to begin sharing the feeding responsibility and the accompanying bond. 

While most women gush "LUCKY" when I tell them of my oversupply, they often cannot empathize with the strain, struggle, and stress of managing it. Did you know that breastmilk is not consistent? It actually changes throughout the day (for example it is more watery during the early morning due to loss of hydration over the night) but also over the course of each feeding. The initial milk, called foremilk, is more watery, hydrating, and gets the baby's appetite going. Then hindemilk follows, which is the fattier, more nutrient-dense milk. When mothers have an oversupply, the balance of hindemilk to foremilk can be thrown off. This can actually negatively impact the baby's digestion and nutrition. And alas, this was a problem we contended with. Genevieve was having very green poop, which is a sign of this imbalance. I began researching methods to combat this issue. I tried pumping out milk prior to feeds, something I didn't love doing because I worried the stimulation would further increase my supply. I even read that you can shake your breast prior to feedings to mix the milk--Kelis' song 'Milkshake' played in my mind and I rolled my eyes every time I attempted this, though it actually did help. The added dishes, attempts at perfect timing, and inconsistent results made me feel like I was constantly weathering a storm on a row boat. All the while, I still enjoyed feeding G and feeling her little hand wisp and dance on my chest and make eye contact as she fed. 

Around 4.5 months, Genevieve had started getting a few more bottles each day and began preferring them to feeding at the breast. She began turning her head at the breast (with my nipple) and twisting and turning in frustration. A lot. And boy was it uncomfortable. Certain feeds she would cry and struggle to latch when she realized she had work to do in order to get her meal. I would sometimes need to go grab pump materials, get my letdown started and pop her on and hold her frustrated head on to get a latch. Of course I could have continued to weather the storm, eliminate bottles, and require us to 'stick it out' at the breast. However, after contending with this (on top of everything else already mentioned) I decided to lean in to Genevieve's lead and switch to exclusively pumping. We switched one Tuesday cold turkey several weeks ago, and haven't looked back. 

How We Hold It Determines How We Experience It 
I want to take some time to describe the emotion behind this transition and how I chose to handle the situation. The phrase "they grow up so fast!" is often uttered. I hear it multiple times a week if I am being honest. I prefer not to cling to this sentiment because it feels like we are missing out and that time is being stolen from us. Rather I prefer to think (and say) "growth and development in the first year is so rapid." This is different because I am acknowledging that our babies change seemingly before our eyes but without the attachment that I am mourning the loss of the stages they have already moved beyond. I am grounded in my choice to be present during Genevieve's wakeful periods and to stay home with her and I do not feel a sadness for all the phases she has moved beyond. I hold reverence for all those phases of the past (oh my gosh those newborn full-body stretches), and I am grateful to have been present for them. Even Andrew who works away from home and is away for most of the day is focused on where she is right now so that he feels adequately filled up by the stages that are behind us. The only thing constant in this world is change, and we choose to surrender ourselves to that and feel a greater peace because of that outlook. All those phases of the past are built in the the tiny person she is in this moment and therefore they are not lost or gone, but rather a building block to the foundation of this present version. 

When I chose to make the switch cold turkey to all bottles I did not allow myself to cling to thoughts and judgements that would make me feel shame, guilt, or attachment. To me, the goal is always to ween Genevieve off the breast. Instead of forcing us both to continue on, I leaned in to HER desires and cues. I did not let my emotional attachment to our connection during breastfeeding sessions to make us force breastfeeding to continue. I still value feeding Genevieve with breastmilk and plan to do so for her first year of life, but I am unattached to how she receives the breastmilk.

I am comforted by the fact that we have all those special moments and memories of her feeding at the breast and will cherish them, but I did not allow myself to even think sadly 'this is the last time she is at my breast...' I could spent time and energy there but I chose not to. Instead I tell myself  "If I really need that connection I can pop her back on..." And guess what? I do not feel that need. Actually, I think as her mother it is important to check in on my motivations and make sure I am making choices that make sense for our reality and NOT my own emotional attachments. This perspective coupled with the more regular routine with pumping has made exclusively pumping feel less arduous and works for us in this phase. I also attach myself to the notion that we had so many breastfeeding sessions together that bonded us (and took pictures to capture the memory) and now when she bottle feeds I still see her connection and love in her eye contact and feel it in the way she squeezes and holds my pointer finger. The love and connection is there, albeit different. But the only constant in life, as previously mentioned, is change and this is just one of many transitions that we will experience of how our connection adjusts with age and time.

The Mechanics of Exclusively Pumping 
I want to begin this section by stating I am not advertising that anyone should switch to exclusively pumping, nor stating it is better or best. I am merely expressing what it looks like and the benefits it has afforded me based on our circumstances. There is no right way. I want to share how switching methods and navigating a new and different way gave Genevieve what she wanted while having mental and emotional benefits for me. 

Moving to exclusively pumping at 5 months postpartum afforded me benefits I hadn't previously considered. The first was that I could determine exactly how much milk I was (over) producing. Most women produce 24-32 ounces of milk per day. I was producing double that at 75 ounces per day (I could literally feed twins). Related, I could then pump at set times fit in to a routine and hopefully try to bring down my daily supply to be more manageable. Considering I avoid foods that promote milk supply and talking to my own mom about her abundant supply while breastfeeding, I believe there are certain biological and genetic factors beyond my control that will keep me overproducing. For example, during my first pump session of the morning (usually when milk is most abundant) I was pumping close to 30 ounces at once (basically what most women normally produce in one single day) and now I pump closer to 20 ounces.

 I could also determine how much milk Genevieve was eating per day. Genevieve was always a long feeder--during some cluster feeds she would eat for a solid TWO hours, though her normal length of breastfeeding was 25-45 minutes. I joked that Genevieve's cool and relaxed temperament were related to her life of abundance in that milk was never in short supply, and I do think there is some truth to that. Genevieve has always taken in more milk than average babies her age, and again I think this is related to the supply at her disposal.

Another benefit for me is I can relieve both breasts at one time. Since I produced so much, I could only ever feed Genevieve off of one breast. I would collect my letdown on the other breast with my haakaa and collect an additional 2-8 ounces per feeding. But with pumping I am able to drain both breasts and boy, the relief I feel is wonderful. Similarly, I am dry and need to change clothes much less often. Genevieve would just spit out milk, kick off my haakaa, and my letdown would leak all over me. It drove me crazy and not needing to contend with that has been very welcomed.

I am also better able to control the balance of foremilk to hindemilk because I can dump some of the initial foremilk to make bottles that are balanced and therefore aid Genevieve's digestion and nutritional intake. I keep five bottles prepped and ready in the fridge and usually one bottle drying on the rack/ out on the counter that is ready to pump into. I am mindful that upon first waking and last bottle of the night are 'made' roughly around the same time of day because she needs the more foremilk-dominant morning milk upon waking and the more nutrient-dense hindemilk concentration found in evening milk to keep her belly full through the night. Genevieve sleeps 10-11 hours at a time at night and I find if I accidentally give her a morning-pump bottle she will not sleep as long. 

My daily  pump schedule is as follows: 

• First Pump Session of the day sometime between 4-6 am (my boobs are a built in alarm clock and I wake and pump when they require it) 
• Second Pump Session of the day is between 9-10 am when Genevieve goes down for her first nap 
• Third Pump Session of the day is between 12-1 pm when Genevieve goes down for her second nap
• Fourth Pump Session of the day is between 5:30-6:30 pm when Andrew gets home from work and can occupy G 
• Fifth Pump Session of the day is between 8:30-9:30 pm which is just before we end our day and go to bed, though occasionally it is a bit later on weekends

Like anything, it is important to state that this is a loose schedule and I always ebb with the needed flow of a day and some days I may add more pump sessions if I ate more indulgently the day before or if our schedule deviates a bit from our normal routine. However, overall this is roughly the schedule I keep. Pump sessions usually take around 15-20 minutes total plus time to do the dishes. Doing pump dishes--for whatever reason--is my absolute least favorite part. I absolutely despise it. I don't know why, but I do. Fortunately, Andrew knows this and if he is home will grab them and handle it to relieve me of the duty and I am genuinely grateful for the 'break' of that responsibility.

Pumping does not result in the same happy connection that feeding from the breast affords. Many mamas I talk to actually despise it and have described pumping as 'sucking the life out of them.' I can empathize with that description since pumping is not my favorite activity, but it isn't the worst thing either. I hold at the forefront that doing this affords me the ability to breastfeed Genevieve (yes, EP mamas are in fact still breastfeeding their babies) while also aiding me in myriad ways that I detailed above. 

I truly believe fed is best. And while I anticipated feeding Genevieve from my breast for longer and in doing it exclusively, conditions required me to relinquish some of my preconceived expectations. By leaning in to the winging it I am better able to be at peace with what we have done, what we are doing, and embrace the next phase of change once we begin introducing solids next week. Yes, change is inevitable. Our littles grow and their needs adjust, if we release attachment and lean in to what this version of them needs, we can better service them and feel a greater sense of peace about 'the how' too.