By Sheena Thompson, Hamilton, New Zealand
After becoming pregnant the first time, one thing I knew right from the start was that I would breastfeed my child. I knew it might require a little bit to master breastfeeding after birth, but I felt confident that my baby and I could achieve it. Little did I know that my baby’s severe tongue-tie and lip-tie would make it a lot less simple than I imagined—and forever change my preconceived notions of there being only one “right” way to provide human milk.
Breastfeeding challenges with tongue-tie and lip-tie
My baby was born with severe tongue-tie and lip-tie. Despite a frenulotomy (tongue-tie release surgery) and frenotomy (lip-tie release surgery), follow-up treatments, frequent lactation consultant visits, and a whole assortment of approaches to get my baby to the breast, I just was not getting the results I hoped. I had tried just about every breastfeeding tool in the toolbox—from using a nursing supplementer (with baby at the breast and me wearing a tube device attached to a bottle of expressed milk), to nipple shields, and an array of positioning styles. My baby was unsuccessful at being able to take the milk without causing serious damage to me over time. Ouch!
Call me stubborn or dedicated, but I would not give up. I knew my body was making breastmilk because after every try at breastfeeding, I would then express and produce more than enough for the next feeding. So, with every breastfeeding attempt, I thought “This could be the moment she will breastfeed successfully!” But every time it resulted in her crying with hunger and me having to resort to feeding her my breastmilk expressed from the previous session.
By then, my mental health had declined. I was judging myself for not being able to breastfeed directly from the breast. I was someone who achieved things; I thought “practice makes perfect.” Yet here was something I just could not master.
I am so glad I fought my way through that postnatal depression fog because in doing so, I came to realize what I was doing right. I was still exclusively feeding my sweet baby my own breastmilk—only just using a different method: exclusive expressing using a breast pump.
Coming to terms with a new way to feed
By three months postpartum, I finally accepted that the way I fed my child would be breastmilk, only it would be breastmilk that had previously been expressed for her. Breastmilk was my first choice even if the method of delivering it was not my preference. My focus changed, and I felt empowered. I often was told, “I don’t know how you do it!” which now made me swell with pride.
I won’t lie; it was not easy. Exclusively expressing for my baby required dedicating about three hours per day to the task, which despite having a hands-free style of pumping bra was mainly “lost” time. It is like doing things in double-time as you must express the milk and then feed it back. Then there is the washing of breast pump parts. It was difficult to hold my baby as she would dislodge the pump bottles and I certainly did not want to spill any liquid gold! I also found it a bit isolating as I had my pumping station set up in one place, and if I wanted to be around others, I had to traipse a power extension cord about because my pump did not have a battery option.
Planning my pumping sessions around other household tasks and baby activities was also tricky. I quickly learned that public places are not very well thought out for expressing mothers and needed to map out power outlet options if I was going to be out and about.
I often considered stopping, but my reasons for wanting to provide breastmilk would persuade me to head back to my pumping station, time after time. I had established a good day-to-day supply and managed to build up a considerable additional supply in my freezer. Since I was producing more than enough to meet my baby’s daily needs, I even donated some excess breastmilk from my freezer supply!
Successfully reaching the finish line
Then, my sweetie started to self-wean, and reduce the amount she wanted each day. But I am happy to share that I exclusively expressed for her a total of 10 months. She then used up the rest of my freezer breastmilk supply until just after her first birthday.
New breast pump designs aid exclusive expressers
With my second pregnancy I had fingers and toes crossed that my breastfeeding journey would be more straightforward than my first. I still wanted the health benefits that breastmilk can provide to my baby and didn’t want the expense of buying formula. I also like that producing breastmilk helps with postpartum weight reduction and also long-term breast cancer risk reduction. But unfortunately I experienced similar struggles to my first.
So I first started out my journey for my second child using my non-battery powered pump, I knew that it would be harder to accomplish than with my first. This time I had a toddler running around me while I pumped. I didn’t have the three hours that I used to devote each day for expressing for my firstborn. So, I started to dream up ideas for a breast pump that would enable you to do your day-to-day activities while expressing, without being limited in radius of movement by a silly power cord! Thanks to late night pumping and searching on Google, I found that such a pump had already been invented! I quickly purchased it.
I now have a rechargeable battery mobile pump that sits inside my regular bra and is hidden from view to the public. I can express while I’m out and about and no one even knows I’m doing it! I just pop it in and carry on with my busy day. Even better there are no bottles sticking out, so I can cuddle my baby while using it! I have pumped while driving, doing kindergarten drop-off, shopping, visiting friends, housework, and even helping bathe my little ones. Now at the ten-month milestone for this current pumping journey, I have no thoughts of stopping anytime soon! And once again, I am also donating my excess freezer breastmilk supply to help others.
Despite all the challenges of exclusive expressing, I have learned that there are positives too. Being an exclusive expresser has allowed me to return to work with a fairly seamless transition. It has also given me a great sense of fulfillment by allowing me to supply extra expressed milk to babies in great need of donor breastmilk, due to health issues with the mother or baby.
10 Tips for Successful Exclusive Expressing
- Consider purchasing a mobile pump with discreet collection cups to allow you more freedom to pump anywhere and around anyone. And make it ideally a double pump—it halves the time frame needed to express. When both sides are stimulated together, the output is typically higher.
Consider, however, that “wearable” or “mobile” breast pumps are generally not designed to establish milk production. They may be adequate for some parents with a robust supply, but may not be for others who might need to establish and maintain milk production with a multi-user breast pump (also sometimes called a “hospital-grade breast pump” in some areas of the world).
- Ensure you are pumping eight to ten times a day and at regular intervals (every two to three hours) in the early days postpartum (or per your provider’s recommendations), to establish your supply. And consider including a session between the hours of one to five a.m. as well if baby is sleeping then. If you need to boost your supply, pumping once during this timeframe while maintaining your other pumping sessions may help. Another trick to increase supply: Extend each pumping session a couple minutes longer. Then, when your weekly pumping output totals show you that your supply is well established from week to week, you can consider cutting back to five to seven pump sessions per day (or to whatever frequency your provider recommends).
- Relax—it encourages letdown to occur. If you are stressed and worrying while pumping it will affect the output. Reading is relaxing to me, so during stressful periods I read while pumping. Sometimes I would get carried away reading and the milk would pour out. For other people, having a piece of clothing that smells like the baby, or a baby photo, can aid let-down.
- Stop worrying and don’t look if you are concerned about the volume you are expressing. Concealed collection cups are a great solution for two reasons: if you don’t see it, you can get on with another activity and forget all about counting milk drops. And use breast compressions, especially when establishing your supply.
- Put your pump parts in a sealed bag in the fridge between pumping sessions to save time cleaning, and then wash them approximately every 12-24 hours or according to your pump manufacturer’s guidelines. Just keep in mind that you may want to “warm up” the flange/s by placing at room temperature awhile before using them, as cold flanges can sometime impair milk ejection. For more information on cleaning pump accessories, check out this article from the La Leche League International website: https://www.llli.org/breastfeeding-info/cleaning-and-sanitizing-pumping-accessories/.
- Drink to thirst. One way to remember is every time you express, have a glass of water handy to consume if you are thirsty. If your hydration drops too low, your production can drop too.
- Keep a spare pump parts collection on hand. There is nothing worse than needing to replace a part and having to revert to single-sided pumping while you wait to obtain one.
- Have a spare charger in the car/at the office in case you forget to charge it.
- Check out the book Exclusively Pumping Breast Milk by Stephanie Casemore. People often confuse exclusive expressing with the occasional pumping session, but in reality, the two are very different. This book made me feel like “Yay, they actually understand what it’s like!” You can find a synopsis of the book on La Leche League Great Britain’s website at https://www.lllgbbooks.co.uk/store/p130/ExclusivelyPumpingBreastmilk.html.
- Visit a local La Leche League Group for support and encouragement in your exclusive expressing journey, and look for exclusive expressing support groups on Facebook, too.
Take it from me: if you are exclusively expressing, you are awesome! Congratulations on achieving it for however long you choose.
Sheena Thompson is a nutritionist and personal trainer specializing in pregnancy and postnatal services. She lives in Hamilton, New Zealand, with her husband and two daughters.