Dinsdag, 12 April 2011

Extreme Breastfeeding: Pumping for NICU Without Losing Your Mind

-or- Free Your Hands and Your Mind Will Follow

When our littlest geek (locally dubbed the Baby Detective) ended up in the NICU, I found myself back in familiar breastfeeding territory.  My role on supply side of breastfeeding began in the NICU.  As a first time mom who gave birth by c-section, my milk didn't come in for days.  That newborn, a "sugar baby" in NICU lingo, had low blood sugar and a low body temperature, so my first attempts at breastfeeding were bedside in the NICU.

It was awful.  There's no just way to prepare for breastfeeding or the hormonal postpartum roller-coaster.  Throw in the physical separation, heightened anxieties, and lack of privacy of NICU, and the natural act of breastfeeding dials itself up to an 11 (on a scale of 10 for those who haven't had the senseless pleasure of This is Spinal Tap [available on Netflix streaming]).

I won't tax you with all the gory details (although keywords like nipple shield coupled with a multitude of synonyms for breast might spice up my Google hits).


When we decided to grow our family to five, I assumed the third round of nursing would be without surprises. Then BabyGeek 1.3 arrived six weeks early after swift and furious pregnancy complications.


Instead of a bassineted baby in my hospital room, our teeny geek was an isolette half a building away.  She was challenged to digest liquid food, much less consume it.  While she drew most of her nutrition from IVs and lipids from a feeding tube, I pumped every 3 hours in an attempt to provide breastmilk that she could consume by bottle.

The only things previous breastfeeding experiences had taught me were I hated pumping, I didn't have much success with it, and with growing sleep deprivation, the low moan of the pump motor turned into crazy words that made me loathe pumping all the more.

With 8 pumping sessions a day on the horizon, things had to be different this time.

In order of importance, here are the big changes:

Easy Expression Bustier Hands Free Pumping Bra (Large 38-40 D-f, Black)1. Go hands-free: this list-topper may seem painfully obvious to the working moms, but somehow I managed to miss the advantages with earlier infants.  Maybe it was the early '90s era models in their shoulder padded power suits, but somehow hands-free seemed inappropriate for someone who spends most days in jeans, tees, and a sea of Cheerios.

Prior to this baby, I loathed pumping and avoided it at all costs.  The deeply bovine feeling of hooking up to a milking machine felt humiliating (especially in the hospital with people walking into the room all the times).  Holding the flanges in place kept my hands and mind focused on the pumping process.

This time, with the phone ringing off the hook, and hardly a moment to bolt a meal, I walked my hospital gown clad self into the lactation boutique and bought an Easy Expressions hands-free bustier.

Suddenly, I had my hands back, and along with them came a solid measure of dignity.  Yes, I was still fastened to a very dairy machine, but I felt more 80s throwback (think Madonna) or crazy fashion forward (Lady Gaga) and even a bit Amazing Stories.  It was the best kind of ridiculous.  When my hands were unshackled, my brain and soul were now free to contemplate something, ANYTHING, other than the pumping process.  Pure awesome.  Worth every penny.

Man vs. Food: Season One2. Kick back and watch something distracting.
I hesitate to offer this advice as television kills brain cells and such, but there are times in life where really senseless shows can be blessedly soothing and distracting.  While I couldn't sleep and pump, I could pump while watching every episode of Sons of Tuscon, Doc Martin, The IT Crowd, Toddlers & Tiaras, and Man v. Food on Netflix streaming.

3 . Hospital grade pumps should be considered.
Medela Symphony Breast PumpBefore Ranger was born, we bought a Medela Pump-In-Style Advanced pump.  I still own it, but I instead opted to rent a Medela Symphony from the hospital boutique.  When pumping 8 times a day, it's important that the pump works well- 10 minutes more per session adds up to 80 more minutes per sleepless day.

4.  Lactation consultants can help immensely, but tend toward generalizations.
I love the lactation department at our hospital.  The consultants have helped me over the years.  This time they lent me a DVD copy of Hands-On Pumping (the 3 videos are available free online at http://newborns.stanford.edu/Breastfeeding/).  Those techniques improved my supply quickly.  Pumping every 3 hours (at the hospital or at home) is an insane challenge.  Undersupply broke my heart because (in my hormonal insanity) it felt like the only thing I could do for my vulnerable baby (in more reflective moments I realized the error in that thinking, but I'll save that for a later post).

While I appreciate their expertise and enthusiasm, I've also been given general advice that didn't apply to my specific situation and made me feel like I was failing.  Go breastfeeding, but skin-to-skin contact, homeopathic supplements, and 2 hour pumping schedules just weren't options I could consider.  They really wanted my baby to feed directly before leaving the NICU, but it was simply too difficult for her and taxed her limited energy.  I understand their concerns that breastfeeding might not last as long if she's bottle-fed, but I also knew my daughter was overtaxed by breastfeeding.  The neonatologist agreed that the baby would come home sooner if bottle-fed, so I focused on more effectively pumping and bottle-feeding.  For us, bringing the baby home sooner was a much higher priority than direct breastfeeding (or even breastfeeding).

Once the baby was bigger and stronger, the transition to regular breastfeeding was easy.  We were so glad to say goodbye to bottles.

5.  The White Wave -or- What to do with all the milk

Lansinoh 20435 Breastmilk Storage Bags, 25-Count Boxes (Pack of 3)During time I pumped daily, the surplus milk quickly engulfed our fridge's freezer.  The hospital can only store so much per patient, and the nurses told me about other moms buying deep freezers.  I started freezing the surplus in Lansinoh breastmilk storage bags instead of the space-hogging NICU bottles.  They freeze flat, and 10 can be neatly stowed in a gallon freezer bag .  With Amazon Mom and Subscribe and Save, I was able to get cases of these delivered to my doorstep at an excellent price.

6. Washing Up
Munchkin Deluxe Bottle Brush, Colors May VaryCleaning the pump parts after every session brought to mind Sisyphus forever rolling the stone up the hill to watch it immediately roll back down.  In this sleepless rendition of the classic tale, it's easy to feel that the stone is actually rolling over you on its disheartening downward fall.  This is where a kindly clan of magic bottle-washing elves would come in handy, but my neighborhood owl seems to have taken them out (along with the toilet paper fairy).  Wash up all the parts as soon as you put the milk in cold storage.  It feels even worse to start the whole process with the washing.

We went through 3 different bottle brushes before again settling on the Munchkin's Deluxe Bottle Brush which we liked back when Ranger was formula fed.

All in all, it's no small feat to pump for a NICU baby.  If you are a parent who is going through this now, take care of yourself as much as you can.  Your kiddo needs YOU more than breastmilk.  Sleep as often as you can, eat, and drink lots of water.

If you know someone else going through this, feed them a meal (or, even better, set up a food registry for them at mealbaby.com).

***Baby Toolkit is the ongoing story of a couple of Midwestern geeks and their kids.  We are not affiliated with Medela, Munchkin, Ziploc, Meal Baby, nor Netflix, but we are Amazon affiliates (so a small portion of purchases made through our Amazon links go toward the Baby Toolkit jet fleet).

And be sure to check out related post The Boob Wars. 

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