Saturday, February 1, 2014

Let's Get Pumped! Part 2

Maintaining a good supply of breast milk while exclusively pumping can be very challenging. Looking back on the last 8 months, I would like to tell any new mom attempting this a few things.

1. Don't think you are not bonding with your baby!  You are working your ass off to make sure they get the best thing in their bottle, and for that you are already a great mom! Even if your baby doesn't nurse, you can still do plenty of skin-to-skin time and cuddling. When you are feeding your baby a bottle, speak to him, play with his hair, hold his hand. It is still beautiful.

2. This is for woman with low supply or multiples: If you end up having to top bottles off with some formula, who cares?? You're baby certainly won't. He is still getting all the breast milk you make with all the antibodies and nutrients you have to give. Try not to feel guilty about this! For one thing, stress will decrease your supply. And when you think about it, its just formula added to breastmilk to increase the quantity of milk, not decrease the quality of it.

3. If you have to skip a pump or push it back a little to cuddle with your new baby, do it. So what if your boobs start leaking everywhere! Enjoy the cuddling.

That being said, I have a lot of 'tips and tricks' to make the process easier and to increase supply.

TIPS FOR PUMPING:

You don't have to wash the pump accessories after each use. I unfortunately didn't learn this until a month ago! This would have helped me out so much in the beginning. After you pump, put the accessories in a Tupperware container in the refrigerator. You can do this ALL DAY with one set of accessories. Then at the end of the day, wash them. Viola!

Invest in some Freemies if you are finding it difficult to pump AND hold or cuddle with your babies. Or even do the dishes. Or driving! Freemies are amazing. Check them out! 
*WARNING* your boobs will look bigger than Pamela Anderson's when you wear them. 

Lanolin for your nipples. I personally like Lansinoh, but I bought a jar of organic coconut oil, and I LOVE it. It helps with sore nipples & you can apply it before and after pumping.

Have a strict 3 hour pump schedule (4 hours at night) for the first 12 weeks. Once your milk supply is established, you can drop a pump.

Use an app to keep track of when you last pumped, how much you pumped, your weekly/monthly stats, etc. I use Milkmaild & MommyLog for iPhone.

Encourage a second letdown by pumping past the point of no milk coming out.

Power pump once or twice a week! I usually save this for the weekend when my hubby can help out with the twins. 
Power Pump
Pump 15-25 minutes like normal
10 min break
Pump 10 min
10 min break
Pump 10 min
10 min break
Pump 10 min
Basically, you do one normal pump and then 10 on 10 off for one hour. This mimics cluster feeding and signals your body that baby needs more!
It can take a couple of days before you see results. 

Hooter hiders or something similar is nice to have when company is over or if you just don't feel like you want your boobs hanging out all the time. 

DIY Hands free bra. I bought the medela hands free bra and it was O.K. I made my own using an old sports bra and cut slits where the flanges go. That worked much better than the medela one and cost about 1/4 the price! 

High quality milk storage bags for the freezer. I personally do not like the medela bags at all. I use Lansinoh or up&up target brand. You can lay them flat in the freezer & once they are frozen, you can 'file' them according to date in the freezer and save so much space. Just remember, you are feeding your baby, not your freezer! Have realistic goals! And always try to feed your baby/babies freshly pumped milk at least once a day. This will provide your baby with the nutrients and antibodies that they need for their age. If you let the baby suckle or if you kiss their mouth and hands, your body will know exactly what your baby needs. Isn't it amazing?!

Increasing Lactation
Water (64 oz a day)
Gatorade
Steel cut oats
Lactation cookies
Emergen-C 2x a day
Calories (an extra 400-500/day per baby)
Sleep (which you won't get the first 12 weeks)
Rest (kick your legs up and use your pumping time as 'you' time)
Brewers yeast (capsules, or cook with it, or have a dark beer here and there)
Fenugreek capsules
Mothers milk tea (3-5 cups/day)
Reglan (prescription)
Domperidone (cannot get in U.S.)
Flax seed

If there are more tips or ways to increase lactation, let me know! What worked for you? 



Let's Get Pumped! Part 1

Exclusively pumping... I never heard of anyone doing this before I had my twins. I didn't even really know it was an option! I feel as though I am quite the expert on pumping (I am on month 8 of exclusively pumping).  Here's what happened...

My twins were born two months early. Therefore, they had to spend their first 6.5 weeks of life in the NICU. The first two weeks they were in NICU they had to be fed through a tube 100%.  When a baby feeds by breast or bottle, they use a lot of calories working to get the milk. This is something you DON'T want a preemie to do at first. Preemies need to conserve all the calories they can until they start gaining some weight.  Also, their suck/swallow/breathe reflex doesn't start that early.

The evening they were born a lactation consultant came into my hospital room to teach me about the pump. She placed the flanges on me, and showed me how to turn it on, and all about the speeds and suction options. About 2 minutes in, I started producing a tiny bit of colostrum! I was very lucky to be able to have my milk come in this early. I set my phone alarm for every 2 hours and I pumped all through the night and all day. I pumped in my hospital bed and I pumped in the NICU in between the twins' isolettes. Around 2 weeks I extended my pumps to every 3 hours. My husband and sister were such a big help at this time. I was recovering from a brutal emergency C-section and they woke up all through the night with me to get me my accessories, help me get set up, wash all the parts afterwards, and take the milk down the hall to the NICU. They did this every 2 hours for 3 nights.  When I was sent home, my husband still helped me all night. When I didn't set an alarm, he would remind me when it was time to pump. It was so nice that the boys' getting breast milk was important to him, too. It really does start to take a toll on your body!

When the twins were two weeks old I was allowed to start 'non nutritive nursing' with them.  This is when the baby is placed at the breast as if it were going to nurse. Some do this early, some don't. My twins did! I thought this meant they would be exclusively breastfed, but that wasn't the case. More about that later...

Reid and Dayton breastfed 2-3x a day in the NICU. It was a wonderful way to bond with them. I would take my Breast Friend Twin nursing pillow and everything went well.

When the twins came home from the NICU I had a freezer FULL of breast milk. That didn't last long once they started hitting growth spurts, though! My plans for breastfeeding did not work out. The twins had severe reflux and would choke, aspirate, scream, and pull awake whenever I tried.  If I had only one baby, I probably would have kept trying more than a few weeks. Finally I started to accept that they would mainly be bottle fed. The perk to that was I could have my hubby, family members, and friends help me feed them. The con was that I still had to pump every 3 hours. 

Here is an idea of what my schedule looked like:
Let's say we start at 7 a.m. to make things easy (of course with preemies there is no 'start' and 'end' to a day. It is a cycle of 3 hour feedings non stop).

7-7:10 AM: Wake up and start bottle in warmer
7:10AM: Change both diapers
7:15 AM: Prop babies up on Boppys in the Playard
7:20 AM: Feed babies (*note: the twins had severe reflux so feedings were very difficult for us.  Feeding them consisted of the babies screaming, arching their backs, and spitting up constantly. Some feedings went well, some didn't.)
8:00 AM: Babies finish eating and spit up for about 5-10 minutes while I attempt to burp them. Then they cry some more. I console them and they finally settle down.
8:15 AM: Take babies back to co-sleeper and swaddle to go back to sleep.
8:30 AM: Sit down to start pumping.
9:30 AM: Finish pumping and store milk in refrigerator.
9:35 AM: Wash all pump accessories and bottles
9:45 AM: Lay down in bed to sleep. Guess what? The babies will need to eat again in FIFTEEN MINUTES!!!!!!!!

Do you see something wrong with this?? My hubby started out helping with each feeding during the night so it wouldn't take as long and I could pump. This would allow me about an hour of sleep. That wasn't working for either of us. So instead, we took turns with the night feedings. I would take the 1AM and he would take the 4 AM, then I would take the 7 AM. That worked best.

My life at this time was rough. Having twins is hard enough. Then to throw pumping every 3 hours and reflux on top of it all was very hard.  I was a wreck. I felt like I was going to die of exhaustion at any minute. I can't believe I survived! GO ME!

Anyway, pumping at that stage was very difficult but it got easier when the boys got older.  After 12 weeks pp, milk is established. I started increasing my time between pumps to every 4 hours during the day, and one time at night. That helped a lot.

Now at 8 months pp,  I am pumping 4 times a day and not at all in the middle of the night. My last pump is around midnight and my first pump of the day is around 8am.

I survived!

My next post will be about tricks I have learned to make pumping easier, and ways to increase your milk supply.

Products I couldn't live without & Products I hardly use

I am by no means calling myself an expert on products each family will need when baby/babies arrive.  However, I do have a lot of things I have found necessary, helpful, and things that I could have lived without. My list is based on having twins and being an (almost) exclusive pumper (they will nurse randomly, but 99.9% of their feedings are from me pumping and supplementing with some formula).
Here is my list!

Things I have DOUBLE/MULTIPLES of:

2 Boppys & extra boppy covers
2 Bouncy/Vibrating Chairs (we have the Fisher Price Crusin' Motion Soother and it is AWESOME!)
This chair simulates a car. It vibrates like a car ride, and even has the motion of going over small bumps. The sounds are great, too. One sound option imitates windshield wipers and rain.
4 sets of pumping accessories
During the NB phase we had about 6 bottles
After the NB phase we use the same bottles each time and wash in between feedings
2 boxes of diapers at all times+ an extra box of the next size up
2 Jumparoos
These are great when I need to get something done around the house or pump. They can be entertained and exercise at the same time without requiring me to do it!
Bibs (about 10)
Clothes dividers for the closet to separate clothing by size

Sheets for the crib (2 sets for each crib)
2 cribs
Receiving Blankets (at LEAST 10) & my favorite are the really thin large ones
2 sunshades for the car
2 mirrors that attach to headrest of backseat for car
24 pkg baby wash cloths (not only are these great for washing baby, but I use them for washing bottles and pump accessories. My dog gets up on the counter and actually takes them and eats them, so I always have extras hiding!)
2 Fisher Price Space Saver High Chairs (with multiple babies, its nice to have things that don't take up a lot of space!)
Baby hangers
Toys that attach to the handle of each car seat
Rattles (they LOVE rattles)
Motorola baby monitor with TWO cameras
 
 
Two large diaper bags. I keep one in the house, and one in the car.

Things that I have SINGLES of:

Arms Reach Co-Sleeper (do NOT get the mini! Even with a singleton! More than likely your baby will outgrow it within 2-3 months. With twins, it would pointless. The co-sleeper also converts to a Playard so unless you want a TEENIE TINY playard, don't waste your money on the single.) My co-sleeper still fits both of twins and they are 8 months!
Bottle warmer (we use Dr. Browns and LOVE it. It was $19, and heats the bottles of fast! It can also be used to sterilize pacifiers)
Bottle drying rack
Dishwasher basket for small bottle and pump accessory parts
Babyganics Dishwasher Detergent
Palmolive Baby Dish Soap
Dreft (I LOVE the smell of Dreft. Sometimes I just smoosh my face in their clean laundry and inhale)
Sound and Projector machine
Bottle Brushes
Graco electric nose aspirator (only about $15-$20 and well worth it!
Saline nose spray (gets those stubborn boogers to come right out!)
Desitin Maximum Strength diaper rash cream. This is the BEST cream we have found.
Those fabric books that are crinkly. The twins LOVE those books
Wipe warmer (no more cold-shock on their bum and seems to decrease the amount they pee when cold air hits them)
Foam puzzle pad for the floor. Great for tummy time, rolling over, and starting to crawl on.
 

Probiotics (we use the Gerber Soothe brand)
Humidifier
Bathtub with built in thermometer to regular water temperature. My lil dudes ALWAYS have perfectly heated water)
Baby Q-Tips
Glider (I have the Newco Rosie. It is SO COMFORTABLE! It also came in handy when I was huge preggo and on bed rest. When the twins were newborns I would put them on my chest and nap so hard in that chair.
Maya Ring Sling for baby wearing

Baby Bjorn (I actually won one of these from a giveaway by Baby Bjorn!) This might be in the DOUBLES section if our SO wants to wear a baby, too.
 
Infant Swing
 
Toybox
 
Over the door shoe organizer for nursery closet. I put all their extra bath products, diaper rash creams, travel wipe containers, lotions, q-tips, etc in this.
 
Lavender baby lotion
 
Thick quilt to lay on the floor for tummy time
 
Double stroller ( I have the Contours Option LT and I'm in love with it!!) I could probably do an entire post about a review for this stroller because it's amazing.
 

Car Seats. I went with the Peg Perego SIP 30/30 after much research (what else was I going to do on bed rest?) The NICU nurses gawked at these for about 20 minutes when they saw them with my stroller. One of the charge nurses was telling me about how she went on scene to a car wreck where the car seat was found down the road from the car. It had been thrown out of the car with the baby in it. Guess what? Baby was fine! That definitely made me feel better. The CON to these are they are not convertible and the max weight is 30 lbs.

Laundry basket designated to babies. With multiples, you will be going to be washing laundry all. the. time.

Changing pad that can be taken from room to room. While in the NB phase, I was changing diapers everywhere. In my bedroom, on the couch, on the coffee table, in the nursery, on the floor...anywhere!

Cuisenart baby food maker
This steams the food before pureeing it! It also has a bottle warmer built in.


Infantino Fresh Squeezed Squeeze Station

Things I could have done without:

Swaddle sacs. I learned to do a mean swaddle with just a receiving blanket, and the Lil Dudes seemed to prefer my swaddle over these.

Tummy Time activity Mat. A quilt on the floor will do the trick nicely. I hardly used their tummy time mat because as newborns, they didn't care about it. When they were old enough to want to interact with things, they were too big for the mat! So a quilt or the foam pads with toys all around them did the trick.

Baby Oil and Baby Powder. I've never had to use it.

Newborn Hats. Research suggests these can case baby to overheat during the night anyway.

Newborn shoes

So, there's my list! Hope it helps an expecting mother of multiples in preparing for new arrivals!