blank'/> A LITTLE BIT OF LACQUER: The great big pumping post

June 9, 2016

The great big pumping post

Hi everyone! Today I am bringing you a post that I have literally been working on for months! And it comes based off of what is now hard to believe but true - years of breastfeeding and pumping! 

I'll start with a bit of background so that you mamas know where I'm coming from:

  • I breastfed my first daughter, Olivia, from the time she was born and finally weaned her at 18 months. I had a pretty decent maternity leave and was almost exclusively nursing her for the first 4 months, and then I had to go back to work (eh, medical school) full time. Once I was working it was a mix of breastfeeding and bottle-feeding my pumped milk.
  • I'm currently also breastfeeding my second daughter, Elliot, and she's 6 months old now. She didn't take to the breast as easily as her sister did, and though I knew it was bad because of how much pain I was in, I didn't realize just how bad until she actually started vomiting ingested blood. With her I started pumping much sooner, and because of the latch issues that we were working on and then unfortunately going back to work so soon (I went back to work the day she turn 1 month), I ended up almost exclusively pumping. 
Alrighty, with that bit of background out of the way, let's jump into the post!

Exclusively pumping

The choice to exclusively pump is a hard one - and for most mamas it really just comes out of necessity - if I had it my way we'd have a nice mix of pumping and nursing, but that just didn't work out that way this time around! Exclusively pumping calls for some extra dedication and commitment, but I know many mamas who make it work! Most difficulties start with latch issues, and if you're having them I'd highly suggest seeing a lactation consultant! For my expecting mamas, don't even waste an ounce of your time or money on this yet, wait until you have a babe who is trying to nurse before you seek help! Some babies will have no trouble at all (I'm convinced I just got lucky with Liv), and others will have a harder time. Will breastfeeding initially is not necessarily comfortable in the first few months, it should not be excruciatingly painful - if it is, get help! Aside from latch issues, I know many mamas who exclusively pump because they had to be away from baby for some reason or other - either mom or baby had to be hospitalized, or mom had to go back to work much too soon! And for some others it really is a decision they make - some just don't enjoy nursing, and others really appreciate the extra help that comes with bottle feeding. Whatever your reason is for doing whatever it is you decide to do, that's fine. I like to say that a lot, because I truly think mamas don't hear it enough. Everyone wants to say that their way is right or better or healthier - but guess what - you just do what's best for you and your family and ignore any unsolicited advice! I always like to joke with other mamas that I was exclusively formula-fed (I was) and I'm healthy and happy and most days relatively smart - so seriously, it'll be fine.

There are many reasons to build up a stash - for most mamas it's because they need to head back to work at some point. For others maybe they know they're going to have to be away for a weekend, and still others are battling illness and need to start medication or chemotherapy that will keep them from being able to breastfeed. Whatever your reason, building up a stash usually helps making you feel a little more at ease with the next step, but is a huge stressor in itself!

As I was building up my stash in anticipation of heading back to work (and being out of the country for 3 days) I always had random unsolicited comments from "know it alls" who told me to "trust my body" and that I'll be able to make enough milk for my baby. I'm above responding to comments like that, but what I will tell you, is that those people should mind their damn business. Not all of us are only pumping for the next day; if they don't know your story, don't listen to them.

Now what I will say, is that your body definitely can make enough milk - but what's the absolute worst that can happen? Well, you don't, and need to supplement with formula. And guess what? That's not the end of the world either regardless of whatever anyone says. While it definitely is worth it to try and provide for your baby with your own breastmilk, too many women feel so incredibly defeated if they can't, guilted into feeling like bad moms at the most basic level. If you have to give your baby formula you have not failed your baby! We'll talk more about this towards the end as with my second I definitely have had to supplement here and there!

And don't be intimidated by the pics of insane gold mine stashes (like the pic I used above, that's actually terrifying because I feel like I could never measure up to that)! But we are all "stashing" for different things - just know why your are doing it and build up accordingly. Maybe you only need a stash of one day's worth - that would literally only be a couple of bags - don't compare that to someone else! Mine looked more like this as I was getting ready to head back to work - enough for 2-3 day's worth of milk:

A few tips for building up a stash?

  • Start pumping early, as soon as your milk comes in. While you should always nurse your baby before pumping, many women find it helpful to pump for a few minutes after nursing, even if you only get an ounce! Start storing this in freezer bags and add to it until you have 4-6 ounces in a bag and then pop it in the freezer. Breastmilk is all about supply and demand so the more you pump the more milk you will have, and our bodies are most responsive to those cues when our milk is just coming in. 
  • Use a handheld pump and pump from the opposite side while the baby nurses on the other. With my first, I loved the ease of my manual pump - and with a nursing pillow it really does make it easier to do this. I usually didn't completely empty that breast in case baby wanted to nurse on the other side too, but many women find this helpful!
  • If you're lucky enough to have a baby whose sleep is relatively predictable, pump right after they've fallen to sleep or at a time that works in between nursing sessions.
  • Don't feel like you have to pump extra everyday. Start early and just build slowly, once your milk really comes in you will have milk!
  • Most women want at least enough milk to provide for their baby for whatever amount of time it is they can't nurse. When I was headed back to work I knew I at the very least wanted 3 days worth (because I knew about an upcoming trip) - and you can calculate baby's needs by how much they're drinking. It's obviously easier if baby is already bottle feeding (I knew Elli was drinking 4-5 ounces roughly every 4 hours, so I knew I needed at least 30 ounces). This is actually average - most doctors say about 26 ounces is the "normal" amount infants drink (obviously more as they get bigger). So calculate your goal and take baby steps toward it. 
  • Below we'll talk about some tips for increasing supply, but I really only use these if my supply has taken a dip for some reason or other - if you are nursing and pumping regularly you don't need to use any supplements! 

Pumping at home presents its own set of difficulties, especially when pumping with an infant and toddler at home! The easiest thing is really to find time when both babies are sleeping - this usually means I'm pumping early in the morning or late at night! Some days it's impossible to get them both to sleep when I need to pump, and we just take a little trip in the car so I can have them in their carseats and I can pump undisturbed while driving (I was initially terrified of this but it quickly became one of the smartest tricks ever! See the pic below)!

Pumping at work this time around is actually the hardest thing for me. With my first I was spoiled in an environment with a relatively flexible work schedule, and even on the toughest days I could always at least count on a lunch break! Now as a physician in the hospital (and frequently being the "on call" physician, which means I am the only one available to respond to nursing or patient questions or any emergencies) it has been so much harder. I know my mamas who are fellow hospital workers or in retail, etc might feel me! We have no official break time, so I really do need to advocate for myself, but even then I can still be interrupted! It's been tough for sure but we're making it work! For those with a decent commute to work in their car, pumping then is a great time. My commute is only 7-10 minutes most days so it's not enough for me to pump (I usually pump for 20-30 minutes to completely empty both breasts given that I only do so every 6-8 hours).

A few things that have helped.

  • Having a small, no-fuss pump. At home I usually use my Medela Pump In Style (I bought this one to use with Liv, and then for Elli my health insurance provided this pump for free), but for work I love having my Freestyle (thanks so much to the team at Medela who sent me it)! I charge it maybe every few days, but I can pump anywhere and don't have to worry about being near an outlet since it's wireless. For those of you with the pump in style there definitely is the option to buy a battery pack, but the pump itself is still on the larger side.
  • Pump handsfree so you can catch up on emails or whatever while pumping. Personally, I have small enough breasts that I've always been able to just put my pump inside my nursing bra and use that (along with the suction of the pump) to be able to pump handsfree. They also make nifty tops for women who might need more support like this one. And for my DIY mamas I loved the idea of cutting two holes into an old sports bra and using that (like this) - that was totally my plan until I figured out any bra actually worked for me!
  • Skipping cleaning parts in between pumping sessions. After I've pumped I literally just toss my parts in a gallon-sized ziploc bag and put them and my pumped milk into the fridge. The cooler temperature keeps bacteria from growing. I just wash my parts all together at home at the end of the day with plain old soap and water - boiling etc. etc. is really not necessary! 
  • Another space-saving/parts-saving tip - just bring two bottles to pump in and then store your milk in breastmilk bags - I know too many mamas who are carrying around 4-6 bottles to pump in while at work! 
  • Drink plenty of water throughout the day. As busy as it gets you can't forget to stay hydrated!
  • Coffee is ok. Many women are terrified to drink coffee if nursing/pumping, but coffee in moderation is absolutely ok. I would definitely recommend observing your baby, but neither of my girls have ever been bothered by my 3+ cups of coffee habit. If you are concerned, just pump right before you have your coffee and limit your intake to an amount you feel comfortable with. There is also rumor that coffee decreases your supply. While it is true that caffeine is a natural diuretic (meaning it makes you pee more) - coffee isn't just caffeine - it's mostly water! So it really should all balance out. Regardless, though, if you're at all concerned just make sure to drink plenty of non-caffeinated beverages throughout the day as well.
  • Wear pump-friendly tops. There are amazing companies that make nursing/pumping tops (check out a great selection here), but many of them can be pretty pricey - I have a few though and completely love them! But, there is no need to invest in a new wardrobe. One of the easiest things to do is wear any top you like and always wear a stretchy v-neck camisole underneath (pretty much what I always do when wearing scrubs) - that way you can just lift up your top but still stay covered. You can also get away with pumping easily with a button-up top or most V-neck cut tops. Even dresses that have a few buttons up top or are V-neck or wrap-style are pumping friendly! There are days that I've completely forgotten to dress "pumping-friendly" (think, full on sheath dress) and pretty much just had to completely undress from the waist up and it's not the end of the world either!
  • Don't be embarrassed to speak up for yourself. It was always hard, especially with my first when I was on rotations as a "student" having to tell new professors or attending physicians that I was going to miss lunch, but I still never let that stop me. "I'm sorry I have to pump." is enough. Those who don't know what you're talking about will ask, and then likely feel embarrassed for asking when you explain (it happens to me all the time and it's alright) and those who know will completely understand.
  • Know your rights. Check out this site to educate yourself as an employee or arm yourself to educate your employer. 
  • Legally your employer has to provide a place to pump, but this again can get tricky. I pumped in a call room which really was the best option; sometimes I had to pump in the car or in a shared workroom though. 
  • Random troubleshooting tip - if your tubing starts building up condensation, just make sure to run your pump for a few minutes after you're done pumping - I like to keep mine running while I store my milk. 
  • I was spoiled during most rotations having access to our work room refrigerator where I could store milk, but it wasn't always available. I always use an insulated cooler lunch bag and make sure to have an ice pack if I don't anticipate having access to the fridge.

Traveling with Liv when she was still nursing was always a breeze - I could simply nurse her whenever we needed to and that was that. Traveling with Elli takes a tiny bit more planning - I need to pack along my pump and parts, as well at least a bottle or two of already pumped milk so I wasn't playing catch up all trip. For the most part, though, I try to stick to my "regular" pumping schedule - again, having a pump that doesn't require an outlet is a huge plus - I can even pump on the plane if I need to!

Traveling without the girls is the bigger issue - but we've now done it multiple times and I think we've got a great system! I will say though, my milk supply almost always takes a hit when we're traveling without the girls, simply because I do try and space out my pumping sessions as much as possible. I know it's not good (again, it's all about supply and demand, so if the demand drops so will the supply!) but sometimes it's hard to pump while celebrating a wedding weekend or something of the sort - even with the smallest and most convenient pump! Alright with that out of the way - here are some tips for pumping while traveling.

  • Bringing along the right bag. I love traveling with our XLR8 backpack - technically it's a diaper bag and functions amazingly as such, but I actually think it makes for the perfect travel bag even without the kiddos. Obviously leave the changing mat out, but the insulated pockets are key when it's time to bring my pumped milk back home after traveling. And there are the sweet extras like a charger, a blue tooth speaker (makes for fun dance parties in the hotel room), the little LED flashlight to find your stuff when you're hunched over the airplane seat trying to find a pack of gum, and of course all of the organization! And as a bonus my husband has no problem carrying it around like its his (in fact, he tends to pack his stuff in it more than I do and I just bring my purse)!
  • Booking the right place to stay. For a while we were doing a ton of air bnb's, and while it always was a great experience, the more and more I read about landlords evicting tenants (and usually those with lower incomes) to convert the apartments into airbnbs that they can make more money on has somewhat turned me off (although I've still used it for renting out entire homes etc, it's overall still a fantastic service)! Anywho, lately I've just been using the app on my phone to book places - I love that their reward system is so straight forward and I find better deals on the app then I do on the website (I'm not sure why this is). The key is to find a place that at the very least has a fridge/freezer. This is key for storing pumped milk and being able to bring it back home! Now obviously if you're someone who really has built up a serious stash, you may be able to simply pump to keep your supply up but dump where you're staying and don't have to worry about bringing any back - lucky you! For most of us though, I need all the milk I can pump! 
  • Bring along a convenient pump and milk storage bags (I initially used these, but now find that these are usually cheaper - at least in store - and I find the bags actually hold up better). When you pump and fill your bags, lie them flat in the freezer. When it's time to head back home these flat little bricks of frozen milk make for easy packing! Honestly I'm not sure what the latest airline regulations are about bringing frozen milk in your carry-on, but I will say that I've done it now at least 4 times at different airports and have never had any problem. I just leave it in my bag and figure if it's a problem they'll tell me, in which case we'd just check the bag, but again, so far I've never had an issue. 
  • Try to stick to a regular schedule. As I mentioned above, this is personally the hardest part for me when traveling with my husband. It's so rare that we get "just us" time that I don't want to be spending it pumping every couple of hours! But it is key to making sure you keep your supply up! Everyone's schedules are different, especially if you usually nurse and pump, but as someone who exclusively pumps, I actually tend to pump only 3-4 times a day - roughly every 6-8 hours. But each session I get 5-6 ounces from both breasts so my body is just adjusted to that schedule! When I do come back after screwing with that schedule, I tend to increase the frequency of nursing sessions to build my supply back up and follow some of the tips below.

Keeping up supply

The key to keeping up supply is increasing demand, which means pumping (or nursing) more frequently! It's also critical that you drink enough fluids throughout the day (and calories). One other factor that plays a huge role is stress. I can directly see the effects of stress on my milk supply - there are days that I've changed absolutely nothing except for being stressed about an upcoming presentation or whether or not I'll have time for xyz, and I'll only pump 2 or 3 ounces instead of my usual 5 or 6. When pumping, it really is best to keep your mind off the task at hand and instead relax - if I'm having trouble I'll scroll the pictures or videos of the girls doing something adorable, or even play a mindless game on my phone that distracts me. It's hard because especially when our supply takes a dip, the first thing we do is stress about making enough milk and becoming hyperaware of our output, but seriously try and keep your mind off of it as this only exacerbates the problem!

I love having snacks I can depend on to boost my supply - Mrs. Patel's has been a go-to of mine since having Liv and I still love her peanut butter fenugreek bars more than anything! Others love mother's milk tea, although I can't always tolerate the licorice taste - these supplement pills also have great reviews, but when I tried them I couldn't get over the licorice taste and felt it made Liv more gassy (it could have been pure coincidence though as others love them)! When it comes to snacks - oatmeal is a great one, and there are even lactation cookies too!

One thing I will add in is that supplementing with formula is not the end of the world. In fact many moms choose to only formula feed and that is their decision and should be respected. Like I say, I was a formula fed baby (as was my husband) and I think we turned out ok! Seriously, there are far worse things than having to supplement with formula. Obviously if having more supply is your goal, you should make sure to continue pumping even when you need to supplement (ie, make sure you're not substituting). I've had to supplement with formula many times with Elli - mostly the times I was traveling and flights got delayed or there was some other extension of the trip that meant my milk supply I pumped in advance ran out! And even on days that I'm working 14+ hour shifts at work and working on getting my stash back up my mother-in-law might have to supplement with a bottle of formula at the end of the night. When we first started supplementing we loved the Enfamil formula; Elli never had any issues with it. The packets were especially convenient. Recently I found out (I'm likely just way behind) that infant formula is actually highly regulated though, so store brand/non-name brands are pretty much exactly the same as name-brand (but cheaper). We have used Target brand and Kroger's brand and have had no issues. I found I was spending a lot of money on the travel packets, and so I actually bought this nifty stackable storage cup with spout that makes pouring powder formula on the go a breeze!

Bottle feeding

When it comes to bottle feeding, I've absolutely loved my Dr. Brown's bottles. With Liv we used mostly the medela bottles and these were great as well, I think for traveling and packing up diaper bags these ones are just easier (and I'll shamelessly admit that I think the pink bottles are adorable). I initially got this Ergobaby pillow with the intentions of nursing (it came highly recommended from my lactation consultant), but when that didn't work we still use it just for more comfortable bottle feeding. It also frees up a hand for those late night feeding sessions when I almost need to be reading something to stay awake!

Alright y'all, I feel like I've exhausted most of what I know about pumping, but I'm sure there's always more - make sure to leave your questions or comments below!

Aaaand, for those of you mamas needing a new pump - I'm teaming up with Medela to give a lucky winner my favorite pump - the Freestyle! Enter using the Rafflecopter widget below!

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  1. What a great post! I am hoping to have be successful with nursing my second and going back to work scares me! It was a huge stressor with my first. This post has some great information, is easy to read and makes it seem totally doable! Thank you!

  2. Thank you so much for sharing, this is a great post! I am an almost-done-with-first-year medical student and am expecting my first baby in October. Seeing how you do it all inspires me so much!

  3. Thank you for posting this! I'm due in 3 weeks and most of the nursing/pumping posts I've read are written by SAHMs or WAHMs, and what works for them won't work for me (going back full time after 8 weeks). Very encouraging!

  4. Thank you for this wonderful post. I am in a similar boat with my first, where he does not latch and I have had to exclusively pump from the beginning. How did you transition from pumping to build supply at the beginning (I am pumping 8 times a day) to pumping to maintain?
    Also, what is your system for handling all the bottles? I have been using Dr. Brown's bottles too, and while I love them, their extra pieces and parts are an inconvenience when it comes to cleaning and prep.

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  6. Thank you for the post! I'm waiting until after med school to have a baby, so it's nice to read about things like this and think ahead!


  7. this is such a useful post!!! I'm definitely counting on pumping to keep the supply coming and also once I go back to work and can't breastfeed all the time. It's always good to think ahead (and I consider myself a planner, so knowing I should start storing from the beginning is really good to know)

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  15. Now that I've been nursing for 2 months and back to work for 3 weeks (Peds PGY2, soon to be 3 and senior on the floor), I'm trying to find ways to cut down on pumping prep/take down at work. I use the simple wishes hands free corset type bra but I'm trying to figure out how to just stash the flanges in a regular bra because I'm sure it should work with my size. I wear the bravado nursing bra for both work and home and the flanges definitely don't work with that. Any recommendations? Also looking for more nursing bras (quantity) so if there's a nursing bra you love I'd appreciate the recommendation! I bought the Lamazze nursing bras for nighttime per your rec and they are wonderful!


I love getting your comments, they make my day! If you have a specific question you want answered, please send me a message by clicking the Contact tab at the top, or even better, contact me on twitter or facebook and I'll get back to you ASAP! Thank you so much for reading!

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