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Thread: pumping while nursing the other breast

  1. #1
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    Question pumping while nursing the other breast

    Hello. I've heard people talk about pumping on one breast while nursing on the other, and it seems like a good idea, but I can't figure out how people manage it. I try to pump about 4ozs in the morning, usually in bed right after I've breastfed my 11-week old son. But I always leak profusely from the nonnursed breast while breastfeeding and would much rather that the milk went into a bottle rather than dripping into a diaper. I'd also like to take advantage of the letdown from the pumped breast to get some more hindmilk into my baby (I have a bit of an overactive letdown and am working on eliminating green poops).

    I'm using a medela harmony hand pump, which I think is pretty good (although I heard that the Aventi manual pump is somewhat better). I tried using a medela electric single pump but I don't like the whirring sound (it bothers the baby) and find the manual pump much more comfortable and efficient. But I can't seem to manage my baby and the manual pump at the same time Any suggestions?

    Oh, one more question. I often try to pump about an ounce from the nursing breast before putting the baby on, to cut down on his foremilk consumption. Then I make up the other 2-3 ounces from the other breast, sometimes returning to pump the first breast after the baby finishes. Will this make my pumped milk too "thin" (i.e., with too much foremilk)? Is this a good strategy for dealing with overactive letdown?

  2. #2
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    Default Re: pumping while nursing the other breast

    Hi Annie,
    Congratulations on doing so well with ds and BF!

    Before I answer your questions in too much depth, it would be helpful if I had a little more info. Sorry!

    What are you using the EBM for? Are you working or leaving ds for some time during the day? Is it just for back-up or the occasional time away? Or is it just to aid in OALD? If you want to let me know, I can give you some better answers to you questions on OALD.

    Many moms who pump while nursing are using an electric pump, but it is certainly not necessary. They get the pump all ready next to them, and then latch db on in the football hold (so little feet don't kick the flanges!) Then they start the pump, or right after they feel a letdown on the other side. (Whenever works for you) Also, have tried letting the extra milk drip or run down into a large-mouthed jar? (clean, of course!)

    Thanks!

  3. #3
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    Default Re: pumping while nursing the other breast

    Hi Kate, thanks so much for your reply. I'm home on maternity leave from university teaching, but I still need to go into the office occasionally for meetings or to see students, and I try to get to an exercise class occasionally when my partner is home. I try to always have a fresh bottle on hand for him to use with our son, and I'm also trying to build up a good reserve in the freezer for when I'll need to travel to a conference later in the spring. I had been pumping sporadically throughout the day, but Rebecca (aka Quakermomma) on the infant forum suggested I pump at the same time each day so that my body knows what to do and it doesn't contribut to OALD at other times of the day. I'm now also using it to siphon off some of the copious foremilk in my engorged breast at first feeding in the morning (about an ounce before having him latch on). I'm trying to balance by going back to get some hindmilk from that breast after ds finishes, but I'm not sure I always succeed in balancing, since the second breast (the nightime breast) is usually rather full too, so I'm getting more foremilk there. I don't know, maybe this is too much obsessing? I wrote a long update post about it on the infant forum but so far no responses. The poops are looking better, mostly yellow yesterday. I'd appreciate any suggestions!

    Also -- is the Aventi manual pump better than the Medela? I have a feeling that the Medela harmony isn't working as well recently..........

    Thanks! Annie

  4. #4
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    Default Re: pumping while nursing the other breast

    Hi Annie,
    Here are your questions from your post on the Infant Forum. I thought it might be helpful to address everything together!

    1. When you block feed for, say, four hours, does this mean that you just feed on one breast during that time and then start the other breast at, after, say, 6 hours, or actually 8 hours, assuming two hours between feedings (with two hours on either end of the block)? That gives the un-nursed breast a lot of time to engorge -- which happened the first few days. Now the second breast seems to have less milk when I finally switch, and he doesn't seem satisfied. Hmm, I just reread that and realize it's very confusing. I'd appreciate it if someone could explain exactly how you time the blocks and what this means for the unnursed breast.

    You have this exactly right! When block feeding, you are trying to downgrade supply. So you should notice a difference. But hopefully it is not a negative difference, just helpful for your ds. Most moms with oversupply start with 2-3 hour blocks of time, for a couple of days. If that doesn't seem helpful they will increase the blocks to say 4-5 hours. If you experience engorgement during this time it is helpful to pump or express just enough to feel more comfortable, but not enough to tell breasts it is a full feeding!

    2. One strategy I tried was just to nurse twice on each breast and then switch to the other. Is this an effective blocking strategy?

    If you are trying to downgrade supply then you would want to limit feedings on each breast for a designated period of time. If you are still stimulating both breasts during that time you will not see a downgrade in supply.

    3. Why am I still getting greenish poops? And why especially at night? Can someone tell me how long it takes to go from breast to poop? I'd like to be able to tie a given pooping episode to a feeding block. For example, is a green poop at night linked to an engorged breast in the morning, when he might get a big dose of foremilk?

    I can't say exactly how long from breast to poop, but I can check for you. But yes, it would hold that one episode could cause a green poop.

    4. One thing that may have contributed is the fact that we traveled to see family last weekend and I also took my son to a faculty meeting on Wed, in which I breastfed. In both cases I was BIPing on the go, and didn't have time to have him nurse or fuss on a slow-flowing breast for a long period, so I switched breasts more quickly, just so he would be satisfied more quickly. Could this be a source of the return of the green poops?

    Absolutely! Switching too soon could definitely have caused the green poops!

    I will come back in a little while and try to address your concerns from this post! DD's are hungry for lunch so I have to run!

  5. #5
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    Default Re: pumping while nursing the other breast

    Thanks Kate! So let me see if I have this straight. If I am trying to do a 2-3 hour block, and my baby is feeding every 2-3 hours, then what I'm essentially doing is offering one breast per feeding and switching to the second breast at the next feeding. Is this right? That's the part I find confusing. Or should I be nursing two times in a row (or more) on the same breast? I'm a bit worried about cutting supply too much as I think my oversupply issues are really mild. And yesterday evening he seemed really frustrated that he wasn't getting enough, even after several letdowns.

    On the pumping question -- I haven't been able to get really comfortable with the football hold, I think because my ds has a bit of a recessed chin and in the football hold I can't see what's going on with his bottom latch. That's not so much a problem now as he basically knows what to do and latch isn't really an issue (even if the latch is imperfect, he's getting enough to eat and my nipples aren't sore). But we've fallen into a pattern of using the crossover hold to latch on and then relaxing onto the my brest friend pillow. That's a really awkward position for simultaneous pumping. But I find the football hold awkward and uncomfortable -- he always feels like he's slipping away. (He's a big baby, 13 1/2 lbs at 11 weeks). Any suggestions?

    I look forward to your response to my other pumping issues above. I'm finding these exchanges so helpful!!!! This forum is a terrific resource.

    Annie

  6. #6
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    Default Re: pumping while nursing the other breast

    Hi Annie,
    Ok, let's go over this!

    [QUOTE=annie]Thanks Kate! So let me see if I have this straight. If I am trying to do a 2-3 hour block, and my baby is feeding every 2-3 hours, then what I'm essentially doing is offering one breast per feeding and switching to the second breast at the next feeding. Is this right? That's the part I find confusing. Or should I be nursing two times in a row (or more) on the same breast?

    I'm sorry I wasn't clearer on this! Block feeding is accomplished by feeding from one breast any time during the time period that you have chosen. To put it another way, if you are shooting for 3 hour blocks, anytime ds wants to nurse during those 3 hours you would ONLY put him on the right side. Then for the next 3 hours, anytime he needed to nurse (whether it was once or 5 times) you would only put him on the left side. What happens is during the down time the unused breast slows in production. Eventually they even each other out and both will slow in production.

    It is important to follow your instincts on this. You are with him and know him better than any of us! If your oversupply issues are pretty mild and you feel like he was frustrated than definitely do not go longer than 2-3 hours with block feeding.

    I'm using a medela harmony hand pump, which I think is pretty good (although I heard that the Aventi manual pump is somewhat better). I tried using a medela electric single pump but I don't like the whirring sound (it bothers the baby) and find the manual pump much more comfortable and efficient. But I can't seem to manage my baby and the manual pump at the same time Any suggestions?

    If you are happy with the pump you are using and you find it comfortable and efficient, I wouldn't think a change is necessary. You mentioned not being sure that the Medela is working so well lately. Was this a new pump? Why do you think that?

    I understand you are having a hard time trying to pump and nurse at the same time with the manual pump. Instead of looking into buying a new pump would you consider renting a pump for a couple of months? I know you are happy with your current pump, but if you don't like the fact that you are losing milk while single pumping, a rental would allow you to double pump and get all of that precious milk! Also, some moms have found that direct pressure to the opposite breast will stop leaking during let-down. Have you tried this? Also, have you tried putting some pillows under him during football hold? Your right, this does get to be a harder hold as babies get bigger. This is out there, but would it be possible to lie down and nurse him on one side while pumping? Just brainstorming for you! Maybe some other moms will chime in with suggestions from their own experiences.

    I think it is important to look at the two different reasons you are using a pump. The first is to down-grade your supply. You can accomplish this with any type of pump, because you do not need the pump to perform as your ds would during a full feed. The second reason is to provide milk for ds while you are separated. In this case, you are pumping as a full feeding session. Is this correct?

    Oh, one more question. I often try to pump about an ounce from the nursing breast before putting the baby on, to cut down on his foremilk consumption. Then I make up the other 2-3 ounces from the other breast, sometimes returning to pump the first breast after the baby finishes. Will this make my pumped milk too "thin" (i.e., with too much foremilk)? Is this a good strategy for dealing with overactive letdown?

    Ok, you got me here! Let me see if I can understand and shed some light...I see you are trying to take off the first of the foremilk for ds by pumping off a little. Then you put him on that breast, so he gets to the hindmilk more quickly, right? Then does he nurse on that side until he comes off on his own or falls asleep? That is usually the recommendation and it is how you will know he is done. If you are dealing with oversupply I wouldn't suggest putting him to the second side after this. This is where block feeding comes into play. But if you sensed, as you did last night, that he was frustrated, then you may wish to change the block feeding schedule a bit. Can you help me understand why you go back and pump the first side again? Bear with me here!

    I don't know, maybe this is too much obsessing?

    Worrying about our babies is not obsessing! But I do think that you should be cautious not to take a pretty good situation and possibly add some issues. It sounds like things are going pretty well. Ds seemed a little fussy and frustrated lately and that could be a number of things. Maybe you did downgrade you supply enough for him before but now he is experiencing a growth spurt and is trying to stock it up again! Maybe he is getting a little cold. Maybe he just was bothered by x, y or z. You see where I'm going! If he continues to be bothered, then some adjustment might be needed. Your ds is lucky to have such a concerned mom!

    As far as pumping for planned separations goes...of course when you will be out of town you will need to have milk stored up because you can't get the fresh pumped milk from that day to ds. But for other times, like going to class, meetings, etc, you should be able to use milk that is fresh and not frozen. Here is a link to guidelines for storing milk. It is always best to use fresh if possible.

    http://www.lalecheleague.org/FAQ/milkstorage.html

    I will look forward to your response! I hope I haven't confused you any more!

  7. #7
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    Default Re: pumping while nursing the other breast

    Thanks Kate! These responses are really helpful. Let's see, to answer your questions:

    -The reason I suspected the Medela harmony wasn't working so well is that it seems a bit harder to get a good suction. The pump is new, and I may be imagining it, maybe I was just holding it wrong that day or something. It seemed fine this morning. I may just be jealous of the nice massage function on the Aventi manual pump. I pump really quickly when my breast is full, I can usually get 4+ ozs in 5-10 minutes (less of course after feeding). At this rate and for my purposes it's not really worth it to rent a pump. It just would be nice to pump while nursing. I'll try the football hold and see how that goes. I've been experimenting with side feeding in bed but this morning this resulted in milk leaking all over the mat since we both fell back askeep (we don't cosleep except for naps and some morning time).

    -Yes, I do sometimes use the pumped milk for full feedings, so I want to have an adequate hindmilk/foremilk balance. I know the way I described my strategy is very confusing. In the morning, I don't put ds on the second breast -- I let him nurse until satisfied on the first breast (after pumping the initial ounce or so to drain the foremilk). Then I pump the second breast. After getting 2-3 ounces there, I sometimes return to pump a little on the first breast, since what's left after nursing is usually very rich hindmilk and I want that to balance the initial foremilk. Does that make sense?

    What has been complicating things lately is that it is hard to figure out when my son is satisfied. Sometimes he'll come off for a while, either because he's frustrated at the slow flow (mostly in the evening), or because he just wants to smile and have a conversation (any time of day). Then he'll want to nurse again. So while he's taking a break like this in the morning, I sometimes start pumping the second breast. This of course triggers additional letdown in the first breast, and as I'm loathe to let that good hindmilk drip away (given my green poop issues) I try to latch him back on (to breast 1) quickly, which sometimes works and sometimes doesn't. Lately my morning nursing/pumpinig sessions have fallen into this kind of juggling pattern, with lots of leaking on both breasts. Is this clearer? I thought that pumping while nursing might make this whole process more efficient. Any suggestions?

    (I feel a little like Dr. Seuss in the Cat in the Hat: Breast 1 and Breast 2 have almost become characters like the Things in his story!)

    You're right, things are basically going pretty well, although I do have these subtle issues. I'm less frustrated now that I basically know what's going on, thanks to the help I got on this forum. The good news is that I had all yellow-brown poops yesterday! (But we also had company in the evening, which disrupted our pattern and might bring the green poops back today). I'm just trying to fine tune things, and learning a lot in the process. Thanks for the help, I really appreciate it!

    Annie

  8. #8
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    Default Re: pumping while nursing the other breast

    Annie,
    Ok, you have a lot of milk! I think I have established that!

    I would not suggest that you pump the second side after ds is finished with the first. I would suggest 2-3 hours blocks of time per breast. Period. Going back to pump the second side after he has already finished the first and is satisfied is telling your breasts to make MORE! He is actually telling them what he needs, so I would suggest that you just stimulate the one side at a time. If you find that you have down-graded too much or he is not as bothered by supply issues, then you could try going back to the other side. But that is something that only you know!

    So now you are left with about 1 oz of milk that we are thinking is all foremilk. And you are concerned about giving that to him on its own as it will just aggravate his green poops, right? I would suggest that you just stick that milk in the fridge. Milk can be kept in a refrigerator for up to 8 days.
    Then, another day, you may do a full pumping at the office. You can bring that milk home and mix them together and then freeze them, or give them to ds within the next few days.

    Also, according to LLLI's tear-off sheet on Storing Human Milk: "You can add fresh milk to a container of frozen milk as long as ther is less fresh milk htn frozed. Cool the fresh milk for 30 minutes in the refrigerator before pouring it on top of the frozen milk in the freezer."

    You may find that getting the exact portions of foremilk/hindmilk with the EBM is not as important as it once was. As ds gets older, this may become less of an issue. You will certainly know if it is, because you know what to look for.

    What you described with him losing interest and coming off to smile and play is very normal! Welcome to the world of nursing an older baby! Some moms find it helpful to nuse in a darkened, quiet room during these times to eliminate distractions. If he seems consistently frustrated at the breast due to a possible slow flow, then I would consider stopping the block feeds. Let him nurse as long as he wants on the first side. If he comes off, offer it again. If he refuses, then try another tactic with him. Maybe he really is done and just ready to do something else: walk, play, sing. Get dp in on the act at this point. Sometimes others can comfort babies in ways that we can't! If that doesn't work, try the other breast (if you have decided to quit block feedings). This is not the time I would suggest breaking out the pump again. I know I mentioned this before, but have you tried putting direct pressure on the nipple of the leaking breast? I know lots of moms do this in public to stop let-downs on the non-nursing side.

    Let me know how things are going. BTW-loved the Cat in the Hat analogy!

  9. #9
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    Default Re: pumping while nursing the other breast

    Hi Annie--just wanted to let you know that I had the same issues you did...and wanted you to know that my daughter was able to handle the overactive let-down at about 12 to 14 weeks old. For some reason she was able to handle all the milk. Now she's almost 4 months and eats five minutes on each side. I used to do the block nursing only in the evenings and that helped a lot. Just wanted you to know that it will change a lot in the next few months! good luck!

  10. #10
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    Default Re: pumping while nursing the other breast

    Kate -- yes, I guess I do have a lot of milk, at least in the morning. The supply really seems to dwindle by evening. However I think that he is getting more patient at working for the additional letdowns. I had several good nursing sessions today where he kept at it until the milk came down repeatedly. He was very fussy right before bedtime, though. I think he may be entering his 3 month growth spurt a bit early.

    His poops are back to mostly yellow, although he's still had one burst of green poops in the evening for the past two days. If you ever find out about the "time from breast to poop" issue, let me know. I'd like to know if I should trace the green poop in the evening to the first morning feed (where I have a lot of built up foremilk) or to sometime the previous day, say 24 hours earlier.

    I'm only pumping in the mornings so that I maintain the capacity to get that extra serving when I need it (like today when I went out to lunch with a colleague while dp gave him a bottle of ebm). Otherwise I'm leaving the pump alone.

    And yes, he is currently more and more alert and discovering the world. And he loves Dr. Seuss! Who would have known. I think there's something in the rhythm and rhyme that makes him babble along happily through repeated reads of The Cat in the Hat and One Fish Two Fish.

    Mom-to-Emily -- thanks for the encouragement! I'm loving this forum for being able to talk about the nuances of these various stages to other moms who also spend most of their days thinking about the fascinating subjects of breasts and poops! What a learning curve!

    Annie

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