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Thread: Do I NEED to Pump?

  1. #1

    Default Do I NEED to Pump?

    QUESTION:
    Do I NEED to pump?? Or, can I just try focusing on exclusively nursing?

    BACKGROUND:
    With my first, I was in labor for five days and my daughter was taken to the NICU for precautionary antibiotics because I spiked a fever while pushing (unsurprising, I literally hadn't slept in FIVE days—baby ended up being totally fine).

    The nurses INSISTED I pump in between feedings even though I was able to be with her and nurse her in the NICU constantly(?) So, after nursing for 40+ mins, spending 30 mins walking each way from the NICU back to my maternity room to change my own diaper, on top of no sleep through 5-days of labor, I LITERALLY got no sleep in the hospital either. I was so physically traumatized and exhausted by the nursing/pumping schedule, I only made it six weeks breastfeeding and I think that may have been a contributing factor.

    When we got home, she nursed for 40-60mins each time, then it would take me another 30-40 mins to pump and I could only get 4oz. MAX ever (even when I switched to exclusively pumping and was pumping every 2-3 hours at 6 weeks).

    I feel that focusing on nursing and not worrying about pumping after each feeding may have helped me A LOT. It felt impossible to let her nurse and THEN take time to pump and clean pump parts. There was literally no time for me to sleep. But the NICU nurses and my in-home lactation consultant all told me I HAD to pump (the hospital nurses were mean about it when I begged to skip a session because I was SO exhausted )

    Do I NEED to pump?? Or, can I just try focusing on exclusively nursing?

    My next baby is due in two months and I'm terrified to fail at this again. I will be treated for my post partum depression right away this time and I'm hoping that will help with my stress/supply.

    Thoughts?

  2. #2
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    Default Re: Do I NEED to Pump?

    I feel like I must be missing something. WHY were you told to pump...was baby being supplemented? Were you using nipple shields? Was baby nursing less than 8 times in 24 hours?

    Of course pumping is not part of the normal course of breastfeeding, so normally it is not necessary to pump at all, and even when pumping is needed, it usually does not need to be after every nursing session.

    Pumping is only needed if 1) baby cannot nurse well or often enough and requires supplements, or 2) moms milk production is low, and again, baby requires supplements. 3) If a mom is using a nipple shield to get baby latched, it is often encouraged she pump at least at first because there is some link between shields and low production.

    But in none of these cases is it typically needed for mom to pump after every nursing session, unless baby is nursing an unusually low number of times in 24 hours. And in that case, the solution might be to encourage baby to nurse more often rather than pump! How often a mom in such a situation needs to pump would depend on what the problem is that is causing her to need to pump and how much supplement baby actually requires over and above what baby can get at the breast.

    As long as your baby is nursing at least 10-12 times a day and gaining normally, baby does not need supplemental feedings. If baby does not need supplements, mom does not need to pump, unless again, she is using shields and then some amount of pumping make sense as a safeguard for her milk production.

    Nurses are usually not equipped with appropriate training for advising in breastfeeding situations. The professional that is more likely to give accurate advice in this area is an IBCLC. I see you had an LC come to your home and say basically what the nurses said, so again, I am wondering if I am missing something?

    It is important that moms (and their helpers) be prepared for the reality of how a newborn behaves, and how milk production responds. After a baby is born, at first there is the first milk, colostrum. There is not much of it, but it is all a newborn needs. Babies lose a little weight after being born. This is expected and usually normal. Each day, the moms milk transitions a little more from the colostrum to the "mature" milk. This takes about a week or two. During this time, milk production increases very rapidly, particularly the first week.

    A newborn baby can be expected to nurse at least 10-12 times in 24 hours, often more. This is important and needs to happen so that milk production is adequately stimulated and also so that when mom begins to have lots of milk, she does not get overly full. Also of course lots of nursing means baby gets enough milk. Frequent nursing is needed because individual meals are so small.

    A baby may be very sleepy at first and may not nurse quite that often at first. Usually this is ok, but in some cases a baby who is not nursing often enough needs to be encouraged to nurse a bit more often for those first couple "sleepy" weeks.

    A typical meal in the first couple weeks (and after the first day or two) is as little as an ounce or two. Later it increases to 2-4 ounces. So if your were pumping 4 ounces when you pumped, that would indicate normal milk production and actually above average pump output.

    Since your first breastfeeding experience was so far outside the norm, I think it would really help you to read up on what is normal. For this I strongly suggest The Womanly Art of Breastfeeding (8th edition) Kellymom is a good website if you prefer a website but best would be to use both! If you have a local LLL meeting I would suggest go. Your older child will be welcome at most LLL meetings. Or call a LLL Leader so you have someone you have already talked to to go to for support if you have any difficulties with this baby.
    Last edited by @llli*maddieb; April 5th, 2017 at 05:58 PM.

  3. #3

    Default Re: Do I NEED to Pump?

    That's what I thought! No, you're not missing anything. Perhaps because she was in the NICU and I didn't have access to her for the first two hours? Maybe that's why they insisted I pump? They were SO insistent after every nursing session I HAD to. I kept being told it was to make sure my milk came in and to keep up a good supply. But, pumping never increased my supply. Maybe it was my pump, but again, at 6-weeks pp (by then I had switched to exclusively pumping) I couldn't get more than 4 oz. at a time—maybe that's normal at 6 weeks pp?

    The LC weighed the baby after I nursed and confirmed she had gotten 4oz. at about 1 week pp. I guess seeing all of these images of women having giant freezer "stashes" of pumped milk had me not questioning the pumping at all. I just know that I won't be successful on a nursing AND pumping schedule if I do it again. It was absolutely exhausting. My friend who just delivered at the same hospital was just told the same thing and she's home now, nursing and pumping a few days pp.

    Is it normal for a baby to nurse for 40-60 mins? I'll check out that book, thank you. This next time around, do you suggest a sling or wrap of any kind to help with that? I can't imagine chasing my 1-year old around while sitting still in a chair for an hour every three hours, so I'm wondering how woman make that work?

    I just feel like I was made to be super freaked out about "my supply." I was having trouble with her latching, but that was within the first four days—we were both still learning, right?! I just needed some confirmation that it's okay for me to "keep it simple" and just focus on nursing this time. Thank you!

  4. #4
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    Default Re: Do I NEED to Pump?

    Well I am pretty flabbergasted. I have seem too many times to count moms who are undermined when they are given advice that harms (lowers, kills) milk production. But it is much more rare (although not unheard of) for a mom to be undermined the other way as you were. But your experience is almost beyond belief!

    If your baby transferred 4 ounces in one nursing session at one week, I have absolutely no idea why you were not told to stop pumping immediately and just nurse. I can kind of understand being told to pump that first week just as a safeguard. But once baby transferred like that, it should have been crystal clear that not only did you have fantastic milk production, but that baby was able to transfer brilliantly. And that, plus nursing with normal frequency of 10+ times in 24 hours, is absolutely all that is needed.

    Here is why I am in shock. According to the Breastfeeding text Breastfeeding Answers Made Simple, at age TWO weeks or older, transfer of TWO ounces at one nursing session indicates normal milk transfer. It does not prove entirely normal transfer and production, because that may have been the only time baby every transferred that much. But it is a reassuring number, especially if overall weight gain was also close to normal.

    So your baby transferred twice that at one week. Basically, this was not just good transfer, or reassuring transfer, which is all you need. This is remarkable milk transfer.

    A baby of about one month needs about 25-30 ounces per day. Some need less, some more, that is the average,

    If a baby consistently got 4 ounces each time baby nursed, and they nursed the norm of at least 10-12 times in 24 hours, that baby would be getting 40 to 48 ounces a day. There is nothing wrong with this, and this might happen if mom has temporary over production. But it is not the norm. The norm is for a baby NOT get 4 ounces when they nurse, but more like between one and four.

    So please do not think that baby getting 4 ounces or you pumping "only" 4 ounces means you do not make enough. This is simply incorrect.

    It appears your milk production was great and your baby nursed great. You never needed to pump as you did.

    Hopefully you also will not have to pump with this baby either. But if you do, make sure it is done in a way that works for you. Not after every nursing session which again, is almost never required.

    Again my best suggestion is the book The Womanly Art of Breastfeeding. IF (and it is unliklely) you do have an issue with production or baby not transferring well, a good book specific to that situation with lots of pumping tips and real world ideas is the book Making More Milk.
    Last edited by @llli*maddieb; April 7th, 2017 at 09:21 PM.

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