The Boob Group
Exclusive Pumping: The Basics

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ROBIN KAPLAN: There are times when a mother who plans to breastfeed is faced with the challenge of a baby who is unable to feed directly from her breast. Her choices may come down to completely drying up or exclusively pumping. How can a mother make exclusive pumping work for her? What are the benefits and the challenges? Today I’m thrilled to welcome a new expert to the show. Stephanie Casemore is a mother, teacher and writer living in eastern Ontario Canada. After pumping for her son for one year, she wrote the book Exclusively Pumping Breast Milk: A Guide to Providing Expressed Breast Milk for Your Baby. Today we are discussing the basics of exclusive pumping. This is the Boob Group.

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ROBIN KAPLAN: Welcome to the Boob Group broadcasting from the birth education center of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an international board-certified lactation consultant and owner of the San Diego breastfeeding center. Did you know that we have now over 90 episodes ranging from breastfeeding newborns, infants and toddlers? Just download them from our website, www.newmommymedia.com , or you can use one of our fancy little apps on iTunes or Amazon market place or you can subscribe to our podcast through iTunes and have the episodes automatically added to your account each week. Today I’m joined by three lovely panelists in the studio. Ladies will you please introduce yourselves.

CYNDY ALARCON: Hi my name is Cyndy. I am a planner scheduler at NASCO. I always plan electrical planning for navy ships and I have two children they’re both boys and one is actually going to be sixteen years old in April and I have a two-year-old boy, Orlando and Romeo.

ROBIN KAPLAN: Awesome! Thank you!

JANE GAMBLE: Alright! My name is Jane Gamble and I am a stay-at-home navy wife and I have a two-year-old boy Kayden.

ROBIN KAPLAN: Wonderful! And last but not least.

SUNNY GAULT: Hi everyone I’m Sunny and owner of new mommy media which produces The Boob Group, Parent Savers, Preggie Pals and our new show Twin Talks. I’m a mommy of four under four and that includes two boys ages 3 and almost two as well as a new I guess they’re not newborns anymore but twin they’re two and a half months old and I finally got my little girls. And those are the ones that I exclusively pumped.

ROBIN KAPLAN: And I’d like to introduce MJ who is our producer and she’s going to talk a little bit about our virtual panelist program.

MJ FISHER: Yes and so our virtual panelist program is amazing if I do say so myself. Although it has nothing to do with me, it’s our listeners are just so helpful it’s kind of a sneak preview of our show before it releases. So if you’re not local or you can’t be in the studio, you can be a part of our show. You can give your opinions, validate others you know it just makes you feel normal when you got somebody that’s a got your back and husband in the same situation so and we in the studio may even read your comment while we record and I try to post info as we’re getting it from the shows. You’re kind of get it as a sneak preview so check out the www.theboobgroup.com under the community tab for more info on the VP program and possible perks for participation.

ROBIN KAPLAN: Awesome. Thanks MJ.

MJ FISHER: Yeah.

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LARA AUDELO: Hi boob group listeners. I’m Lara Audelo a certified lactation educator, volunteer best for babes and author of the virtual breastfeeding culture. I’m here to answer some of your most common questions about how you can achieve your personal breastfeeding goals without being undermined by cultural and institutional booby traps such as what do you do when you can’t get your provider to treat your baby’s tongue tie. Well healthcare providers have all heard of tongue ties. Getting one to recognize its impact on breastfeeding or finding a provider who can treat one in a timely manner can be very challenging.

It can take weeks to get an appointment with a physician sometimes as not all of them will deal with the tongue tie. But what about moms who can’t find a doctor who will one acknowledge that a tight frenulum is causing breastfeeding difficulty and two treat it with the frenotomy if that’s what parents choose. In the days before bottle feeding became the norm, frenotomy, clipping a tight frenulum were done frequently and routinely. It fell out of favor starting in the 1940s as bottle-feeding became more common.

According to Catherine Watson Genna author of Supporting Sucking Skills In Breastfeeding Infants. But its 2013, forty years after breastfeeding rates begin to climb and we’re stuck searching for providers who help with the condition that affects up to 13% of all babies. And it’s even more difficult to get care or even acknowledgment for a posterior tongue tie which is less represented on the [inaudible]. Just in case you need research to prove how big of an impact tongue ties have on breastfeeding research that shown were mothers of babies with tongue ties are three times as likely as other mothers to wean in the first week. Care for tongue ties is improving but until every mom has access to providers who can simply diagnose and treat it, it remains a significant booby trap.

A special thank you to Tania Beaverman IBCLC for writing the booby traps series for best for babes. Visit www.bestforbabes.org for more great information about how to meet your personal breastfeeding goals and check out my book The Virtual Breastfeeding Culture for collection of breastfeeding stories and be sure to listen to The Boob Group for fantastic conversation about breastfeeding and breastfeeding support.

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ROBIN KAPLAN: Well so today we’re talking about the basics of exclusively pumping. I’m thrilled to introduce Stephanie Casemore to our show. Stephanie is the author of two books, Exclusively Pumping Breast Milk: A Guide to Providing Expressed Breast Milk for Your Baby and Breastfeeding Take Two: Successful Breastfeeding the Second Time Around. Welcome to the show Stephanie.

STEPHANIE CASEMORE: Thank you for having me Robin.

ROBIN KAPLAN: Absolutely. So Stephanie, tell us a little bit about yourself. Why did you decide to exclusively pump for your son and was this a difficult choice?

STEPHANIE CASEMORE: Well okay so my son was born 9 weeks premature. He was born at 31 weeks and I had developed a very severe preeclampsia and was hospitalize at 30 weeks and they decided to induce me at 31. So initially I began exclusively pumping out of necessity. My intention was always to breastfeed my baby. And so when he was born so early you know the pumping I became close friends early on. After about two weeks in the hospital he did began short attempts of breastfeeding and he continued to make attempts not terribly efficiently and we weren’t transferring much milk.

I eventually moved in to the hospital with him for close to two weeks in to a care by parent unit and we continued efforts you know nursing each time he would feed and me continuing as well the pump. But in an effort to get him home earlier, we decided to introduce bottle and brought him home and things just continued. We had challenges. He started projectile vomiting. I developed stress and things just became very overwhelming. The cycle of breastfeeding, pumping bottle feeding you know became exceptionally overwhelming and so it was around his due date and breastfeeding still haven’t improved at all I made the decision partially just for my own sanity and partially just because I felt I needed to move forward and know where I was heading.

I decided that I would just continue pumping. It was working well for me. I didn’t know that anybody else in the world did it and I felt that often from most women that you know they stop there they think they’ve invented exclusively pumping. And so that’s really the reason why I pumped. Was it a difficult choice? I think at that time it wasn’t a difficult choice because I really felt that I couldn’t emotionally hang on any longer with the where I was at there were you know a number of things going on in my life.

My father was ill. Just the physical toll that having preeclampsia had on my own health. All of those things kind of built up so the choice to exclusively pump wasn’t really difficult but I think the laws of breastfeeding to me was what became more challenging in the end.

ROBIN KAPLAN: And you have a very active Facebook page for exclusive pumpers and so what are some of the main reasons that you find that these other mothers are also choosing to exclusively pump.

STEPHANIE CASEMORE: I think the vast majority of women that I’m in contact with are women who wanted to breastfeed, who went into their pregnancy with that understanding that they would be breastfeeding so most of them end up exclusively pumping because of challenges that they faced with breastfeeding. Latch problems, pain, tongue ties, supply concerns those kinds of things. There’s also a lot of women who have had preemies who end up pumping initially and who often you know hoped to transition to breastfeeding.

There’s many babies who are born with cross palates and cross lips and their mothers will pump for them and then there’s another group of women who have babies with Down syndrome or Prader-willi syndrome, heart defects so health concerns and there’s also quite a few surrogate moms on the group who continue or not continue but they provide milk for their surrogate babies after they’ve given birth and ship it to the parents.

So there’s a real wide variety I would say that the vast majority of women who wanted to breastfeed and were unable to and there are still a few not majority but there are some who for whatever reasons have chosen that that is a better option for them than direct breastfeeding and so they make the choice to provide breast milk in that way.

ROBIN KAPLAN: Okay and I’d love to open this up now to our panellist to talk about kind of what was their reason for deciding to exclusively pump and so Cyndy do you want to start off?

CYNDY ALRACON: Sure. I actually had the intention of exclusively breastfeeding from the beginning. I have to sons I’ve said earlier and I did not breastfeed my first son and breastfeeding just wasn’t part of my house. My mom didn’t breastfeed any of us so I kind of didn’t have any information about it. I didn’t really know. I had my first son when I was very young. I was 17 so everything was just really overwhelming for me at that time and it was just an easier option to formula feed when I was that young.

Its inside I didn’t know very much about breastfeeding. I was kind of uncomfortable with it and I was totally fine. Other people do it and I had no problem with that at all. I think it’s great, beautiful and all of that. It’s just wasn’t for me but I still wanted to make sure that my son got the best food that he could get even if it was going to be harder than formula feeding now that I’m an adult I can make better decisions. So that’s why I decided to exclusively pump.

ROBIN KAPLAN: Alright. How about you Jane?

JANE GAMBLE: I decided to pump because my son had latch issues from the beginning, undiagnosed tongue tie and later undiagnosed lip tie and he also has a central processing disorder which also help with the latch issue. So I initially decided to pump because I wanted to breastfeed I wanted to pump initially for a year and then I ended up continuing because he ended up having some feeding issues later on and I knew that breast milk was kind of give him the best. So I pumped for two years.

ROBIN KAPLAN: Definitely our several success stories in here because Cyndy you pumped for a year correct?

CYNDY ALARCON: Yeah.

ROBIN KAPLAN: Amazing. How about you Sunny?

SUNNY GAULT: Well mine is not that much as a not that much as a year.

JANE GAMBLE: It doesn’t matter oh my gosh.

CYNDY ALRACON: Yeah.

JANE GAMBLE: Exclusively pumping is very difficult in any amount.

SUNNY GAULT: Yeah my little girls, my twins, were born at 35 weeks and I didn’t know that there was a problem at first at all. I put them right to the breast and you know in the beginning new-borns don’t really need that much anyways and their kind of rutting around but I was noticing a lot of pain with it and it just didn’t quite feel right and I was seeking the advice of a lactation consultant and you know we’re looking on their mouths and notice a little bit you know possible tongue tie, lip tie situation.

But I have to say you know if I really pushed forward I could’ve done it and then it would’ve been painful probably but I really when you’re feeding twins it’s all about schedule. And the idea of just always feeding a baby at the breast was a little overwhelming to me and the tandem thing when they’re that young really doesn’t work you really got it, unless you have someone else helping you, you really have to focus on one baby at a time.

So the tandem thing was kind of off the table and like I said breastfeeding all the time wasn’t really a possibility so I really like the ability and they had to eat very frequently you know so as every 3 hours and I’m thinking you know if I did this I would just always have a baby on me so I was able to get a hospital pump which was great. Covered by insurance and everything straight out of the gate right when I left the hospital and that open up a whole new world for me. I have had personal problems in the past, never really had a really good relationship with the pump with my sons.

I always tried to avoid it if I could but this is been a lifesaver for me with the girls because I’m all about feeding at the same time and honestly because I’m putting out so much milk which is fantastic, and I’m very appreciative of that but sometimes I just want to feel empty. I want my breast to just deflate for a while and it’s rare that the girls will do that. So pump helps me get everything out and then helps me keep up my supply.

ROBIN KAPLAN: Alright cool. So Stephanie when making a choice to exclusively pump, what do you notice of some of the positive outcomes if especially breastfeeding has been challenging and then what are some common challenges that a mother should maybe prepare herself when considering exclusively pumping?

STEPHANIE CASEMORE: I think it’s the breastfeeding has been challenging. There is often a lot of stressed and a lot of exhaustion so making the choice to exclusively pump can be a bit of a relief of some of those pressures that a mother might be feeling. Gives a bit of a new focus so that you rather than focusing so much on the problems, they can focus on solutions. So I think emotionally it can be helpful. I think sometimes also moms who are experiencing difficulties of breastfeeding also feels a sense of rejection from their baby and they maybe aren’t able to bond with the baby as much as they had expected to or hope to.

So finding kind of a solution to resolve some of the challenges can also allow them to start connecting with their baby. And I hear that a lot. A lot of mothers saying they didn’t feel that they were connecting and bonding with their child until they started pumping. You know it’s a different situation that breastfeeding is going well but when you’re with face to a campaign every time you try to latch your child or your baby is not getting enough milk or you know whatever other situations that are involved it’s a real struggle emotionally.

I think that’s one of the biggest positive is that you’re moving away from a lot of those challenges and offering a solution to those. In terms of the challenges of pumping I think probably the most common one is simply the time commitment that’s required especially early on in the first few weeks in order to establish a strong milk supply you’re looking at pumping at least usually about 8 times a day, sometimes more. And fitting it all in can be challenging.

It’s hard enough having a new-born to care for and then when you put in 120 minutes sitting having [inaudible] breast milk and then feeding your baby and then adding in you know cleaning of bottles and management of milk you’re adding a lot more into it as well. But it’s not as emotional so it’s not the emotional challenges that you were experiencing when breastfeeding. So the challenges I mean there’s lots of other positives that women will feel better there and definitely other challenges but those would be the ones that would I highlight as probably the biggest.

ROBIN KAPLAN: Okay. While you were talking, all of our panelists were nodding their heads in agreement with you. So ladies let’s talk a little bit about what did you notice maybe as one of the best benefits that you saw with exclusively pumping and then maybe one of the biggest challenges that you had. Jane how about you?

JANE GAMBLE: I would say probably one of the best benefits that I saw was that he was getting my milk and it’s something that he can tolerate. And later on we found out a lot of food allergies but it’s something that made me proud that it’s something that I could give to him. And then one of the challenges again was time and time management as far as making sure I got all the bottles clean and trying to take care of a newborn and my husband was deployed. All this stuff it’s a lot of challenges and luckily, living here in San Diego, I’ve got a group of friends that have a lot of support that I know that there’s a lot of bonds that I get a lot of pushback and that’s a lot of big challenges. There’s the so called mommy wars of formula versus breast milk and what’s best and whatever. As long as you’re feeding your babies and making sure they’re healthy but that’s the big challenge.

ROBIN KAPLAN: Yeah absolutely. How about you Cyndy?

CYNDY ALARCON: I would say that the biggest challenge is definitely the time, the amount of time it takes to pump and then you have to feed you baby and kind of time all that out. I mean luckily my husband was here so bravo to you. Doing it alone. So if I was pumping you know and he my son was hungry and my husband would feed him the milk I have pumped earlier. So and also I got weird challenges that I had so much milk I didn’t have a room for it in my fridge or in my freezer. That was a little bit challenge it was a good challenge that was a good thing. A good surprising good thing about it was that I had so much milk I got to give my milk to my friends who could not breastfeed. That was really nice and I was happy about that that was really cool.

ROBIN KAPLAN: Okay cool. How about you Sunny?

SUNNY GAULT: The biggest benefit was the ability for other people to help feed my babies. That is just, that is huge.

CYNDY ALARCON: Especially with two.

SUNNY GAULT: Yes because I would literally pump and then give the bottles to someone – even my parent were in town for a while so they each wanted a baby and I said great I would pump and I would give you the bottles and you could feed them. So that was probably the biggest benefit just and the ability now just to keep on a schedule like I said I feel like I have more control over the situation and I know their getting all the nutrients and everything that they need and so there’s no guilt or anything tied to that.

The biggest challenge I think just like the ladies mentioned it’s just that time that’s involved and you now I got to do all the dishes and then oh clean the pump bottles and then you know I’ve got two other little boys that like to play with the pump. Literally, I just put a video up on YouTube recently like my older sun is like has the pump parts attached to his stomach and said I want to help feed the baby. But still like I’m like that’s like a thousand dollar pump what are you doing.

So yeah so it’s just all the you know just coming here you know in my diaper bag most of it is pump stuff. It’s the pump itself, it’s the bottles, it’s the nipples and you know just making sure you know you just carry all that with you. And you have everything you need with you when you need it.

CYNDY ALARCON: Yeah that is definitely a challenge.

ROBIN KAPLAN: And Sunny you know you started kind of touching upon on emotional stuff as well and so Stephanie I’d like to talk a little bit about that emotional aspect of exclusively pumping especially for moms who were planning on breastfeeding and then end up choosing exclusively pumping. You discuss in your book the difference between guilt and grief. Can you describe how these emotions can come into play when exclusively pumping?

STEPHANIE CASEMORE: I find a lot of women will self-identify themselves as being guilty, as feeling guilty I should say. They feel guilty that they weren’t able to breastfeed that their baby is losing out on something and they often will say that they’ve failed which I have difficulty with that term of feeling breastfeeding. But these are women who are doing so much to provide breast milk for their babies after they’ve faced in some cases just extreme challenges and things that you know when I hear what some women are going through I’m absolutely amazed and in awe at the strength of so many women.

So I really don’t believe that women who were exclusively pumping failed at anything and I think the word guilt is often misused since it implies that you’ve done something that you shouldn’t have done that you knew you shouldn’t have done or that you’re not doing something that you should have done. But in almost all cases exclusively pumping moms are doing you know huge amounts of you know their putting their effort, their time, their dedication, their commitment into doing you know what they can to be the absolute best for their baby and to give their baby the absolute best they can in a difficult situation.

So instead I would say that moms are feeling a lot of of breastfeeding and that it’s something breastfeeding is something that’s biologically expected and I believe that most women have a desire to breastfeed. And when they don’t get that experience you know our society often tells us to get over it. You know that you should be happy. You can feed formula. Someone else can feed your baby. And as mothers we’re made to feel sometimes that our emotions are either not real or that we’re just being silly and we’re being too emotional.

So ultimately I think some women may feel guilty but in most cases I think its grief that women are feeling for that loss of breastfeeding and the loss of the expectations that they have around breastfeeding. And I think that women need to be told that it’s okay to feel sad and it’s okay to grieve and you know at the same time being encouraged that they can still love their baby and they will still bond with their baby and they’ll still develop you know strong relationship without direct breastfeeding.

Often times mothers express grief or excuse me express guilt over that sense that they won’t be able to bond in the same way because often breastfeeding as presented to mothers as you know the best way to bond with the baby. So you know in my work when I’m talking with mothers I find that they often need to be reminded of everything that they are doing. And be told that it’s okay to grieve and feel sad but that what they’re doing is enough and it’s in many cases more than anyone could be expected to do.

ROBIN KAPLAN: Absolutely!.Alright! Well, when we comeback, Stephanie and our panelist will discuss their top tips and tricks for exclusive pumping. We’ll be right back.

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ROBIN KAPLAN: Alright welcome back to the show. We are chatting with Stephanie Casemore and our topic is exclusive pumping. So Stephanie how important is choosing the right pump and correct flange sizes?

STEPHANIE CASEMORE: I think the pump is really it can make or break your whole experience and the flange size would be almost as important. It’s important to get a pump that can first of all withstand the frequency of use with when you’re pumping you know up to 8 times a day you know a hundred and twenty minutes or more every day for as long as you pump. In many cases women are pumping for 6 months even a year or beyond. You need to have a pump that is going to withstand that type of use. And I think it’s also important to have pumps that have appropriate cycling speed, appropriate suction levels and preferably ones that are adjustable for both cycling and suction.

For moms of preemies, and those who have risk of low milk supply if you’re pumping from multiples, hospital-grade pump really is the best choice you can make. And so I think since the pump is really the primary means of removing milk, it’s got to be the best that you can afford and the best that you can find. Having said that I think there’s a lot of women who do find success exclusively pumping with the double electric personal pumps. And I’ve even heard from women who have pumped long term with manual pumps and there was one woman I know of who actually pump long term [inaudible] hand express exclusively for a significant amount of time and was very successful doing that so in the end really it’s about removing milk and I always remind women that it is an individual thing.

One pump is going to work for one group of women and another pump will work for another group so finding the best pump that you can is really important and usually that the best pump are hospital-grade pumps. And as for flanges I think they’re important for comfort which is obviously important because if you’re in pain and let downs are affected and milk removal tends to be more challenging but also if the flanges aren’t pinching on your ducts then that can affect the ability to remove milk and in the end that’s affects milk supply so both of those really are key to finding success in exclusive pumping.

ROBIN KAPLAN: Okay and for moms who are using the double electric pumps or even single pumps do you recommend I know you recommend pumping both breasts at the same time if possible and also using breast massage. How do you feel that this helps while pumping?

STEPHANIE CASEMORE: Well there have been studies that show that double pumping is more effective. You’ll get more milk when you do that. Since Oxytocin when its released and that’s what [inaudible] the milk let down. It affects both breast so if you’re only pumping one breast, you will get a little bit of a let down on the other breast as well so really you’re just kind of making the most efficient use of that oxytocin release on let down but beyond that it saves a lot of time.

So when you consider that most exclusively pumping moms are pumping about a hundred and twenty a hundred and forty minutes a day and some will pump longer than that you would actually be having the double your time sitting and expressing milk if you were only single pumping. So I think the time constraints alone are good reason to double pump. And as for massage definitely I think massage it helps to stimulate let down and it also helps to remove milk and when you’re breastfeeding but I think when you’re pumping even more, you really get to know your breast well and so getting hands on and feeling for spots that are hard whether the ducts are maybe getting blocked.

Getting your hands in there and you know massaging it in those areas is really important because you know sometimes the pumps don’t remove milk as well as we like them to. So using massage, using breast compressions while you’re pumping it can help make the milk expression much more efficient than if you’re not using your hands.

ROBIN KAPLAN: Okay and talking about efficiency, what tips can you offer for setting up a pump schedule?

STEPHANIE CASEMORE: To some extent, scheduling depends on how old the baby is, what you’re personal responsibilities are and I think to even some extent what kind of personality you have if you’re you know very type A and like things that are scheduled you probably will enjoy a much more regimented kind of schedule. If you’re pumping from birth, it’s important to pump very frequently so in the first few days you probably wanting to pump at least 8 times a day and even that it would be 10 to 12 times a day for the first few days.

And then once your supply starts to increase, you can drop that down a little bit and then again when your milk supply increases to a point where you are able to meet your baby’s needs for the first two level their going to be at for the next few months. A lot of women will even be able to drop it down to about 5 times a day or so and still maintain supply so it’s kind of depends where you are in terms of how to setup you’re schedule. Basically the big thing I would say is you know that the number of sessions per day is usually considered to be more important than spacing them out evenly.

So if you can’t you know do a regimented every 3 hours or every 4 hours through the day know that if you can get every 2 hours for the morning and then you have to take slightly longer breaks in the afternoon for example that’s okay. And then in the end it will all kind of even out. Early on I would always suggest never going much more than 4 hours without pumping and once your supply has increased and you’re kind of that a maintenance stage where you’re just kind of holding and trying to maintain your supply not going more than 5 to 6 hours between sessions is always a good strategy.

And I always recommend I don’t have any women take me up on this but I always recommend that women get a really good working knowledge of how milk production happen because I think when you understand how supply is maintained then you can make the best decision with regards to your own schedule and know what’s a good thing to do and what is probably best to avoid.

ROBIND KAPLAN: Okay ladies on the panel in our studio, I would love to know kind of what your schedule maybe look like especially for Cyndy and for Jane since you’re no longer exclusively pumping. How did that change overtime starting from kind of the beginning, how often you’re pumping and how did you kind of modulate the schedule through that first year and second year? And then Sunny kind of what you’re schedule looks like now? So Cyndy do you want to start?

CYNDY ALARCON: Sure since I was planning on exclusively pumping from the beginning I started right away at the hospital kind of on my own. Tried to pump and you know nothing really came out for the first couple of days but I just kept at it and I kept doing it every 2 hours even if only a drop came out I still wanted to try so I kept doing it. By about the third day I started getting maybe 2 ounces so I would do it for every 2 hours maybe for like the first month. And then after that I kind of increased it to every 3 hours just depending on how full my breast would get. I would empty them but usually I did it around 2 to 3 hours in the beginning. And then when I started to work he was about 3 or 4 months old and I pumped before I went to work, twice at work and twice when I got home.

ROBIN KAPLAN: So you’re able to kind of back it up to just 5 times in a 24 hour period?

CYNDY ALARCON: Yeah.

ROBIND KAPLAN: Okay how about you Jane?

JANE GAMBLE: I think I pretty much started the same where I was doing it every 2 hours at the very beginning and then kind of suddenly started spacing them out every 3 and then as my son got older I started spacing them out even more. I had low supply so whatever I could get was the best so.

ROBIN KAPLAN: When you’re son was over a year old do you remember how often what you kind of switch to about that point?

JANE GAMBLE: When my son hit a year old I was doing between 3 to 4 pumps a day .

ROBIN KAPLAN: Okay.

JANE GAMBLE: It just kind of depended on what he would allow me to do and when I could squeeze those in and then when he started getting closer to the age of 2, I started dropping my pants right around 18 months. I started dropping my pumps on to that 2 pumps a day because he was getting way more active than I can handle.

ROBIN KAPLAN: How about you Sunny, what is your pumping schedule look like right now with two and a half month old twins?

SUNNY GAULT: Well it’s actually transitioning. When I first started, it was every 3 hours and I would you know really find the get go. I was getting really you know really good milk supply from once my full milk came in which is probably about day 3. I mean I was able to give the twins exactly what they needed. I wanted to get to the stage where I was you know building a surplus like in my freezer. I’m still really not at that stage but you know I think the bottles themselves you know it’s a double hospital grade pump. I think the bottles are about two and a half ounces of you know push it right to the rim and that’s what they were taking for the first couple of months in but I was doing it in every 3 hours.

I’d literally set it on my phone every 3 hours I would do that. And then once they got to you know passed the their due date on when they were supposed to be born then everything kind of switch I don’t know like a trip it’s like they knew it was passed their due date now. And they started to get much better at latching so I was trying to do a little bit more of the breastfeeding. Still you know it was painful at times so really wasn’t my preference yet and I knew there was some tongue tie lip tie issue so I wasn’t pushing it so much. But as far as how it is now I’m really trying to back off the schedule a little bit.

And if I can always have at least a couple of those you know 2 to 3 ounces of bottles around I try not to really pump until I feel uncomfortable. And I don’t know if that’s a really good thing to do for you know supply but when I start to feel uncomfortable I know I need to pump. You know if I’ve got those bottles around, if the girls need to eat before then you know then I feel like that’s my fail safe that’s my okay I can give them a bottle so I don’t have to run around.

There’s nothing worse than two babies crying at once. Okay because I’ll try to balance two babies and pump at the same time and that does not work. So that’s why I need those bottles to the sides so I mean how many times I was thinking about the [inaudible 00:35:15] I’m not sure how much I am pumping because the girls are starting to breastfeed a little bit more, I’m doing some stuff at night, that’s my big thing right now, night time can I avoid you know can I do like a 2 am pump and not pump again until 6 or 7 in the morning or that’s what I’m trying to do and if the girls wake up then we do some side nursing and that seems to be working for us. So I would guess we’re probably around to 6 times a day pumping.

ROBIND KAPLAN: Okay.

SUNNY GAULT: Yeah.

MJ FISHER: Robin I have a virtual panellist question kind of I think she has had issues with supply because she’s asking, what’s a good schedule to go by? She’s currently on regulin 10 milligrams 3 times a day plus doing kangaroo care, drinking teas plus taking mother’s milk and still only getting about 2 ounces total and she’s been pumping sporadically about 6 to 8 times a day so I wonder I mean with people that have issues of slow supply, what is it every hour every you know like when I was doing it, it was like I haven’t do it for so long because it made me crazy but it was tried it nursed and supplement at the breast and then once I was done it was pumped and then once I was done it was nursed again and it so like it just made me crazy so with people with low supply it’s like you know what does a schedule look like for them if you’re not getting very much.

ROBIN KAPLAN: Stephanie would you recommend that she pumps more than I can’t imagine recommending pumping more than every 2 hours.

STEPHANIE CASEMORE: You know it’s kind of an individual thing. I think the first thing that you always need to look at is the schedule and I would always say start pumping at least every two hours? Yeah sometimes you can do like clustered pumping at night just like the baby cluster nurses at night and you know take a period of a couple 2 or 3 hours and pump for about 10 minutes and then take a break for 10 minutes and then pump for 10 minutes and take a break for 10 minutes. And so you get a really intensive period of pumping and sometimes that can help. In this case you know I would ask what kind of pump you’re using, do the flanges fit you properly?

MJ FISHER: Right.

STEPHANIE CASEMORE: Are there issues with insufficient glandular tissue or are there any history of there’s often you know medical issues that might also affect supply. So really in cases where it seems like you’re doing everything right and on the surface this seem would be the case with this lady you know sometimes a little more investigation is needed. And ultimately I think you always got to remember that any amount is good and often times I can be so easy to get caught up in the numbers when you’re pumping because you know you see the volume every time you sit down to pump.

You see the amount you’re giving your baby and you can get caught up in those numbers and start your own value as a mother can often get tied up with those numbers and so it’s really important in cases where you’re not maybe quiet meeting your baby’s needs to remind yourself of that that even 10 ounces a day if you see value in that 10 ounces then that 10 ounces is amazing. And it doesn’t matter if you’re needing to supplement with formulas so that’s a really long answer. No easy answer.

ROBIN KAPLAN: Yeah. Alright so final question for you Stephanie, this is the question that came up most on our Facebook page for you. How do answer the question are you breastfeeding when you are exclusively pumping?

STEPHANIE CASEMORE: Personally I always encouraged women to say that they are exclusively pumping that they are expressing milk and feeding expressed breast milk to their baby. And the reason I say that is because I think it’s an option that needs to be more visible. In our society, I think, there’s a lot of women who faced breastfeeding difficulties and who think their only option now is to feed formula. So I think the more we talk about it as an option, as an alternative to formula feeding when breastfeeding isn’t working out, I think that can only be positive.

I think there’s a lot of medical professionals who often need to be told that it is possible you know there’s always you know women commenting that you know my doctor said I’ll never be able to maintain supply or whoever it might be that they’re come across saying that it’s impossible you shouldn’t do it. So I think you know in many cases saying I’m not breastfeeding but I’m pumping and I’m feeding my baby expressed breast milk I think that from an advocacy stand point is sometimes a good option. Sometimes though you know you might be talking to somebody in passing or a nosy neighbour who wants to know these things and I don’t see anything wrong in saying yes I’m breastfeeding you know.

Sometimes you know there’s a feeling some women feel that there’re no difference to breastfeeding and feeding expressed breast milk. And you know it really is it’s a personal choice as to how you answer the question and what you’re comfortable with and in what you believe and in the end you know every mother who is feeding expressed breast milk is doing so because they loved their child and you know it’s the same reason that any of woman who is breastfeeding her child is because you loved your child. So ultimately it comes down to that. That you know we’re all doing what we can do and how we do it is really not as important so you know, I don’t know if that answers the question

ROBIN KAPLAN: That’s a great answer.

MJ FISHER: I think the answer is yes you know.

ROBIN KAPLAN: Yeah I loved that. Alright well thank you so much Stephanie and to our incredible panellist for discussing this really important topic. I’m super excited because Stephanie is actually coming back on the show in a couple of weeks to really delve into this a little bit deeper since this was such an extensive conversation that we didn’t have time to touch upon on everything in this. So we’re excited to have you back in a couple of weeks Stephanie.

STEPHANIE CASEMORE: I’m looking forward to it.

ROBIN KAPLAN: And for our Boob Group club members our conversation will continue after the end of the show as Stephanie will offer her top tips for relaxing while pumping. For more information about our Boob Group club, please visit our website at www.theboobgroup.com

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JONA ROSE FEINBERG: Hi Boob Group. This is Jona Rose Feinberg editor of www.breastfeedingtwins.org I’m a mom of twins and a board certified lactation consultant in the Seattle area. Today we’re going to talk about managing breastfeeding without a helper or a second set of hands. In the early days we hope you have some extra help around the house. You’re partner, mom or postpartum doula can help position babies for breastfeeding and can help at burping, rocking and of course diaper changes. But chances are at some point you need to manage both babies by yourself.

Here are some tips. Make yourself a nursing nest. Bring together everything you might need for a long stretch of sitting with nursing babies. Have snacks, water, your phone, the TV remote and anything else you might need nearby. Make your nursing nest comfortable. Just [inaudible] from the couch, in bed, or even on the floor with lots of pillows for support. Pick some place where you will be comfortable and will have plenty of room to spread out. Create safe spaces to rest babies while you’re getting settled for breastfeeding.

When they are younger and not yet rolling, place them in the middle of the bed or in the back corner of the couch briefly may be sufficient. As they get older, you may want to use lots of pillows or bouncy chairs to hold the baby as you get settled with your breastfeeding pillow and again when you’re finished. Both help keep the baby a bit upright after feeding which may be helpful for some baby with gas or reflex. If possible make the transition gradual.

This may mean your partner starts out back to work part time for a few days before going back to a regular schedule or that your mom comes by in the afternoon to lend a hand for a while. It’s helpful to know when your back up coming when you feel overwhelmed. Once you managed to be alone for a little while you’ll have the confidence to handle larger stretches. For more tips and personal breastfeeding stories, please visit www.breastfeedingtwins.org and keep listening to The Boob Group for more twin tips.

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ROBIN KAPLAN: That wraps up our show for today. We appreciate you listening to The Boob Group.
Don’t forget to check out our sister shows:
• Preggie Pals for expecting parents
• Parent Savers for parents with newborns, infants and toddlers
• Twin Talks for parents of multiples.

Thanks for listening to The Boob Group; Your judgment-free breastfeeding resource.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: New Mommy Media is expanding our line up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com .

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