When did I start pumping?
As I mentioned in my previous post, I started pumping 4 weeks post-partum to test out if Maddy would take a bottle. So far she has been, but we're trying to make the milk flow slower by making her more upright when she drinks and holding the bottle at a 45-degree angle or lower to mimic the position of a mother's breast/nipple.
How often do I pump?
I started pumping at a time when Maddy was really feeding almost hourly. In order for me to be able to store milk even while nursing her the whole day, I had to pump little by little 30 minutes before or after her feed.
It's been 2-3 weeks that I've been doing this, so my breasts are now used to being pumped almost hourly; if not, they already feel heavy and tingly. At most, I went without pumping for 2.5 hours, but my breasts were already really heavy and full by then.
I've heard that pumping in the morning yields more milk, so I pump most of my milk right after I hand Maddy over to the yaya for her morning sunlight at 6:30am, mid-morning, noon, and early afternoon. By early afternoon or evening I don't pump anymore, or I only pump out maybe 1 oz to get a head start on next day, because (1) Maddy usually cluster feeds early afternoon or in the evening so I want to make sure I have enough milk for her needs; and (2) my pump parts need to be sterilized at the end of the day so I don't want to use them after sterilizing, only to pump for a short while and sterilize them all over again before I sleep.
Now, Maddy is starting to sleep longer - around 1.5-2 hours, but I still pump hourly since it's better to pump more frequently to stimulate milk production.
How much do I pump?
I pump based on how much milk Maddy takes in per bottle. After a couple of trial and errors (when we first introduced 2-oz, she still cried out for more. So we increased gradually until she was satisfied with how much she got from a bottle, which was around 3 oz), we confirmed that Maddy wants 3 oz per bottle feed.
I therefore pump to store 3-oz breastmilk per container. I can usually produce 2 to 2 1/2 containers of 3-oz each in a full day while nursing Maddy too.
How much do I pump out every session?
Since I generally pump hourly or every 2 hours, I don't really get the full 3-oz immediately per session. In the early morning, I can pump out 2-oz out of a full breast. Throughout the day, I get half to a full ounce per breast every session.
In each session, I usually only pump the breast that wasn't offered for the last feeding. It's better that I offer only one breast during feeding and let Maddy empty it out, then just pump the unoffered breast after. Not only do I yield more milk that way and get both the foremilk and hindmilk, but also by emptying out a breast each feeding, I can stimulate more milk production (milk production slows when milk accumulates in the breast).
How do I store the milk?
I use Avent containers or the milk bottles with sealing discs to refrigerated breastmilk I'll be using within 6-8 days. For my freezer stash, I use milk bags. I always have a Sharpie and masking tape in my pump bag or everywhere in the house, so I can always label my containers or bags with the date and time (and amount, for the bags) of when I pumped the milk.
At any one time, I have at least 5 containers of refrigerated breastmilk. If they go past the 6-day mark without being consumed, I transfer them to milk bags for freezing. When I start working, I aim to always maintain 10-15 containers/bottles of refrigerated breastmilk for Maddy's consumption when I'm at work. I expect that she'll take in at least 5 bottles daily - 1 in the morning, 1 right before noon and 3 in the afternoon.
Since I don't pump out 3-oz fully from each session, I just put the container with less than 3-oz of milk in the ref and keep adding to it during the day after each session. My rule is, I can add freshly expressed milk to an already refrigerated or cooled one throughout the day or within 24 hours. The label, however, reflects the date and time of when you expressed the first/earliest portion of the milk.
I have not yet tried adding cooled breastmilk to an already frozen stash.
How do I bottle feed?
Babies can smell their mommies, more specifically, their mommies' milk. They will not take a bottle from their mother since they know that they can get the milk directly from her breast. This is true! I've tried to bottle feed her with my own breastmilk a couple of times - she will not take them from me! Try not to be in the same area as the baby is when she is being bottle fed. If she senses your presence or gets a whiff of your eau de milk, she might refuse the bottle altogether.
Have someone else bottle feed the baby, like hubby, in-law or the yaya. And for the first couple of bottle feed sessions, drape a piece of your unlaundered shirt or blouse (like your pajama top from the night before) over the one bottle-feeding, to comfort the baby with your scent as you introduce the bottle.
(the dad, trying to bottle feed)
Also, find the right bottle nipple. We use Avent Natural bottles, as they have breast-like nipples. We use the nipples that came with the 4-oz bottles, which are the newborn flow nipples with 1 hole.
In addition, pace your bottle feeds. Try to draw the baby's mouth into the bottle nipple, instead of forcing or pushing the nipple inside the baby's mouth. Mimic the behaviour of how the baby breastfeeds, which is, the baby is the one who approaches the nipple and the nipple is usually at a level position, with baby's body facing yours. It's not tipped down to the baby's mouth, with the baby on her back. The bottom of the bottle should not be tipped towards the sky. Try to pause once in a while, similar to how the baby pauses as he/she drinks from the mother's breast. Remember that it'll be hard for the baby to feel full if he/she consumes the milk from the bottle too fast. He/she might ask for more milk even if it's not needed.
For Maddy's first bottle feed, it was the yaya who fed her the bottle, with me peeking inside from the door.
(Maddy's first ever bottle feed)
To avoid nipple confusion, we started introducing the bottle one day at a time, and only during the times when I will be at work. For example, we only feed her a bottle anytime from 8:30am to noontime, and 1:30-5:30pm.
How do I pump using the Medela Swing?
It's pretty straightforward in the sense that just switch the motor on, go through the 2-minute stimulation phase, and then it proceeds to the expression stage.
However, as I don't have the time or patience for the entire thing sometimes (fine, most times), I massage my breast first and express a few drops of milk before I start pumping. I skip the stimulation phase entirely as I've already kickstarted the "let-down".
As the Swing pumps, I simultaneously breast compress. No, breast compression is not squeezing the breast. I just use my hand to apply pressure to certain parts of the breast while pumping, to get more out of the ducts/milk nodules. I pump out the milk faster, and I feel like I more effectively empty the breast this way. They advise to pump 15-20 minutes per breast, but I usually pump in half the time because of how effective breast compression is.
Why do I have a Medela Harmony manual pump?
The Medela Harmony is a single, manual pump, designed supposedly just for occasional pumping. Its assembly of the handle+diaphragm+o-ring enables the 2-phase expression as with the Medela Swing (stimulation and expression) and other electric pumps.
I chose to get a manual pump in addition to my electric pump, and still a Medela model at that, because I need a more portable pump to bring around in malls or during dinner-outs. The Medela Swing just isn't compact enough for me, particularly because I also need to bring the heavy transformer around (since I bought mine online, at 110 volts). If I need to use the Swing without the power adaptor, I'll need 4 AA batteries, which is only good for 2 hours of pumping. Not practical at all.
And to be fair, while the Harmony may not be able to get as much milk as the Swing does (because breast compression is harder to do with a manual pump than with an electric, since I have to continuously pull on the handle with one hand), I can still get at least an ounce with every manual pump session. And for someone who is expressing to store 3-oz, an ounce is very precious already.
Plus, since they're both Medela brands, they both use the same breast shield, stem and valve+membrane assembly! At least when a set is being sterilized, I have an additional set to use which I can just store in the refrigerator after my late night session to be sterilized the next day.
When I go out, I only need to pack the breast shield+stem+valve assembly, and the Harmony's handle+O-ring assembly!
(the Harmony's handle and O-ring)
Do I take lactation aids?
For now, yes. I've tried the oatmeal and chocolate chip lactation cookies and banana oat muffin lactation bites from Mommy Treats. I'm also currently going through the dark chocolate lactation cookies I ordered from Sweet Spot Homemade Cookies. I also take Natalac malunggay capsules.
Lactation treats are called such because they contain ingredients that are referred to as "galactagogues", like fenugreek and blessed thistle.
Do they all work? I think they do! But I don't depend on these aids entirely for my milk supply. They're here to supplement what I already have. Their purpose is not to create milk from nowhere. Plus, they have certain side effects, such as causing gassiness in the mom and/or the baby.
I don't rely heavily on lactation treats and just continue taking oatmeal and Milo for breakfast (oatmeal and Milo believed to also help increase milk supply). Also, I drink a lot of soup, those with malunggay, with lapu lapu and with shellfish, which are also believed to significantly aid in breastmilk production.
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