Exclusive Pumping, Taming the BEAST Part 02: Storage & The Battles Within!

Overproduction isn’t exactly a ride in the park. One feels like a ticking time bomb! The struggle is REAL!

There are ways of dealing with over production and options one can exercise. Pumping and dumping is not one of them. There is a method to this madness which paid off for me in the long run.

Storing:

I saved the amount my baby required for the day and I froze the rest. Below is a chart Illustrating the guidelines of breastmilk storage (for full term babies) which I got off the internet.

milkstoragechart-01

The milk was frozen in sterile breastmilk bags and then, slowly started the process of getting together a “stash”.

Here’s how it’s done:

  • Fill the BM bag never more than 6oz, anything more and you stand a chance to rip or damage them while defrosting. Date it and name it.
  • Lay it out on a flat tray first, pop it in the freezer let it freeze completely.
  • Once I had 12 bags frozen, I created a “Brick” and stored 11 bags vertically (one after the other) in a regular large zip lock bag with the 12th one placed horizontally on the top. Hence creating a “Brick” I popped in a post-it with a serial number that way I knew which brick to pull out first or rotate while starting to use the stash. Date and number it as you please especially if you foresee saving multiple bricks a month.

brick

Excess Lipase , the hidden speed bump :

Thankfully, I didn’t have an extra lipase issue. But I feel it’s necessary to make a mention of, as one can avoid wastage if excess lipase is a part of ones natural breast milk chemistry.

Basically, Lipase is an enzyme that breaks down the fats in human milk to help baby digest it. When lipase occurs in excess, this process happens much more rapidly and can make the milk taste sour, soapy or really off! They say, milk with excess lipase is safe to drink but some babies dislike the taste and refuse it. However, excess Lipase is not an issue for donation and one can explore that option after verifying with the milk bank it’s being donated to.

How would you know you have excess lipase? Freeze some milk, thaw and taste/smell it. If it tastes soapy or off you know you’ve got an excess lipase issue. More often than not I’ve seen mums on forums discover excess lipase issues a little too late in the game. Like, when they’ve thawed a bag after several months of collection only to discover it tastes disgusting and their bubs JUST WON’T drink it. That can be heartbreaking. So I certainly see credit in doing a “Lipase check” before you start the freezing process to avoid future heartbreak.

Deactivating lipase before freezing (Scalding milk):

  • Heat milk to about 180 F (82 C), or until you see little bubbles around the edge of the pan (not to a full, rolling boil).
  • Transfer to a sterile container.
  • Quickly cool by immersing the container in ice water.
  • Bag and store the milk.

Scalding the milk will destroy some of the antiinfective properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated.

Below is a visual guide to heat treating (scalding) milk before freezing.

past01past02

Thawing: (source, Kellymom)

  • Thaw slowly in the refrigerator (this takes about 12 hours – try putting it in the fridge the night before you need it). Avoid letting milk sit out at room temperature to thaw.
  • For quicker thawing, hold container under running water – start cool and gradually increase temperature.

Previously frozen milk may be kept in the refrigerator for up to 24 hours after it has finished thawing. NEVER refreeze.

To warm milk,

  • Heat water in a cup or a small shallow container, then place frozen milk bag in the warm water.
  • NEVER microwave human milk or heat it directly on the stove.

 

Blind sides: Mastitis, candida, clogs and engorgement:

A plugged duct, engorgement and mastitis are a pumpers ultimate nightmare because these nasties are always lurking around the corner ready to blindside you.

I had serious discomfort and constant clogs without any usual symptoms of mastitis. I kept blaming overproduction for it. As it turned out it was in fact asymptomatic mastitis & a candida infection which magically disappeared after a full round of antibiotics and I remained clog-free and infection free for the rest of my journey. I fed my daughter through all of it and she did very well in spite of the situation.

My learnings:

  • Recurrent clogs are NOT normal, something is wrong.
  • After completing a session one should NOT feel heavy as though you the need to pump again.
  • Sudden shooting pain is NOT normal.
  • Pumping should NOT hurt.
  • Candida is a VERY common fungal infection especially in humid conditions like ours, it won’t spare anyone, pumping or not.

 

Donation:

Beyond a point when I ran out of all my storage options I considered the next logical step, donation.

I contacted several hospitals to ask if they had milk banks and it broke my heart that even the wealthiest private hospitals did not have a human milk bank. I was told that operating a milk bank requires following several protocols, which ends up becoming cumbersome to manage, thereby giving the convenience of sterile formula the edge.Then, I contacted SION hospital. Theirs is the first human milk bank in the city and the people there are just wonderful. However, we had a very unfortunate turn of events when none of my donation cleared the criteria for use in spite of having a chit for clean health and the fact that my own baby was thriving rather well on my milk alone didn’t seem to help. It’s a mystery that remains unsolved till this day. Even so they continued to welcome my donations with open arms and I am grateful that they were with me all along and never once turned me down.

To qualify for donation, one needs to clear a couple of mandatory tests as a donor and then collect the milk in sterile containers making sure that the bottles and the pump parts are also sterilized before expression. Milk can be frozen immediately after collection and transported to the facility at the earliest. Alternatively, milk, which is refrigerated immediately after collection, can also be transported to the center at the earliest possible.

Please note that Sion hospital is always in need for milk donors and their doors are lovingly open for any donor mums. 

Milk sharing:

Along the way I had the joy of discovering “milk sharing”.

Milk sharing, exchange or wet nursing is not advised on paper since the milk may not be pasteurized or one may not be aware of the mothers medical history BUT it’s a universal phenomenon, which takes place unofficially all over the globe. It happens within families, amongst strangers, between friends and it happened with me. My closest friends were really generous in their offer to share their milk at the time of Tara’s birth. I just wanted to make sure that there was backup available in case my milk kicked in late.

Last year a very dear friend of ours adopted a beautiful baby girl and she called up inquiring about milk banks for procuring human milk. I jumped in and asked her if she would be comfortable accepting my milk and made clear to her my unexplained and unresolved history with the hospital donations. She was brave enough to test it out on her bub and the decision was made to home pasteurize the milk to further ensure safety and start our what we jokingly called the ‘milk mafia’ exchange! To this day I applaud her courage for even thinking of an option like this for her bub and taking a chance with me. Her daughter will always be my little ‘milkling’. It was with her that my pumping journey completed a full circle. It gave me the closure I was looking for and I will always be grateful for it.

Concluding, I consider myself fortunate to have experienced the whole spectrum of feeding which is not restricted to the breast or the bottle alone. In Feb this year, after 14 months of going strong I decided to hang my flanges.

Next up,  Exclusive Pumping, Taming the BEAST Part 03: Bittersweet Weaning

Please note: I am not a professional in the field of lactation and the above is only an account of my journey as an exclusively pumping mum.

Thank you for reading!

Taming the BEAST, Part 01: Exclusive Pumping & Befriending the process!

 

tara02

This journey is one that is very close to my heart.

I am doing a three part series on exclusive pumping because I feel like not enough information is out there for a first time pumping mum and I very strongly feel that it needs to be advocated more than it is, especially so for conditions which require a mum to pump.

One can also store colostrum if they know that they’ll be welcoming a baby with feeding challenges. I had the good fortune of working with a great certified lactation consultant to help me with the same.

I want to say that IT IS POSSIBLE and exclusive pumping is a beast we can tame!! However, please note, I am not a lactation expert and the following is an account of my very private experience.

The one thing that I thank God for everyday is the fact that I had enough supply to feed my daughter exclusively for the first 7 months and continued to do so post the introduction of solids until her palate repair surgery till year one.

She still enjoys the benefits of her mamas milk and will continue to do so thanks to modern storage technology even though my journey is officially over.

This whole experience has been bittersweet for her and me. I mourned the loss of our breastfeeding relationship, I could never just have her latched on even for comfort. Our several skin to skin and comfort nursing sessions only just lasted a few minutes before it all got a little too overwhelming for her.

What kept me going for 13 months non stop was excellent support from the husband and family. Sticking to a pumping schedule no matter what. Readiness to pump anywhere and I mean anywhere! The downside was that I couldn’t really socialise outside of my house all that much unless I carried all my supplies BUT I wouldn’t change any of that because it was for her, and I’d do it again in a heartbeat if I had to!

Getting started:

Here are a few things I kept in mind at the time of purchase and some I learnt via experience.

  • Select a good hospital grade pump especially if you’re in it for the long haul.
  • Make sure its a “Closed system pump” to maintain hygiene and safety. Read more on closed system vs. open system pumps. 
  • NEVER use a second hand pump unless it is a “closed system pump” (motor only) Always buy new tubing, bottles, flanges, membranes and accessories. Please note Medela themselves recommend that one should not share pumps or even use them second time around for the fear of “cross – contamination”. Read more on it here.
  • Make sure it is a double electric so you don’t have to be hooked onto the pump for hours on end.
  • If possible, always have spares of membranes, tubing, valves or any delicate parts handy to avoid wasting time in re-ordering or even God forbid “missing a pump”!
  • Select the right flange size. A wrong flange size can be unforgiving.
  • I used a Spectra S1. It was beautiful and the customer service was great too (US customer service). Absolutely gentle on the body and wont rip your skin. I LOVED my pump for its “night lamp” feature as well as how quiet it was, made the middle of the night pump actually possible and that too without waking up my babies or husband. Another great feature is that it’s chargeable with a decent battery life. Seriously, I couldn’t have asked for more!
  • Last but not the least, lube the flanges, the reduction in friction will lend you more comfort than one can imagine! I used organic coconut oil. Just a drop rubbed on the funnel would do the job.

Some Rules:

A little rigid in the beginning but well worth the time invested. Someone would watch the babies and if that wasn’t possible they’d just be hovering around me. Yes! we normalized pumping for my then 2.5 year old just as we would with nursing a baby.

  • They say it takes a good 12 weeks postpartum for the supply to get established. Which means pumping in the “Middle Of The Night” (MOTN) becomes a necessity. There will be a spike in supply for the first few weeks and then sometimes a sudden dip so in view of that “sudden dip” I could NEVER let go of that MOTN pump. Plus, a pumping schedule needs to mimic a new borns feeding pattern and almost all newborns will nurse at night.
  • Sticking to the schedule. I started pumping at first every two hours for 10 mins at a time but soon realized it wasn’t for me. Each body is different constitutionally and I could manage well with longer gaps. Below is a pumping schedule I got off the internet and used as a broad guideline. It took me time to understand my body to be able to decide the time interval between two pumps and the length of each pump.

Pumping schedule-01

 

  • Always pump until empty. That is how a baby would nurse. Emptying will cue the body to keep the production going. Incomplete expression has the potential to manifest into clogs and worse still, mastitis.

When the production dips:

For an exclusive pumper a drop in production sets off immediate alarm bells because we can always “measure” what we make and that can be rather unnerving! One can take several routes to bringing up the production with the aid of supplements etc. But what seemed to work for me was POWER PUMPING. Below is a chart which represents a power pump schedule. Power pumping essentially mimics “cluster feeding” therefore, the body attempts to increase supply.

Pumping schedule-01

 

Finally, I wish to reiterate the fact that the information I represent here is what I’ve learnt through my journey and via being a part of various exclusive pumpers communities on social media, guidance from a couple of lactation counsellors and the internet in general as a source of information and inspiration.

Thank you for reading!

Next up,  Taming the BEAST, Part 02: Storage & The Battles Within!