Saturday, December 11, 2010

Guest Blog: Why Exclusively Pump?

While the answer seemed obvious to me I quickly learned that this was a question that surfaced to many people’s minds when they learned that I exclusively pumped for my daughter Camille. First the insurance company initially refused to cover my hospital grade pump because when they asked why I pumped I gave the wrong answer. Inability to latch and low supply are not insurance worthy reasons to pump. We don’t have a lot of extra money so we thought it was worth trying harder to get coverage. Insurance companies used to cover pumps more liberally but lately they have become much more discriminating as to who truly needs to pump and who doesn’t. My insurance company covers the pump for infants with medical problems such as cleft lip or prematurity. Of course these infants need that extra help to get the breast milk they deserve BUT…Who chooses to pump for the pure enjoyment of it? The vast majority of EPers (exclusive pumpers) do so b/c they have to. Some full term babies don’t latch for whatever reason and some mothers have to go to work. Why are these reasons somehow less valid than cleft lip and prematurity? Bottom line is that all of these babies need their mother to pump in order to get breast milk. Well, I was pretty determined and I don’t know how I EVER found the time or energy to do this going on basically no sleep but with a lot of calls to different people I finally did get the insurance to cover my wonderful hospital grade pump.

Another source of questioning came from my in-laws, specifically my mother-in-law. Now I’m not knocking mother-in-laws and many are wonderful additions to the family but my mother-in-law hates me. No kidding, she has made it pretty clear that she doesn’t like me but I’m still married to her son so she’s going to have to deal. Anyway, she hated that I exclusively pumped and was constantly recommending that I switch to formula. I told her how important it was to me that Camille get breast milk and all the reasons why I pumped but if anything that made her more set against it. I’m not sure exactly why it bugged her so much, maybe she thought I was showing her up b/c she gave her son formula even though she didn’t have any latching or supply problems at all, but it just unnerved her that I was pumping. She enlisted the help from the women in her family and her hairdresser to try to get me to switch to formula. When my husband and I visited that first Thanksgiving with our brand new daughter they all tried to persuade me to switch to formula. They undermined the benefits Camille was getting and gave me absolutely no credit for all the hard work I put into making sure Camille got the best food. One of them actually said “weird” when I explained what I had to do. The hairdresser, also a NURSE, told me that the benefits of breast milk were only in the first couple of days. Does she think I’m stupid? Also, how mean! That was the short period of time Camille was actually on formula due to my low supply. Now I’m not sure if the hairdresser knew this but how hurtful to say all my work was for nothing b/c the one time Camille needed it I couldn’t give it to her. Of course I know better and I was shocked a nurse would give me mis-information just to undermine me. The question “why are you pumping” quickly morphed into the demand “you should just switch to formula b/c pumping is worthless.”

Why pump? Even the most superficial research over breast milk will give you many reasons why breast milk is the perfect food for babies. (Research also shows that this benefit is amplified with premature babies. Babies that are, as a group, probably less frequently breastfed than term babies due to latching problems actually benefit more from breast milk.) I was determined that my daughter, Camille, get these benefits. She was a very high strung little baby and refused to latch. She hated nursing and would scream continuously every time I tried to nurse her. Even if she did latch I think pumping would have been more practical in the beginning b/c she ate such small amounts at a time. For many months she would eat every hour or more and then usually not more than an ounce. The most she would eat at a time was at night and it was usually 2 ounces. We suspected acid reflux was at the root. It was actually easier to pump larger amounts fewer times a day than to breast feed her for little spurts 20 times a day! My little girl was not premature but there were in-utero problems. I had preeclampsia and there was an unknown length of time (probably several weeks) where she was not getting nutrition from the placenta. She had stopped growing and was small for her gestational age. I was heartbroken. After she was born people frequently commented on how small she was and said she looked like a preemie. One woman walking by at the store said “look at that baby! It doesn’t even look real. It looks like a toy.” It cut me to the quick to hear that. If I could give this tiny person a special gift that would last her a lifetime and for which there could be no substitute I would. And I did.

I’m proud to say that with the exception of several bottles of formula the first few weeks, my daughter ate exclusively breast milk the first five months of life and after that breast milk with a slowly increasing amount of solids. For the first 7 months I pumped 8 times a day, then I tapered down to 6. At 11 months I was down to four. After 12 months I pump a few times in the evening after my husband’s home and Camille’s in bed. At 12 months I introduced cow’s milk but she still gets breast milk. Although now, at 16 1/2 months, she’s down to two ounces of milk a day. Even though it took a lot of pumping to establish a supply in the beginning (my body had turned off due to the preeclampsia) I eventually produced more than she was eating. I would adjust my pumping to keep more in line with her appetite. I wouldn’t pump less frequently b/c I tried to mimic her eating frequency as much as was practical. (Nursing/pumping duration, spacing, and frequency modulate fat levels in breast milk) Instead I pumped one breast instead of two and lessened the amount of pumping at night. I didn’t store milk other than saving extra milk in the fridge for up to a week. There were several reasons why I decided not to freeze my milk. One reason is I believe strongly in the La Leche League mantra that supply will keep up with demand. I was never worried about losing my supply again b/c all I had to do was pump extra if Camille began to eat more. Within a couple of days my supply went up to meet her needs. A lactation consultant also gave me this very valuable piece of advice: milk production increases the most between 1 and 5 am. If I pumped an extra time in that window it had a bigger impact on my supply than if I pumped several extra times during the day. If Camille was especially fussy and high maintenance one day and I just couldn’t find many chances to pump, I’d have my week’s worth of stores in the fridge. Another reason is that freezing destroys some of the beneficial components of breast milk. So it wasn’t necessary and it was not as good of milk (although still very good to all those who do freeze their milk). It just wasn’t worth the extra hassle. If I had a bit more time and a bit more sleep (i.e., if Camille was an easier baby) I would have frozen my milk to donate to milk banks—definitely keeping this in mind for next time.

There is no question that exclusively pumping is a pain in the butt! You don’t get any of the bonding pleasure associated with nursing—I mean you’re hooked up to a machine. My daughter was colicky and chronically over-tired (some days she got as little as 9 hours of sleep in a 24 hour period—not including the few 10 minute naps she’d sneak in). Do what I could, I couldn’t make her sleep. But I could control what she ate so while her sleep problems made things more difficult they motivated me even more to pump. With her fussiness and sleep issues it was difficult to find good times to pump during the day when my husband was at work. We have no family in the area so I ended up hiring a low cost nanny to watch Camille a few hours during the day. For the first six months she would come for three hours two-three days during the week. Those were my easy pump days! I would pump once before my husband left for work, once when the nanny first arrive, once just before she left, possibly one more time before hubbie came home from work, once as soon as he arrived from work, one or two more times before bed, and once in the middle of the night. When Camille and I were alone together and there was no one else there to watch her, I would put her in her bouncy seat while I pumped. We’d play with toys, sing songs, or just chit-chat. If she got fussy I’d turn on a vacuum I placed near-by and that magically soothed her. Sometimes she’d even go to sleep while the vacuum was on. In order to get the hind-milk I would always pump both breasts for 15 minutes. Often there would be two let-downs during one session.

I’m proud of what I’ve done for my daughter and when she’s older I’ll be happy to let her know she was breastfed. Of course, many mothers would have opted to use formula and that decision does not make you a bad mother! Everyone’s family situation is different. Perhaps some women would think that the stress of pumping and time spent doing it would impair their ability to enjoy and engage with their baby. I can definitely understand this but for my situation, pumping was the best for both me and my daughter. All of the support I received made it possible for me to keep my sanity while I pumped. I know a few other mothers who exclusively pump(ed) and I’m advising a long distance friend on the matter. Her daughter is 5 months now and she’s still an EPer! Other moms have praised my pumping so I knew there were people out their who appreciated what I was doing. Every little compliment or word of acknowledgment helped me to feel good about what I was doing. There is also a wonderful yahoo community of EPers that a fellow EPer introduced me to. Knowing other EPers and visiting this online community let me know that I wasn’t alone and that my way of doing things was not “weird” at all. For my baby shower my aunt gave me The La Leche League’s Womanly Art of Breastfeeding. Whenever I was tempted to give up pumping I just read this book’s section on the benefits of breastfeeding. Almost all of these benefits (and it is a long list) apply to expressed milk as well as nursing. Most important of all was my husband’s support. He was always hugely supportive of my decision and bragged on the good quality food Camille was getting. He also told me that if I decided to go to formula instead that would be okay too. He was behind me 100% and he let me know that he was aware of the benefits of EPing AND its difficulties. Without all this support, especially from my husband, I couldn’t have done it. Several mothers I met at ECFE (I think there were about three) also had latching/supply problems. They said they tried to EP in the beginning but their husbands persuaded them to stop b/c it took too much time or for some other reason. I think lack of support was the ultimate factor behind these women’s decisions to switch to formula. So if it’s something you want to do tell people how important it is to you and get as much support as you can. Remember, the benefits of breast milk last a lifetime. You can never undo that.


4 comments:

  1. Good for you!!!! That's amazing mama! EPing is TOUGH WORK!!

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  2. I know what you mean about the MIL. Mine loves to complain about how I'm always pumping. She says that it makes it harder on my husband and that it takes up all of the time I should be spending doing housework and visiting with the family. PUH-LEEZ! I am so not taking advice from a 15 year old mother who fed her infant son cow milk because it was convenient....

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