Ask Judy: Is It Me Or My Pump?

Dear Judy, I am having trouble getting a let down with my pump. Even when I am all alone. Is it me or could it be my pump?

Lots of mothers have difficulty responding to a breastpump vs. nursing their baby. If you have normally been able to pump efficiently in the past, and are experiencing difficulties now, then it is most likely a problem with your pump. The first thing you should do is to make sure you are getting a good suction with your pump. Make sure there isn’t any condensation in your tubing and make sure your parts are in good working order. Most breastpump manufacturers recommend replacing your breastpump parts (tubing, diaphrams, valves, connectors) every 3 months. Just like you change your oil on your car on a regular basis, you also need to change the parts on your pump for optimal performance.

I remember one time not getting a good let down with my pump and it turned out that my tubing was loose on one side, so I wasn’t getting a good enough suction to stimulate my letdown. Once I figured out the problem and replaced the tubing, everything worked great!

Take a look around at your situation as well. Has anything changed? Are you undergoing more stress than is typical? Are you in a different environment? All of these things can effect your milk output.

If you have replaced all of your parts and evaluated your environment and you are still having difficulties, then it is time to call the manufacturer of your pump and see if they have any trouble shooting exercises to walk you through. There may be something wrong that requires more than just replacing spare parts.

Did you ever have a problem with your pump? How did you solve it? Do you have any tips for a mom who is having difficulties letting down with her pump? Please leave a comment to share your advice.

Returning To Work? Yes, You CAN Continue To Exclusively Breastfeed!

by Wendy Armbruster Bell
(How a Nanny and a Good Breastpump Can Help You Reach Your Personal Breastfeeding Goals)

As the end of your maternity leave fast approaches, nursing mothers have a number of choices to maintain their breastfeeding relationships with their babies. This holds true no matter how long your maternity leave will be or if you have chosen to return to work early on your own accord.

If you are fortunate to live fairly close to your place of employment, your nanny can bring your baby to you at work for as many feedings as desired. This is especially beneficial when you first return to work as it is a transition for both you and your baby. The sustained contact will be good for both of you emotionally and will facilitate your letdown as well as help to maintain your milk supply as you both adjust to the new routine.

Remember to discuss your breastfeeding and/or pumping schedule with your employer prior to your return to work so that there are no surprises for either of you. It is also a good idea to return to work on a Wednesday or Thursday so you have a short first week. Finally, plan a dry run of your morning routine, including the drive to work, before tackling the Real McCoy. This will do wonders for your stress level on that first day of leaving baby.

Following is a typical schedule that can be adapted to suit (based on a baby that is 3-6 months old):

6:00 am: Wake up, get ready for work and eat a healthy breakfast.
7:00 am: Wake and nurse your baby.*
8:30 am: Leave for work.
9:00 am: Arrive at work.*
11:00 am: Nanny brings baby to work to nurse.
12:30 pm: Eat a nutritious lunch.
2:30 pm: Nanny brings baby to work to nurse.
5:00 pm: Leave work for the day.
5:30 pm: Arrive home, eat dinner.
6:00 pm: Nurse your baby, then bed time/bath time routine for him/her.
7:00 pm: Put baby to bed.
8:00 pm: Prepare for you work day tomorrow (pack your lunch, plan tomorrow night’s dinner).*
10:30 pm: Wake baby to nurse if he/she is not sleeping through the night yet. If baby sleeps through, you may want to pump then off to bed.

* The asterisks in the schedule indicate prime times for additional pumping if your nanny is unable to bring the baby to you for whatever reason (e.g. you are out of town on business or your baby is ill). If you will be pumping at work even once per day, you may want to invest in a hands-free pumping bra so that you can still answer emails or take phone calls while pumping. Make sure you have a comfortable chair to sit in, a footrest to raise your knees to parallel while sitting (so that you don’t hunch over) and if you have problems with letdown, a picture of your baby or an article of clothing that smells like him/her. Remember that you should wait 4-6 weeks to introduce a bottle to your newborn to reduce the chance of nipple confusion.

If you don’t have an office with a lock on the door, then you will also need to find a private room that you can use for nursing and/or pumping – and try to avoid the restroom! Approach your employer to set-up a lactation room. You can pitch him or her on the benefits of having a breastfeeding mother on staff. Never mind the extensive long-term health benefits. In the short-term, research shows that:

• breastfed babies are sick less often and when they do get sick, then aren’t as sick
• breastfed babies are less likely to have ear infections, colic, diarrhea and other childhood illnesses
• babies who are breastfed are 10 times less likely to be hospitalized during the first year
• nursing mothers have a lower incidence of postpartum hemorrhage
• nursing mothers enjoy a decreased risk of iron-deficiency anemia (delayed return of menstruation) and the longer the mother nurses, the stronger this effect

Therefore, because you and your baby will be sick less frequently, your employer will benefit from reduced sick days and in turn, increased productivity from you!

After your baby starts solids at around age 6 months, whether this is before or after you return to work, he/she will be taking less breastmilk. If you do not live close enough to work to warrant having your nanny bring the baby to you, you may choose to pump during the day and breastfeed first thing in the morning and at bedtime as well as on the weekend. Your nanny can feed your baby one bottle of expressed breastmilk in the afternoon (2:30-3:00 pm) and you will still successfully maintain your supply. These types of arrangements along with an open mind, flexibility and support will help you reach your personal breastfeeding goals.

Speaking of support, a lack thereof is one of the top reasons for the extreme decline in breastfeeding rates after moms leave the hospital. The best thing you can do is to keep the following in mind:

• breastfeeding is not “instinctual”, both mom and baby need to learn how to do it
• if you are having difficulties, ASK FOR HELP from your Public Health Nurse, Doctor, Midwife, Doula, Lactation Consultant, La Leche League Leader, friend or family member
• there appears to be a learning curve for the first 6-7 weeks postpartum – if you can persevere until then, you are usually home-free
• resist the temptation to give your baby formula – as little as one feed per day can cause your supply to diminish – keep a small stash of breastmilk in the freezer instead

Following is a schedule for a baby that is 6 months or older:

6:00 am: Wake up, get ready for work and eat a healthy breakfast.
7:00 am: Wake and nurse your baby.*
8:30 am: Leave for work.
9:00 am: Arrive at work.*
12:30 pm: Eat a nutritious lunch.
2:30 pm: Pumping break.
5:00 pm: Leave work for the day.
5:30 pm: Arrive home, eat dinner.
6:15 pm: Nurse your baby, then bed time/bath time routine.
7:15 pm: Put baby to bed.
8:00 pm: Prepare for you work day tomorrow (pack your lunch, plan tomorrow night’s dinner).*
10:30 pm: Wake baby to nurse if he/she is not sleeping through the night yet. If baby sleeps through, you may want to pump then off to bed.

Many people are under the impression that a live-in nanny is out of reach financially; however, if you do the math, this choice is actually quite affordable compared to group daycare, especially if you have more than one child. Remember, there is also the option of arranging a “nanny share” with a friend, family member or co-worker.

As with many “seemingly” insurmountable challenges in life, one day you will look back on your choice to maintain breastfeeding after your return to work and say, “It was a bit of a challenge initially, but soon it was just another routine. I did it and it was absolutely worth it!”

Wendy Armbruster Bell is the Founder & Creative Director of Snugabell Mom & Baby Gear, creators of PumpEase hands-free pumping supports. When she is not helping thousands of breastfeeding Moms around the world pump hands-free and in style, she and her husband Mike are busy raising their two young daughters in beautiful British Columbia, Canada. She has been featured on Cool Mom Picks, Parents TV, Breakfast Television, Celebrity Baby Scoop and was named a Top Mompreneur for 2009 by The Mompreneur Magazine. Wendy can be contacted at wendy@snugabell.com or toll-free at 1.866.963.SNUG (7684).

Pump Ease and Snugabell are also proud to be sponsors of the Mommy News & Views Blogiversary Celebration! Please visit the Review and Give-away of Pump Ease Hands-Free Pumping Support in our Blogiversary section.

Did you work while breastfeeding your baby? What were your experiences pumping or breastfeeding at work? Please share any tips that you have with our readers by leaving a comment below.

Ask Judy: How Can I Get My Milk Supply Back Up?

Dear Judy, I returned to work in April and was pumping 3 times a day. I found that I would get a good amount in the morning but the mid day session and afternoon sessions would not yield quite as much. I reduced my pumping to twice a day because I was getting the same amount in the afternoon session pumping only twice as I was when I combined the mid-day and afternoon sessions while pumping three times.

I guess my question is, is it better to pump more often or does it matter since I am getting the same amount with fewer sessions? My baby is 8 months old and I had a really good supply until just a few months ago when we went on vacation and it seems to be going down lately. I am not sure if it matters but things were great until July when we traveled to Wyoming. Due to travel times, I went around 15 hours without nursing or pumping then the next day we were so busy with family stuff that I went almost the entire day before I pumped. Needless to say I was extremely engorged both days. After that it seems levels have steadily dropped. I was getting up to 20 ounces from both feedings now I am lucky to get 12-15. I usually send 16 ounces to daycare (not that she ever drinks that much) and then we need 8 ounces for our bedtime bottle. I do not supplement with formula. I do have to get some of my freezer stash out once or twice a week now where before our trip I was able to put 12-18+ ounces away away every week.

I would like to increase my supply so that I don’t have to take anything out of the freezer. Thanks for any advice or tips – Carrie.

Hi Carrie,

I have found that while in the short term you can get the same amount by condensing two pumping sessions into one, over the long term it will end up decreasing your supply. So I would recommend pumping more frequently. It sounds like your supply took a dip when you went on your vacation and now that you are back and pumping less frequently, it isn’t bouncing back. I would recommend that you do not combine your pumping sessions into one. Remember that your body gets used to the times that you pump – so if you don’t pump for a few weeks at a particular time, then it will take a few times before your body starts producing more milk at that time.

Here are some tips to help you get your milk supply back up to where it used to be:

1) Nurse your baby as often as possible when you are together – nurse before giving solids
2) When you are pumping, pump for a full 15 minutes, even if you stop producing milk. The extra stimulation with help to increase your supply and send signals to your body to make more milk
3) Try to pump at the same (or nearly the same) time every day – consistency helps with milk production
4) Try pumping for 10 mins, turn your pump off for 2-3 mins, then pump again for 5 mins – this ALWAYS gave me a 2nd let down
5) Make sure you are using the correct size flanges with your pump. Your nipple should not touch the inside walls of your flange at all while you are pumping. Many moms need a larger size flange when they are pumping as their nipples swell when expressing milk. Going up a size can often increase milk production.

For more pumping tips, please take a look at my pumping tips article.

Do you have any advice for Carrie? Did you combine feedings while working? Did you ever have a dip in supply? What did you do to get your supply back up? Please leave a comment to help this mom out!

Ask Judy: Should I Pump?

My son is still nursing at least twice a day at 20 months: long one at wakeup time and variably at bedtime (20 min to 1 hour depending on his mood). I work part time, so we also nurse for naptime on the days I am with him.

Next week, I need to work at night (very odd for me) during his bedtime. I will be able to be home with him for naptime nursing and will try to offer a “last” nursing 90 min before our typical bedtime nursing before leaving him with my husband.

I suspect he will be fine, but wonder if my supply might be affected. Also, I haven’t pumped since he was 14 months, do you think I should plan for a nighttime pump when I get home late. (I won’t wake him, as it would probably just bug him and disrupt his overall sleep hours that night).

Any advice would be most welcome!

Hi Nicole,
Thanks for writing in to Mommy News & Views with your breastfeeding question. There are a lot of different opinions on this subject, so I will give you mine, and hopefully some of the readers of this blog will chime in with their thoughts as well.

At 20 months, your milk supply is very well established. Since it is an on-demand system, you supply will adjust based on the demand. So if you are going to miss your night time nursing session for a week, then you may see a dip in your supply during that time. But since you have a well-established milk supply, my first inclination is to tell you not to worry about it. When you start nursing again at night, your supply will come back. You may see a slight dip, but it should rebound once you go back to your regular schedule. If your baby were younger, I would encourage you to pump, but since you have been nursing for a long time and you have a well-established supply, then I don’t think it will be necessary for you to pump.

The first night or two that you are away, you may want to bring your pump with you, or plan to pump when you get home, just in case you are engorged. You wouldn’t want to get mastitis by getting overly engorged and you wouldn’t want to be uncomfortable by being overly engorged either. If you don’t experience any discomfort, then there is no need to pump. If you do, then you can pump to relieve the pressure.

When you start nursing again, drink lots of extra fluids to help your body to start making milk again. Your son may be a little frustrated the first time he nurses at night again if your milk is slow to let down, but it should come right back to where it was in a few days.

To our readers: Have you ever had to go a period of time without nursing? Did you pump? Are you able to offer any additional advice to Nicole?

Ask Judy: How Do I Relactate?

Dear Judy: I want to start breastfeeding again, well pumping my breast milk for my 2 kids Jacob 3 years old, Danielle 2 years old. Do you think this is a crazy idea? My doctor is not supporting me, she says that I was done a year ago, and I should leave it that way… I just want the best for my kids, they are very picky eaters and I think going back to feed them with breast milk will really help them. Do you have any suggestions? Lucy A.

Hi Lucy,

I’m sorry to hear that your doctor is not supporting you. I think that you are the mother and you know what is best for your kids – so if you think that pumping your breastmilk will be what is best for them right now, then that is what you should do. The good news is, re-lactating is much easier after you have already breastfed, so while it will be difficult to get your milk supply back, it will be easier than if you hadn’t already breastfed a baby.

The first thing you will want to do is to start pumping. You should pump every 2-3 hours around the clock for the next month or so. You’ll also want to change your diet so that you can incorporate foods that lead to good milk production. Here are some suggestions for you.

1) Drink Mother’s Milk Tea: This will help to increase your milk supply.
2) Eat Oatmeal: Not the instant kind, the kind you have to cook – it is called “Steel Cut Oats” and it is great at increasing milk supply.
3) Take Fenugreek: read more here to find out how much to take.
4) Read this article for great pumping tips.
5) Drink 1/2 beer per day – the hops in the beer actually serves to increase milk supply – so you don’t need a lot – but a little will go a long way.
6) There is a drug that is fantastic at increasing milk supply and most moms who relactate use it. It is called Domperidone. It is not FDA approved and can not be purchased in US, but if you are in Canada you are in luck. There are potential side effects so you should read up on them. Here is an article to point you in the right direction. You do need a prescription to take it. You can get one from your own OB/GYN or you can email Dr. Jack Newman, he will write you a prescription which you can use.

Have you re-lactated? What tips worked best for you? Please share your tips and tricks by leaving a comment on this post!

Ask Judy: How Do I Keep My Milk Supply Up While Working?

Dear Judy, I have a question for you already. I just returned to work Monday. I noticed yesterday and today that I am not pumping 4.5 to 5oz like I did Monday. My lactation consultant has me taking Fenugreek, which I have been on for about a month. My daughter seems to still be satisfied when I feed her at home. I believe my cycle is due in the next week or two. Considering the above information, do you have any suggestions to keep my milk up? Also I’ve tried pumping for 10 mins taking a 2 min break and pumping againg for 5 mins. Then I have tired 20 mins straight. Okay, I think that is everything I am doing.

It is pretty common for moms to have lower than expected milk out-put during their first week back to work. Your body is adjusting to spending so much time on the pump and you may be feeling stressed or anxious about being away from your baby and about getting caught up on work. I wouldn’t worry too much about it this week. Keep pumping regularly and see how it goes. If you are still noticing lower than expected volumes next week, let me know and we will brain storm some ideas. In the meantime, please read this article – it is all about pumping and working.

Keep in mind that your baby is much more efficient at getting your milk out than your pump – so you may have to add in an extra pumping session to be able to keep up with what she will need while you are away. What worked for me was to pump every evening after my baby went to bed. He would go to sleep at 8 PM and I would pump at 10 PM. I only got 2 ounces, but it was enough to always make sure that I had enough for him to drink the next day. Adding in a pumping session like this works best if you are consistent about it. You will get more milk if you do it at the same time every day.

How much of the fenugreek are you taking? You should be taking 3-4 pills 3-4 times per day. Your body should smell like maple syrup. You can read more about fenugreek here.

Also, have you ever experienced dips in your supply due to your cycle before? Many women see this. It may be due to your time of month as well.

One final tip – it is easy when you are at work to forget to drink water – having enough to drink will directly affect your supply – make sure you are drinking LOTS – even EXTRA water!!

Kelly Mom also has some great tips on pumping and working which you can read as well.

Did you experience a dip in supply when you went back to work? What did you do? Please share your experiences by leaving a comment. The mom who wrote me this question will be checking in to see what advice you have for her. She has gotten lots of great tips from Mommy News & Views readers in the past – so she is looking forward to what you have to share with her today too!

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Have you used this pump? Please share your experiences with our readers by leaving a comment!

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