Am I PUMPING the Right Way? | PUMPING 101| Dr. Amna Husain

Am I Pumping the Right Way? In this video, board certified pediatrician and lactation consultant Dr. Amna Husain discusses FAQ's on pumping!

Transcription

Dr. Amna Husain:
Hey everyone. Welcome back. My name's Dr. Amna Husain, board certified pediatrician, board certified lactation consultant, and mom. So today I want to talk to you guys about pumping, how to know if you're pumping enough, ways to set yourself up for success when you are pumping, and take you through some of the most commonly asked questions when it comes to pumping. Now for those of you who may not know, I actually exclusively pumped for a good bit of my nursing journey with my first daughter. Now, I learned a lot along the way. I was not a lactation consultant at the time, and it was a huge steep learning curve. So I want to help you guys skip over that learning curve or at least get a head start on it by watching this video.

Dr. Amna Husain:
First of all, I've discussed breastfeeding, that's in the past. I'll link that video here, but I want you to know that breast size does not determine how much milk you're going to make. Breast size is determined by the amount of fatty tissue you have. The amount of milk you produce is determined by the amount of glandular tissue you have. Those are very important distinctions. Now in general, if you wanted to really determine how much is a normal pump volume, usually we say a woman produces one ounce of breast milk for every hour of the day. So typically most women might make about 24 ounces of milk. There's a little bit of a range there. So let's say 22 to 26 ounces. Someday. You might have a day where you make a little bit more, maybe one day you have a day where you make a little bit less and some women may never meet that 24 ounce mark.

Dr. Amna Husain:
And that's okay as well. Every woman is different. Typically, if you had a smaller capacity, we would say that's one to two ounces per hour of breast milk made your baby might need to be fed more frequently. So let's say if you have a newborn baby, they might need to be fed like 10 to 12 times during a day. If you have more of a medium capacity, you can hold about three to four ounces of milk and you might be feeding your baby every three to four hours. For some women, this might be normal for them. And for some women who have more of a larger capacity, they're actually able to make sometimes about six to eight ounces per breast. Those women often run into sometimes problems with oversupply or clogged ducts or feeling like they can't control their let downs. If you are somebody who does produce that large of a volume, sometimes your baby might not be taking six to eight ounces during a feed.

Dr. Amna Husain:
That's very, very normal. You might need to pump to really relieve your breast or empty it completely after a feed or your infant might only feed on one side. And that's okay. Every woman's a little different before we go into the specifics of pumping. I do want to talk about that passive let down that you might initially have in the first few weeks after having a baby. So initially you might feel like you're having let downs very frequently. And a lot of women use nursing pads, myself included. But I actually think it can be more helpful to catch that passive let down. Don't let it go to waste. So sometimes you can even use things like a haakaa, which basically works by suction, and it can sit on the opposite breast and really catch any let down that you might be having, or there's even options that you can put directly into your bra.

Dr. Amna Husain:
For example, elvie, which allows for hands-free pump pumping also has something called the elvie curve that you can actually just stick into your bra and it catches any passive let down. That's a great option as well if you're not really ready to jump into pumping, initially, you can just catch that passive let down that's happening without the active pump attached to you. Now, when we are talking about breast pumps, I want to go through some of the basics with you. Usually there are two modes to every breast pump. There's a let down or a massage mode and an expression mode. The let down mode is light and fast. Typically this works just like the baby would, so it starts to really stimulate milk let down and the expression mode usually has a higher section and works a little slowly, so this works like the baby sucking and swallowing, sucking and swallowing.

Dr. Amna Husain:
Once you've already had the let down, the expression mode typically is what would start. Some breast pumps automatically switch between the two and others you might actually have to hit a button where you switch over to expression mode. There's a couple of other features that might vary slightly on each pump. Some of them might be the vacuum strength and that determines really how hard the pump pulls. The other is the cycle speed, and that determines how fast the pump pulls. Some pumps might not let you really change the cycle speed. Others like spectra do let you change it. So it's just something to be aware of. Now, when you're pumping, it's a common misconception that you should have the pump going strongly. It's going to help you get a more efficient section or a stronger section and make your pump session go by faster. That's not really true.

Dr. Amna Husain:
In fact, it can actually do more damage and cause microtrauma. Also, it can be painful and guess what? Pain inhibits let down. So typically I say slowly, move it up to higher suction. And when you get to a point where you just can't stand it, you should definitely dial it back and then start to think about, okay, this is the suction that I can't really go past and find your sweet spot somewhere between the too low and almost one notch below the too high. So you never really get to that feeling of that painful sensation. Now let's talk about pump parts. So pump parts might vary a little bit from traditional pumps to maybe the more wearable pumps have a few less parts for ease, but typically this is what a breast pump would include.

Dr. Amna Husain:
So there's a flange and then some of the most important parts, so these connect outward so the flange can actually change sizes. But right here, you actually have a valve and a membrane. So this is the medela pumping style. And this is the bottle that you would be pumping into. There's also typically tubing that would come as well. So the tubing connects from here and goes into your pump and the tubing, contrary to belief, doesn't actually have any milk in it. In fact, if you do get milk in your tubing or water in your tubing, it can actually hinder how well the pump performs. Any of these parts really, if they stay wet too long, it can really hinder how well the pump performs, which actually gets me to my next part. So when it comes to all of these different parts, tubing, flange, the bottles, the membranes, the valves, it's a lot. And if you're pumping, you may not be able to really wash or sanitize or sterilize your parts as you go along.

Dr. Amna Husain:
Now, the CDC has recommended that you wash at least after every pump session and then sterilize once a day. And you can either sterilize by boiling the parts, or you can sterilize them in these types of microwave bags, be aware that these bags can sometimes warp your pump parts. So just be aware of that. However, it's incredibly inconvenient to constantly try to wash these pump parts. I totally get it. It's a time suck. So some women might have actually just put their pump parts into a big jumbos, Ziploc bag, and just stuff this straight in the fridge. And that's fine. That works for some people, but it's important to know again, that if your pump parts are wet, they may not perform well. And the second thing is when they're cold and you put a cold flange against you and you're trying to pump, you might have, again, a hard time having a let down because cold can actually sometimes inhibit a let down.

Dr. Amna Husain:
It's not comfortable, of course, it might actually tense you up a little bit. So instead you might consider just rinsing the accessories out and wiping them dry. There are also sanitizing wipes that you could use, and that's an option, or just have a second set of pump parts. So if you do put, let's say you're at work and you have to pump twice while you're at work. So then you have one clean set of pump parts, go ahead, put them in the fridge and you already have your second set that's ready to go and clean and you can use those ones. Then at the end of the night, when you're at home, you can wash all your pump parts and then have them dry for the next day. And then make sure you go to work with your two sets of pump parts.

Dr. Amna Husain:
Does that sound complicated? Yes, it kind of does, but don't worry. Just try to keep doing it every day and then make it part of your routine. And you won't even think about it. Speaking of how do you make it part of your routine? Well, I think hands free pumping is the way to go. Especially if you're a multitasker like me, then you want to have your hands free to do something. I mean, holding your pump there can get exhausting. It gets annoying. You don't want to do it. Handsfree pumping can have a lot of great benefits. Something you need to know is that you absolutely should invest in a good handsfree pumping bra. If you don't have a handsfree pump and a lot of women might just look up hacks online. You can take a sports bra and cut holes in it. That actually is not something I recommend because sports bras work to actually compress and you don't want to compress here because that can actually hinder milk supply or cause clogged ducts.

Dr. Amna Husain:
So instead actually invest in a good handsfree pumping bra. Other things that you should have with you are coolers and bottles that you can absolutely pump into. Some women prefer to pump into bags. For me, it's just one of those things that I would worry about a bag leaking. I feel like with a bottle you can screw on the top and it's a little bit more durable versus a bag, I would worry about it leaking and breast milk is like liquid gold. So it's completely your preference. Speaking of what can help with the let down, sometimes when you're at work, women might be struggling with getting a good let down and moving onto the expression phase. So it's helpful to either have pictures of baby or a video of baby on standby.

Dr. Amna Husain:
Some women actually take their child's favorite toy or blanket with them. And those kinds of things can actually help stimulate milk let down. Seriously. There's good evidence to support, there's actually an emotional component to it as well. Other things that can help is actually to take your mind off pumping completely. So watching a show on Netflix, or this is your time to read books, or maybe if you were like me, you were charting at the same time, but try to maybe actually take your mind off of the bottle as well. So if you're pumping into a bottle, one of my tips is actually putting a baby sock over it, because if you don't see it, then you're not freaking out and making yourself anxious over how much you're pumping.

Dr. Amna Husain:
Another important tip is make sure you take care of yourself. So if you're like me and you're not maybe drinking a lot of water during the day or getting snacks in, then when you sit down to pump, make sure that that's the time that you eat some snacks or you decide to drink your water bottle and you at least drink a good couple of ounces out of it.

Dr. Amna Husain:
It's really important to take care of yourself and make sure you're getting good nutrients in while you are pumping or breastfeeding. Another important thing to think about is clothing. There's specific nursing clothes out there. Also nursing covers that you can wear. I used to actually wear scrubs. So I'd have to take my top off to really be able to pump efficiently. And for me, there was a curtain in the mother baby room that would separate three or four women that could pump. And it worked. It wasn't a big deal for me, but just think about this when you're deciding you're going to have a handsfree pumping bra, what clothes you're going to wear. And again, this is something that if you wanted to look into nursing tank tops or having your own separate office, if you wanted a curtain that you could pull for your own privacy and ease of wardrobe while you are pumping.

Dr. Amna Husain:
Lastly, a few closing remarks, remember that pumping at work is really hard and it really only works somewhat well if you advocate for yourself and you have to advocate for yourself, fiercely. Be protective of that time. And don't let somebody tell you, well, it's only going to take you 10, 15 minutes. They probably have never pumped or haven't pumped in a very long time. I think it takes you... For example, for me, I used to work in the ERs when I went back to work and they would tell me, well, it'll only take you 15 minutes. It took me like five minutes to walk up to the room, and that was a fast walk, then to sit down and have a good pumping session was a good 20 minutes. And then rinsing the parts or putting everything away was, I don't know, five minutes and then walking back.

Dr. Amna Husain:
So yes, that was about a good 30 minute time span that I was away. And I shouldn't have felt guilty about that nor should I be made to feel guilty. So make sure you stand up for yourself and you get to determine how frequently you take the breaks. Nobody gets to tell you, well, it's only been three hours. You don't have to go for another hour. You get to determine that and make sure that you clarify that policy before you go back to work. Lastly, I want you to know your baby's going to going to love you whether you make five ounces, 50 ounces or even five drops, you're still going to be a rockstar to your baby. So try to set yourself up for success, but don't worry. Don't judge yourself by the amount of milk you make. That's not going to help you. That's not going to help your parenting journey or just how you feel as a mother in general.

Dr. Amna Husain:
So I hope this was able to help answer some of your questions. Get you started on the right path. I know these were questions that I had before I started pumping. And like I said, I was an exclusive pumper for some time. If you like this video, make sure you share it with someone else. Subscribe if you'd like, and tune in next week for another video.