Wednesday, July 13, 2011

Pumping, Pumping, Pumping

I have gotten a second job. It doesn’t pay well and requires lots of nights and weekends. In fact, it requires around the clock work.

Medela Symphony

“Whoosh, whoosh, whoosh.” I hear this sound even in my sleep. It’s the muffled, repetitive suctioning sound of the Medela Symphony, a state of the art hospital grade double electric breast pump. It’s a bright yellow thing, about three feet high, on wheels. Much better looking than the antiquated Medela Lactina I had to rent from Mayo for home use. The Lactina is a bright blue square thing with a yellow pumping widget inserted on the front that just looks like it shouldn’t be there, or like it’s cobbled together from spare parts.

The room is small and dark, complete with a dimmer switch for the lights, as well as a radio, rocking chair, sink and cleaning supplies. I now spend a lot of my time in rooms like these. Pumping rooms, we call them. Each pumping session takes about a half an hour per session, 10-12 pumping sessions every 24 hours. This amounts to pumping every 2-3 hours, except for one four hour stretch during the night so I can sleep a little. I calculate that this amounts to about 33 hours of work per week.

Why? Because my baby cannot nurse yet. Due to hormonal levels, you only have a two week window after birth to establish your milk supply, so you must begin pumping right away if your baby cannot nurse. Thereafter, you must pump to maintain your milk supply (it’s all supply and demand), pumping frequently much the way a newborn would nurse.

No wonder why I’m tired! Don’t get me wrong, I am not complaining, but rather marveling at this new, alternate universe I now live in. My concept of breast feeding was based on the experiences of friends and co-workers, all who had full-term babies. I saw that working moms generally pumped twice per day, once in the morning and once in the afternoon and I thought, I can do that. Plus it’s the best thing for the baby, and it’s free. Free? Now I have to admit, that dollar amount on formula doesn’t seem so expensive anymore compared to working another full time job!

I am attached to my breast pump. Pumping every 2-3 hours, this guideline is from start to finish, so by the time I’m done with one pumping session I only have 1.5 to 2.5 hours until the next session. It’s challenging to cram everything else into these small sockets of time, such as the two hour drive from the hospital to our home, kangaroo care with Wesley, dealing with the never ending amounts of paperwork and phone calls that need to be made, hosting visitors, etc….I barely do one thing and it’s already time to pump again.

I recently started working 1-2 days a week, to conserve some of my paid time off for when Wesley comes home. But with my pumping situation, working is quite the process! Before I went back to work, I asked one of the nurses in the neonatal ICU if I could use my Medela Pump In Style (the small, discreet kind of breast pump that comes in a black shoulder bag) while working.

“That pump is not for a mom with a baby in the hospital,” she replied sternly. “That pump is for a working mom who only has to pump twice a day.”
Medela Lactina


And so I cart a suitcase to work with me, complete with the Medela Lactina and a plethora of other equipment required.

I also calculate that for now, I am barely keeping up with Wesley’s needs. Right now, he eats 1 ounce every three hours, eight times per 24 hours, for a total of 8 ounces. I recently started tracking it and I was pumping about 12 ounces of milk per 24 hours. I gasped. All that work for 12 ounces! And will I even be able to keep up with him?

I flew into a frenzy, calling lactation consultants and researching ways to increase my milk production. I would be so disappointed if I lost my milk supply before he is even able to start nursing. After adding—yes, more pumping sessions—and making sure I’m hydrated and eating more, this week I am up to almost 16 ounces per 24 hours. Ideally, I should be at 19 or more ounces. I also produce more milk when I have direct contact with Wesley, such as after kangaroo care. (I also wonder if my lower milk production is partially due to the fact that I am separated from my baby.) Take fenugreek, the lactation consultant told me. This is an herb that is known to increase milk supply by increasing prolactin levels. This is my next step. She also encouraged me, saying that milk supply often increases on its own after the baby starts nursing. No electric pump can remove milk from the breast as efficiently as a baby can, isn’t that amazing?! Once again, it’s all supply and demand.

But regardless of the time required or the amount of milk you can produce, the benefits of breast milk in any amount are undeniable. Did you know that a woman’s body produces milk uniquely suited for the age of her baby? In other words, when Wesley was born at 28 weeks, I produced milk specifically formulated for a 28 week old baby, rather than for a full term baby. Isn’t that amazing? Pre-term milk is higher in calories, protein, and fats, as well as an enzyme that helps digest the fats. Pre-term babies have trouble digesting fats, particularly the fats found in formula.

Providing breast milk is the one thing I felt I could do for him. Even when he was in an isolette, and I couldn’t hold him without enlisting the help of at least two nurses, I could always produce his milk and know that I was doing something he really needed. In the beginning, he received only one milliliter of milk every three hours and now he is receiving 33 milliliters (about an ounce) of milk every three hours, still through a tube inserted in his nose and stomach. In six weeks, Wesley has grown from 1 pound 15.3 ounces to just under four pounds. He is making steady gains every day, in addition to now breathing independently and maintaining his body temperature, which means he is now in a bassinette and we can pick him up and hold him whenever we want. I love knowing that I played a role in helping him thrive.

But I am getting anxious. I really want to feed him. The pumping thing is getting old. It’s a machine. Right now the closest I have to feeling like I am feeding him is by holding him while he receives his 33 milliliter “bolus feed” via a pump attached to his feeding tube.

We have tried breastfeeding three times now. Still no luck. Recreational breast feeding, the nurses call it. One night the nurses were laughing hysterically because one of the new resident doctors wrote the order for recreational breast feeding as “the mother may recreate at her breast.” Anyhow, I guess “recreational breast feeding” means that we still haven’t gotten the hang of it. He’s still not quite ready…so far Wesley gets sleepy very quickly and not much happens. It’s more of a “getting to know you experience” the nurses say. We are told to practice “recreational breast feeding” once per day. Thus the pumping sessions continue, to maintain the milk supply until Wesley is ready to eat.

So for now, I keep pumping, pumping, pumping.
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