Dumping the pump
Since Ess was born, over five weeks ago, I have become very friendly with the breast pump. Since she went into the NICU right away, I started pumping in the recovery room, and continued from there. She got breastmilk through her feeding tube in the hospital, and breastmilk in bottles when I wasn't there to nurse her. And when I was there, I was using the glorious nipple shield, the piece of silicon that allowed me to get this baby to the breast successfully.
The shield came with one drawback, though: according to the lactation consultants at the hospital, I had to pump *every time* I nursed her, since some studies (and, notably, the website of a major manufacturer of breastpumps) show that babies who are fed via the shield don't transfer as much milk as babies going commando. (Technically, I guess it's the mom who's going commando, but it sounds funnier the other way...). So when Ess came home from the hospital, I was spending pretty much my whole day either nursing her, pumping or sleeping, with the occasional interval of adult conversation. Finally, the LCs said I could cut out the middle-of-the-night pumping and decrease the others to 10 minutes (which I'd already done on my own).
So my freezer filled with breastmilk, and Ess gained weight fabulously, which indicated to me that she was having no problem getting enough milk. So I called the LCs, and they insisted I continue pumping as long as she was on the shield -- which could be at least until her due date, if not beyond. That seemed crazy to me. So, in search of an answer I liked better, I talked to the local La Leche League leader. And sure enough, she said I'd be fine to quit pumping entirely, as long as I did it slowly -- eliminating one pumping every day or two, taking longer between eliminations if my breasts were engorged.
That's what I did. As a result, Sunday was the first day since Ess was born that I did not pump at all. I have more time in my day (though you'd never know it to look at me, or our house), and Ess hasn't suffered a bit.
The whole experience, though, was typical of the time we spent in the hospital. We got lots of advice, much of conflicting. Recommendations for how to care for Ess changed as the shifts did, with one nurse insisting that she not take bottles at all, ever, while another cheerfully noted that in her 20 year career she'd never seen an instance of nipple confusion. Most nurses encouraged our attempts to do kangaroo care; another was clearly uncomfortable with the fact that the baby was not dressed while she was eating.
For a new parent -- let alone a new parent who's gone through an unexpected, and overwhelming, birth experience much earlier than scheduled -- this was really difficult to handle. It's the thing I think about the most when I look back on our time in the hospital -- the feeling that we were having to make decisions about things we'd didn't know anything about, based on little more than gut instinct. Was it ok for Ess to have a pacifier? Sure, we said. Did we want a visiting nurse to come? Why not. In the end, these weren't life and death decisions, but making them on the fly, in an environment where I already felt incompetent to care for my child, just contributed to my feeling of inexperience and, frankly, idiocy.
And then there were all those issues like the pumping, in which we were told How Things Are Done, despite any evidence we might've had to the contrary. Some of this, of course, is simply the result of the differing personalities among the hospital staff, which I don't think you'd want to mandate away. But the completely contrasting recommendations... that was too much. I don't know that the creation of blanket policies on things like bottlefeeding for preemies whose moms want to breastfeed is the way to go, but there's got to be a way to help parents through the blizzard of information they are given at such a vulnerable time.
If I were less sleep-deprived, this would be the place where I'd have a clear, well-thought-out idea of what that would be, as well as a conclusion that neatly tied together these strands that don't connect so well on their own. But I'm not, so it isn't. Your thoughts?
The shield came with one drawback, though: according to the lactation consultants at the hospital, I had to pump *every time* I nursed her, since some studies (and, notably, the website of a major manufacturer of breastpumps) show that babies who are fed via the shield don't transfer as much milk as babies going commando. (Technically, I guess it's the mom who's going commando, but it sounds funnier the other way...). So when Ess came home from the hospital, I was spending pretty much my whole day either nursing her, pumping or sleeping, with the occasional interval of adult conversation. Finally, the LCs said I could cut out the middle-of-the-night pumping and decrease the others to 10 minutes (which I'd already done on my own).
So my freezer filled with breastmilk, and Ess gained weight fabulously, which indicated to me that she was having no problem getting enough milk. So I called the LCs, and they insisted I continue pumping as long as she was on the shield -- which could be at least until her due date, if not beyond. That seemed crazy to me. So, in search of an answer I liked better, I talked to the local La Leche League leader. And sure enough, she said I'd be fine to quit pumping entirely, as long as I did it slowly -- eliminating one pumping every day or two, taking longer between eliminations if my breasts were engorged.
That's what I did. As a result, Sunday was the first day since Ess was born that I did not pump at all. I have more time in my day (though you'd never know it to look at me, or our house), and Ess hasn't suffered a bit.
The whole experience, though, was typical of the time we spent in the hospital. We got lots of advice, much of conflicting. Recommendations for how to care for Ess changed as the shifts did, with one nurse insisting that she not take bottles at all, ever, while another cheerfully noted that in her 20 year career she'd never seen an instance of nipple confusion. Most nurses encouraged our attempts to do kangaroo care; another was clearly uncomfortable with the fact that the baby was not dressed while she was eating.
For a new parent -- let alone a new parent who's gone through an unexpected, and overwhelming, birth experience much earlier than scheduled -- this was really difficult to handle. It's the thing I think about the most when I look back on our time in the hospital -- the feeling that we were having to make decisions about things we'd didn't know anything about, based on little more than gut instinct. Was it ok for Ess to have a pacifier? Sure, we said. Did we want a visiting nurse to come? Why not. In the end, these weren't life and death decisions, but making them on the fly, in an environment where I already felt incompetent to care for my child, just contributed to my feeling of inexperience and, frankly, idiocy.
And then there were all those issues like the pumping, in which we were told How Things Are Done, despite any evidence we might've had to the contrary. Some of this, of course, is simply the result of the differing personalities among the hospital staff, which I don't think you'd want to mandate away. But the completely contrasting recommendations... that was too much. I don't know that the creation of blanket policies on things like bottlefeeding for preemies whose moms want to breastfeed is the way to go, but there's got to be a way to help parents through the blizzard of information they are given at such a vulnerable time.
If I were less sleep-deprived, this would be the place where I'd have a clear, well-thought-out idea of what that would be, as well as a conclusion that neatly tied together these strands that don't connect so well on their own. But I'm not, so it isn't. Your thoughts?
posted by mc at 11:52 AM
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