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By the time my son was two weeks old, I felt like I had been milked by everyone in town. During our three days in hospital I’d been assessed by three different nurses, one lactation consultant, a paediatrician, and our midwife. On day two, my baby was dehydrated and limp, unable to properly breastfeed, and I started using an electric pump 12 times each day to extract my breast milk.
On day five, I felt triumphant that I was officially feeding my baby with my own breast milk. But as he was still unable to latch properly at the breast, I saw three more lactation consultants, dragging myself through the haze of the first days out of hospital, all while recovering from a C-section.
Finally, because none of these consultations were working (and because of a separate health scare), I decided to work exclusively with the breast pump. And though I had accessed all of these different services from four different organizations, nobody I saw told me that what I ended up doing—pumping and bottle feeding—was normal and could even be healthy for me and my baby. Instead, I was made to feel like I was a failure, and that pumping was far inferior to feeding at the breast.
No one told me that the proper term was “exclusive pumping,” or being an “EPer.” No one told me that pumping comes with its own set of guidelines and tactics, and that traditional breastfeeding advice wasn’t going to work for me. No one told me about all the resources out there to help me. Instead, I was presented with an either-or choice: either breastfeed the traditional way, or bottle-feed with formula.
I believe that information on exclusive pumping wasn’t available to me in the postpartum weeks because of the intense advocacy to breastfeed at the breast. The lack of advice circles around one idea: if women are given options to choose from, they will make the wrong choice. This ignores the wide variety of situations in which parents find themselves, and the iron will of mothers to do their very best for their children.
“You can do this,” says Sandy Green, a lactation counsellor and postpartum doula specializing in exclusive pumping. “Your paediatrician, lactation consultant, or friend might tell you that you can’t, but it’s not true.”
While a combination of formula and pumping may be needed at times, it is possible to maintain and even grow a supply of milk with a pump. I want moms to know that you have the best understanding of your own situation, goals, and capabilities, and how you feed your baby is your decision.
But I learned all of this the hard way, on my own.
“There’s not enough professional support, and the information that is out there is inadequate, or written for part-time pumpers and NICU pumpers,” says Fiona Jardine, whose PhD in information studies research at the University of Maryland centres on exclusive pumping.
“Many exclusive pumpers have found their lactation consultant incredibly judgmental,” says Jardine. “We should be able to choose how we feed our babies.”
When I chose to exclusively pump, my gut told me that I was making the right choice for myself and my family. At the same time I felt I was a disappointment to the medical and breastfeeding supports around me; I was the side of the statistic that they didn’t want to see. None of the half-dozen maternal healthcare workers I saw told me the truth I most needed to hear: Exclusive pumping is breastfeeding.
I needed access to good information on exclusive pumping and encouragement to push forward. Being on the receiving end of unsolicited advice about tongue-tie surgery and getting baby back to the breast was never helpful. In the vulnerable postpartum days, it was enough to make me feel terrible while simultaneously working double-time to make sure my son had breast milk.
I eventually learned to fend off those interactions with a forced smile while asserting that what I was doing was, in fact, breastfeeding. It counts.
When I began, I didn't have the vocabulary to start looking for help. I just assumed that there were moms like me out there, trying to figure it out on their own. After some clumsy Googling, I found the EPers who had come before me, organizing the resources they found and documenting their experiences. One of those was Amanda Glenn, whose website, ExclusivePumping.com, gave me great help and comfort.
“I learned how to exclusively pump from an iCloud forum,” explain Glenn. “It’s a huge problem that there are not many medical professionals familiar with exclusive pumping. You have lactation consultants telling exclusive pumpers not to pump for more than 20 minutes, and that just doesn’t apply.”
While you may find you are the only one in your own social circle who is exclusively pumping, it's helpful to know there are hundreds of thousands of mothers out there doing the same thing, many of them feeling isolated as well. (Glenn says her website receives over 200,000 unique visitors per month.)
“The emotional side of it can be very difficult," she adds. "Most moms didn’t choose to do this, so there’s a sense of grief and a sense of failure. More visibility, and more health care professionals who know about it—that will help.”
I asked Glenn what she would tell a parent who is just starting out with exclusive pumping. “Number one, get a hands-free pumping bra. You need to be able to pump and do other things at the same time. Number two, you need to get good breast shields," she says. "You don’t have to settle for whatever came with your pump.”
Breast shields are also known as flanges, and come in different sizes, depending on your nipple size. (Note: breast shields are not the same thing as nipple shields.) Breast shields usually range from 21 to 37 millimitres (tip: don’t include your areola in your measurements) and you can special-order online or go to a breastfeeding support centre or maternity store, where they might have samples you can try out before purchasing.
Glenn also outlines how important it is to understand “let-downs” (how your body responds to stimulation and releases milk) in order to get the most milk possible out of each pumping session. Unlike feeding at the breast, let-downs can be seen while pumping, and EPers shouldn’t stop after the first one. Many people can achieve two let-downs in a pumping session, and sometimes more. Fully emptying the breasts stimulates milk production and provides extra milk for freezer storage, both of which are important for EPers who are in it for the long haul.
You’re also going to want to invest in the right pump. “For long-term pumping, for the first 4-6 weeks we recommend a hospital-grade pump,” says Britt Pegan, the owner of Milkface Nursingwear in Ottawa. “Consumer pumps are designed to maintain a supply, but in the first 4-6 weeks you're trying to bring in and increase your supply.” Hospital-grade pumps are expensive to purchase, but are safe to rent and can be rented at breastfeeding support centres and pharmacies.
Another practical tip is to buy extra pump parts, so that you don’t have to clean them after every single pumping session. Some EPers choose to buy enough parts to cover an entire day to minimize their amount of clean-up and prep. Whatever you choose to do, be sure to follow exclusive pumping safety guidelines. The biggest risk with exclusive pumping is contamination, and not all advice on sterilization is created equal. (For instance, you might have heard you can place pump parts in a clean zip-lock bag in the refrigerator between pumping sessions to save time. This may be acceptable for when your baby is older, but it's not recommended for newborns, or infants with compromised immune systems, and the Center for Disease Control and Prevention doesn't recommend it. Start by checking out their cleaning guidelines and storage guidelines.)
Taking an inventory of your support network and daily rhythms can help when deciding on your pumping schedule. Will your baby be content to be placed in a bassinet or bouncy chair at certain times of day, freeing you up to pump? Can someone else hold your little one during pumping sessions? Would supplementing with formula help your family make it all work, and succeed at pumping for longer? Make sure that the options you choose work for you. Your mental health is paramount.
When you need help navigating all of the options, don’t be afraid to reach out. Just be sure to ask for exactly what you want: help with exclusive pumping, not with feeding at the breast.
There’s a mistaken assumption that exclusive pumping is a lifestyle choice. Fiona Jardine’s research has found that this is rarely the case. Of the first-time mothers she surveyed, 74 percent reported their baby’s inability to latch, and 23 percent were exclusively pumping due to their baby spending time in the NICU. (Some premature babies are not healthy or strong enough to nurse.) It’s possible that some women are EPers for professional reasons, some choose EPing for mental health reasons, and this article doesn’t even touch the reasons why genderqueer parents and same-sex couples may choose exclusive pumping and bottle-feeding. Some women may not feel comfortable sharing why they’re not breastfeeding at the breast—and that’s perfectly OK, too.
The majority of EPers that participated in Jardine’s research mentioned feelings of disappointment and failure, which is how I felt, too. But it was complicated: at the same time, I felt I needed to prove to those around me that I was not taking the easy way out.
The reality is, pumping is hard. What would have been a 20-minute breastfeeding session becomes an hour of pumping, bottle-feeding, and sterilizing. Depending on what your body needs, your pumping schedule can continue to be gruelling even as your baby starts to sleep longer stretches.
I remember one particular night in sharp detail. My husband had finished the 2 a.m. bottle-feeding of our little one, and they both immediately fell back to sleep. I sat in the cold, dark bedroom, strapped to an uncomfortable machine, dying for some shut-eye, while listening to them both snoring softly. That's when it really sank in: this sucks.
With all the difficulty involved, exclusive pumpers should try to enjoy the benefits EPing does have. Anytime you have someone who can hold your baby while you pump, you can spend that time reading, watching your favourite show, or partaking in some other luxury such as, say, being alone in a quiet room for more than five minutes.
The beauty of exclusively pumping is that your baby is accustomed to taking a bottle, and anyone can give it. This perk made a huge difference in my life, as my husband was able to care equally for our child, and I was able to leave them for several hours at a time when I needed a break. It’s worth saying again: anything that supports your physical or mental health is a good thing.
Regardless of why you’re exclusively pumping, what new parents need is unbiased advice from healthcare professionals and solid exclusive pumping information. Every professional I told about my pumping plans gave me a skeptical look, acknowledging that I was going to try to pump, but implying that I probably wouldn’t be able to keep it up.
Seven months later, my exclusive pumping journey came to an end. With the tools I was given, this was as far as I was able to go. Had I been supported from the beginning, I could have fed my son breast milk for longer. I would have increased my supply in the early months instead of trying to curb it. I would have built up a significant freezer stash, so that weaning from the pump could have been followed by several months of continued breast milk feeding from everything I’d stored away.
It still makes me angry that these are things I could have done, if only I’d known how; if I’d felt empowered instead of doubted and defensive. I could have done more for my baby—and felt better about myself and my choice—at the same time.