Our Little Muenster

Undesirable Tummy Time

Breastpumping Tips & Routine

For anyone about to embark on pumping, here are my biggest tips:

1. Get a hands-free bra. 
It's the only way to go. It looks ridiculous, but pumping is ridiculous. Without it, it's hard to even hold the cups in place and turn the machine on at the same time. Worth every single penny.

2. Buy two sets of parts
If you are going to pump multiple times a day, it will be immensely helpful to have an extra set of parts to swap in when one set is dirty. Part-washing is one of the biggest time-sucks of the process. Which brings me to...

3. Minimize pump part washing with refrigeration or steam bags
The reason you need to wash your parts after every use is to avoid bacteria growth. You know what stops bacteria from growing? Cold. So after one use, put your parts in a gallon ziplock back and stick 'em in the fridge. Use them the next time.
What else kills bacteria? Heat. Use steam bags to wash and sterilize. They're fast (3 minutes in the microwave) and make everything hot and clean.

4. Olive Oil
If you have to pump multiple times a day, use a drop of olive oil to lubricate the shields. I keep a tiny tupperware with 1/2" of OO in a small ziplock in my pump bag. Before each pump, I just dip a clean finger in there and smear it around in the neck of each shield. It's a lifesaver. Once I tried it, I could never go back.

5. Napkins
Fold up a wad of napkins to keep in the pump bag. They're great for wiping up afterward, or for the occasional spill or drip. Replenish as needed.

6. Tiny changes save big time in the long run
To try to motivate myself at the beginning, I would use the stopwatch on my phone to time myself setting up to pump, and packing up afterward. It was a little race against myself. At first, it would take me more than 5 minutes to get everything assembled, plugged in, connected, and ready to go. By now, I'm down to less than 2 minutes. That's 3 minutes per session, over 500 sessions - 25 HOURS of time saved. Little things that help:

• Keep the tubes and power cord plugged in if you can. (The Medela Pump-in-Style bag I use let me gently coil the tubes and tuck them in the little mesh pouch next to the pump connections, and the power brick could tuck into the bag without detaching.
• Don't haul the pump around if you can leave it in one place. I left mine in the nursing room at work - dropped it off in the morning, picked it up at night.
• Using tip #3 above, be smart about part storage and avoid washing after every use
• When taking the pump out of the house, pre-assemble the parts you will need. That way you will be sure you're not forgetting any pieces!

So putting it all together, here's my pumping routine. I pump 4 times a day, once when I wake up, twice at work, and once just before bed. (Approximately 7am, 12:30pm, 5:00pm, and 9:30pm)
Session 1 - 7am
Pull the parts out of the dishwasher. Assemble both sets, swipe 'em with olive oil. Bag one set in a gallon ziplock for work. Bring another gallon ziplock with me, along with two extra empty bottles. The pump is still set up next to the couch in the same place it was from last night. Sit down, and pump. When finished, screw the parts onto empty bottles and stash the parts + bottles in the clean ziplock. Place in fridge, ready to go for after work. Cap the full bottles and put in fridge. Unplug the pump and pack up the clean bagged parts to take to work.
Session 2 - 12:30pm
I had already dropped the pump off in the nursing room when I arrived at working in the morning, so all I have to do is go there. Unzip, plug into the wall, pull out pre-lubricated parts, hook up, and go. Whip out the cell phone for an episode of something good on Netflix :)  Afterward, I would wipe down the parts with a clean napkin and olive oil them and screw them on to clean bottles for the afternoon session. I don't know that doing this at this point in my day really saved that much time, but it was nice to come down to the nursing room in the afternoon and do less setup work. Stash full bottles in the fridge. Back to work.
Session 3 - 5:00pm
I hated pumping at the end of the day when I would have much rather been finishing up work or going home to my boy. But the practicality of the situation won out - if I went home, I would still have to pump, so I couldn't hang out with the baby. And since the pump was already packed and ready to go at work, I was actually faster to do it there with no distractions. So, a repeat of what happened in session 2.
Session 4 - As late as possible (usually around 9:30pm)
One last pump to empty before bed. Use the parts that were in the fridge from Session 1. Put all the parts in the dishwasher to run overnight.

Breastfeeding

Everyone seems to be unanimous these days that breastfeeding is one of the best things you can do for your baby. The message is everywhere - parenting books, websites, classes, hospitals, even on containers of baby formula. That's why I felt like such a failure, at least at first.

I was totally on board with breastfeeding Ben. I read the books, went to a class. I bought a breast pump before he was born. I started nursing him in the hospital, and got used to nurses and doctors barging in on me topless. A lactation consultant came to visit me at the hospital and gave me really helpful latching tips and techniques that made it less painful and more effective. Everything seemed to be going great.

Then we took Ben to his first doctor's appointment, 3 days after his birth. He had lost a lot of weight - almost 10% of his birth weight. I still hadn't experienced the engorgement and discomfort I had read about when milk "comes in" after the baby is born. The doctor suggested I see a lactation consultant. So I found one, made an appointment, and went in with Ben. She gave me a few more tips, but said that things looked good. She weighed him before and after a feeding, and said he was getting a good amount of milk. I was told to feed him every two hours around the clock to make sure my milk supply was increasing and that he was eating enough. So we did that for a week. It worked! His next weigh in was great, gaining weight just fine.

But something was bothering me. Ben never stopped his feedings on his own. I would nurse him for 20 minutes on each side, and he wouldn't un-latch. My breasts would feel emptier, and he was definitely getting milk, but he never pushed away full. At first, I thought it was just newborn sleepiness. He would doze off, I would try to keep him awake, and eventually just give up and let him sleep. I emailed the LC about it, and she didn't seem concerned. I asked the ladies and the leader of my mom's group about it, and they didn't have any answers. So I just kept doing was I was doing.

I was breastfeeding obsessed. Feeding him 8 or 10 times a day, for 45 minutes each time, I had HOURS of time sitting and looking at the internet. I read every breastfeeding site out there

At about the 6 week mark, I started getting worried. I was between 1 and 2-month doctors visits, so I weighed Ben at the Sequoia Wellness Center. He was still gaining a few ounces a week. I called the LC one more time, and asked if there was anything I could be doing wrong. This time, she was concerned. Based on his birthweight, he wasn't gaining nearly as fast as he should. She said he wasn't un-latching, because he was still hungry. She asked how we had been dealing with him being upset over the hunger. The thing was, he wasn't upset! He would suck and suck and suck until I took him off, and then he would usually just take a nap. But my poor baby had been hungry pretty much his whole life? I was horrified. The LC actually asked ME what I wanted to do about the situation, and I mentioned formula. I was expecting her to balk, as most lactation experts seem to be vehemently anti-formula. But she said that topping him off with a little formula after each feeding would be fine.

Buying that first canister of formula was a huge step. Everything says that "exclusive" breastfeeding is best. Clearly I had failed in some way.  Maybe I should have fed him more frequently to increase supply. Maybe I shouldn't have given him a pacifier. Whatever the reason, I was not making enough milk for my baby, and that made me a bad mother. I felt so incredibly guilty.

I was nervous. Ben had had a few bottles of breast milk by this point, but only a few. And in my obsessive internet research, I had read stories of babies that reject various types of formula, or have allergies. Neil went to the store immediately and bought a few small bottles of pre-mixed formula. We gave one to Ben, and... he was happy as a clam. Sucked it down, no problem. We even switched to a different brand, due to our pediatrician's recommendation. No sweat, just as yummy.

Since I didn't really know how much he was getting from me, I started pumping rather than nursing. Then we could totally measure his intake, and know how much he was eating and from which source. The difference in Ben's attitude was remarkable. He was happier, more relaxed. He slept so much better. His appetite, when presented with an unlimited supply, was amazing for such a little baby. I breathed a huge sigh of relief.

I obsessed a little more over the next few weeks, meticulously counting and calculating how much of his intake was breastmilk (about 75%). Since I was still contributing a good majority of his nutrition, I felt better. I actually really liked pumping. For a very analytical person like me, being able to measure gave me great piece of mind. And it freed me from being Ben's slave. I would pump whenever it was convenient for ME. Then one of us (not just me!) could feed Ben whenever it was convenient for him. So long as Neil was around to keep an eye on Ben while I pumped 5-6 times a day, it was a win-win situation.

For a long time, I pumped during the day, but still nursed Ben at night. Then, for a stretch while he was 2-3 months old, he started sleeping through the night. Hallelujah! But unfortunately, that meant I suddenly dropped one feeding. For a while, I would wake up in the middle of the night and pump, to try to keep up my supply. But after a week or two of that, I rationalized that a mother who wasn't pumping wouldn't get up in the middle of the night if the baby was sleeping. She would sleep til he woke up. So I figured it would be ok for me to do that as well.

By the 3-month mark, it was time for me to go back to work. So my pump came with me. And by this point, Ben really didn't want to nurse anymore. I would occasionally try in the mornings and evenings. Sometimes, if he was really relaxed and sleepy, he would nurse for a while until he fell asleep. But more often, he would tug, squirm, claw, and kick at me. Nursing was hard. Bottles were easier. So I officially became an "exclusive pumper."

So after 20 weeks of pumping (and over 500 pumping sessions), here we are. I have been counting down to this magic 6-month mark, which was my goal. I have to say, it's getting old. I spend 2.5 hours every day packing the bag, pumping, cleaning parts, storing milk. It's the first thing I do in the morning, and the last thing I do before bed. By now, I have the process streamlined for maximum efficiency - I defy anyone to come up with a way to make this faster or easier. But I'm ready to be done. I'm ready to wear normal bras. Ready to stop hauling this pump everywhere I go. Ready to not have two pumping interruptions in my workday. Ready to be back in control of my own body.

Yesterday was Ben's 6 month birthday, and the first day that I have gone more than 24 hours without pumping. It was... anticlimactic, to be honest. I am so ready to be done with the hassle, but at the same time, slowly weaning over the last few weeks has been heartbreaking. To have spent months obsessing over breastfeeding and milk supply, I felt horrible to stop pumping before being totally empty. Getting the milk come used to be a sign of success, and a great relief. But now, I turn off the pump mid-way through. All that precious milk! I felt wasteful and... guilty, I guess is the right word. Like this is something I'm supposed to be doing to provide for my baby, and I'm choosing not to.

But Ben is a healthy, happy boy. He eats like a champ, breastmilk or formula. And it's time for me to close this chapter of my life and move on. I hope that what I've done for him so far will pay off in the long run.

Starfish Sleeper

One legged swaddle

Fingers!

This used to be a swaddle

First Easter

Delivery!

DISCLAIMER: I'm going to be pretty open about the details. I'll try not to be too graphic, but be warned that having a baby is pretty gross.

I woke up late on Friday, February 14. Very big, and not sleeping well, I had been snoozing til 8 or 9 every day while on prenatal disability leave. Neil was out for a run. I had my weekly appointment with my OB at 10am, so it was time to take a shower and get dressed. As I walked out of the bathroom to put clothes on, I felt a big gush of liquid rush out and down my legs onto the floor. My first thought was that I had finally lost bladder control. All the books and prenatal classes told me that labor almost never starts like it does in the movies, where the girl's water breaks in a big gush and they run to the hospital. But that's exactly what happened.

TIP #1: Have some pads handy. Even though you haven't needed them in 9 months, they will come in handy if your water breaks.

I cleaned myself up as best I could, and Neil got back from his run. I must have had a goofy look on my face, because he asked me how I was doing, and I said, "I think my water just broke." Neil exploded with excitement, "Did you call the doctor? What do we do now?!?!" I was totally relaxed. "We're about to go to the doctor's office," I said. "We can just tell her when we get there." Neil was adamant that I call the office and ask them what to do, so I did. And they said to go straight to the hospital.

We showed up at Sequoia Hospital around 10am and checked in. I still wasn't feeling any contractions.  They took us to the delivery room that was to be our home for the next three days, and the first of many nurses helped me get settled. She had me change into a gown and told me to get onto the bed. But the thing they don't tell you about your water breaking is... it doesn't stop. It just keeps leaking out. And according to the nurse, your body keeps making amniotic fluid as needed. So every time I stood up or shifted in my seat, I felt another warm gush. It was the strangest feeling. The first nurse did a quick test with a little strip of paper to check that it indeed was amniotic fluid, which by then was pretty obvious.

Next, I got hooked up to machines. There was a contraction and fetal heartrate monitor on my tummy, which was cordless so I could still get up and walk around. According to the monitors, I was having tiny contractions every 5 minutes or so, but I still couldn't feel them. The nurse told me that once the amniotic sac ruptures, there is a larger chance of infection reaching the baby, so they want the baby to get delivered in 24 hours. When I asked how far along I was, she told me she actually wouldn't examine me until I was having stronger contractions, because any examination brings more risk of infection.

So it was clear that we needed to get me in labor. They hooked me up to an IV to give me fluids and Pitocin, to induce contractions. The Pitocin drip went on a scale from 2 to 20 - they started me at 2, and then checked on me every hour or so to see how things were progressing and to bump it up as necessary. They try to increase the medication slowly, to let my body get involved and take over, so as to not be totally reliant on the drugs. It was the first time I had ever had an IV, and it freaked me out. I didn't watch the nurse insert it, and didn't move my arm for at least an hour. I didn't want to touch it. Having a tube in my arm seemed so foreign and strange. But I got used to it. And it all honesty, it wasn't that bad. It didn't hurt. More than anything else, it was just cumbersome. The nurses wanted me walking around to encourage contractions, so I had to wheel the stupid IV cart up and down the halls. And I had to take it with me into the bathroom, trying not to get tangled in the tubes as I got up and down.

Before I left the house, I ate a Luna Bar. In hindsight, I should have eaten more, because at the hospital, I was on a clear liquids diet. Tiny juice boxes and generic-brand gelatin were all I was allowed to eat. Yum.

My OB showed up mid-day to check on me. She said that everything looked good, but that she was likely not going to be around for my delivery. President's Day Weekend, soccer games for her kids, etc. I was disappointed, but not really concerned. I never felt like we had any sort of special relationship, and all the doctors in her practice were highly recommended. So I was going to meet a new random doctor that would deliver my kid. That's cool.

Then came the waiting. I read a John Grisham book on my Kindle. We watched the Olympics. I called my mom and my sister. I awkwardly strolled the halls, toting my IV, and sipped tiny juice boxes. The hours passed. The nurses bumped up the Pitocin.

By evening, I was finally starting to feel the contractions a bit, instead of just watching them pass on the monitors. The nurse asked about my preferences for pain relief, and I relayed my philosophy of "Don't be a hero." I wanted to remain mobile and flexible for a while, but at some point would likely want an epidural.

At one point in the evening, I had a mild wave of nausea. It was brief, just a few seconds. I thought to myself, "That was weird," and went on watching TV. I figured it was probably just my empty stomach or nerves or something. A short while later, I immediately felt the strong urge to vomit. Neil and I were alone in the room, and I said something like, "I think I'm going to throw-" and must have made a pretty obvious face. Neil ran and grabbed the garbage can and stuck it under my face just in time. I heaved a few times and it was over. The nurse came in just as I was finishing up, and took the trash can from Neil. She got me a cool washcloth and showed Neil the drawer where they keep the neat little barf bags.

TIP #2: Locate the barf bags EARLY in the process. And keep one within reach of the bed at all times.

The nurse basically said that was normal, and it was good that I got it "overwith" - hopefully it would just happen that once. I would later learn that I was not that lucky.

Finally at about 10:00 pm, 12 hours after arriving at the hospital, that point came. The contractions were getting intense. I was breathing through them and squeezing Neil's hand. Damn, they really hurt. I could have lasted a bit longer, but I figured that if an epidural was on the menu, there was not really a reason to suffer when I could be more comfortable. I flagged the nurse, who called for the anesthesiologist.

As a sidenote, around this time I started shivering. Massively, uncontrollably shivering. My legs were shaking all over the place, and I felt like a huge dork. I piled on blankets, but it didn't make a difference. I wasn't cold. I was just anxious.

TIP #3: You might get the shakes. It's ok. Apparently that's normal?

The epidural terrified me. Big needle in my spine? Ugh. The anesthesiologist was a young, dark-haired white kid. I feel like he was probably in a frat in college. He could have been on Grey's Anatomy. I actually had that cliche moment where I thought, "This can't be a doctor - he's just a kid!" He had me sit up on the side of the bed and lean forward, holding a pillow on my lap. I was absolutely convulsing with shivers at this point, and concerned about whether that would make the whole giant-needle-in-my-spine thing more difficult. But the doctor said it was normal and not a problem. He made me chuckle by telling me I had a great spine. He felt my spine with his fingers for a few moments, and robotically asked me things about allergies and whether I had had an anesthetic before. I could feel him rubbing some sort of disinfectant on my back. The poke itself was really not bad - not really any worse than a regular injection in the arm. A quick pinch, and it was over. The weirdest thing was actually all the tubes and tape. He put a giant sticker all down my back, holding the tubing in place (which was a good thing, obviously) and a tube with a small button over my shoulder that I could push for more drugs (obviously with a limit). He didn't have the greatest bedside manner (he accidentally yanked on my iv, and wheeled away my table with my water so it was out of reach) but he apparently knows his epidurals - the nurse later commented that I recovered feeling in my legs quickly, which is the sign of a good tap.

I didn't feel relief right away. And I actually called the anesthesiologist back in a bit later when I was still feeling fairly strong contraction pain. He bumped up the drugs a bit, and all was well. I was surprised at the effect - I was expecting not to be able to move my legs or wiggle my toes, but I could. The drugs didn't affect the ability to move my muscles, just the tactile sensation. If I touched the skin on my legs, I couldn't feel it. I guess it's kind of like getting a cavity filled? You can still move your jaw, but your skin feels numb. At that point, I really didn't feel the contractions anymore at all. I could see them happening on the monitor, but only felt the faintest tightening in my tummy. No pain.

After I was thoroughly numb, the nurse put in a catheter. While on the epidural, I couldn't get out of bed, so I wasn't able to go pee. Again, this was something that totally freaked me out in concept, but in practice wasn't at all bad. I couldn't feel anything, since I had the epidural. So other than the nurse looking up my gown and then having a pee tube taped to my leg, it wasn't a problem.

A few more hours went by, and the nurse kept coming in to check on my progress. Finally at about 2AM, the nurse informed me that I was fully dilated and ready to start pushing. She went to get the doctor to double-check. Then I met the on-call OB that would be delivering my child! Dr. Merryfield was nice enough - she basically gave the nurse the ok for me to start pushing, and then left, joking that she hoped it would be quick because she wanted to get home by 4am. Ha. I'll do my best, lady.

The nurse at that time was a nice eastern European lady named Uta. She was great at explaining everything as we went, and very calm and in control. Exactly what you want in a nurse. The pushing went like this: I watched the monitor and looked for the start of a contraction (sometimes I could feel the tightening, sometimes not) When it was rising, I signaled to Uta and Neil, usually saying something like, "Ok, here's another one" or "Ok, here we go". Uta stood on one side of the bed, and Neil was on the other. They each held one of my feet, and I grabbed behind my thighs and pulled my knees up to my chest. Neil would say, "Breathe" and I would take a deep breath. Then he would slowly count to ten, while I held my breath and pushed. Then I took another breath. Another count of ten. Sometimes a third breath and push for ten, and then I would relax. I had about a minute to relax before the next one came.

Honestly, I wasn't sure I was doing it right. I was pretty numb below the waist. I could feel some pressure, but that was about it. I tried to do something between an abdominal crunch and pushing out a poop, but without any feedback sensation, I really didn't know whether it was working. Uta would check my progress every half hour or so, and said that I was steadily moving the baby downward. It's a slow "two steps forward, one step back" process. So I had to trust her that I was doing something right. She would give me tips along the way, like better body mechanics, slower pushing, shifting position, etc.

I pushed FOR. EV. ER. Uta gave me a cool washcloth for my forehead, which felt nice. And she gave me an oxygen mask to breath between pushes, for extra energy. Really, it wasn't that bad. I started getting a little tired after a few hours. But I felt like I was in some sort of trance or time warp. I didn't feel bored or frustrated. I didn't even realize how much time was passing. I just kept focusing on each push, and trying to relax between. Neil was amazing. He kept that steady count coming for hours, totally focused on making me as comfortable as possible. 3 o'clock passed. Then 4 o'clock. The OB came in to check on me, and Uta told her that I was still making progress, just slowly. So Dr. Merryfield told me to keep at it, as long as I had the energy. She said that after 3 hours, we could see about using a vacuum extractor to help get the baby out.

At the 3 hour mark, Uta asked if I was ready to quit. I asked if I was still making progress, and she said yes, so I said I was willing to keep going. The baby's heartbeat was still very strong, and the contractions were regular. The only concern she had was that if I need help with the vacuum, I would have to have enough energy left to really push it out. I said that I was tough, and would let her know when I was running out of steam.

Finally at 6am, Dr. Merryfield said it was time to finish this up. She asked if I was ok with the vacuum extraction, and I was. The next half hour was a blur. Dr. Merryfield scrubbed up, and the room filled with people. I don't even know how many or for what purposes. I was still focused on the counting, breathing, and pushing. They pulled up stirrups on the bed, and removed the part of the mattress that was under my legs, so I was magically in the position to have a doctor deliver the kid. I saw that Uta was standing next to the bed with some sort of pump and hose. Lots of people talking and bustling around. Dr. Merryfield told me that I was doing great with the pushing and that she could see hair. She needed me to rest for a second while she got the vacuum in place, and then she would tell me to push really hard. Again, with the epidural, I didn't feel anything at all. Later, they told me that we had to do two pushes with the vacuum attached - I didn't even notice at the time. All I knew was that there was a little pressure in my pelvis and a lot of intensely focused medical professionals looking up my robe. I heard words like "shoulders" and "big." Then, at 6:31 am, there was a release of pressure and some slipperyness, and a baby started crying. MY baby!

Next thing I know, there were two people on either side of the bed sort of toweling off a sticky baby that they plopped on my chest. No one made any big announcement, so Neil had to try to get a peek underneath and excitedly whispered, "It's a boy!" This little pink, sticky miracle of life was suddenly right in my face. He now had a gender and a name, and everything else in the room disappeared. There was just me, Neil, and Benjamin. His little eyes were squeezed shut. He had a head full of wavy hair. 10 tiny curled fingers and 10 little nubby toes. Long slender legs and arms. He laid peacefully on my chest, just breathing and making small wiggly movements. We had both had a long day. But he was finally here. He was mine, and he was perfect.

Progress

According to the doctor this morning, I'm about -2 station, 1cm dilated, and 60% effaced. On her schedule - 36 weeks, on mine 37. So it's happening!

No guarantees what that means in terms of when I could deliver, but she says I will almost certainly be "not late" at this point :)

Baby Muenster's Afternoon Dance Party

Baby Bump Progression

It's been 8 months now, and I almost can't remember a time when I wasn't pregnant...