Had a request recently to talk about how I have managed the inventory of human milk in our house. Glad to oblige.
When I was pumping for my first baby, I couldn't keep up with her demand, and the question of managing a freezer stash never arose.
This baby, however, never got into the groove of accepting expressed milk from any device (bottle, cup, spoon etc.). Rather he would wait, sometimes for hours, to nurse directly when I got home. The amount of milk in the freezer grew and grew.
Here's how I managed it.
I was pumping 3 times a day in the beginning, when I still thought that he would eventually get interested in consuming the milk, and regularly bringing home 15-18 ounces of milk. I froze it in 4-5 ounce aliquots in Lansinoh brand storage bags. I tried some other types but settled on these because of the zip top and ease of use. If you click on that hyperlink it will take you to Amazon.com, and that is actually where I purchased them. Best deal I could find and even better with the 'Subscribe and Save' option in which they send you a fixed amount of product on a schedule that you determine all with free shipping and an extra 15% off. Even better, they send a warning email when product is about to ship and if you don't need it you have a couple of days to cancel without penalty.
The bags seem kind of pricey, but it is important to note that regular zipper bags or drop-in bottle liners are not a good choice. They aren't tough enough and may tear. It is still cheaper to use actual milk storage bags than to use artificial milk, and how sad would you be if your hard work and milk were wasted by poor storage?!
Each bag was labeled with date and approximate volume. I lay them flat when they first went into the freezer so that they would freeze nice and flat. The next day when I added more, I would take the now flat, frozen bags and add them to a gallon-sized zipper bag. This helped with cohorting by time, also known as rotating stock. Also kept the bags from diving out of the freezer when someone else opened it.
In the rare instance that one of the frozen bags was needed, we would either let it thaw in the fridge or run warm water over it.
Guidelines are: fresh milk can be refrigerated for 7 days; thawed milk should be used or refrozen within 24 hours; frozen milk will 'keep' in a regular fridge top freezer for 3-6 months; and in a deep freeze for 6-12 months. Milk stored longer in the freezer will likely still be microbially safe (How would it have become contaminated?), but the nutrition breaks down over time, particularly the lipids. Even old frozen human milk has more specific nutrition for human babies than artificial milk.
If you run across an old bag of human milk that you had forgotten, you could put it into smoothies even for older people (children included) who might not accept drinking thawed human milk straight up.
There have been a couple of times when I had as much as 6-7 liters of frozen milk at a time!
Showing posts with label breastfeeding. Show all posts
Showing posts with label breastfeeding. Show all posts
Wednesday, September 1, 2010
Monday, August 2, 2010
World Breastfeeding Week 2010
The first week of August is World Breastfeeding Week.
Here's to a future world in which this observance is thought of as quaint and out of touch with reality. Why celebrate or mention something so perfectly normal?
There is an article today in the Salt Lake Tribune about our Breastfeeding Cafe.
Here's to a future world in which this observance is thought of as quaint and out of touch with reality. Why celebrate or mention something so perfectly normal?
There is an article today in the Salt Lake Tribune about our Breastfeeding Cafe.
Tuesday, July 27, 2010
Thoughts about breast pumps - part 3
This is a follow up to my earlier post about working and breastfeeding.
Part 1, When to get a pump
Part 2, Used Pumps
Troubleshooting
This is a common scenario presented at LLL meetings, "I have returned to work and am pumping for my baby and suddenly I am not getting as much as I did before. I guess I am losing my milk and will have to start using formula."
Maybe, but it is more likely that something else in your environment has changed.
Milk production is a demand and supply system. The more milk that you remove from your breasts, the more milk your breasts will produce. If you notice less production when you can actually see it, then the most likely cause is that less has been demanded from your breasts.
First, check the pump.
Is there a cut in one of the tubes? I accidentally ran over the tubing once with my office chair and cracked it, resulting in dramatically different suction. If there is a break in the tube, do not despair, depending on where the break is you can simply cut it and then replace the flange attachment at the new cut site. This can get you through until you can buy a new tube (so that it is long) or forever. I have been using one short tube for months.
Is there a tear in one of the white flexible membranes? You need to pull on them a bit to see if they are completely intact. Often there will be a tear that you can't see if you just look at it, but if you pull a bit you will see the hole. This ruins your suction. Keep a spare around. This is the 2 cent piece of plastic that makes the pump work after all.
Have you changed the way you operate the suction? Changes may help or hurt depending. Sometimes I find that I need to turn up the pressure a bit, but generally I use the lowest setting. Sometimes if the milk ejection reflex seems to be slow I will turn the pump off and then on again to get back to the initial fluttery sucking stage. This sometimes stimulates another round for me. Bottom line -- play with those knobs and see what happens. Your baby doesn't nurse the same way every time after all!
What day is it? Many moms find that they pump less volume each day that they work so that Friday they don't bring home the least milk. This makes sense because if you have been away from your baby all week working you aren't likely pumping as often as he is eating AND pumps aren't as good at milk extraction as babies. Your breasts are compensating by not producing what isn't being demanded. On the flip side, many moms report that they pumps lots on Mondays after nursing their babies all weekend. Production responds to demand.
Has your baby been nursing differently? For example, has he been sick and nursing less, or have you started more solids and perhaps cut back on nursing sessions when you are together? Production responds to demand.
Have you started a new medication or been ill yourself? Both of these can be associated with reduced milk supply.
What's to be done?
Nurse your baby more often.
Replace any broken parts on the pump for when you can't be with your baby.
Repeat.
As you remove more milk, your breasts will produce more milk. Elegantly simple system.
If none of these ideas seem to help or at any time, phone a La Leche League Leader. Helping women work through breastfeeding concerns is what they do.
Part 1, When to get a pump
Part 2, Used Pumps
Troubleshooting
This is a common scenario presented at LLL meetings, "I have returned to work and am pumping for my baby and suddenly I am not getting as much as I did before. I guess I am losing my milk and will have to start using formula."
Maybe, but it is more likely that something else in your environment has changed.
Milk production is a demand and supply system. The more milk that you remove from your breasts, the more milk your breasts will produce. If you notice less production when you can actually see it, then the most likely cause is that less has been demanded from your breasts.
First, check the pump.
Is there a cut in one of the tubes? I accidentally ran over the tubing once with my office chair and cracked it, resulting in dramatically different suction. If there is a break in the tube, do not despair, depending on where the break is you can simply cut it and then replace the flange attachment at the new cut site. This can get you through until you can buy a new tube (so that it is long) or forever. I have been using one short tube for months.
Is there a tear in one of the white flexible membranes? You need to pull on them a bit to see if they are completely intact. Often there will be a tear that you can't see if you just look at it, but if you pull a bit you will see the hole. This ruins your suction. Keep a spare around. This is the 2 cent piece of plastic that makes the pump work after all.
Have you changed the way you operate the suction? Changes may help or hurt depending. Sometimes I find that I need to turn up the pressure a bit, but generally I use the lowest setting. Sometimes if the milk ejection reflex seems to be slow I will turn the pump off and then on again to get back to the initial fluttery sucking stage. This sometimes stimulates another round for me. Bottom line -- play with those knobs and see what happens. Your baby doesn't nurse the same way every time after all!
What day is it? Many moms find that they pump less volume each day that they work so that Friday they don't bring home the least milk. This makes sense because if you have been away from your baby all week working you aren't likely pumping as often as he is eating AND pumps aren't as good at milk extraction as babies. Your breasts are compensating by not producing what isn't being demanded. On the flip side, many moms report that they pumps lots on Mondays after nursing their babies all weekend. Production responds to demand.
Has your baby been nursing differently? For example, has he been sick and nursing less, or have you started more solids and perhaps cut back on nursing sessions when you are together? Production responds to demand.
Have you started a new medication or been ill yourself? Both of these can be associated with reduced milk supply.
What's to be done?
Nurse your baby more often.
Replace any broken parts on the pump for when you can't be with your baby.
Repeat.
As you remove more milk, your breasts will produce more milk. Elegantly simple system.
If none of these ideas seem to help or at any time, phone a La Leche League Leader. Helping women work through breastfeeding concerns is what they do.
Assume Positive Intent
Thanks to Charity for providing a title to my post-in-draft.
I recently attended a conference about human fertility. This topic is, of course, intimately related to breastfeeding. Another attendee had a baby with her, and as we talked about traveling and moving in the adult world with little people in tow another attendee, a female physician, joined the conversation. She shared a story from one of her patients who nursed in the front pew at church until the priest asked her not to because it was distracting to him. The mother was upset and humiliated and didn't know what to do. The physician suggested that she should respect his wishes not to see her nursing and move back. At this point the discussion turned to ways to cover up and nurse discreetly and how mean people could be to nursing mothers.
Until I brought it back to the idea of positive intent.
My experience is that if you give people the opportunity to treat you well, they will. If you are able to assume positive intent, you will feel better about the interaction.
Instead of thinking "that mean old man thinks that breasts are shameful and normal infant feeding should be hidden" think "wow - he is so moved by the beautiful interaction between mother and baby that he can't concentrate on the homily".
Who knows which version is really true, but really, who cares? I promise that version #2 will make you feel better about the power of mothering and yourself as a mother, whether or not you move back a few pews.
I recently attended a conference about human fertility. This topic is, of course, intimately related to breastfeeding. Another attendee had a baby with her, and as we talked about traveling and moving in the adult world with little people in tow another attendee, a female physician, joined the conversation. She shared a story from one of her patients who nursed in the front pew at church until the priest asked her not to because it was distracting to him. The mother was upset and humiliated and didn't know what to do. The physician suggested that she should respect his wishes not to see her nursing and move back. At this point the discussion turned to ways to cover up and nurse discreetly and how mean people could be to nursing mothers.
Until I brought it back to the idea of positive intent.
My experience is that if you give people the opportunity to treat you well, they will. If you are able to assume positive intent, you will feel better about the interaction.
Instead of thinking "that mean old man thinks that breasts are shameful and normal infant feeding should be hidden" think "wow - he is so moved by the beautiful interaction between mother and baby that he can't concentrate on the homily".
Who knows which version is really true, but really, who cares? I promise that version #2 will make you feel better about the power of mothering and yourself as a mother, whether or not you move back a few pews.
Wednesday, July 21, 2010
Thoughts about breast pumps - part 2
This is a follow up to my earlier post about working and breastfeeding.
Part 1, When to get a pump
Part 3, Troubleshooting
Used pumps, what's the big deal?
Many popular, consumer-grade pumps are single-user products and are regulated by the FDA as such. Medela Pump in Style is an example of a popular, single-user pump. Ameda Purely Yours is a closed-system pump which could, theoretically, be used safely by multiple mothers without the worry of infection as long as each mother had her own milk collection kit.
Although small, there is a chance of infection being passed from mother to mother with the pump as the vehicle. HIV and hepatitis are the ones that get tossed about, and that would be really rare, but the probability is not zero. I think a more likely pathogen transfer via a used pump would be thrush (yeast).
Now is when someone says, "But I know my friend/sister etc. doesn't have those diseases, and pumps are expensive. Why shouldn't I take hers?"
Here is a reason:
These devices have a 1 year warranty. Manufacturers expect that 1 year is about how long people might use them, and performance will begin to deteriorate over time. A mom relying on an old pump to express milk or maintain supply may not realize that it is not as effective as it should be and her supply may dwindle as a result, or she can't pump enough and winds up turning to artificial milk for the care provider to use.
The issue of pump life applies to the single-user devices and the closed-system devices.
* Particularly for moms considering buying used pumps from the internet or a yard sale *
This is a bad idea because: 1) possibility of infection, and 2) if you spend $100 and the thing conks out then you have no recourse or warranty and will likely wind up spending for a new pump or artificial milk anyway.
It's true, pumps are expensive, but I submit the following:
1) many moms who think that they need a pump don't really need it -- mom returning to work full time probably does need a good double electric pump, but mom wanting to express milk occasionally for a caregiver can do just fine with hand expression or a good manual pump (much cheaper)
2) medical insurance may cover the pump as durable medical equipment - mom should check with insurance company
3) mom returning to work should find out if there is a pumping room at her workplace - there may be, and it may be equipped with a hospital grade pump. It's true that most workplaces don't have such amenities, but the more people ask the more common they might become. There are resource guides available for workplaces about how to create such a room and how it can benefit the company.
4) moms who receive WIC and must return to work can often get a hospital grade pump to borrow from WIC
Do people buy used pumps? Sure, but it is a good idea to consider the risks and costs and make a smart decision. If I were planning to use a pump regularly for several months I would decide it is worth the investment to know that it is both safe and covered by warranty. If I only needed it for occasional use, then I might consider a manual pump (new or used) that is both cheaper and can be sterilized.
I would not sell a single-user pump at a yard sale or donate it to a charity. If it were a share-able (closed system) electric pump, I still wouldn't because of the pump life issue and possibility of compromising milk supply in an unsuspecting mom. I would sell a manual pump that could be boiled.
Thinking about eco-consciousness, it bums me out that these devices aren't built to last for generations, and I would love to know what I could reasonably do with the old Pump in Style in my closet (any my current PIS when I am done with it). I have been considering what sort of science experiments or plant watering system I could build with a small electric pump. ;-) A La Leche League Group or a childbirth/parenting/breastfeeding educator might use one donated pump for teaching purposes.
Finally, here is an article from the La Leche League Leader magazine, Leaven, on the topic.
As the economy has gotten worse the past year or so, I get this question A Lot - can you tell?
Part 1, When to get a pump
Part 3, Troubleshooting
Used pumps, what's the big deal?
Many popular, consumer-grade pumps are single-user products and are regulated by the FDA as such. Medela Pump in Style is an example of a popular, single-user pump. Ameda Purely Yours is a closed-system pump which could, theoretically, be used safely by multiple mothers without the worry of infection as long as each mother had her own milk collection kit.
Although small, there is a chance of infection being passed from mother to mother with the pump as the vehicle. HIV and hepatitis are the ones that get tossed about, and that would be really rare, but the probability is not zero. I think a more likely pathogen transfer via a used pump would be thrush (yeast).
Now is when someone says, "But I know my friend/sister etc. doesn't have those diseases, and pumps are expensive. Why shouldn't I take hers?"
Here is a reason:
These devices have a 1 year warranty. Manufacturers expect that 1 year is about how long people might use them, and performance will begin to deteriorate over time. A mom relying on an old pump to express milk or maintain supply may not realize that it is not as effective as it should be and her supply may dwindle as a result, or she can't pump enough and winds up turning to artificial milk for the care provider to use.
The issue of pump life applies to the single-user devices and the closed-system devices.
* Particularly for moms considering buying used pumps from the internet or a yard sale *
This is a bad idea because: 1) possibility of infection, and 2) if you spend $100 and the thing conks out then you have no recourse or warranty and will likely wind up spending for a new pump or artificial milk anyway.
It's true, pumps are expensive, but I submit the following:
1) many moms who think that they need a pump don't really need it -- mom returning to work full time probably does need a good double electric pump, but mom wanting to express milk occasionally for a caregiver can do just fine with hand expression or a good manual pump (much cheaper)
2) medical insurance may cover the pump as durable medical equipment - mom should check with insurance company
3) mom returning to work should find out if there is a pumping room at her workplace - there may be, and it may be equipped with a hospital grade pump. It's true that most workplaces don't have such amenities, but the more people ask the more common they might become. There are resource guides available for workplaces about how to create such a room and how it can benefit the company.
4) moms who receive WIC and must return to work can often get a hospital grade pump to borrow from WIC
Do people buy used pumps? Sure, but it is a good idea to consider the risks and costs and make a smart decision. If I were planning to use a pump regularly for several months I would decide it is worth the investment to know that it is both safe and covered by warranty. If I only needed it for occasional use, then I might consider a manual pump (new or used) that is both cheaper and can be sterilized.
I would not sell a single-user pump at a yard sale or donate it to a charity. If it were a share-able (closed system) electric pump, I still wouldn't because of the pump life issue and possibility of compromising milk supply in an unsuspecting mom. I would sell a manual pump that could be boiled.
Thinking about eco-consciousness, it bums me out that these devices aren't built to last for generations, and I would love to know what I could reasonably do with the old Pump in Style in my closet (any my current PIS when I am done with it). I have been considering what sort of science experiments or plant watering system I could build with a small electric pump. ;-) A La Leche League Group or a childbirth/parenting/breastfeeding educator might use one donated pump for teaching purposes.
Finally, here is an article from the La Leche League Leader magazine, Leaven, on the topic.
As the economy has gotten worse the past year or so, I get this question A Lot - can you tell?
Thoughts about breast pumps - part 1
This is a follow up to my earlier post about working and breastfeeding.
Part 2, Used pumps
Part 3, Troubleshooting
I am often asked about breast pumps, when to buy, which to buy, buying a used pump, troubleshooting etc. So often that I have developed standard answers which I will share with you in segments.
When to get a pump - it's later than you think!
Pumps are on the list of 'must-haves' from baby-industrial-complex retailers. Why? Because they want you to buy stuff. Let me say this clearly, not every breastfeeding mother needs a pump. Pumps, particularly the double electric ones that get so much ad space, are expensive. Yes, it would be nice to have someone else purchase it for you, but wouldn't it be even nicer to have the money or equivalent in other stuff (perhaps diapers) if it turned out that the pump was going to sit in the closet? Therefore I submit the following suggestions for different situations.
Employed mother, planning to return to work full-time, outside the home, where baby is not welcome: You will need to express milk in order to maintain your supply and have something to feed your baby while you are away. Most mothers in your situation find that a double electric pump is the most efficient means of milk removal.
First, have a chat with your employer. As a part of healthcare reform, your employer is required to provide time and space for milk expression. Perhaps your employer will also be interested in creating a dedicated milk expression room equipped with a hospital-grade pump. Benefits of hospital-grade pumps include long lifespan, efficient to use, ability to be used by more than one mother (not at the same time!) by having individual collection kits.
If your employer isn't ready to shell out for a common pump, read your health insurance policy and/or call a representative to find out if you can get a pump as part of your durable medical equipment (DME) benefit. In this scenario, your healthcare provider writes a prescription, and you fill it through the insurance company's DME provider. You may not get to choose which brand you get, but I for one am willing to sacrifice some choices for a savings of a few hundred dollars. With my second baby I used this route and got a new double electric pump delivered to my home for a $25 co-pay.
If your insurance won't cooperate, then you will likely be purchasing a pump yourself. Wait until after your baby is born. Why? Well, it may turn out that you have a lot of other gifts to return to some major retailer and can use the credit generated towards the pump. There may be some change in your life circumstance such that you don't need to return to work or can work part-time instead of full-time. If there is some unexpected or unfortunate circumstance and your baby isn't able to breastfeed immediately you will need a hospital-grade pump in order to help establish your milk supply. The hospital will help you arrange this, and it might change the response from your insurance company.
Even if you have to pay full price for a pump, it is a better value than buying artificial milk!
Employed mother, planning to return to work part-time outside the home or in a setting where baby is welcome: You may not need to buy a double electric pump. For short separations a good quality manual pump or hand expression may suffice. Best scenario might be to keep your baby with you while you work, if that is possible. If you do want to acquire a double electric pump, see above suggestions.
No planned separation - mother is primary caregiver for baby: You don't need to spend a lot of money on a double electric pump! If you want to be able to express some milk for a temporary caregiver, invest in a good quality manual pump or learn to hand express.
I was pleased to see a very similar discussion included in the new, 8th edition of The Womanly Art of Breastfeeding!
Part 2, Used pumps
Part 3, Troubleshooting
I am often asked about breast pumps, when to buy, which to buy, buying a used pump, troubleshooting etc. So often that I have developed standard answers which I will share with you in segments.
When to get a pump - it's later than you think!
Pumps are on the list of 'must-haves' from baby-industrial-complex retailers. Why? Because they want you to buy stuff. Let me say this clearly, not every breastfeeding mother needs a pump. Pumps, particularly the double electric ones that get so much ad space, are expensive. Yes, it would be nice to have someone else purchase it for you, but wouldn't it be even nicer to have the money or equivalent in other stuff (perhaps diapers) if it turned out that the pump was going to sit in the closet? Therefore I submit the following suggestions for different situations.
Employed mother, planning to return to work full-time, outside the home, where baby is not welcome: You will need to express milk in order to maintain your supply and have something to feed your baby while you are away. Most mothers in your situation find that a double electric pump is the most efficient means of milk removal.
First, have a chat with your employer. As a part of healthcare reform, your employer is required to provide time and space for milk expression. Perhaps your employer will also be interested in creating a dedicated milk expression room equipped with a hospital-grade pump. Benefits of hospital-grade pumps include long lifespan, efficient to use, ability to be used by more than one mother (not at the same time!) by having individual collection kits.
If your employer isn't ready to shell out for a common pump, read your health insurance policy and/or call a representative to find out if you can get a pump as part of your durable medical equipment (DME) benefit. In this scenario, your healthcare provider writes a prescription, and you fill it through the insurance company's DME provider. You may not get to choose which brand you get, but I for one am willing to sacrifice some choices for a savings of a few hundred dollars. With my second baby I used this route and got a new double electric pump delivered to my home for a $25 co-pay.
If your insurance won't cooperate, then you will likely be purchasing a pump yourself. Wait until after your baby is born. Why? Well, it may turn out that you have a lot of other gifts to return to some major retailer and can use the credit generated towards the pump. There may be some change in your life circumstance such that you don't need to return to work or can work part-time instead of full-time. If there is some unexpected or unfortunate circumstance and your baby isn't able to breastfeed immediately you will need a hospital-grade pump in order to help establish your milk supply. The hospital will help you arrange this, and it might change the response from your insurance company.
Even if you have to pay full price for a pump, it is a better value than buying artificial milk!
Employed mother, planning to return to work part-time outside the home or in a setting where baby is welcome: You may not need to buy a double electric pump. For short separations a good quality manual pump or hand expression may suffice. Best scenario might be to keep your baby with you while you work, if that is possible. If you do want to acquire a double electric pump, see above suggestions.
No planned separation - mother is primary caregiver for baby: You don't need to spend a lot of money on a double electric pump! If you want to be able to express some milk for a temporary caregiver, invest in a good quality manual pump or learn to hand express.
I was pleased to see a very similar discussion included in the new, 8th edition of The Womanly Art of Breastfeeding!
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