Pumping and Storing

This is the MOTHER of all posts in this blog.  I can't tell you how excited I am to share with you my secrets to pumping and storing breastmilk.  If you are a new mom, a veteran mom or a woman who is about to be a mom and is wondering about pumping and storing breastmilk, then you have come to the right place for answers!  

First thing's first:  Pumps

I only have experience with one kind of pump:

Medela Double Electric Breastpump (Pump In Style Advanced)

I can tell you that I love this pump and I probably wouldn't go with any other brand.  I don't have anything else to compare it to, but Medela has been around for a very long time and they strive on quality assurance in their factory.  Double Electric Breastpumps are expensive.  This one runs about $300.  I got mine for around $150.  How?  I'll tell ya:

I had a 20% off coupon for buybuybaby and some store credit from stuff I received as gifts on my baby registry that I realized I would never, ever use such as an ass wipe warmer, newborn bibs (my kid has a huge head!) portable diaper changing pad kit (seriously, something else to drag around? no thanks) A&D diaper ointment (pediatrician recommends Vaseline over that stuff) a $50 crib mobile that baby would have never looked at (it really just went with the theme to the nursery...which he is never in, but that's for a different post!) and a few other random things.

How to get a free Double Electric Breastpump:

If you have health insurance you may be eligible for a free or reduced priced double electric breastpump.  No, they aren't used.  The Affordable Care Act (ACA) of 2010 has a section of this law that covers breastfeeding support and supplies.  If you have insurance through your employer, then chances are they have implemented this law as of 2012.  Check with your insurance company to see if you are eligible to receive the benefits of this law.  I checked with my insurance company a few weeks after Baby D was born and unfortunately, I was "grandfathered" into my plan and could not participate in these benefits.  This happened, because the coverage was able to be implemented with insurance companies after August 1, 2012 and my employer renews their policy July 1st; therefore I was grandfathered into it and not eligible for coverage.  Once my employer renews the policy with the insurance company on July 1st, 2013, the ACA coverage will be implemented and I will then be eligible for coverage.  I know, blah blah blah..how do we get a free pump?!?!  I have an HMO, so everything goes through my primary physician first.  In this case, it would go through my OB/GYN.  She has a list of approved manufacturers of double electric breastpumps to choose from.  She then writes a referral to the manufacturer and then I get a free pump!  I'm seriously thinking about participating in this benefit, because it's no cost to me.  I can keep one at home and then use the other one at work.

Second Thing: Pump and Store Bottles and Storage Bags

You will need extra bottles to pump in and storage bags to store breastmilk in.  Start out by buying about 75 storage bags (25-count of 3 boxes), four 4-5oz bottles,  four 8oz bottles and Quick Clean Micro-Steam Bags .  If you know me, you know that I am a HUGE fan of Amazon Prime.  

Third Thing: Storage Supplies

• Avery Labels #5267
• Calendar 
• Dollar Store Plastic Drawer Organizer

Last Thing: Confidence and Commitment

You are an amazing woman who has come a long way from conception, to the ups and downs of pregnancy all the way to labor and delivery of the birth of your child.  Pumping and storing milk is just another step that you are going to tackle and master, just like you did with every other step leading up to this point!  Ready....Set....PUMP!

Process to Pumping and Storing Breastmilk

Introduction:  After the first month of birth, you should get into a regular routine of pumping and storing breastmilk.  If you are a working or stay-at-home mom, then the first part of this section applies to you.  If you go back to work soon, then the second section will be helpful to you.  If your baby is going through a growth spurt and cluster feeding, there will probably be no time to pump.  Baby D cluster fed during his 3rd week of life...he fed on the hour, every hour for about 10 days.  If that experience wasn't enough to bring me to my knees of formula, nothing will!

Part I: Pumping and Storing Breastmilk at Home

• Label the date and time onto an Avery label and stick it on the body of the 5oz bottle before you start pumping into it.  If you are just starting to pump and your Medela pump came with the 2oz storage containers, pump into that if you are only producing 1-2oz per feeding:

• Once baby is full from feeding on one side, pump the other side into a 5oz bottle or a 2oz snappy lid storage container immediately after baby has fed.  If you are just starting to pump, don't get discouraged if you only get 1-2oz of expressed breastmilk.  During the first month baby will only consume 1-3oz of breastmilk.  The 1-2oz of breastmilk that you expressed is a perfect amount!

• Take out a Lansinoh Breastmilk Storage Bag and write the same date and time onto the bag along with the amount of oz of breastmilk that is on the bottle you pumped into:  

• Carefully, pour the newly expressed breastmilk into the storage bag.  Squeeze the air out of the top of it and seal it closed with the two zip top fasteners:

• Place the bag sitting straight up in the plastic bin labeled 1-2+oz.  If you pumped more than 2.5oz, then place it in the other bin labeled 2-4+oz (I am using 4oz in the example below).  Put the plastic bin in the waaaaaay back part of the refrigerator.  When you store the next bag of expressed breastmilk, place the new bag behind the older bag.  That way if you end up using expressed breastmilk instead of freezing it, you are using the oldest one first.  The reason why  you would use the oldest one first, is because it will expire first.

• Repeat this process throughout the day.  I started with pumping once a day and then increased it up to four times a day. 
• At the end of the day, mark off the date on the calendar.  This will help you keep track of the date that is labeled to your expressed milk:

• Expressed breastmilk can be stored in a standard refrigerator for 3-8 days.  Always go with the minimum instead of the maximum, even if you aren't planning on freezing the milk and instead going to give it to baby.  Remember, FRESH IS BEST!

 

• On the fourth day, if you did not use the expressed breastmilk, take it of the refrigerator and massage the contents.  You will notice that the milk has expanded and separated in the bag with the fatty goodness on top.  Never shake breastmilk, as you will break apart the proteins and fats.  After massaging the bag, lay it flat in the freezer.

• After the contents are frozen (I would wait 24 hours before moving it), place the frozen breastmilk in a storage container within the freezer.  Do NOT waste your money on something like this.  I bought it and the damn bags wouldn't even fit in it.  I had to angle them to fit and I seriously could only fit 5 bags of frozen breasmilk in there.  A shoe box would be a better storage container!  No really, if you have a shoe box, use it as a frozen breastmilk storage container!  I never use my freezer in the garage, so I just stored the milk in the door. It is recommended that you store frozen breastmilk in the back of the freezer.  You want to keep it as cold as possible and if the breastmilk is being exposed to the outside air (which is much warmer than the freezer) then you run the risk of the breastmilk's temperature changing or even thawing.  

(my stock has since grown)

• Store breastmilk in various amounts.  In my stock I have bags with 1oz, 2oz, 2.5oz, 3oz, 3.5oz and 4oz.  Do not ever put more than 4oz of breastmilk in these bags.  Breastmilk expands when it is frozen and you don't want the bag to burst open in the freezer.

Part II: Pumping at Work

Maternity leave has ended and it's time to go back to work. Congratulations for making the decision to continue to nourish your baby with breastmilk, even when going back to work!  I thought long and hard about the pumping process at work.  I wanted pumping at work to not be something that I worried about, because my job is demanding.  Before having a baby, I rarely took breaks.  I would eat at my desk and sometimes run over to the Walgreens right up the road to just get out of the office for 15 minutes.  Now that I have made the decision to continue to breastfeed my baby, that all has changed.  The labor law in my state says that I am supposed to get two 15 minute paid breaks and an unpaid hour break.  Now I have something worth taking a break!

Scope out a place to pump at work BEFORE you go on maternity leave, because the first day back to work, you will need to pump.  Check out this website to read about your rights to pumping at work in your state.

You will need to pump at least 3 times during the day for about 10 minutes, at work, to keep your milk supply.  I use the Dr. Brown's bottles for Baby D.  This type of bottle mimics the breast, by not letting air in or out of the bottle.  This is especially good to help reduce gas and to keep the nutrients from the breastmilk IN the breastmilk.  Here is a clip on how these bottles work:
 
Yes, these bottles have extra parts and you will probably spend an extra 15-20 minutes each day washing and sanitizing bottles, but I think it's worth it.  You work so hard to provide milk for your baby, why would you let some of those nutrients just go to waste in a regular bottle?

Supplies Needed to Pump at Work:

1. Breast Pump: If you are using a Medela pump, bring the pump, 2 shields, 2 valves and 2 connectors.  In addition to this, bring a few spare parts in case one drops on the ground or a membrane rips.  I have a separate little bag in my pump bag with spare parts that are sanitized.
   
   Pack spare membranes in case one rips
   
2. Bottle Storage Bag and Ice Pack: I bought this one on Amazon for about $10 and it is awesome! It stores up to six bottles.  I only use four at a time for pumping at work with the Medela Ice Pack that came with my pump.  The top part of the bag stores 2 Medela shields, 2 valves and 2 connectors perfectly!
   
   This bag comes in a few different colors: blue, green, and pink. I also bought a blue one to transport the bottles from the day before to Baby D's childcare provider.
3. Bottles: Bring four bottles in the bottle bag.  If you are just starting to pump, then you will need nine 4-5oz bottles (or three boxes of the 3-pack).  If your baby consumes more than that (around 3 and a half months Baby D started to drink four 4.5-5oz of breastmilk while I was at work), then you will need nine 8oz bottles (or three boxes of the 3-pack).  Why are you getting 18 bottles?  I'll tell ya.  You will need four bottles today to pump in and store the breastmilk in for tomorrow.  Tomorrow, you are going to need four more bottles to pump in and store breastmilk in for the next day.  This process repeats Monday through Friday. You really only need eight, but again if something happens to one of the bottles you want to have a backup.  Unless you have a hungry kid like mine, then the extra one comes in handy.
   
   
   
4. Burp Cloth: Two reasons to bring the burp cloth: 1-You will need something to place on your lap while you are pumping, because when you are finished there is a chance that a few drops of breastmilk will drip out of the breast pump shield onto your lap!  And if you haven't had experience with breastmilk before, it stains.  The contents of the milk have fat and proteins in it and will therefore leave an oily spot on your clothes.  I have had to throw away a few tops because of the stains. 2-You will want something to remind you of your little one, especially if you are having problems with let-down.  Relax! Take a deep breath and a big gulp of water.  The best pump for your milk supply is your baby, but since baby can't be with your right now you may want to think of him to help with let-down.  I brought a pair of his PJs one day and draped them over my shoulder.  It felt like he was there.
   
5. Entertainment: If you have a tablet or smartphone, bring it with you when you pump.  This is the time I catch up on Facebook, personal emails and random baby articles.  I also have tons of photos of Baby D that I look at to help with let-down.
     
   (Yeah, I had to take a picture of my phone with my iPad, but check out those baby apps...oh yeeeeeaaaah)
6. Water: You can't produce breastmilk without drinking water, so drink up.  I drink almost two of these bad boys everyday.  That ends up being around 3.78 liters of water (I factor in my 2 cups of a caffeinated beverage and all the running around that I do).  If you drink coffee, pop or any other type of caffeinated beverage, you will need to drink a little bit more water since caffeine is a diuretic (any substance that promotes or increases the production of urine).  A good way of finding out how much water you need is take your weight and divide it by 2.  The result is the amount of water you should consume on a daily basis in ounces.  For example, an average woman weighs 160lbs.  160 divided by 2 is 80; therefore she needs to drink 80oz or a litter over 2 liters of water a day.I got this at Meijer for about $8.  But you can get one on...you guessed it...AMAZON!
   
   
   
   
7. Optional Sanitizing Wipes and Steam Cleaning Bags: I bought pacifier wipes to sanitize...you guessed it...pacifiers.  I then read an article from the American Academy of Pediatrics that sanitizing your baby's pacifier by sucking on it could help protect your baby from developing certain allergies. If you don't already, follow them on Facebook.
   
   Ok, so I wasted $4; this won't be the last time I do that and it's definitely not the first time.  I now use them to wipe off my pump parts that...yep you guessed it...fall on the floor.  I'm such a clutz that it wouldn't surprise me if I spilled an entire bottle of milk on the floor. I would just cry if that happened.  That's where that saying, "Don't cry over spilled milk" came from.  Also, Medela makes these handy Steam Cleaning bags to sanitize pump parts in the microwave.  I have only used the bags a couple of times when I was too lazy or tired to clean just four parts.  You can use the bag up to 10 times, I think.  Needless to say, I also have these in my pump bag, just in case.
   
   (I was at a red light when I took the picture)

Ready, Set, Pump!

1. When you get to work, immediately put your bottle storage bag (with ice pack and bottles) into the fridge
2. Break #1 
3. Grab your pump, water and your bottle storage bag and bring to the room in which you are pumping in
4. Lay the burp cloth on your lap
5. Drink water
6. Twist on two bottles to the pump connectors and pump for 10 minutes
   
7. Disconnect the bottles from the connectors and pour the contents of one bottle into the other.  You never want to mix cold breastmilk with warm breastmilk!
    
8. Put the bottle tops on both bottles and put back into the bottle storage bag
   
9. Do a quick wipe down of the pump shields and place the pump shields, connectors and valves in the top zipper part of the bottle storage bag
   
10. Put the bottle storage bag back in the fridge (there is no need to clean or sanitize the pump shield, valve or connectors.  The milk that is on them will keep in the fridge.)
11. Break #2
12. Repeat steps 3-6 (in step 6 this time, grab a bottle that you have not pumped in and the one you pumped into on the first break and connect them to the pump)
13. Repeat step 7 (You should now have two bottles with breastmilk in them and two without)
14. Repeat steps 8-10
15. Break #3
16. Repeat steps 3-6 (You should now have all four bottles with breastmilk in them)
17. Repeat step 8-10
18. Set an alarm on your phone 10 minutes before you go home to remind you to get the bottles out of the fridge.  

Part III: Cleaning and Sanitizing Process

Intro: Take care of baby, your significant other and any other tasks included in your nightly routine.  Don't let cleaning and sanitizing bottles run your night. After Baby D is asleep is when I start the cleaning and sanitizing process.  I want to spend as much time with him during waking hours as possible and by the time I pick him up from our childcare provider, he has about 2 hours (at the most) before he is ready for bed.  The below process is the one I have been using since the very start of pumping at work.

1. As soon as you get home, put the bottle storage bag with the breastmilk you expressed today, into the fridge and the ice pack into the freezer. (I got into the habit of putting the bottle storage bag on the floor of the car in front of the seat that the car seat is in.  That way,  I see it when I get Baby D out of the car.  I set Baby D, who is in his car seat, down on the  kitchen floor and put the bottle storage bag in the fridge)
2. See Intro above
3. Fill the kitchen sink with warm (not hot) soapy water.  There is no need to buy expensive bottle soap.  Soap is soap.  I used to use my regular dish soap until I found a deal on Amazon for the Palmolive Baby soap.  For under $30 you can get three 20oz bottles of this soap, which is hypoallergenic BTW! There is a fragrance to it.  Some people hate it, I happen to enjoy it! It smells like a fresh baby.  Plus, the fragrance will go away after the bottles have been sanitized. Don't waste your money on the Dapple soap.  It's expensive ($13 for a 16.9oz bottle) and does the same exact thing.

 

The asterisk after Removes milk refers to whole milk and formula, but it takes the film off the bottles from breastmilk as well. 

1. Wash the pump parts that you used today to pump: 2 shields, 2 connectors, 2 valves with membranes on them (to reduce the risk of ripping the membranes, just leave them connected to the valves).
2. Wash the Dr. Brown's bottles and its parts.  I use the munkins bottle brushes for all the stuff that I wash.  The pink one works great for nipples, because it has softer, wider bristles and the green one works great for the Dr. Brown's bottle parts, because it has firm, narrow bristles.  I use the blue brush for everything else. I recently purchased the Dr. Brown's bottle brush for under $6 at BRU and it is much better than the blue munchkin brush! It comes with a suction cup stand that enables the brush to stand up and dry. Also, the blue sponge at the top really cleans off breastmilk residue! This is a must buy!

Check out this one!!  Super Deluxe!

This is the normal Dr. Brown's brush.

 

I keep the brushes in plastic drawer organizer that I bought from the dollar store by the side of the sink.  Separating the brushes from my other kitchen utensils lessons the chance that other food particles get on them.  Once a week I will throw the brushes in the sanitizer with the bottles and other stuff.

1. Load all the washed and rinsed bottles and pump parts into your sanitizer.  I HIGHLY recommend the Cuisinart Baby Sanitizer.  You can fit a lot of stuff in there!
    
2. After the stuff has been sanitized, put them onto a drying rack or a drying pad.  I have both.  It depends on how much stuff I have to dry which will determine what I use, but typically I use the $10 drying rack from The First Years.  You don't need to spend extra money on name brand drying racks like the Dr. Brown's one or those new ones that look like grass.  You can barley fit anything on those grass drying racks anyway.
   Or both
   
3. Wait until morning to pack your bottle storage bag with the ice pack and the newly cleaned bottles and pump parts to make sure they are dry.  If there is a little condensation inside the bottles, no big deal.  Pack 'em up anyway.  A little moisture never hurt anyone.  Plus the bottles are going to be in the fridge all day, besides when you are pumping.
4. Speaking of moisture.....if you notice that the tubing to your Medela pump has moisture in it, run the pump with only the tubing connected to it for 2 minutes after each time you pump.
    After 2 Minutes
   
5. If you can't spare those two minutes at work, then do it at home while you are washing the bottles and pump parts.  2 minutes on a double-electric Medela pump ends when the pump starts the "let-down" cycle.  You will hear the pump's motor rhythm change to a slower paced pump.  If you still see moisture in the tubes, continue to run the pump for a few more minutes.

And those are my secrets to pumping and storing breastmilk!

FAQ:
Q: "I'm ready to start pumping to store breastmilk, but after I feed baby my breasts don't feel full enough to pump.  Am I going to be able to get milk out if I pump?"

A: Yes.  Let's look at the science of the breasts when you pump or feed baby.  When baby latches onto your breast and begins sucking, the stimulation from the nipple tells your brain to produce a chemical called oxytocin.  Oxytocin is the hormone that triggers the "let-down reflex" and expresses milk out of the nipple.  Your body does the same thing when you use a pump to express breastmilk.  Even if your breasts don't feel full, you will be amazed that you are still able to express breastmilk.

Q:"I just started to pump after baby fed on one side and I am only able to get 1 oz!  Is there something wrong?"

A:  No.  If baby is older than a month, but younger than two months and you are only getting 1-2oz of breastmilk after you pump, then chances are that is all that baby is eating per feeding.  You will notice that you will be able to express more breastmilk as baby grows.  For example, when Baby D was 2 months old, I expressed 1 to 1.5oz at the beginning of the month.  Towards the end of 2 months I was able to express 1.5 to 2oz of breastmilk.  By the 3rd month I was able to express 2.5-4oz of breastmilk and now at 4 months I can get anywhere from 4-7oz of expressed breastmilk.  See the pattern?  The older baby is, the more he or she will eat.  Your breasts only produce as much as baby eats.  Even if your baby is going through a feeding frenzy, your breasts will work overtime to make sure that he or she is getting the right amount of milk at each feeding.  Our boobs are smart....haha...that's an oxymoron...smart boobs...get it? Aaaaanyway.....

Q:"My baby eats every 2-3 hours for 30-40 minutes at each side and is almost 2 months old.  I can't find time to pump! Help!"

A: If your baby's weight gain is on track and he is not going through a growth spurt, then you don't need to keep him at the breast for 40 minutes on each side.  After 20 minutes on one side, if baby is still eating, all he is doing is burning calories.  During the first 10 minutes of let-down is the foremilk.  This is the low calorie milk.  The next 10 minutes is the hindmilk that contains all the good fats and proteins (the stuff that you have to scrub off the bottles).  After that, it's back to the low cal stuff.  I was told by Baby D's pediatrician to only let him at each breast for 20 minutes.  Each pediatrician may have their own expert advice, so if you aren't sure how long to feed baby, check with the doc.