Pumping on the go

This post was inspired by this post: Pumping and working

It is tough enough to pump every day at work, but that's a walk in the park compared to pumping while traveling or when out all day in meetings. At work I can lock myself in my office and do my business whenever I need to. If i'm just on the computer it is not a big deal to stop working for 20 minutes to pump. On the go is a whole other ball of wax.

There are many stories online about how women can feel humiliated when they find themselves leaking or having to pump in relatively public places. For instance this incident TSA breast pump blunder just fills me with rage. Unfortunately society has put women in these positions where we have to expect to feel humiliated at times, or like me, just develop a thick skin and do whatever it takes to do what needs to be done.

On my first trip outside the country after giving birth I was very anxious about pumping and how I would fit it into all the moving around I had to do. In the end it turned out fine, I just had to suck it up and improvise as I went from point A to point B. My first piece of advice to traveling moms is to bring a manual pump, not an electric one, so much easier to sit somewhere and pump indiscreetly. Second, bring a nursing cover with you along with extra pads and tissues. Here's a hierarchy of options for places to pump in airports:

1. If available look for a lounge or a nursing/breastfeeding room. Odds not high you'll find one but you might.
2. A bathroom for the disabled. In Philippine airports these are typically separate rooms altogether that have a big enough space to lay out your luggage and set up. Just tell the bathroom attendant you will need it for a few minutes to pump and odds are they will even stand there to guard the door for you. Women, we protect each other. Men, they are afraid of us, so even if the attendant is a man go ahead and tell him, he will stand there with his mouth hanging open just agreeing to do whatever you tell him to.
3. The largest bathroom stall in a public bathroom. Or the one in the far end usually, the one that doesn't get a lot of traffic. I also decided to tell the attendant what I will be doing in there so she can tell people waiting in line that it won't be available.
4. In some corner somewhere. When I was left with no other choice, I just plopped myself down on a row of seats in an uncrowded area, put my rolling luggage beside me so I occupied the whole row, and put on a nursing cover. This was quite a success surprisingly, more comfortable for me than th ebathrooms, but if you're squeamish about pumping in public them perhaps not for you.
5. During the flight of course you'd have to use the lavatory. Do it during the time that food is being served so most people are trapped in their seats and you won't be holding up a long line of people desperate to pee. On my return flight the plane was not full, I transferred to an area where I didn't have to sit next to anyone, and again hid under my nursing cover and just pumped in my seat.

*extra tip, when I ran out of milk storage bags I just bought a bottle of water and emptied it out then put the milk in there.
**extra extra tip, ALWAYS consider the ability pump when selecting clothes to wear. Not a good idea to trap yourself in a one-piece dress that doesn't open or pull down the front when you find yourself having to pump outdoors.

Photo credit: http://www.nursingfreedom.org/2010/12/pumping-in-bathroom-is-like-putting.html

Working in pumping sessions can also be tough when you are having a hectic moving-around day of meetings and errands in various places. When this happens to me I would park my car in the most secluded slot I can find and cover up with a nursing cover then pump in the car before heading to a meeting.

I am fortunate enough to have cars to hide out in and to be able to afford an extra pump to bring with me. Many women don't have that, so all you out there judging moms for ceasing breastfeeding when they return to work, back off, it is incredibly hard.

Disposable diaper reviews

We are now cloth diapering happily, basically the entire day the baby is in cloth diapers except when it has been raining and we can't get the laundry to dry in time. At night we are on disposables because no matter how many soakers I put in the cloth ones they will have leaked by morning, and I don't want to have to wake him up to change his diaper in the middle of the night. Our experience with disposables is also quite vast because we were on disposables for the first couple of months.

Upon extensive consultation with mom friends we settled on a fantastic system that was recommended to us by at least 3 people independently: cheap diapers for the day when moving and Mamy Poko at night. Now deciding to use Mamy Poko is sort of a big deal because it is literally twice the price of the cheap ones, not for use with every diaper change (something like 14 pesos per piece). Still, it is the only brand that will hold a baby's overnight pee, when I take that thing off in the morning I swear it weighs 10 lbs! And no leaks!

Photo credit: http://www.limsimi.com/leisure-entertainment-johor-bahru/johor-bahru-shopping/baby-products-in-johor-bahru/

These reviews have a caveat, my baby is a big pooper, in so many ways. So his diaper requirements may be more stringent than the average kid's. His poops are very runny and exit his body in an explosive way, so he was leaking a lot, and the search for the perfect disposable diaper to contain all this poop was a matter of some importance. We were wiping off leaks from carseats, our bed, his crib,  our hands, the couch. He would leak out almost every time he pooped which meant a whole outfit change every time he pooped! It was exhausting. Anyway, so we also needed cheap diapers, because he was going through a dozen of those in a day.

Here are capsule reviews of the rest of the diapers we have tried:

1. Huggies newborns. These were my fave in the beginning, they are a good size for a tiny baby and the paper-like cover I think gives his nether-regions a lot of breathing room. They're pretty cheap too but kind of hard to find.
2. Huggies smalls and mediums. These were mid-priced but weird, some bags I bought seemed defective. Some bags have diapers that have tabs on the side to extend the rear onto the front resulting in a snug fit, but some bags have diapers without the tabs. WIithout those tabs leakage is a real possibility, so avoid. These are in the red packaging, not the blue packaging (discussed in #5).

Photo credit: http://www.limsimi.com/leisure-entertainment-johor-bahru/johor-bahru-shopping/baby-products-in-johor-bahru/

3. EQ. Got these from the hospital, while cheap, very prone to leaks and not a snug fit around the legs. I like how the whole thing feels like cotton or paper, no plastic, and the tabs are velcro as opposed to scotch tape. The colors were kind of obnoxious, all cartoony.
4. ProKids. Leaky!
5. Huggies "dry" Ugh I HATED these things. We were in the province and in a pinch for disposables, these were the only ones in the store. They are in the blue packaging, very cheap and feels very plastic-y. They are super thin, but what I really objected to was the plastic. I felt like I was cling-wrapping my baby and that his potoytoy can't breathe. The sticky tabs literally feel like scotch tape. Ack, stay away.

Photo credit: http://mommassage.multiply.com/journal

6. Pampers "sulit" something. These are the inexpensive pampers in the orange packaging. Only half a notch better than the huggies 'dry', which means they also feel very cheap. All plastic, not as bad as the huggies, but not something I would buy again given a choice.

Photo credit: http://www.lazada.com.ph/Pampers-Comfort-Value-Pack-Medium-42s-25332.html

7. Mamy Poko "value". There's a scaled-down version of Mamy Poko, these were strange. I laughed out loud when I opened it because the diapers were so thin, like 2 sheets of paper. THey are supposed to be super-absorbent. They're fine for day, does NOT feel as cheap as #5&6 above, but definitely will need a change every time baby pees. It's very "presko" though because it's paper-y and thin. Would buy again but my husband didn't like them.

8. Last and best in my opinion, Drypers. These were the winner, one of the cheapest ones on the market (7 pesos per piece thereabouts of the small) but does not feel like you're wrapping your kid in plastic. It's paper-y and thick enough to hold runny poo and a lot of pee. The tabs are like scotch tape yes, but the rest of the diaper is paper. Not thick enough for overnights, but definitely the best for daytime use given how cheap they are.

Photo credit: http://www.diapersph.com/index.php?route=product/product&product_id=60

Baby turns his head a lot while nursing

Once baby starts gaining clearer vision and hearing, he will be so excited about seeing things around him that he will become easily distractible when nursing. Even bottlefeeding moms will notice this. Kid is happily drinking away at his bottle then dad walks in, baby turns his head to look... ooh light!, baby turns his head... pretty hair mommy, turns his head. This is fine when attached to the bottle because bottles can travel with the head-turn, boobies, not so much.

Distractible babies can inflict real pain on breastfeeding moms. My baby would look at my eyes, give me a big grin with my nipple between his gums, then clamp down and turn his head. It's really cute but it is PAINFUL! I do the nursing time-outs where after 3 of these head-turns the bra goes on and mom closes up the soda shop. Baby gets a firm "enough!" shout from me, which is greeted by a happy smile btw so I don't think it does anything really.

http://www.drmomma.org/2010/08/tips-for-nursing-strikes.html

It may seem mean to stop nursing your baby when he is really distractible and making it painful, but in my experience, when they are more interested in looking around than continuously eating, then they are not really hungry. When baby J is 100% there to eat, he is ALL BUSINESS, he closes his eyes even and goes to town on the boob.

Now that he is getting bigger I find that he asks to nurse less and less. In fact I offer him a boob every now and then even though I know he hasn't asked for it just because I'm starting to miss our private nursing time.

For more info on dealing with distractible babies:

Kellymom on the distractible baby

Uses of Lampins

Cloth diapering aside (see my review on cloth diapers), I own a dozen of the traditional lampins or flat diapers that I never use for diapering. My OB told me to buy a few of these for other purposes, mostly to wipe off snot and spit-up, but I found that they have many other uses as well. These things are great as a go-to basahan because they are made of pure cotton, they are thin so they soak up liquids very quickly, and they are a better size than the pre-made burp cloths in the market.

Photo credit: http://glamomamas.com/2011/07/diaper-revolution-2/

Right now I have two of these wrapped around the top railing of Baby J's crib to keep him from chewing off the paint and ingesting it. I've tied one around the handle of his car seat when he was teething because he wanted a rough fabric to rub his gums on. I've used it as an ice pack to relieve his sore gums and my sore nipples from breastfeeding. It's big enough to be a blanket when you forget to bring one, at least until he hits the 6 month mark and outgrows this purpose.

Even without a baby, I think people could use a bunch of these in the house, they're better than kitchen and handtowels! They're expensive to buy for that purpose if you buy them at the mall but I heard they are extremely cheap in Divisoria.

Bebeta manual pump review

I've been trolling local sites about discussions of manual breast pumps and was bothered by two things. First, some moms seem to have been told that you should NOT pump in the first 4-6 weeks of baby's life. Second, that manual breast pumps are expensive (P4-6 thousand depending on the brand). Both beliefs are dangerous for a new mom's chances of continuing breastfeeding.

Pumping is not bawal in the first month. WHat doctors mean is that if you CAN nurse then nursing is better, but if for some reason baby is having a hard time nursing because of latch or strength issues it is not bad to pump. In fact you can pump in between nursing sessions to increase supply. It is true that in the first 2 weeks babies should be nursing as much as possible because the stimulating action of their tongue on your breast will signal the arrival of milk in good volume. What WILL be bad for your supply is exclusively pumping in the first month, the nursing is critical, nursing AND pumping is ok too, but pumping ONLY can diminish supply.

Breast pumps do not need to be expensive, there are ok manual pumps out there for less than 1,000 pesos. Moms who cannot afford to drop a lot of money on a pump when they are not sure that they will be able to breastfeed will just not buy a pump. I think this is a mistake and jeopardizes the chances of successful bfing over the long term. Since some moms seem to think they need to spend at least 4,000 pesos for a manual pump, they end up delaying the purchase to be safe, no sense in spending that much cash if their supply is not enough. In fact the decision process should be reverse, you buy a pump to increase supply, not decide to buy a pump only if there is enough supply.

One of the most important things you need to consider when buying a manual breast pump is that it can be operated with one hand. You'd be surprised how many models out there need two hands to operate. And believe me, when you have a baby you need that other hand to be free. The Medela electric pump I inherited from a friend came with a manual pump that needed two hands, I never used it. The second thing, buy one that has a bottle where the milk will go, you'll see what I mean when I discuss my Chicco purchase below.

I bought my perfectly useful manual breastpump for 700 pesos, some sulit people are selling it for 500-600. It is a Bebeta pump that I picked up from Shopwise (in Libis). It's got some minor issues (described below) but it is a decent pump and has paid for itself over and over.

Photo credit on top of photo. Not an endorsement of seller.

There is only one problem with this and once you learn how to deal with it you can pump without interruption. If you are pumping at an angle where milk travels into the silicone cap on top, or if the silicone cap is wet inside from the wash, you lose suction. So before starting to pump make sure that cap is bone dry on the inside. The whole thing comes apart so it's not that hard to do, a lampin does an excellent job of wiping off all moisture. Then once you start pumping do not hold it at an upward angle, hold it slightly downward so the milk just flows downward. I do not put on the silicone tube thing that goes on the flange, it will help with suction but I find it's not completely necessary.

This thing has taken me through many night-pumping sessions and a 3-day trip to Bangkok. For a few weeks I used only this instead of the electric because it's gentler on the boobs. I never felt the need to buy a more expensive manual pump.

The first one I bought was this Chicco thing that the SM lady recommended. I didn't want to buy the more expensive Chicco manual pump because it was too much money to drop when I had an electric at home, I just needed a back-up. When I got home I found to my dismay that not only was the reserve too small for any real pumping, it was also not recommended that the expressed milk be given to the baby, although honestly I don't believe that part. So stay away from this one:

Photo credit: Chicco

I still don't understand what it's for, but it's apparently not for expressing milk that you want to feed to your baby. Go figure.

Increasing milk supply

Many moms go through this phase where they think their milk is not enough. I've heard the phrase "kulang ang gatas ko" often when discussing bfing, and most of the time this is enough reason for moms to decide stop bfing altogether. I went through this, or at least I thought my milk supply was low, but upon researching online figured that my supply was probably never low (Kellymom on low milk supply). Still I did a bunch of things to try to help it along, and all of this helped immensely, helped a little too much even that I ended up dealing with oversupply for a couple of months. Here's a rundown of advice from friends and websites I followed.

1. Fenugreek. The REAL galactagogue. My OB told me to take these. It can be pricey, P800 for a bottle of 60 pills (if i remember correctly) at Health Options stores. It is also available at GNC but for a much higher price, like 60% more. You'd need to drink around 6 pills a day to see an effect. It only took 2 days for me to notice that my supply improved, I kept taking it so ended up with too much milk. For most women once your supply improves it will stay that way even without the fenugreek.

http://www.sallybernstein.com/food/columns/ramachandran/fenugreek.htm

2. Drink lots of water. Lots and lots of water. Generally healthy for you anyway so no harm in doing it.
3. Relax. It is hard to be relaxed when your tiny little infant is screaming in hunger, I know this, but you have to do it. Breathe deeply, consciously let the tension your muscles go, and put yourself in a "bfing frame of mind." Look forward to the nursing sessions. When tensed up and stressed your letdown will take longer, this will make baby more and more frustrated because he will keep sucking on your breast and will get nothing out.
4. Co-sleep and spend a lot of time skin-to-skin. Dr. Sears had it completely right. Physical contact and constant close proximity to your baby will stimulate your body to make more milk. I was basically topless for a couple of months, and we had a lot of nursing sessions in the beginning when the baby was only in a diaper.
5. Get a good pump, and pump as often as you can. Breastmilk works on a simple demand-supply basis, the more you use the more milk your body will make. When you feed the baby expressed milk make sure you pump also so that your body knows the baby ate at that time.

Photo credit: Sulit seller Phershy (not endorsing! I bought mine from Shopwise) 

When you get a good supply going, watch out for oversupply. I got so obsessed about increasing supply that I ended up with too much milk which can also be bad for baby. The most telling sign of oversupply is green runny explosive poop, when that happens stop the Fenugreek and cut down on the pumping, then read up on oversupply and how to remedy :-)

Plugged ducts: Dealing

I've had 3 episodes of plugged ducts since I started breastfeeding. It doesn't get easier to deal with, but at least the accumulating experience makes me confident that I can fix it before infection sets in. I've heard some scary stories of mastitis from friends and these were enough to scare me into acting quickly as soon as I suspect a plugged duct.

Lately I've been prone to these. I started working again and my unpredictable schedule makes it hard to schedule regular pumping sessions. One is prone to plugs when the breasts are not emptied out regularly, they get engorged and milk solids block the ducts so that even after pumping or nursing a part of the breast remains full. It can be painful, you will be able to feel a lump on your breast, it will be tender like there's a bruise, sometimes there's a redness on to the skin and it feels warm.

Moms who plan to breastfeed should have small hot/warm compresses handy. These are useful for a lot of things, faster letdown, soreness, mastitis, and plugged ducts. A lot of websites say it helps to take a hot shower and let the water run against the part of the breast with the plug. In the Philippines though not all homes have hot showers, so warm compresses are a must. A low-cost option is to put some uncooked rice in an old sock and sew it closed, then microwave for 30 seconds at a time until warm, you can use this indefinitely but make sure you don't get it wet!

Place the warm compress on top of the breast where the lump is, massage the lump from the outside of the breast toward the nipple, do this for 5-10 minutes then start pumping or nursing. Nursing is better, especially if you have an older baby, because his suction will be stronger than a pump. What you are trying to do is soften up the milk solids plugging up the duct, then suck it out (literally). Joke all you want about getting your husband to suck out the plug, but don't do it, your baby has a stronger suck I promise. If you're pumping, keep the warm compress on while pumping.

The plug might not go the first time, repeat the process every 2 hours until the plug is gone and you can feel the duct drain off the milk. Soreness may stay for another couple of days, but you'll know the duct is clear if the lump is gone.

So remember, as soon as you feel that lump do the warm compress thing, don't wait for more milk to accumulate in there because it will get more painful as that happens and then infection is next.

For more: Dr. Sears on Plugged Ducts