Extreme Breastfeeding: Pumping for NICU Without Losing Your Mind

-or- Free Your Hands and Your Mind Will Follow

When our littlest geek (locally dubbed the Baby Detective) ended up in the NICU, I found myself back in familiar breastfeeding territory.  My role on supply side of breastfeeding began in the NICU.  As a first time mom who gave birth by c-section, my milk didn't come in for days.  That newborn, a "sugar baby" in NICU lingo, had low blood sugar and a low body temperature, so my first attempts at breastfeeding were bedside in the NICU.

It was awful.  There's no just way to prepare for breastfeeding or the hormonal postpartum roller-coaster.  Throw in the physical separation, heightened anxieties, and lack of privacy of NICU, and the natural act of breastfeeding dials itself up to an 11 (on a scale of 10 for those who haven't had the senseless pleasure of This is Spinal Tap [available on Netflix streaming]).

I won't tax you with all the gory details (although keywords like nipple shield coupled with a multitude of synonyms for breast might spice up my Google hits).


When we decided to grow our family to five, I assumed the third round of nursing would be without surprises. Then BabyGeek 1.3 arrived six weeks early after swift and furious pregnancy complications.


Instead of a bassineted baby in my hospital room, our teeny geek was an isolette half a building away.  She was challenged to digest liquid food, much less consume it.  While she drew most of her nutrition from IVs and lipids from a feeding tube, I pumped every 3 hours in an attempt to provide breastmilk that she could consume by bottle.

The only things previous breastfeeding experiences had taught me were I hated pumping, I didn't have much success with it, and with growing sleep deprivation, the low moan of the pump motor turned into crazy words that made me loathe pumping all the more.

With 8 pumping sessions a day on the horizon, things had to be different this time.

In order of importance, here are the big changes:

1. Go hands-free: this list-topper may seem painfully obvious to the working moms, but somehow I managed to miss the advantages with earlier infants.  Maybe it was the early '90s era models in their shoulder padded power suits, but somehow hands-free seemed inappropriate for someone who spends most days in jeans, tees, and a sea of Cheerios.

Prior to this baby, I loathed pumping and avoided it at all costs.  The deeply bovine feeling of hooking up to a milking machine felt humiliating (especially in the hospital with people walking into the room all the times).  Holding the flanges in place kept my hands and mind focused on the pumping process.

This time, with the phone ringing off the hook, and hardly a moment to bolt a meal, I walked my hospital gown clad self into the lactation boutique and bought an Easy Expressions hands-free bustier.

Suddenly, I had my hands back, and along with them came a solid measure of dignity.  Yes, I was still fastened to a very dairy machine, but I felt more 80s throwback (think Madonna) or crazy fashion forward (Lady Gaga) and even a bit Amazing Stories.  It was the best kind of ridiculous.  When my hands were unshackled, my brain and soul were now free to contemplate something, ANYTHING, other than the pumping process.  Pure awesome.  Worth every penny.

2. Kick back and watch something distracting.
I hesitate to offer this advice as television kills brain cells and such, but there are times in life where really senseless shows can be blessedly soothing and distracting.  While I couldn't sleep and pump, I could pump while watching every episode of Sons of Tuscon, Doc Martin, The IT Crowd, Toddlers & Tiaras, and Man v. Food on Netflix streaming.

3 . Hospital grade pumps should be considered.
Before Ranger was born, we bought a Medela Pump-In-Style Advanced pump.  I still own it, but I instead opted to rent a Medela Symphony from the hospital boutique.  When pumping 8 times a day, it's important that the pump works well- 10 minutes more per session adds up to 80 more minutes per sleepless day.

4.  Lactation consultants can help immensely, but tend toward generalizations.
I love the lactation department at our hospital.  The consultants have helped me over the years.  This time they lent me a DVD copy of Hands-On Pumping (the 3 videos are available free online at http://newborns.stanford.edu/Breastfeeding/).  Those techniques improved my supply quickly.  Pumping every 3 hours (at the hospital or at home) is an insane challenge.  Undersupply broke my heart because (in my hormonal insanity) it felt like the only thing I could do for my vulnerable baby (in more reflective moments I realized the error in that thinking, but I'll save that for a later post).

While I appreciate their expertise and enthusiasm, I've also been given general advice that didn't apply to my specific situation and made me feel like I was failing.  Go breastfeeding, but skin-to-skin contact, homeopathic supplements, and 2 hour pumping schedules just weren't options I could consider.  They really wanted my baby to feed directly before leaving the NICU, but it was simply too difficult for her and taxed her limited energy.  I understand their concerns that breastfeeding might not last as long if she's bottle-fed, but I also knew my daughter was overtaxed by breastfeeding.  The neonatologist agreed that the baby would come home sooner if bottle-fed, so I focused on more effectively pumping and bottle-feeding.  For us, bringing the baby home sooner was a much higher priority than direct breastfeeding (or even breastfeeding).

Once the baby was bigger and stronger, the transition to regular breastfeeding was easy.  We were so glad to say goodbye to bottles.

5.  The White Wave -or- What to do with all the milk

During time I pumped daily, the surplus milk quickly engulfed our fridge's freezer.  The hospital can only store so much per patient, and the nurses told me about other moms buying deep freezers.  I started freezing the surplus in Lansinoh breastmilk storage bags instead of the space-hogging NICU bottles.  They freeze flat, and 10 can be neatly stowed in a gallon freezer bag .  With Amazon Mom and Subscribe and Save, I was able to get cases of these delivered to my doorstep at an excellent price.

6. Washing Up
Cleaning the pump parts after every session brought to mind Sisyphus forever rolling the stone up the hill to watch it immediately roll back down.  In this sleepless rendition of the classic tale, it's easy to feel that the stone is actually rolling over you on its disheartening downward fall.  This is where a kindly clan of magic bottle-washing elves would come in handy, but my neighborhood owl seems to have taken them out (along with the toilet paper fairy).  Wash up all the parts as soon as you put the milk in cold storage.  It feels even worse to start the whole process with the washing.

We went through 3 different bottle brushes before again settling on the Munchkin's Deluxe Bottle Brush which we liked back when Ranger was formula fed.

All in all, it's no small feat to pump for a NICU baby.  If you are a parent who is going through this now, take care of yourself as much as you can.  Your kiddo needs YOU more than breastmilk.  Sleep as often as you can, eat, and drink lots of water.

If you know someone else going through this, feed them a meal (or, even better, set up a food registry for them at mealbaby.com).

***Baby Toolkit is the ongoing story of a couple of Midwestern geeks and their kids.  We are not affiliated with Medela, Munchkin, Ziploc, Meal Baby, nor Netflix, but we are Amazon affiliates (so a small portion of purchases made through our Amazon links go toward the Baby Toolkit jet fleet).

And be sure to check out related post The Boob Wars. 

To Tell a Tale: Rory’s Story Cubes

We are a family in love with stories.

We tell them, we read them, and as this blog attests we often write them down and share them in some form or another with total strangers. Adrienne and I have been readers our whole lives. We even turned to stories, in the form of Barbara Lehman’s wonderfully illustrated but wordless books, to help Ranger learn to better express himself as he described the details of the quirky scenes in Lehman’s illustrations.

For the past year or so, as Ranger has passed from a toddler to a preschooler, he and I have begun to play “story games” to pass the time. While we’re waiting in line somewhere or when car trips are lasting longer than either of our patience, I’ll start asking Ranger semi-directed questions similar to what we’ve practiced with Lehman’s books to fill out the details of a free form story. I might ask, “Who is in the story?” or “What should our story be about?” and as Ranger fills in the details, we begin to explore these free form worlds that we create together. It has become such a part of our life, that Ranger will often interject into any long silence, “Let’s make up a story!”

It’s tremendously fun and puts our creativity through the paces. As I hadn’t done a lot of this sort of thing for a long time, I was rusty at first, but persistence has paid off. What was difficult and awkward at first, is now second nature to us both. We roll with any suggestion and seem to be able to incorporate most any idea into at least a semi-recognizable narrative.

This sort of thing was easier when I was younger. As a young geek child of the 70’s and 80’s, I came of age slinging polyhedral dice while playing role playing games ( or RPGs). My friends and I imagined adventures in underground lairs filled with traps and monsters, smashing cars into each other, going insane from viewing nameless horrors, and hiding out from “The Computer” during endless story telling sessions of Dungeons and Dragons, the Palladium Role Playing Game, Car Wars, Call of Cthulhu, and Paranoia. These “games” were exercises in imagination and storytelling more than winning some sterile objective. I think they helped my writing, encouraged my reading, exercised my imagination and generally improved my overall communication skills.

Ranger’s a little too young for these types of games but luckily there are other games and play activities that are springing up that we happen to really enjoy and that accentuate the story play in which we already engage. One of those play/game activities is Rory’s Story Cubes. Published by Gamewright, Rory’s Story Cubes are nine six sided dice that come in a sturdy magnetically fastened box. Each white dice has a unique black doodle or pictogram on each of its six faces. The pictograms include doodles of a water fountain, a turtle, a bumble bee, a bolt of lighting, a castle keep, fire, and a shooting star. If you do the math, there are 54 images across the die faces. That’s quite a lot of potential story inspiration when you consider all the possible combinations.

The simple idea of Rory’s Story Cubes, is to take some or all of the dice and roll them, and then work alone or together to make up a story that includes elements from all of the face up pictograms. That’s it. It’s a simple activity and, while there are suggested ways to use the cubes, the included booklet also encourages you to use them in any way that inspires fun and creativity. Since there’s no “right” way to do it, kids are free to let their imaginations wonder unhindered by any “correct” interpretation of the images that  they randomly encounter from any particular roll. For instance, one doodle is of an Egyptian scarab as you might find on a pyramid burial chamber wall painting or depicted in an ancient Egyptian cartouche, but Ranger usually incorporates it into his stories as a generic “bug” or a slightly more specific “beetle”.

Some people may be turned off by the randomness of the activity, but I’ve found the activity of making a story (and perhaps not even a good story) from the randomly occurring images to not only be mentally challenging but also very inspirational. I have imagined seeing them being used by writers as a warm up exercise or a way to work through writer’s block. Perhaps teachers could use them in creating writing or speaking prompts for their students. I can just hear high school speech students groaning at the idea of giving a recitation of an extemporaneous story inspired by the fateful roll of the cubes.

I know from experience that the exercise of using the cubes and pushing ourselves to work within their imaginative constraints has broadened Ranger and my general story telling and creation abilities. He’s become surprisingly good at taking a random word or phrase that we may come across and turn it into wonderful little tales. He’s one heck of a storyteller these days. As an example of the types of stories that he now come up with on his own after a couple of months of playing with the cubes, this is my favorite story that he created after I tossed out the phrase “octopus soup” to him in car trip a couple of months back.


Octopus Soup
------------------

Once upon a time, there was octopus soup sitting in a cup on a table. A little girl sitting at the table wanted to try it.

She took a sip and it was wet... and slippery... and yucky. It made her feel dizzy. Then she wobbled off her chair and fell on the floor.

All of the sudden, she turned into an octopus.

When her mommy came into the room, she yelled "Oh no! There's an octopus in my house!"

She picked up the octopus right away and rushed it over to the aquarium and said, "Here. You take it."

When she got home, she couldn't find her daughter and figured out that the octopus was her little girl. So she went back to the aquarium and said, "You have to give me back that octopus! It's really my daughter."

The man at the aquarium said, "Oh good. The octopus turned back into a girl after you left. Here you go... She's a little wet."

When they got back home, the little girl said "I'll just have a peanut butter sandwich."
--------

The box can double as a rolling tray.

Making up stories with anyone, but especially with little kids, is a lot of fun and Rory’s Story Cubes definitely greases the imagination in pursuit of that goal. This simple, portable activity is sure to be a lot of fun for any family, though I wouldn't limit it to just families or kids. I can see it as a great party activity for adults, an icebreaker activity for gatherings, or an improv exercise. It’s a wonderful game to play that we highly recommend. Also, for those that are interested, there’s an iPhone App of the cubes, but there is a visceral thrill in rolling actual dice that is really part of the fun of the whole process. The retail price for the physical Rory's Story Cubes game is $12.99 and comes in a sturdy portable box that is slightly larger than a deck of playing cards.


We’re curious what type of stories that you’d come up with using a roll of Rory’s Story Cubes. Given the rolls in the pictures above, what does your mind come up with? Post them to the comments below.

***Baby Toolkit the sleeper hit blog on a short stretch of a quiet street in Southern Indiana- unless of course one of our neighbors has started a blog (like the clown family down the street- amazingly not a joke). We received a review copy of Rory's Story Cubes from Gamewright. We're Amazon affiliates, so a small portion of purchases made through the Amazon links on the site comes back to us and we use it to pay for connectivity or the downpayment on a Baby Toolkit corporate jet (thanks!).

[Note from Adrienne: Jim's new blog at storiedadventures.blogspot.com hosts even more gaming content.]

Ring Around the Sippy: A Clean Fridge Hack

Scout is a milk junkie.  The child's unceasing demand for moo juice means her cup is in and out of the fridge all day long.  The refrigerator quickly starts looking worse for the wear as the grubby cup leaves rings and drops toddler cruft on the glass shelves.  Half full cups vanish into the no man's land of other perishables, not to be recovered until a scarcity of cups inspires a search party.  With organic milk at $5.99 a gallon, this disappearing act can be expensive.

When the ghostly Rorschach of milk rings finally spelled out "wash me," I launched a full-fridge Silkwood scrubdown.  The fridge gleamed as I went to return the slightly sticky sippy.  Would this cleanliness unravel faster than a celebrity marriage?  I couldn't bear the thought.

I grabbed a clean cottage cheese tub lid from the cabinet and we instituted the first Jones' fridge coaster.  What I thought would only prevent cup rings and grubbiness ended up giving us a single location for partial cups.  Far less milk goes to waste now, and we've vanquished the mystery cups lurking in the fridge's dark corners.

We recently added a second lid for baby bottles and breast milk bags.

***Baby Toolkit hacks family life from their now slightly-less-derelict Heartland HQ.  We work to bring you up-to-the-century, completely biased observations on geek parenting.

Our (un)Resolved Life: 2011 Wishes

As 2010 draws to a close at the toy-strewn Jones Ranch, we're commemorating the year's closure by enacting a rather typical 2010 evening- carry-out food and Mythbusters on Netflix streaming.

Beyond "more sleep" and "fewer episodes of Barney" (the price of literate preschoolers operating Netflix streaming), Jim and I are waaay too tired to conjure new resolutions.

We're thankful to be spending this mundane evening with our little family at home.  A quiet night together is welcome respite.

May your 2011 be full of quotidian joys and comforts.  Peace and goodwill to you, friends, as we travel through this turbulent life.