This has possibly been one of my most requested posts in recent months. How I expressed, how I built up my milk supply, what pump do I recommend, how many times did I express, how did I store my breastmilk. Lots of questions.
I’ve expressed with both children. Neither time was it something I particularly wanted to do. With Bill, I knew I would be returning to work by the time he was eight weeks old. Prior to him being born, I said I would probably breastfeed until that point and move onto formula. But breastfeeding went really well for us. He thrived and fed really well. And I didn’t want to break that relationship so soon. So I expressed every day at work until he was six months of age, which fell around Christmas time. I weaned off those feeds, as he was weaning onto food anyway, and we continued to feed during the morning before work, when I got home, through the night, and at weekends, until he was 18 months old. I wrote a post on my advice for expressing at work, which might help too.
With Daisy, I was ecstatic about having nine months off. I could breastfeed and probably only touch a pump for special occasions, or to build up a bit of stock in our freezer. I always knew there was a chance she could be born with a cleft palate, as she had a 50% chance of getting my syndrome, and a cleft is common as a part of it. After all – that’s exact how I was when I was born. But having had a child previously, with no problems, I suppose I just let myself think it would be fine.
And Daisy was indeed born with my syndrome, and a cleft palate, which means that she can’t create suction in her mouth, as air escapes quite easily through her nose. We actually realised Daisy had a cleft when trying to establish that first breastfeed. She was distressed, didn’t latch and I remember thinking her mouth felt weak when she did – but that’s because there was no suckle.
And I remember, when the midwife confirmed it, I turned to Mark and said: “I can’t breastfeed her.”
I was gutted.
Choosing to express
I have added this section because, honestly, I have to be blunt and say that you really have to want to do this. I am not going to tell you that expressing is a walk in the park, because it isn’t. I don’t feel like that is said often enough. There are plenty of pieces of advice online, including mine, but not enough is said to prepare mothers for what lies ahead. There are very few perks, but they are important ones. Which I will list later on, as well as the cons, so you can weigh up whether it is right for you or not.
Either way, you have just had a baby. Maybe they are in special care right now, like mine was. Maybe they have a bad latch and you’d like to build up your supply while you fix it. Maybe you think you have a low supply and want to increase it. Or maybe you would like some stock for a rainy day, or weekend away.
Just make sure this decision is right for you and is not one that you have been pushed into, that makes you feel down or unhappy, or is something you feel like you have to do from guilt.
I want to express (maybe that pun was intended) how important your mental health is, and how a fed baby is all that matters.
What you will need
If you have decided to express breastmilk, there’s a certain amount of kit that you’ll need to do the job. This is what worked for me, so comes well recommended, but there are some variations and you’ll no doubt customise it to suit your needs, which is exactly what you should be doing. I have included links throughout for those things I used, if that helps.
A breast pump – I will go into the ones I used below.
Some storage bottles – I loved these ones by Medela – 250ml size and 150ml size. These are great to pump straight into, as well as store feeds in the fridge. If you buy any, buy the larger size, as your supply will soon increase, as will your baby’s feeds.
Some milk storage bags – I used Medela ones, Lansinoh ones, and some that I had left from my time expressing with Bill, which can’t find online. Boots also do some too, but I found buying the Lansinoh ones from Amazon to be the best deal, financially.
A small cooler bag – my mum actually gave me a branded one from my dad’s work that was for packed lunches, but this is great for transporting milk about, if you are going to and from hospital, as well as doing feeds out and about once baby is home, if that applies to you. Something like this would be perfect.
Muslin cloths – you will most likely have these for baby anyway, but they are great for tidying up, catching any drips, and, to be honest, drying yourself off a bit. I actually really rate the Primark ones you can get for softness and value. But I’ve used a huge range.
Lansinoh HPA Lanolin Nipple Cream – You still need this stuff in the early days and I learnt the hard way.
Breast pads – I like the Lansinoh ones best. Try and look out for deals online. I bought mine from Mothercare in a baby event I think.
A good nursing bra – I liked my Bravado Body Silk Seamless Yoga Nursing Bra best.
Steriliser – I used the Milton cold water steriliser, as that is what was used at my hospital and I wanted to continue that at home. What I love about it is that you change the water once a day, but you can just clean and rinse any bottles and pump parts and chuck them in, and just take them out when you next need them. No waiting for an electric or microwave steriliser to do it’s thing, or waiting for things to cool down either. Here is the Milton cold water steriliser, and here are the sterilising tablets.
More about my breast pump
Prior to having Daisy, I was offered the chance to review a Medela breast pump. I had used another brand of breast pump last time around and, while it worked, it broke twice, and it wasn’t incredibly efficient. So I obviously said yes, because Medela are the number one choice in hospitals (more on that in a moment) and I had honestly heard that much about them that I felt like I was getting the best product out there.
I chose the Medela Swing Maxi Double Breast Pump, which meant that I would be able to express both breasts at the same time – something I had not done before.
Now, I will do a full review at a later date, but I liked this pump for three main reasons:
- You can use batteries – I know a lot of pumps now feature this, but I felt like this pump still worked just as efficiently with battery, as opposed to mains supply. I loved having the choice of both, and I used this pump in the car on the way to hospital (sometimes time can be tight), in the garden (covered by a muslin – we had just got Daisy home and the sun was shining and after six weeks being cooped up in hospital, I wasn’t going to miss a moment), and I also used it in hospital if the hospital pumps were being used by someone else.
- The functions – Two boobs in one go means less time pumping, and this is so efficient. It has a variety of levels too, which I like as I find my boobs like the suction to be quite strong, and the cycle quite fast. And having that choice was a huge help. I also liked the fact that it had a suckle action at the beginning, that mimic a baby’s first suckles, which I remember well from Bill, and this really does set off my let-down quickly.
- Hospital approved – The first pump I used in hospital was a Medela one. The Medela Symphony, which is a double pump on wheels, that could be attached to your own set of pump parts. There were around two or three on the ward, and all the mums would share them. And I loved that pump, for how efficient it was (do use it if you have one available to you at hospital) and for what it represented at the time. But my point is here is that the Medela bottles and lids are universal with the disposable bottles that the hospital provides for expressing mums, so they all fit together easily. And I felt like going from one Medela machine to another was convenient for me and effective too.
Pros about expressing
I’m putting the pros and cons next, so you can get a feel if this is for you, before reading about my schedule and tips. There are only a few pros, I find, but they are important ones.
- Breastmilk itself – I am not going to spout a load of breast is best nonsense at you, because I was formula fed (as I had a cleft too and pumping wasn’t available to my mum at the time), and my daughter is now on formula. But there is the small fact of breastmilk being the best for your baby from a nutritional standpoint. As well as the various antibodies etc. And I can’t deny that fact. It’s the main reason I chose to express for as long as I did. I wanted Daisy to have my milk while she was at her most vulnerable.
- Purpose – This may not apply to everyone, but when your baby is in special care, in an incubator, and you can’t hold her, or give her the care she needs, expressing gives you a purpose. It gave me one at least. I would feel like I was still her mother, and I needed to feel like that at the time.
- Pride – You’re allowed to be proud of those bottles of white stuff sat in your fridge, or the bags collecting in your freezer. You worked hard for that, and it’s a great feeling.
- Feeding – I actually found grabbing a bottle of pre-measured breastmilk so much easier than the scoopy, powdery formula faff. And I still miss those days. I have some frozen milk in my freezer, which we use on occasion (I’m saving it for weaning) and it reminds me how simple it was to grab and go!
- Convenience – If you are expressing for, let’s say, ‘recreational reasons’ then it’s brilliant. You can have a drink. You can go out. Have some freedom. And that’s good for you.
Cons about expressing
- Pain – Initially, like a baby would, my nipples were sore. But actually worse than when I breastfed Bill. I had several blisters and the suction of the pump would make me wince. And that was hard, because there was nothing keeping me going in those early days, as I was feeling so low. It’s not like I could look down at my baby and feel determined. It was really painful. I also found I didn’t look after my nipples as well as I did with Bill, as I was in control of pumping times and wouldn’t even think to apply nipple cream.
- Time – I would pump, initially, eight times a day, usually for around half an hour, if not more. That is at least four hours of my day, not counting the additional time spent bottling the milk up and sterilising things. And then I had to feed her. If you have more than one child, you will know how hard this would have been. I felt very stuck to a schedule and extremely time-poor.
- Lack of flexibility – If I needed to pump, I would need to rush home. If I needed to pump, I would have to hint at people to leave. If I needed to pump, I would need to wait before we left to go out for the day. If I needed to pump, I would have to ask Bill to wait a second. I would have to hope my baby stayed asleep. I would have to wake in the middle of the night and sit there on my own in the dark, trying not to fall asleep, which I did sometimes. I was the pump’s bitch in all honesty. I couldn’t do anything unless it fit with timings and I found that incredibly hard.
- Energy – It took a lot out of me, but that was, in part, combined with the responsibility of two children, one of which had additional needs at the time. So I was very tired. I was also staying up late to express, waking at 3:00am to express, and getting up again at 6:00am to express. That was extremely tough. And you don’t realise the impact that it has on you sometimes.
- No bond – It’s not like breastfeeding where you look lovingly down at your baby. Or the 3:00am feed isn’t so bad because they are there, clinging to you in the dark, and you know they need you and that you are making it better. I never felt that. I felt empty. And I had to remind myself why I was doing it, often.
- Frustration – I was always anxious, angry, frustrated. I would worry about my milk supply on a daily basis. And that stress didn’t help the matter. I would get frustrated when I had health visitors or community teams due to visit. I would want them to leave me alone, because they would come and I would sit there with rock hard, leaking breasts, hoping I had remembered to put breast pads in, while they spoke to me and I would try and concentrate. It changed me as a person for a short while.
- Double the work – As Daisy is also tube fed, someone once remarked to me that it’s like having triplets. I express, which is the time for one baby, I bottle feed, which is the time for the second baby, and I tube feed, which is the third. It’s the worst parts of breastfeeding and formula feeding combined into one.
Building up your supply
Now for the nitty gritty stuff. I built up my supply to quite a decent amount. But please, before you start to think that is a target, don’t. We all have different capacities, and any breastmilk is great. You are great for trying. Great for choosing to do this. That’s enough.
When I was in hospital I was told three key things:
- Try and pump initially between 8-12 times a day, as that is usually how often a newborn would feed. This tells your breasts to encourage your milk to come in and aids production.
- Make sure you pump every day at some point between 2:00am – 4:00am. This is apparently when milk production is at it’s best, and can have a positive impact in the amount you produce.
- Rest, eat and drink. An obvious one, but you know how easy it is to forget.
So that is what I did. I spent five days in hospital in the end, before discharging myself. My mental health was at a low, after too much time spent watching other mums have their babies and go home, being woken by other babies in the night, when mine wasn’t there, and missing my boy. But I have to say that, in hospital, all I did was sit by Daisy and pump. There was nothing else to do, so those first days set me up well I think.
My milk came in around day four or five. I remember the fullness, and because of my preparation I was able to get a good few ounces off every time once this happened.
I would down bottles of water. Constantly. I would pump through the pain. I would try and rest, but I actually struggled with this, as I would either pump, or go and see my baby and do her tube feeds. I would try my hardest to be everything to everyone and that was particularly exhausting.
I always did that 3:00am session. And only dropped it when I decided to stop expressing. That’s how key I felt that was.
What else would I do? I would make sure I was comfortable. Once I was at home, I had a special spot on the sofa that would mean I was comfy, and the pump could be plugged in. And I would have a book on the go, a bottle of water (I love this one as it reminds me to keep drinking throughout the day), a snack, and my phone for social media or YouTube videos. I tried to make it as enjoyable as possible for myself. Though that was often hard at 3:00am!
I would also call this time ‘quiet time’ once I was home, and I would try and coordinate this time with Daisy having a nap, and Bill having some time out on the iPad. So he wouldn’t wake her, and he was happy as he loves a bit of iPad time, watching animal videos. Do what works for you.
A big part – the key part for me – in building up your supply is to encourage additional production. I gave myself an oversupply on purpose. Why? Three reasons.
- To stay ahead of Daisy’s needs. She would move up tube feeds as she gained weight. I couldn’t predict this, so I would make sure I had enough to always satisfy her needs from the get go.
- To build up a supply in the freezer. This is similar to the above, but I have stopped expressing now for two weeks, and I have an abundance of milk in my freezer, ready for when she’s poorly (extra benefits for her) and weaning.
- To take the pressure off. In the early days, I was making triple what she needed really. And it meant I didn’t have the added worry of panicking about how much I was making. It was a big relief.
So what I did is I would pump an extra five to ten minutes after my let-down(s) had ended for that session. I would sometimes get a few drips here and there, but it was mainly so I was signalling to my breasts that they needed to produce more next time. And so they did. And I kept doing this for the first six weeks, until it became harder for me to fit in.
I would also try breast compression, where I would firmly, but gently compress my breasts to encourage them to completely empty too.
Pumping schedule – month one
Here is my schedule that I followed for the first four weeks.
I would pump at 3:00am, 6:00am, 9:00am, 12:00pm, 3:00pm, 6:00pm, 9:00pm and 12:00am. I would do it for around half an hour each time. Or more if I felt my supply had grown and I wanted to encourage it. It was hard. Very, very hard.
But it was possible as I would go to hospital every day. And I would devote my time there to pumping, next to Daisy’s incubator, and later, cot, so I could be close to her. Your hospital should have screens that you can use to protect your modesty. I found a muslin to work best, and only used the screens to stop others feeling awkward.
I will point out that my little boy was in nursery for three days a week still at this point, and my mum would have him the other weekdays, so I could express this way, while at hospital.
Amount produced – 5oz in the first couple of days, 15oz once my milk was in, 40oz, by week four.
Pumping schedule – month two
3:00am, 7:00am, 11:00am, 3:00pm, 7:30pm (slightly off due to Bill’s bedtime) and 11:00pm.
This time I would express for longer, 45 minutes to an hour, again to encourage production, but mainly because I couldn’t manage the earlier schedule anymore. By this point, we were travelling to Manchester every day – about an hour there and back – as Daisy had moved hospitals and I just couldn’t fit it in like I used to. I found this adjustment so hard. But still I was producing the same amount, just more milk, and less sessions.
Daisy came home in week six, and those fewer sessions meant that I could devote more time to her and Bill too.
Amount produced 35-40oz.
Pumping schedule – month three
This was the month that broke this camel’s back. Life was getting more routinely. The support was less, rightly so, as I was home and doing well. But I had come to rely on that support to get things done, and I needed to work out a way on my own. Life had to move on, and I needed to as well.
I began expressing less, and I found, after the stressful time at Manchester hospital, and the various medical battles we were fighting, my supply took a big dip. And was more at the 35oz mark. Which was still more than Daisy needed at the time.
But as life carried on, and I had to do nursery runs, feed Daisy on my own (as Mark had gone back to work), and manage a house, I had less and less time for expressing. And less and less time for me too.
One week, like this week ironically, I had a medical appointment every day, and I was so frustrated by people putting me off my schedule. I was obsessed. Stressed. Anxious. Worried. And my supply kept dipping until it was around 30oz. At this time, Daisy moved up to around 32oz. Which is where my frozen stash came in useful. And I did have some relief from the panic. But it was just becoming a constant battle of express, feed Daisy, play with Bill, try and get housework done, have medical appointments, try and get out the house, do nursery runs.
Then Bill finished nursery for the summer – he starts school in September – and I decided that, really, I wasn’t coping. I didn’t want to tell my son to wait anymore. I wanted to play. I wanted to live again. It sounds dramatic, but I really did feel down and…trapped?
So I made the decision to wean from expressing. Which brings me to now.
Amount produced – 35oz, then down to 30oz, and then I stopped at three months postpartum, and my stash lasted until Daisy was around four plus months.
I made the decision that was best for me. I did it with my health in mind, which was hard to prioritise. Us mums are used to putting our children first. But for me, I knew I would be a better mum if I had more time, and if I was happier. My children needed a mother, not a cow.
I can do a post about how I stopped expressing, and how I weaned Daisy onto formula sometime soon, if you would like it and find it useful. Let me know if so, and I’ll prioritise it.
I know how hard this is. I know it feels impossible. I know you will spend a lot of time wishing that breastfeeding worked out, or was even possible.
Expressing is a wonderful chance to ease your guilt, and to give your baby an extra boost, or just to give you a break from breastfeeding all the time. It’s not easy, but it is worth it. I would definitely do this again if I had to for a third baby. But not without understanding that challenges lie ahead.
But, ultimately, I feel so very proud of myself. I managed what I managed. And I did what I could for my daughter when she needed me the most.
And you can’t say fairer than that.