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Monday, September 28, 2009

Do you really need a pump?

Welcome to the Carnival of Breastfeeding for September. For this month's carnival, the theme is breastfeeding and working. Please check out the other contributing bloggers linked at the bottom of this post. :D
When I found out about this month's theme, I got really excited as I’ve been living and breathing breastfeeding and working for almost 2 years now. I've written several posts on this topic, from maintaining my milk supply to making breastfeeding part of my daily life. I even have an entire series on how to set up a lactation program policy in the workplace. In my 2 recent talks for LATCH and MommySense, I gave presentations on how to continue breastfeeding even after returning to work.


I've been meaning to write a post on pumps and hand expression after I attended the Milk Code Forum but always got sidetracked. With this month's carnival theme, I decided to pursue this topic with the end goal of convincing moms that even if you go back to work, you don't actually need a breastpump to successfully continue giving breastmilk to your baby.
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The main suggestion given by numerous experts when returning to work is to "get a good quality double electric pump". Since I was not that well-informed during the early days, I immediately ordered myself a double electric pump. I used this pump fairly often when I returned to work, so I decided to get a similar second pump. I religiously expressed my milk while at work but realized that I still needed to hand express to fully empty my breasts.
Contrary to "expert suggestions," a "double electric pump" is not really essential to a working nursing mom. My friend, Pepper, had a Medela Swing (single electric pump) and a manual pump. She went back to work when her Eno was 2 months old. Guess which pump she uses? --> manual. She prefers her manual pump as she is able to control how she "milks" her breasts. Eno is now 7 months old and is still getting expressed milk from Pepper.
I also know another mother who never used a breastpump! Angie, of our office's training institute, has been hand expressing her milk at our office to give to her almost 1-year old son. She also went back to work at the end of her maternity leave (60 days) and has never used a breastpump! She manually expresses her milk by hand and it takes her about 15 minutes to fill-up a 4-ounce bottle. She still continues this method of expressing milk to date and credits learning how to hand express milk to Pam Yap-Magallon.
Pam's experience, on the other hand, was more challenging. She started using a pump at work but eventually shifted to hand expression because she could express her milk faster. You can read more about her experiences, including tips on sustaining breastfeeding while working, here.
The experiences of these mothers show that it is definitely possible to continue giving breastmilk to your baby even when you go back to work and even if you cannot buy a "double electric pump". There is a technique for hand expression developed by Chele Marmet. I was able to access her website last year but lately, it is always down. But her instructions on hand expression are also available on the Medela USA website (surprise surprise!). You can also check out instructions with images here. If you prefer an animated (but Russian version), you can check this website.
A video instruction of Chele Marmet's method of hand expression is also available at About.com and Breastfeeding.com.
Another method of hand expression was also developed by Dr. Jane Morton of Stanford University. A video of Dr. Morton showing a patient how to express milk is available here while text instructions can be read here.
Learning to hand express milk and having resources to study these methods is essential especially to a 3rd world country like ours. A double electric pump sells for at least P10,000 ($200) to P30,000 ($600) and after spending money for birth, only a few middle class moms are willing to shell out more money (one-time) to purchase this breast pump. Although savings from breastfeeding are huge, tingi-tingi or 'bits and pieces" purchases are more attractive to Filipino consumers (no wonder 10ml shampoo and 5ml toothpaste sachets are very popular!). Thus, shelling out money for formula (P1,000) is more attractive to moms going back to work, rather than spending a whopping P10,000 (at least) for a breast pump, to allow them to continue to give milk to their babies. This is the reason why at less than 2 months, almost 50% of Filipino babies are exclusively breastfed but this number goes down to about 34% at 2 months, when the mother's maternity leave ends. It is interesting to note that the Rules and Regulations Implementing Republic Act No. 7600 (The Rooming-in and Breastfeeding Act of 1992) require staff workers of health institutions to "teach all mothers, the technique of manual expression of breastmilk, especially if her infant is unable to breastfeed directly or if she shoul dbe separated from her baby for some time." (Rule IV, Sec. 1.1). However, I doubt whether this skill is indeed being taught, considering that a complete ban of formula milk, bottles and teats is still a challenge to be overcome in Philippine hospitals.
If you can afford to purchase a double electric breast pump, then go ahead. The purpose of this post is not to discredit breastpumps at all (I'm a user!) but rather to emphasize that purchasing a breastpump is not essential to successfully continuing to breastfeed when the mother goes back to work. You can still continue to express milk for your baby using your hand. And as with breastfeeding, you just need practice, perseverance and commitment to meet your goal.

Please check out the other contributing bloggers to this month's Carnival:
Breastfeeding Moms Unite's Breastfeeding At My Family Daycare
Momnesia the Book's Sorry, Facilities Guy
The Marketing Mama's Working and Pumping
Breastfeeding 1-2-3's Tips for Breastfeeding and Working

11 comments:

Amber said...

I think it's great that so many moms who cannot afford breast pumps are still able to combine working and breastfeeding. It goes to show you that expensive equipment is really not necessary to breastfeeding. And that with commitment, mothers can overcome many obstacles to breastfeeding.

Christina said...

I really appreciate your perspective, when everyone tells us that a breast pump is essential for continuing to breastfeed after going back to work. I've been breastfeeding and pumping for 9 months, and although I've tried several times (following the Marmet technique), I never got the hang of manual expression. I want to try again- thanks for the links for more guidance.

My mom had a different experience. When I was born, I was kept in the hospital for a week due to severe jaundice. My mother was committed to breastfeeding, despite the hospital nurses discouraging it. She had no idea that breast pumps existed, so she manually expressed her milk and brought it to me in the hospital. She went on to breastfeed me for two years, working part-time, and she never had a pump!

Melodie said...

I love hearing about all of the different experiences. So good for women to know, especially when low in funds, that there is another way to be successful. Congrats on another extremely educational and enjoyable post.

Sunflower mom said...

It is very nice to hear that you do not need to rely on a breast pump to express milk. I have hand expressed in the past but not with much success. Maybe I will watch the video to learn how to do it properly.

Jenny said...

thanks for your comments ladies, hand-expression is really a technique to be mastered. i'm inspired by my hand-expressing officemate and hope to be able to do it with my second baby :D

Jenifer said...

I have a breast pump Ameda ultra purely yours at my place, i use it quite frequently, I think they are really helpful! Btw, just bought two nursing sleep bras they were much needed!

Van said...

Just when I was toying the idea of stopping from expressing milk and giving my son formula as soon as I return to work, I chanced upon this post. Good to know that there are other breastfeeding moms out there in the same boat. I've been getting discouraged because I've been able to express only 1 to 2 ounces at a time - but because of this post, I've decided to continue to prepare so that my son has enough milk when my maternity leave ends!

Jenbowers said...

I love my manual pump!  I have a double electric pump as well, but don't use is much as I prefer the manual one at work.  The manual pump is just as good if not better at getting milk out and is small and discreet.  

Gladys said...

I'm pregnant with my first baby, and I have set my mind on breastfeeding once the baby arrives. Your blog, as well as the resources included, are super helpful. I have been trying to decide which pump to buy. Knowing that a manual one works just as well is a big help. More power to you! I will continue reading your posts. :)

Jenny said...

thanks for dropping by Gladys! with the right mind set and attitude, I am certain you can do it :D

Brenda Barrientos-Vallarta said...

It pays to know how to express milk by hand!!! 
I learned expressing milk by hand the hard way.  When we went to my parents' house in the province for the weekend i thought i brought the entire breastpump paraphernalia, BUT NOT, i forgot its smallest part - the MEMBRANE! I was really frustrated because i was able to bring the pump, which was  bulky, yet the smallest most important part i forgot.  Desperate to express more milk (in addition to what baby gets directly from breast), i tried to squeeze off milk from my breast!!! I was amazed because i just one sitting i was able to collect 5 ounce in 15 minutes!  

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