Nature never planned ahead for pumping. The pump isn't just sucking the
milk out-- it's stretching and stimulating the nipple to trigger the
oxytocin rush of a let-down, which can be blocked by stress hormones.
Some people are natural-born pumpers, while others need to find their
tricks to letting down milk to equipment. I described this quandary to
one mother, and left the room for some reason. When I came back, she
was cradling a teddy bear, and milk was flowing to the pump. It seemed
that her body needed the cue of something cute and soft (albeit furrier
than her baby) looking expectantly up from her arms. Parents are so
ingenious!
Once someone has faced disappointing pumping sessions, it's hard not to
enter subsequent attempts in a defeated, stressed state. Pumping can be
very stressful, as it wraps up primal fears about your baby being hungry
with this unpredictable technology.
So, yes, because pumping parents have very individual reactions,
continue to experiment with the speed and suction settings, flange sizes
and shapes. The current trend is toward smaller flanges, and sometimes
that tight focused pull is helpful, but also try larger. (Paula Meir's
research from way back -- and is there anything more recent? -- found
that a big percentage of pump-dependent parents did better with the
27mm)). The newer product of soft silicone "nipple cushions" may help
if someone has very stretchy nipple/breast tissue.
The hands-free rig is helpful, and as someone said, try a stretchier
bra, a homemade version, or unzip a little at the top, so the pumper can
reach in and periodically be very hands-on. Try putting a warm gel-pack
inside the bra.
But hands-free, they can also ignore the pump sometimes, and be
distracted and watch happy movies, read a trashy novel, and eat and
drink hot,( and favorite) foods, not staring at the bottles. (There were
Internet pictures of people putting a cute baby-bootie over the
bottles). Or get something else done, if it makes them feel productive
and happy. Try pumping in complete darkness, or by candlelight -- very
hormonal! Put on earphones with favorite music or an audiobook so they
don't hear the pump grinding away.
Try feeding the baby on one side while pumping the other side. (Kathleen
McCue's "Clinical Lactation" article had one idea for hands-free
"parallel pumping,"https://connect.springerpub.com/content/sgrcl/10/2/68
Or at least holding the baby skin-to-skin if one is exclusively
pumping. See if the cute baby triggers the let-down. Perhaps seeing
some milk flow to the pump will create more positive feelings for this
tool, that the parent probably views as just a source of frustration.
Our work has become very pump-focused, (and let's keep celebrating what
parents can give the baby with the normal act of breastfeeding too).
But families often have to rely on this tool to maintain their nursing
relationships in the modern world. So it's difficult that these
products are not a well-regulated piece of medical equipment where we
can look at a lot of independent research.
Good luck to all.
Margaret Wills, IBCLC, Maryland
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