As many of you know, I exclusively pumped for our first son for 13 months after breastfeeding didn't work out in the early days. Exclusively pumping took about 3-6 hours each day and required huge sacrifices. Most of all, I remember the very early days when Ellington would be crying for milk in another's arms while I feverishly tried to pump for him. I remember how when I would hold him, he would be hoping to latch, but the pain was so severe I would hand him to another person to provide comfort and distraction. I do not regret my decision to pump, but when reflecting on that journey, I have decided to take a different path this time.
Our plan is to give direct breastfeeding the best chance it has; to create a supportive atmosphere and establish a good milk supply. And if things are as difficult as they were the first time around, to allow myself more grace than I ever have, and use formula exclusively.
When I announced my second pregnancy, so many of you reached out to ask me about my breastfeeding plans, that I thought I would share the (very detailed) plan here:
Birth Goal: No Separation
We are working with our homebirth midwife again for prenatal and postnatal care. However, because I had a c-section the first time, neither of us feel comfortable going with a homebirth this time around. We are planning a hospital birth, and while a VBAC would be preferred, the #1 priority is that my baby stay with me post-birth. I want immediate skin-to-skin for at least an hour, ability to latch right away, and then as much skin-to-skin with baby as possible in those first few days.
In order to preserve that priority, there are circumstances in which we would elect a repeat c-section. So we are coordinating a baby-friendly c-section with our hospital in the event it is needed. I am stocking up on my favorite Solly Baby wrap to help with skin-to-skin and planning to bring one to the hospital.
I remember heading over to the NICU to feed Ellington for the first time. It had been almost 9 hours since his birth and I had not even received the pump I had requested yet. The nurse helped me arrange him, I simply stuck my nipple in his mouth and then the nurse walked away. It hurt, but I assumed it was supposed to. I also just figured I should let him stay there as long as he wanted.
45 minutes later, the nurse returned and told me to take him off. Oh the horror. He had clearly latched incorrectly, and my nipple was raw and bleeding. Afterwards, it hurt too much to latch him so I started pumping.
I have learned so much about proper latching now. It is hard to learn before you're really in it, and of course every baby is different. This time around, I plan to have lactation consultants (the hospital has them) help me with the latch early on, and be proactive about any pain I have.
If First Latch is Delayed, Pump
If for any reason the first latch is delayed, I plan to pump right away. After they nurses set me up in my room, they just told me to sleep and left. Since my legs were numb and they hadn't given me my phone, I couldn't do anything else FOR HOURS.
Note: For this reason, we will be bringing another person to the hospital with us in addition to our midwife as we did not do that last time. Our midwife will act as our doula and stay until 2-4 hours after the birth. I plan to have someone come when she leaves if I am not with baby in order to advocate for me (my husband goes with baby to advocate for him).
After I slept an hour, I pressed the call button and requested to either see my baby or be given a pump. I was told they would find out if I could go see him. Hours passed, and even though I kept calling them, no one came. My Spectra S2 pump is a hospital grade pump, and got me through 13 months of pumping a full supply. I will be bringing it and all the supplies (including cleaning supplies) and my hand pump with me in my hospital bag. Whoever comes with us to the hospital can assist me in pumping if needed without needing to rely on the hospital to bring me a pump.
The reason for this is to help establish a supply. For reasons we will never know (and may repeat), my milk took 5 days to come in on one side, and 10 days on the other side. I am very open to using formula to fill the gap as needed, but would like to encourage my supply to come in!
This is a weird one, but I am going to put it out there in case anyone else has experienced the same thing. When I use lip balm with beeswax, my lips react and get super red and itchy. I can eat honey and use it on other parts of my body just fine. Well after breastfeeding Ellington, I put the nipple cream I had with beeswax on and had a horrible reaction.
So I will be using nipple cream without beeswax - luckily Earth Mama just came out with a vegan beeswax-free version!
No Guests for the First Two Weeks
Ellington is the first grandchild on both sides and the first baby in our family in a bit, so everyone was excited to meet him. Within hours of getting home from the hospital, there were 9 people in our small home. Besides recovering from major surgery, my milk still hadn't come in, I was still pumping, trying to breastfeed, and get my bearings. Everyone wanted to hold him. I would pump alone in the bedroom, while Ellington was out in the living room with my family. I remember feeling so lonely, and just wanting to grab him and never give him up.
This time around, I plan to hunker down in our home and do as much skin-to-skin with the new baby as possible in the first two weeks, feeding on demand. I don't want to be conscious of who is in our home (its only 1050 sqft!) or frankly, give up skin-to-skin/bonding so others can have a chance to hold him. I just want to soak in my baby.
We have decided that while family may quickly meet him in the hospital, once we are home, no guests. My parents and husband will watch Ellington mostly outside of our home. So I will just be turning on the heat, and cuddling with baby #2. I may make an exception for my mother if I need help preparing meals and taking care of myself postpartum.
Induce an Oversupply
Everyone has an opinion on this, and you need to do what works for you and contact a lactation consultant if necessary. The advice I received for Ellington was that your milk will come in around day 3 and you will be engorged. A baby usually takes 24-30oz milk/day. You will have way too much milk, and you'll need to let your body down-regulate. Because of this, don't pump until 6 weeks.
That is not what happened for me.
My milk came in late. I was never engorged and it very slowly built up over time not peaking for months. At my peak, I pumped 32oz/milk per day. Ellington drank 30-40oz per day, even with paced feeding. He was a big baby (and is now a big toddler!) and just needed a lot of nutrition.
So this time around, I plan to induce an over supply. Here's how:
Eat a lot more! See more details on this below.
Pump after feedings as necessary, especially when baby only feeds on one side or I feel a breast is not empty. Emptying the breast tells your body to make more milk. Through exclusive pumping, I know when there is still milk in my breast. I will probably just use a hand pump at first since I can do this while holding a baby, and save all the extra milk. We may give baby an additional bottle of my milk during the day if we feel it is necessary since I usually make way more milk overnight. In the event of a supply dip or the decision to wean, I will have extra milk.
I will also consider pumping as baby drops night feedings. Ellington did not drop any night feedings until 5 months old (and did not drop them altogether until 8 months). But if this baby drops them earlier, I may pump to keep supply up. This will be weighed against the need for sleep, so I will assess then.
Supporting my Supply: Food + Supplements
Google how many extra calories a woman needs to breastfeed and you'll find the common response is 500 (as compared to 300 extra calories while pregnant). But if you've ever experienced breastfeeding hunger, the idea that only 500 extra calories is enough to keep you satisfied is laughable.
I eat intuitively and do not count calories, but when your hunger changes so drastically overnight, it can be hard to trust your intuition. So if you're like me, and sometimes the numbers help, let me say this: The calories in any ounce of breastmilk differs based on its fat, protein and carbohydrate content, but the average I have seen is 20 calories/ounce. So 500 extra calories per day would make about 25 ounces of breastmilk, an amount that would be great for some babies! However, with a baby needing more or when trying to save extra, a mother may need 800-1000 extra calories per day (40-50 ounces of breastmilk).
On top of this, women recovering from childbirth and going through the stress and sleeplessness of those newborn days will need more calories, especially from protein, to heal and support the hard work their bodies are doing.
All this to say, this time around, I will be eating as much as my body craves and not second guessing it. The first time, I simply underestimated my needs and did not stock up on enough quick snacks for between meals and night feedings. I also did not include as much fat and protein in my diet as I needed.
This time, I am planning Thanksgiving-size meals for myself and will be stocking my freezer, pantry, bedside table and baskets with even more options! I also had success with Legendairy supplements last time around, and will be stocking up on those if my milk supply could use a boost.
The first time around, I thought if Ellington got too attached to formula and bottles, our breastfeeding journey would be even harder. Reality was that formula helped bridge the gap until my milk supply increased. Even so, I tried to limit our use of it and stressed over trying to produce more and more milk, trading even more sleep for pumping time. Two things that don't help milk supply: stress and lack of sleep.
This time, we will have formula stocked in the house before baby #2 arrives. If we need to use it, I will not feel guilt around it. I recognize formula as not only a means of feeding my baby, but also a tool that could potentially increase the amount of breastmilk my baby gets. Seems counterintuitive, but that is what may work for us!
I know that was a long post, but I hope it was helpful to any of you preparing for a breastfeeding journey. Know this: breastfeeding is a magical part of motherhood. But so many other parts of motherhood are magical, and you don't lose out on any of the magic by not breastfeeding. You and your baby will bond and grow and thrive. Being prepared doesn't mean being in control. Breastmilk isn't the holy grail. Because when it comes to mothering, there is no holy grail.