Written by Aubrey Phelps, MS RDN PPCES IFNCP CLC
Many parents choose to pump and continue offering their tube-fed child chestmilk, but this can come with its own set of challenges. As a pediatric dietitian, certified lactation counselor, and momma to a former tubie (for whom I exclusively pumped for over a year), I’ve seen and personally worked through a number of hurdles through which pumping parents may struggle.
One factor to consider is the way that the pump stimulates the nursing parent’s body. When babies nurse at the chest, there is a constant feedback to the parent’s body to help make that milk more appropriate for the baby. Additionally, the stimulation the chest receives from a baby nursing is, in some ways, entirely different than the feedback from pumping or hand expressing. Lactation begins with a hormone shift, starting with oxytocin, and quite frankly, it can be difficult to get that warm and fuzzy feeling when a parent is strapping themself into a cold plastic pump! Yet, without that nice oxytocin release, it’s difficult to get good milk production and letdown. Secondly, no matter how good a pump you have, the efficiency and effectiveness of a nursing baby is always going to be superior! The vacuum formed by the infant’s mouth is better. A proper latch stimulates more of the chest tissue and in several ways, not just the in and out motion of a pump. And the infant itself encourages milk letdown by cupping and stroking the parent’s chest while nursing.
To overcome some of these obstacles, I recommend the following:
1) Have the parent get properly sized for their pump flanges. Poorly fitted flanges can, at best, compromise the amount of milk that can be pumped, and at worst, actually damage the nipple and encourage clogged ducts and mastitis.
2) Consider a medical-grade pump, or at least an electric one. There are a number of “wireless” pumps on the market, but at this juncture, the most common complaint is that they’re not as efficient or effective at removing milk as their wall-plugged counterparts. For an exclusively pumping parent, having an efficient machine is going to be essential.
3) Encourage the pumping parent to pump while watching videos of her little one, smelling their blanket, etc. Anything that helps to create that nice oxytocin release is going to encourage better output. I personally found (and clients have confirmed!) that I produced more milk in less time when my husband massaged my shoulders while I pumped.
4) Chest compression/massage while pumping can encourage better milk output and fattier milk.
Implementing these suggestions, especially for parents of tubies, can really help promote a pumping situation that they can live with – one that doesn’t wear them out too quickly and one that promotes good production over time.