 By Dr. Kathleen F. McCue, FNP, IBCLC and Katie Ralls
As the customer service rep for Simple Wishes and Pumping Essentials, I wanted to share my story, in hopes of helping other mothers out there who might face similar challenges. My story begins with being diagnosed with Vasa-Previa (overlapping blood vessels next to the inside of the cervix) when I was 22 weeks pregnant, I was placed on hospital-based bedrest for the rest of my pregnancy. This story, however, has a happy ending. Baby Harper was born at 33-weeks gestation via C- Section when my liver function tests sky-rocked and I felt really sick. I intrinsically knew there was something wrong and am thankful my nurse listened to me and acted quickly. We have a voice within us that tells us what to do, but listening to that voice can be an art form, especially when we’re pregnant and everything is new. While on bedrest, I was given non-stress-tests twice a day with the plan of an eventual C- section. All in all, I spent a total of nine weeks in bed and was only able to get up twice a day for walks and brief trips to the bathroom. This was one of the most difficult times I ever could have imagined. Thankfully, with enough advanced planning, I had been given two rounds of injected steroids at 24 and 32 weeks; this helped mature my baby’s lungs in anticipation of her early delivery. I had no “Golden Hour,” where I could breastfeed my baby and be skin-to-skin, as she was whisked away to the Neonatal Intensive Care Unit so she could be given the best chance possible of survival outside of my womb. Harper was born weighting 3 lbs., 2oz. and was only 15.25 inches long. She spent her days in a NICU isolette being monitored 24 hours a day. My husband and I spent our days watching and worrying. On day three post-partum, I literally thought my breasts were going to explode. I woke up with breasts that were twice their normal size, tender and rock hard. Thanks to a class I had taken prior to delivering, I learned and remembered the method of hand-expression to relieve engorgement. Although I had access to a hospital grade pump, at this moment in time, this is what felt right to me. Hand expression. How could a hand be better than this super expensive breast pump? Am I a cow? I feel like I could fill a swimming pool but I only have little drops my first day. I think hand expression is the best thing to use, second only to the baby itself. Breast massage. Pull back, compress, release, repeat. You can use it anywhere at any time. You do not need a plug, battery, clean flanges. You always have your hands with you. It’s really interesting to know that my first experience performing hand expression involved two breasts that were NOT my own. Yep, I milked another woman. I had learned all about it in my classes with Evergreen Perinatal and at WIC where I worked for five years. How hard could it be? I had all the confidence on the outside and all the nervous shakes on the inside. My friend was in pain. She had forgotten her pump at home and we had just walked out of the Raider’s Stadium in Oakland, CA. We were making our way to the parking lot when she looked like she might cry. Can I help her?!?! Ok what did they say to do again? Massage around. Feel for lumps. Made a “C” hold. Why weren’t my hands bigger?! Ok now push back….. And compress. And again…. Push back and compress. Oh my gosh it is working! After spraying milk everywhere there was a sigh of relief. I had done it! Again, not too long after the previous incident another friend had forgotten her pump at a family party. Welp… looks like I am going to attempt this again. This time in a bathroom sink. Once again, It worked! Having said that, learning to hand express, hand expressing your friend and hand expressing yourself are not the same. When my own daughter was born at 34 weeks, I knew I needed to get my milk flowing right away. I was so hopped up on Magnesium, pain meds and morphine… … I was all thumbs…. So this is what it supposed to feel like? I was amazed that it worked. 2, maybe 3 droplets came out. Breakfast, lunch and dinner! Haha! I am joking. It didn’t feel great, to be honest as I had bruises all over my breasts which my husband got the stink eye for from a nurse later that day. Sorry about that. I knew the facts about hand expression. When using hand expression correctly you could express more milk than you could with any pump. You did not need a magic bra or a magic breast pump to express milk. My baby was too small and premature to latch and have milk transferred. It was up to me to get it going. The lactation staff at the hospital where I was admitted for observation had a video about what to expect in the first few weeks. How you could potentially go from syringe feeding (another technique rather than a bottle) to possibly breastfeeding directly when the baby was “ready”. Unfortunately, my baby was not cleared to breastfeed until she was 6 months old due to silent reflux (a danger for aspiration). Her epiglottis was under-developed which caused her to inhale thinner liquids. This was heartbreaking. As the months went on I used hand expression in many different circumstances. If I forgot my pump, if an outlet was not available, in the shower for comfort, to release plugged ducts, to express milk into my baby’s eye if it had discharge (it happens). I will be forever grateful for the knowledge I had and the confidence that was built by my experiences and training. I believe every mother should learn how to hand express for these very reasons. I remember using a video clip that was on the Standford.edu website to encourage many moms to use this technique over the breast pump. The method is to start with clean hands and sit down in a place where you can relax and get comfortable. By the way, this should be the case whether you’re nursing, pumping, hand- expressing, or simply holding your baby. You need to build a nest of sorts. Gather a container to catch your milk, then gently massage the breast your expressing in a circular motion from chest wall down to the nipple. Heat can also be an added benefit. In order to stimulate your let-down (a reflex that starts the milk squirting out of the nipples), you’re going to need some rolling of the nipple between your thumb and index finger. You will then place your thumb on the top of the areola (the edge where the darker color ends and your breast begins) and your index finger at the bottom (same placement). Spread the skin back toward the chest wall, squeeze in and gently but firmly pull, aiming the nipple into the collection container. There is a sweet spot that you will have to find. Some moms find that the area needing compression is either closer to the nipple or further back on the areola. It will take practice. Remember, they’re not faucets! You will get faster with practice and yield more milk as you gain confidence.  Thank you Jamie, for sharing part 2 of your journey! I want to tell you all about my breastfeeding journey. My daughter turns 1 in approximately 24 days (but who’s counting!?). Before even becoming pregnant I always knew I wanted to breastfeed and pump. Just hearing stories from my mom and other women in my life, it seemed like such a special bonding time and how cool to be able to provide something for your baby that quite literally keeps them alive! As my due date approached, I began to give this more thought and was preparing myself for the possibility of it not working out. I tried to go in with little expectations. Breastfeeding My baby girl was born July 8, 2017, and it was truly love at first latch. Those first few weeks were definitely challenging in the nursing department though. For one, you’re feeding around the clock and each nursing session was taking a long time. We were both getting used to this new concept. By the time she finished nursing, it was almost time to do it all over again. I finally understood what cows being milked feel like! And I don’t care what anyone says, it hurts! I was fortunate, however, to have had the amazing guidance from Metropolitan Breastfeeding from week 1. Although things were going well, I had wanted a professional to literally just watch me nurse and make sure we were set up for success. Pumping The real fun began when I started pumping. My only prior experience with this was when I had seen my best friend pump when she had her first baby a couple years prior. I couldn’t get that image out of my head – her on the bed, hooked up to wires, bottles and a machine, nipples protruding 3 inches out, and a loud pumping noise, with milk filling the bottles 2 drops at a time. Every ounce deserved applause. I knew that would come with nursing because I was headed back to work at 4 months and would need to keep my supply up for my baby while she was with her various caretakers. At the advice of doctors and friends, I started my pumping journey at about 2-3 weeks postpartum. I had a lot of anxiety about pumping. The idea of it overwhelmed me. How to use the pump, how long to do it for, was I getting enough, the storage of the milk, thawing it, heating, etc. Little did I know, I would become the pumping pro. I was doing it around the clock to store enough for the future and so my husband could have his bonding time with our daughter to give her a bottle when he got home from work (and so I could have a break – only to clean bottles). My IBCLC always reminded me to “feed the baby, not the freezer,” but I couldn’t help myself. I was obsessed with having a solid freezer supply. Liquid Gold There were also several times where I quite literally cried over spilled milk. You may have heard the term “liquid gold.” It’s a real thing. Breastmilk IS liquid gold and if even a drop spills out during the dreaded transfer, it’s very upsetting. It is OK to cry and get frustrated. Let out a big scream and then let it go. You will make more. That also leads me to pumping and dumping. I luckily only had to do it a few times, but it was a few too many – it killed me to watch it swirl down the drain into the abyss. But again, it’s probably for good reason. You needed a drink, and you deserve it. Back-to-Work Going back to work was stressful for so many reasons, but one of them was figuring out my new nursing/pumping schedule. I am an event planner, so I knew I would have to use my professional logistic expertise to make this nursing/pumping thing work, for a year, which was my goal. I am almost there (pumping as we speak)! Throughout the past 11+ months, I have said numerous times to my husband that I feel like I should write a book about all the places I’ve pumped. When mentioning this to my IBCLC, she encouraged me to blog about it. So here we are, but maybe one day you will find my book in Urban Outfitters or something ???? So, here’s to us women. We are incredibly strong, powerful, resilient, and will do whatever it takes to keep our children happy and healthy. I feel so honored to be part of such a remarkable tribe, that of Motherhood. It’s only been 11 months so far, and counting, but I am looking so forward to many more chapters to this crazy novel and to continuing this amazing journey. Thanks for reading! -JK P.S.I couldn’t end this post without attaching a few photos of my breastfeeding and pumping journey. I have had the support and encouragement from friends and family and the constant reminder that no one is looking or watching me, which I still don’t necessarily believe, but if a child needs to eat, you gotta do what you gotta do! Oh, and a huge shout-out to my Udder Cover®, which has helped protect me from all those wandering eyes, and now causes my daughter to pant whenever I break it out! Pumping on a boat on a bachelorette party! (left) Pumping in a public restroom. (middle) Pumping in another public restroom! (Right)
 We’re excited to share the first of two blog posts by Jamie Kramer, mom of Molly! Thank you Jamie!
As I sit here writing this blog post (my first ever!), I reflect on the past 11 months of my life. These have been the craziest, strangest, most exhilarating, joyful, weirdest, most frustrating, happiest months. Now you might be thinking: how can something be the most frustrating but also the happiest time? Readers, I introduce you to parenthood. I wanted to pay my experiences forward to others as I am so appreciative to all of the mothers who blogged, Instagrammed, Facebook posted, called, texted, or emailed me their advice which helped me through my first year as a new mom. So, thank you to Metropolitan Breastfeeding for providing me with this forum to do so. Things I learned that every expecting parent should know
My biggest advice to all new moms out there is to enjoy the journey. There is no “destination” per se in having children. Your ultimate goal of course is for your kids to be happy and healthy their entire lives. But, in my mind, it’s the journey that counts. It’s those memories that your kids will look back on, we hope, with smiles. And even in those earlier years where they won’t remember much, we will. So, try not to sweat the small stuff. Have fun with it. Having babies is an exciting journey and whether you are doing it as a single parent or with a partner, remember to stop and laugh every once in a while, because dirty diapers, baby giggles, delirium and baby gibberish ARE funny!  Note: Metropolitan Breastfeeding is now a Washington DC metro area depot for the NY Milk Bank. Here is information on four easy steps to becoming a milk donor
Have you ever wondered how and why a mother would choose to feed her baby another woman’s milk? And just who was the milk donor? Olivia and Stacy share their story with me and you, our readers. I hope this inspires other of you to help other women and their children in those early critical months. Olivia Ellis: Because of breast reduction surgery, I was unsure if I would be able to exclusively breastfeed. My husband and I were hopeful that our son would be able to receive all the benefits of breastmilk even if he couldn’t breastfeed from me. My doula, Ursula suggested I collect frozen breastmilk to have on-hand in case my milk did not come in. And luckily, she had been recently contacted by one of her previous clients who had a surplus amount of breastmilk stored in her deep freezer and wanted to share it with another mom. Stacy Swayze: About three months after I gave birth to my son Jack, I contacted my doula asking if she knew anyone who may need milk, she reached out to Ursula who subsequently connected Olivia. As I originally understood the situation, a soon to be new mother who was also a client of hers was going to need milk for her new little baby boy. Despite the difficulties, it was crucially important to her that he have the chance to benefit from breast milk, if not by her, then by any source that would allow him to receive those benefits. Having developed an understanding of how much of a benefit breast milk truly is for infant health, I wanted to do whatever I could to assist. I didn’t even need to think about whether to say yes. As I was having no problem with my own supply, I had already been planning on donating the steadily building excess to a milk bank. When I had the chance to instead help a little boy whose needs I learned of first hand, there was really no question that it was the right thing to do. The fact that I was able to make a true, meaningful connection to through this process made the decision to donate that much more important to me. I learned that the little boy’s name was Hugo, and I was glad to learn that he took well to the milk I provided to Olivia. Read the rest of the story at Birth You Desire! Have you ever donated breast milk? Have you provided your child breast milk from a donor? Share your story with us today! We love spreading awareness of milk banks!  Introducing Newborn to their Siblings
Introducing your newborn to their siblings can be an exciting time, but also ushers in a new family dynamic. Metropolitan Doulas has some great tips for how to make this transition a smooth one:
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