Everyone knows that I am a huge supporter of nursing. I've written about it here and here. What many people may not know is that I could never have had a successful nursing journey with Julia Grace if I had not been encouraged to pump within the first six hours after her birth. My daughter, like many babies with Down syndrome, was sleepy when she was first born. She had an excellent latch but a weak suck and an uncoordinated "suck-swallow-breathe" cycle, which is key to helping babies breastfeed successfully. As a result, she would easily tire herself out and was not getting enough calories to sustain weight gain. One of my dreams of having a child was to have a breastfeeding relationship. I wanted that experience for her, and for myself. I was very, very lucky to have a team of supportive medical professionals to encourage me because despite my deep desire to breastfeed and my background in maternal-child health everything was hard in the beginning. I was exclusively pumping and trying to establish my supply as a first-time mom so I pumped 10-12 times a day and I was *exhausted*. I was constantly worried about my supply and if she was getting enough and if I was doing the best thing for my baby. I wondered how long I could keep what essentially felt like a full-time job (I once calculated that I spent over 40 hours each week feeding my daughter, pumping, and cleaning all of the parts).

In many ways, I felt like an outsider in the breastfeeding community. Was I really breastfeeding my baby? I didn't feel like I belonged in a traditional lactation group; I worried about consulting an ILBC because I didn't want her to tell me it wasn't possible (that fear was unfounded, by the way, the ILBC's that I worked with were phenomenal); I felt alone and even though there are groups dedicated to supporting breastfeeding and pumping moms of babies with DS, I didn't really feel *connected* to any of them. I shouldn't have felt alone because our research shows that as many as 70% of moms of babies with Down syndrome have to pump at some point during their baby's journey, either to establish their supply while their child gets strong enough to direct nurse or while preparing for open-heart or other surgery. In our group of women, 90% had to pump at one time or another for reasons other than returning to work, etc. I think it's safe to say that we would not be where we are today with our successful breastfeeding relationships without our breast pumps, for better or worse. 

I'll leave you with the most important thing I heard during that time. I was speaking with my OB during my 6-week check up and I said "well, I'm not really breastfeeding, I'm pumping" and he did not even hesitate before he said, "That is absolutely breastfeeding."