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Ep. 25: Exclusively pumping for twins with Kristen Ross

Tanya: Okay. All right, Kristen. Thank you so much for talking to me today.

Kristen: Yes, of course. I'm so happy to be here.

Tanya: Kristen, do me a favor, I know I already gave you a little bit of an intro, but I want you to tell our listeners what you feel comfortable sharing about yourself and about your journey. Just a little intro, and then we'll kind of dive in a little more systematically to your very interesting story and ongoing journey.

Kristen: Yeah, absolutely. I am Kristin Ross. I'm a former client of Tanya's who helped me virtually during my postpartum time. I have 16-month-old identical twin girls. I am 16 months postpartum and through this very complicated journey of a very high-risk pregnancy and having babies in the midst of a pandemic, I've learned a lot about the transition into motherhood and all that good stuff. And yeah, it's inspired me to join the birth world myself as a postpartum doula. I'm in the process of starting my practice with that, which I'm very excited about. I'm based in Los Angeles. I live here with my partner and my two babies and my cat and that's pretty much it.

Tanya: Awesome. Well, you just touched on so many of the reasons that I wanted you to come on today. I think the only thing you didn't touch on, which we will dive into for sure is you have one of the most fascinating stories of becoming like the master of all exclusive pumpers for twins which we will definitely dive into. I would like to start off just having you revisit and I don't know how often you've done this. It's funny because as I'm asking you this question, I'm remembering that I sent you a link to one of my colleagues and friends, Carrie, she's a doula. She is also a writer and she has this course to help people write their birth stories. And I remember that you bought that. I just thought of it as I'm about to ask you to recount a little bit about your pregnancy and your birth.

Kristen: You wanna ask me if I've completed that yet?

Tanya: No, I actually I'm just remembering that that happened. Here I'm thinking… I'm guessing your answer is no, by the way you just said that.

Kristen: I had a really firm goal that I was like, I wanna do this before my babies turn one. And then that came, went very quickly. I’m reassessing my goal.

Tanya: The reason I wasn't gonna ask you if you've completed it is because my question actually was, I don't know how much you sit around and think about that part of it. I assume you think about it a lot, because you've had such a big transition also with who you are professionally in a certain sense, but I don't know whether your thoughts focus more on the transition to motherhood, or if you really do think about what you experienced during the pregnancy or the birth and all that. Anyway, I'm curious how much time you spend on that in your own private mind. But yeah, let's unpack a little bit of that.

Kristen: Yeah. It's interesting. I have a handful of friends who are pregnant right now. Of course, they're thinking a lot about birthing and that whole process. That has caused me to, you know, think back a little bit more on my time. However, I had a scheduled C-section that was really essential for the safe delivery of my babies and safe survival of me. I just feel like there were so many things around that birthing space that were just kind of decided for me and I, and I felt very at peace with that. Right. I don't spend a ton of time reflecting on that actual birthing process because so much of it was just like, yeah, it was, and I thought I was really well prepared. It still was a really shocking experience, but you know there isn't anything I'd go back and do differently because, you know, I think I walked in as best as I could. I do spend a lot of time though, thinking about those early postpartum days since I am in this like postpartum doula world now and just thinking through, like I really didn't do any real preparation for the postpartum time, as far as reading books and all that kind of stuff. I did a lot of that with pregnancy and I mean, you know, I took any online course that someone threw my direction. I'm obsessed with online courses that people offer. But I, you know, there's so much reading that I'm doing now and work that I'm doing associated with all the training that I'm completing, that I'm just like, wow, this is a totally different mindset than what I was walking into. I walked in saying like, I hired Tanya, so that's it right?

It was like, like that's all the work I'm gonna do. I hired Tanya, she's gonna help me get through it. And things are gonna be OK, but I'm going back and doing all this research now and saying like, wow, I am so glad I didn't do any of this work before, because I was having babies peak pandemic early vaccine when it was like just medical professionals who were getting vaccinated at the time, I was able to get vaccinated when my babies were two months old because I was an educator. I got to be in one of the earlier cohorts, but we're in LA, it's a hotspot of COVID, it was, there were some real peaks around the time the babies were being born. We were not comfortable with anyone coming into our house.

It really was just like me and my partner and my babies. And I'm reading all of these books, like The first 40 days and like all this stuff. I would've been so depressed. You know what I mean? It was just such a totally different time and totally different experience and even different than what I would do now. You know, now that I'm vaccinated and also my babies are vaccinated. I've enrolled them in a trial and they're fully vaccinated. Im so excited.

Tanya: I know, I love that. I get to see all of your amazing Instagram stories and keep up on all these little developments. I was aware of that.

Kristen: We're a fully vaccinated family. My comfort level with all that stuff is just so different now. I do think back on those early postpartum days and how differently I would do it now given a different situation, but how I still wouldn't have done it any differently. I was working with the tools I had at the moment and it was the right thing to do at the moment. But yeah, I've spent a lot of time reflecting on that the past few weeks.

Tanya: Yeah. I don't know, I kind of wanna challenge a piece of this and say, cuz I, now I can ask you to wear your personal hat and your professional hat at the same time, you can always look at it and say, oh, there's all this stuff I didn't learn, right? But then there's another part of me that thinks that sometimes people take it too far and learn too much or wish they had learned too much. And it's not always helpful. Anxiety can beget more anxiety. It's a really slippery slope to find a baseline for the average person of what you think the highlights are that everyone should know and then really tune into an individual and give them the little bit of extra they need without saying what's too much. For instance, in your situation, you know, again, you're the only one who can tell me if this is accurate or not. I feel like you hit a relatively nice sweet spot. I can see how you might be thinking about that differently as you continue to learn, but you had so much going on between the pandemic and a high risk twin pregnancy, which just for our listener's sake, she had mono-di twins, which I'll unpack a little bit further in show notes and such, but just so that everybody understands what this means. When we talk about someone's water breaking. 

We think of that as one sack, but really, it's got two layers to it and we call those layers, the amnion and the chorion. Her twins shared one layer, but not the other, which is actually a little bit safer than another kind of twins where they can live together in both sacks where they can literally wrap up around each other and all of that. She did have a separation, but she also only had one placenta. She ended up having this other complication that's called TAPS, which stands for twin anemia, polycythemia sequence. How's that for a mouthful for our healthcare providers listening, I actually didn't know that phrase. I had to look it up when I met Kristen, but I very quickly understood that it's another form of twin-to-twin transfusion. And it's just one where you don't see this presentation of oligohydramnios, meaning too little fluid in one the sacs and polyhydramnios, too much fluid in the other sac. It's just much more focused on hemoglobin levels that are different in the babies. 

Kristen, just for some background had all of this going on and all of this intensive monitoring, not knowing the timing of her birth, so we started working together early, not knowing how much can you put on someone? We were just kind of in the moment planning things that were very COVID specific because it was the heat of it.

Kristen: Absolutely

Tanya: We just kind of had to trust that we would deal with what came up together. And I wonder what specific things maybe you personally wish you had known, but then I want you to almost apply that to your future clients and yeah. You know, how you would play that out for yourself as the professional on the other side of the situation.

Kristen: Yeah. I think one of the major things that sticks again and like I come to this with a very Zen understanding of like, it was what it was. I have no regrets on how we did anything. But one thing that does stick with me is just the, I think the concept of all these indigenous practices and various cultures around the world of like that first 40 days of rest, that four to six weeks of rest of where it really is expected that the mother is at home with their baby being cared for, by other people, very little movement, you know what I mean? You're not expected to pack up your baby and go out to a restaurant. You know what I mean? It's really meant to be a time of seclusion and enclosure so that mother can focus on healing, on feeding baby you know, all these sorts of things. I think for me, I just wasn't with those concepts and I think I listened too much to like the medical industrial complex side saying the best thing to do after a C-section is get up and move. Everyone was like, I was doing laps around the maternity ward after my C-section, all that kinda stuff. So I think I internalized that message too much and less of the restful message. I had a very rough recovery from my C-section and a lot of nerve pain that went along with that, which made it very difficult to move. And in my mind, it was like, I gotta push through. I gotta stand up and change this baby's diaper.

Whereas, I should have had Blake do everything. Blake could have done everything. He already did, mostly everything. But I was convinced that I had to keep movement as a part of my recovery process in those early days when movement was so, so challenging and hard. And I wish I would've just given myself a little bit more grace to lean into that rest and the idea that I can spend this entire time in a laying position with people handing me babies and that is okay, you know?

Tanya: You're bringing up a really good point about how we can send mixed messages to people because on one hand the medical part of my brain is being very consciously reminded right now that we do want people to move, especially after a C-section because we wanna prevent blood clots with that said, we certainly don't want people leaving with the expectation that they should be like running marathons. All things need balance and unpacking and decisions around when is it appropriate to, start thinking about leaving your house and the other piece here that I think you just touched on, but I don't know that our listeners really picked up on, Kristen also has a history of, is it chronic fatigue, fibromyalgia or both? I can't remember.

Kristen: So fibromyalgia is my main diagnosis. And then I also have a diagnosis of undifferentiated connective tissue disease, which lives in the like autoimmune category. So that's all just pain, joint pain or that sort of stuff.

Tanya: Exactly. Some of what Kristen's talking about for herself and her experience is related to these underlying diagnoses and not necessarily something that everybody would've experienced who doesn't have them. And I've watched a lot of people recover from C-sections and I've taken care of a number of people who have chronic fatigue and fibromyalgia. And I definitely see this burden even from vaginal deliveries, just recovery in general tends to hit people harder who have these underlying diagnoses. You were up against these challenges for yourself and still the messages that got in from the world around you weren’t enough to offset that. It's gonna be so interesting watching you work with people and have all of these principles underlying the work that you do. I'm so excited for you. The recovery was difficult. You also had some interesting professional changes happen. I think everybody's gotten the gist that you have decided that you wanna do postpartum doula work. But tell people a little bit about what was going on for you and your life professionally and where you thought you would land and how that would unfurl for you and then what ended up happening.

Kristen: Yeah. I have spent most of my career in education. I started off as a teacher. I was a music teacher and then I moved into the administrative world. I was the director of a school in Brooklyn for a handful of years. And then when I moved out to LA, I transitioned into the private sector for a little bit, but then came back into education, working in operations. I managed operations for a handful of schools down in south LA. I really loved that work, loved that job and was fully planning on going back to it part-time after I was done with the babies. And it was mostly because I was still living in the very uncertain COVID world. I really didn't love the idea of sending my babies to daycare when you know, COVID is still so rampant, all that sort of stuff.

I knew that I wasn't gonna be able to transition back full-time very easily. And then as the date approached for me to go back to work, I was like, oh, do I wanna do this? And I kinda just had a moment of, like, I could be a stay-at-home mom? We can financially make it work in this household. And I'm fortunate enough to have my partner working from home remotely. And so, you know, there was a possibility that I could make this stay at home mom thing work for a little bit. So yeah, I decided to quit my job and transition to staying at home full time, which is what I've been doing since the babies were born. That was very unexpected.

I do talk to my friends from when I was growing up and stuff and I'm from small town, Wisconsin. Who had on their bingo card that I was going to be married, living in LA, a stay-at-home mom of twins… literally no one could have guessed this. I spent my entire life telling people I was never gonna get married and have kids. This is the furthest possible thing. I spent my twenties being a total career-aholic. This is a very significant transition from where I thought my life would be.

Tanya: And why I love this part of your story is because this is a conversation that I have with so many of my clients, because I find that during pregnancy people come to me with what appear to be extremely clear ideas of their future. And I have to find it within me to not come across as condescending and say, oh honey, you don't know what you don't know, but to say, I've seen frequently enough, both sides of this equation. Somebody who believes that in their heart of hearts, they're meant to be a stay at home mom. And then suddenly they have a baby or babies in front of them and they go, holy shit, this isn't what I bargained for, I think I wanna go back to work and that's hard to accept because it makes you ask a lot of questions about yourself and I've seen the opposite. I've seen hardcore professionals say there is no way I would ever be a stay at home mom, and then their babies are born and they cry every day because they're worried about going back to work and then they don't go. I've seen it all.

Kristen: Well, I also wanna point out that I, that you were the one who perhaps pushed back the hardest on me for the idea of me not going back to work, cuz you very wisely were like, you know, I've seen a lot of women go through this transition. I've talked to a lot of people about the transition back to work and how hard it is, and going back to work is hard, but it's usually not as hard as you think it's gonna be. And plenty of people do this transition and they make it through just fine. I don't want you to quit your job just because you're worried about that step of having to go back to work. You really hammered that home with me, which was very helpful. It helped me to really reconsider what the reasons were for doing this?

Tanya: Well, it's interesting because I think for me, where I sat at the time you had this sweet opportunity that a lot of people don't have, which is the opportunity to go part-time from home. And I was like, oh, I don't want you to lose that.

Kristen: Yeah. Yeah. Mm-Hmm

Tanya: You had to be really darn sure. Right? But you got there and we just continued to unpack and unpack and I'm sure you did 20 million times more unpacking with Blake. Right? You guys came to the place that you came. And we'll come back to this. I don't wanna go down this road just yet, but I love the day that you said, “Hey, can we have a chat because I think I wanna do this kind of doula work stuff.” That was such a fun moment for me. But before that, one of the things we really haven't talked about yet that I think we really should unpack in a big way is I want you to tell your breastfeeding story, like fairly completely, because I think there are a lot of people in your camp and they just don't know how to feel about the choices that they've made or how they got there. They don't know whether they should be super proud or if it means that they didn't do a good job at this other thing called breastfeeding. And you not only navigated that with incredible grace, you created a little bit of a philosophy and a method around it that I've not seen from other people. And I think people can really learn a lot from you.

Kristen: Yeah, absolutely. First let me define what I'm saying. When I'm talking about breastfeeding, I'm talking about any way that breastmilk gets delivered to a baby; bottle feeding, nursing, pumping, whatever. Breastfeeding encompasses all of that for me. When I say specifically nursing, I'm talking about bringing a baby to the breast, right? Bringing a baby to a chest, that's what I refer to when I refer to as nursing and then obviously pumping, using a pump to express milk. When the babies were born, one baby was with me in recovery and the other baby was in the NICU for the duration of the time we were in the hospital. Thankfully, she had a very quick recovery and we were able to all go home together after five days. That was wonderful. But that meant I had one baby with me, who we were able to attempt nursing with on a regular basis. And then I had one baby who, you know, I could only attempt nursing when I was up in the NICU combined with a really rough recovery from that C-section in which I was very immobile. The entire five days here in the hospital, I was only able to go to the NICU twice. And the rest of the time Blake spent a lot of time up in the NICU with Gabby, our baby who was up there. Cuz I just like, I wasn't mobile. It was just going in a wheelchair and getting wheeled up there and even that was too much for me to handle during that phase of my recovery.

And also, my babies were born at 36 weeks. Mono-di twins need to come out early. That's just the way it works because the placenta deteriorates rapidly and no longer is serving them at that point. We had a scheduled delivery at 36 weeks, so I have tiny little preemie babies born a month early one's in the NICU one’s with me, as you can imagine, nursing was not very successful in those early days. I'd make an attempt at every feeding. It was mostly hand expressing into Dani's mouth and then her licking up a little bit of it and then me giving her a bottle because I had walked into this twin delivery saying like, I'm fine with formula. Like I can't have the pressure on myself of exclusive breastfeeding. I'm fine with formula. We introduced it maybe like day two, pretty early on day one for Gabby because I wasn't able to be up there with her in the NICU. It really was like, whatever, I'm doing the best I can, I'm not gonna stress too much about it. Then I started pumping in the hospital so I could get everything going. I had to relieve engorgement because you know, a baby was not doing that for me. And I kind of got into that routine of “triple feeding” where we would try and nurse and then we'd give the baby a bottle and then I would pump and that would happen at every feed, every three hours. The lactation consultant who sent me home gave a hint of it, but not enough of a hint of what I needed in which she was like, “Okay, so triple feeding twins is gonna be a lot for you. So, you know, just make sure you take it easy on yourself.” And I was like, okay, whatever, I've been doing it for five days in the hospital. Like whatever, it's fine. It's a routine. And then of course that's like, I've been doing it in a hospital where someone's delivering me my food and I have a nurse around the clock taking care of me and I only have one baby with me. Like of course it's gonna look way different. Once I got home, it was like immediately unsustainable and I absolutely cannot do this at every feed. I was working virtually with a lactation consultant from you, Tanya. Dana, is that right?

Tanya: Yeah. Her name is Dana Hilsenrath. She is an awesome lactation consultant out of Westchester county, New York. Her practice is called Westchester lactation. She's also in thriving after birth. And I kind of have her on to talk about twins because she, herself is a twin mom who had babies in the NICU and all of that stuff. So she brings a really personal expertise. But while I'm thinking about it, remind me if I have this right. You worked with an IBCLC in the hospital? And at some point you did have someone come to your home, right? But they (the babies) were a bit older. Cuz, I'm remembering that part of the story. It was the IBCLC in the hospital first, Dana, virtually next. And that's the point you're at and then you'll get to the other one later. Okay. 

Kristen: The virtual work that Dana did with me was really helpful mostly because obviously as a twin parent, she's able to very realistically speak with me about what these next few days can look like. She kind of helped me talk through some pumping stuff, some schedule with feeding, all that kinda stuff. And then just realistically was like, “Listen, triple feeding twins, you're not gonna be able to sustain it for them, especially because you don't have extra help at home. It's you and your partner and that's it.” She's like, “So here's what you need to do… You need to try nursing once a day. Like, that's it like attempt to nurse babies once a day. And then if you're up for more, awesome, if not, try once a day and  that'll be enough for you to keep at it for your babies to keep getting to the chest and attempting it and other than that, you focus on just pumping and feeding your babies.”

Tanya: I wanna chime in real quick because you're bringing something up that I think everyone could benefit from. And this is for providers and for clients, everyone needs to think about this more when babies are born preterm, we wanna think about them in terms of their gestational age and not in terms of their birth age. When Kristen had two week old babies, we wanna think of those babies as negative two weeks. And that not only helps us understand what babies are sometimes capable of physiologically, but it also allows us cut ourselves some slack, so to speak, because we start to immediately say things like, well, why can't I get this right? And/or why can't my baby do this? But you know, what if you think about the fact that maybe your baby should ideally still be inside being fed through its umbilical cord. We can give everybody some grace around what's happening. If I recall that was part of Dana's logic was, these babies have a great chance of growing into these skills, but not today and it's not sustainable.

Kristen: Well, and also the idea that like any attempt that nursing was exhausting for them. Any attempt at not getting their food delivered through the bottle was so tiring for them that, you know, how is that serving anyone to have me be super frustrated with these babies at my chest and not successfully feeding and have them be exhausted by the process, you know? We set the realistic expectation. We're gonna try nursing once a day. And even that, which seems really rational and really reasonable after like two days, I was like, I can't do it. I guess like, oh my God, it's too hard. I can't do it. It's too exhausting. Basically at that point I just was like, I'm just gonna focus on pumping and I'm gonna come back to nursing later. But right now, I just am in survival mode where I need to get milk out of my body. I need to get milk and formula in their mouths. And I'm gonna do that the most efficiently possible, which right now is pumping. And then and then there's a meandering journey with thrush multiple times and that caused quite a delay in the process as well. But essentially that ended up being what we did. And then I think the babies were like a month old when I had the other lactation consultant come over... A month or two old, some were around there.

Tanya: Definitely before you were eight weeks postpartum because it's in my notes from our sessions, we were discussing it at your eight-week postpartum visit.

Kristen: Yeah. I think it's when they were about a month old. About four weeks when they were approximately full term that I had an in person, lactation consultant come over, who also is a mom to twins. She was also a very helpful resource. She was able to come in and help me. Primarily she came in first to help me with pumping. I was just like, listen, I'm using the hospital pump that I've rented. I wanna try and switch over to my other pump. I'm so overwhelmed by just the concept of having to switch anything that I'm doing with my process. I was using the wrong sizes, you know, like all sorts of things. She, she was able to come and help me just be that in person, you're doing this right, you're doing this wrong. Let's figure this out. She was super, super helpful, helped me just with pumping first and then came back for another session to help me with nursing. When she was there was the only time that I've tandem nursed my twins, which was an extremely special experience. And I get very emotional thinking about but you know, she was able to get both of those babies situated and get 'em both latched on. And we did one tandem nursing session, it was beautiful, and I took pictures and I remember it fondly forever. She was able to say, yes, you definitely have thrush, which Tanya confirmed. And someone from my OB’s office said, I didn't.

Tanya: Yeah. It was tough though, because I'm telling you that I think you have thrush virtually.

Kristen: Yes. Yes.

Tanya: And then you're told you don't have thrush and then the lactation consultant comes and says you have thrush and it's like, see!

Kristen: You definitely have thrash.

Tanya: Ah, yay. Yay.

Kristen: Crazy. Yeah. And not my OB, my OB is great and I love her. The OB who I happened to see on this day was available, told me I did not have, and I definitely did. Very frustrating process. However so yeah, she confirmed in person that I did have it. I was able to get some treatment for that, which was helpful. But essentially after that point, I was healing from thrush. Nursing was not a possibility. My nipples were so sore, so itchy and my babies were not good at latching. And trying to get them to latch on a thrush nipple, like absolutely not.

Tanya: Tell everybody what your favorite tool was while you were healing from thrush that remained with you for a little while. Do you know what I'm thinking?

Kristen: Oh my God, my silverettes. Oh my God. My silverettes. Okay. If anyone doesn't know who these are, what these are is they're basically… I call 'em nipple caps. They're nipple caps. They're made of silver. And you just like pop 'em on top of your nipples to give them a little bit protection and healing. And most people use them like when their nipples are raw, when they need a little extra protection, a little coverage and the silverettes have, you know, like healing, properties, whatever. Most people use them temporarily. I however used my silverettes every single day for the rest of my breastfeeding journey. Because with exclusively pumping, my nipples were just like so sensitive all the time. It wasn't painful, you know, like I wasn't using the wrongful flanges. I wasn't pumping too hard. Nothing like that. They weren't painful. They were just so sensitive. Like any fabric touching, touching my nipples was really uncomfortable. I just realized, I'm just gonna wear these silver cups in my bra every single day while I'm breastfeeding. And that's what I ended up doing. I just kind of had like crazy looking nipples the entire time that I was breastfeeding, like under my shirt, because, cause I had these silver cups in there permanently. But they were absolutely essential and I don't think they're necessary for everyone. But I think for exclusive pumping people, I do feel like they're essential.

Tanya: Yeah. They're not for everyone. That's for sure. But what I love this, that little tidbit really encapsulates why I think you have a unique story to share. You brought a spirit of experimentation, which I try to impart upon people a lot because I think having a spirit of experimentation in the early days, postpartum is for me, the easiest way to embody that each of these moments is not forever because it is so easy when something hurts or is difficult or we're exhausted to think this is the rest of my life. Like you can intellectually know that's not true, but in your heart and body and some weird part of your mind, you don't believe that part of your brain. Yep. And if we bring a spirit of experimentation to the whole process, we know that something new is coming tomorrow. And in your case, one of the only things that stuck with you was Silverettes and okay, great of all the things. It just goes to show how much variation there is and all the creative ways in which people can find a way to survive, whatever oddity cuz somebody else might have said, well, if nothing can touch my nipples that's fabric, I have to just stop doing this. That might have been what somebody else would do. And a lot of people probably.

Kristen: Right, right. Just the idea that, you know, people will tell you that pumping shouldn't hurt, like all this kind of stuff. I think it'd be really easy to interpret that as, my nipples are really sensitive. That means they're hurting. That means I'm doing this wrong. That means I'm gonna give up. Right? Like I understand where that mentality, especially because the majority of people who are pumping are not doing it exclusively. The messaging out there is not for exclusive pumpers. It's for people who are pumping, you know, twice a day at work kinda thing.

Tanya: No. And it's also a moment for people to remember that anytime you hear a tone of absolutism, you wanna take it with a grain of salt and say that cannot be true for all people at all times. Right? Yeah. When someone says the word never or always all your little bells and whistles should be going off.

Kristen: Absolutely. And you know, I'm thinking through just like so much of with, I mean, I think this applies to all breastfeeding and nursing in general, but I think particularly with exclusive pumping, because it is a unique way of breastfeeding that not many people do, you know, I think there's constantly this like detective work that needs to be done of, you know, why does this feel uncomfortable today when it was fine yesterday? My friend who, you also have worked with Divya, she is exclusively pumping right now. And, and just the other day texted me saying, Hey, did you ever have, thrush, I'm not sure like, blah, blah, blah went through symptoms. I was like, no, it doesn't sound like thrush. Cause you're not experiencing this, this, this, I was like let's talk through like, what have you done differently?

Right. And turns out it was a pumping bra. She like wore a different pumping bra the day before. And I was like, you know what? That was enough for me often to put on a different pumping bra and then it didn't have the exact right fit against my chest. And then that was enough for my nipples to be really sore the next day. And I only found that out through experimentation and through, you know, like trying to piece the puzzles together, detective work of, what did I do differently? Why did things look different today? Again, I think if you don't have the energy for that understandable, right? And if you don't want to spend your time doing that, totally get it. But this just happens to be how my brain works and how I've spent the majority of my career and so, it really worked well for me.

Tanya: Okay. So I, I took you out on a little bit of a tangent and I wanna make sure that we get you back to where you were. Cause I think it's a critical part of your story. You're at the point where, you know, you need to move off of the hospital grade pump and figure out your own pumping situation. And that is part of, I think, one of the more interesting parts of your story. So pick back up there.

Kristen: Yeah, absolutely. Like most people on a Spectra, right. Just like a standard spectra that I got from insurance. And so I was trying to transition off of that and was very intimidated by the process just because again, I'm exhausted. Like I don't have any spare brain energy to spend on this process. But my lactation consultant, Lisa really helped me, you know, make sure my spec was set up correctly and helped with the settings on that, so that I could feel comfortable transitioning over. And and so, you know, I just kind of did that. Like I would do it for a couple pumps a day. I would switch over to this spectra as opposed to the kind of thing. And then eventually was able to just move fully over. And then I also had like a hand me down pump that I got from someone, the Hygeia Enjoye I think that what it's called that I've never heard of, but it was actually a really lovely pump that uses Medela parts. It was very easy for me to transition and I ended up finding an odd system that works, that I would just continually adjust where I would use one pump, sometimes one pump another times I got an Elvie pump for a while, cuz I wanted to try and be more mobile obviously. Cause it's very hard to take care of two babies while being attached to a pump. The Elvie pump, I was not a fan of in the long run, but you know, it served its purpose for a very short amount of time. And then I sold it for what I bought it for. I felt okay with, with that transition.

But you know, it ended up being just a very gradual process of figuring out what pump serves me best at what times, you know, what parts do I have available for the pumps? What things can I supplement so that things are interchangeable between the pumps. You know, it was just like just this constant work of fine tuning and nitpicking and figuring out how to make things work so that it fit best with my schedule and what I have available and like doing dishes and not having to wash parts, pump parts constantly all day. And that kind of thing.

Tanya: You also had a really interesting wheely cart situation that reminds me of how nurses wander around hospitals often.

Kristen: Yeah, I have I actually have two of them in my house now, one for diapers and the other stuff, those little three tier wheely cards you can get from I and target, whatever. I had one of those that I had set up with all of my pump stuff so that all I had to do was sit down on the couch and then I'd wheel it out from behind the couch. And then I had all my pumps ready to go. Basically like my living room was set up to be a pumping zone because that's where I was doing it all of the time. And you know, that's where I was taking care of babies and all that kind of stuff. It was all set up to be variable and accessible. Everything was plugged in on the cart so that I didn't have to mess with wires or anything. It was set up to be very accessible and very user friendly because I did not have any spare energy care about giving things set up like that.

Tanya: And that to me it feels a little like, I don't know if it was the beginning for you or not, but you ended up emphasizing the importance of self-care during pumping more than anyone I've ever known. Kristen found a way to make pumping more enjoyable by figuring out how to take care of herself while she was doing it. What were some of those things that you routinely did?

Kristen: Absolutely. Let's see. What were some of the things I did? I think a big part of it was just making sure I was physically comfortable because it's so easy when you're pumping to just hunch over and sit leaning forward and look at your phone. Your neck is down, right? There's so many things that the natural inclination is to set yourself up with a really uncomfortable position that is not going to serve you in the long run. That was step one, I had a pillow set up that I used so that my pillows were always in the right configuration to make sure that I was sitting as upright as possible. And all that sort of stuff. I got myself a phone tripod so that I could like watch things on my phone without holding it so that it would sit on my coffee table and I'd be able to sit upright and not have my neck hunched over. The one that I know you're referring to is later on, I got a foot bath.

Tanya: Yes, that's it. It's the foot bath and it's the really comfy headphones situation.

Kristen: Oh, the headphones. Yeah. I have a set of sleep headphones that I've used forever and ever because I need to sleep with something playing in my ears or fall asleep with something playing in my ears. They're like a very comfortable fabric headband with headphones that live within there. And so I will put those on instead of putting in earbuds. Cause I just don't like wearing earbuds for long periods of time. I'd put those headphones on. It was nice and comfy around my head with my foot bath. So yeah, it was a very elaborate setup. But it absolutely worked to have me be in a more comfortable space as opposed to… it was already enough of a pain in the butt to be like, oh I have to pump again. Oh my God, it's been four hours already. Oh my God. I gotta pump again. I at least needed to make sure that my physical body was comfortable in the space and that I was doing everything possible to help me get through those 20 minutes or whatever it was in, in a way that was restorative as opposed to like draining more out of me.

Tanya: And that's really important because if you are gritting and bearing it, you are changing your hormonal profile in such a way that doesn't promote optimal milk. Not only production, but excretion, excretion is not the word I'm looking for…expulsion?

Kristen: Yeah.

Tanya: That's not right either. There's another E word that's not coming to me.

Kristen: Ejection. Yeah.

Tanya: Ejection. That's the word I was looking for!

Kristen: Milk ejection. There we go.

Kristen: Okay. I actually talked about this with with Dana when I did my virtual consultations with her over lactation stuff where, she was just like, whatever you need to do to make your setup more comfortable. Right. She had like things like not counting the ounces as you're pumping. Because the more you stress out about the ounces and like that's all I'm getting this pumping? The more I was stressing about that, the harder it was for me to have letdowns. 

Tanya: One of the tricks is baby socks up over the bottles. Don't even look at it, just wait till you're done pumping to figure all that stuff out.

Kristen: Yeah. I just stopped tracking my output altogether. You know, there are apps out there where you can track how much you're pumping every session. And, and I just found that any amount of tracking that I did would send me into a tailspin of like, oh, well I had two less ounces this session than I did yesterday. Was I not drinking enough water? You know? And like sometimes the answer is I, no, you just didn't make more milk today. There's not always a formula for it. For me it was no tracking whatsoever.

Tanya: And we live in an era where it's so unusual not to track as I sit here with my apple watch tracking every single little thing I'm doing. Right. Yes. Every breath I'm taking, every heartbeat I have and I'm fascinated by the data. And yet I understand that this isn't always helpful. I think it's important that we unplug when it comes to this kind of stuff too, not just unplug with our iPads and technology and all of that stuff.

Kristen: My friend Ronnie, who's a stay-at-home dad who has a baby about the same age. We spent a lot of time together, he previously worked as an analyst and so obviously data has been his career and he frequently says when it comes to babies, sometimes the data is just bad data, right? It's like there, isn't always something to crack from the data. And it's really hard for people who love data and love analyzing that kinda stuff. He's like, sometimes it's just bad data. Sometimes it just is what it is and you're not learning anything from it and what we do when you're not learning anything. Why do you have it?

Tanya: Totally. And what I think we need to do is… there's a place for data in the early days, but even then we're looking for patterns, right? Whether we're talking about pees and poops or our milk supply, we're looking for patterns and one time of an anomaly does not make a pattern. Right? And I usually get an anxious text message or phone call or whatever around the time of some sudden change or difference. And I can tell you now, almost always, if somebody tells me something one time, I'm not gonna get my knickers in a twist. We're gonna look at the future. Yep. And almost always it reverts back to something baseline or better than baseline. It just sorts itself out. Okay. Kristen, as we start to move towards wrapping up first, I just wanna say, you are gonna be such an incredible resource to people. I cannot wait to see the impact that you are going to have on your community as you grow your practice. And that's what I wanna wrap up talking about. I want you to take us back to the days leading up to or whatever the process was before you called me and said, I think I wanna do this. What was going on in your mind as you were making that potential professional shift and then give us an update on your learning and how it is that you are gonna set yourself apart from others. Cause I already know what some of those ways are, but I want you to share it with us.

Kristen: Yeah, absolutely. I think a big thing was just trying to figure out like my next chapter. I'm not eager to get back into the workforce. I'm not looking for full-time jobs anytime soon. But I am looking for something that like fits my lifestyle with being home with my babies the majority of the time and looking for more of a freelance type position. Something that offers a little bit more flexibility that will serve me until my kids are at an older age and we have a more reliable schedule. And so starting to think through what that looked like…I see the big gap in postpartum care that I know, obviously you do, and that's why you do this work. But there's just this massive gap of people not preparing for postpartum, people not thinking about postpartum, people having bad experiences with postpartum because they didn't know what to expect and they don't have people to support them. And then of course just in general capitalism and individualistic society and all that sort of stuff that leads to people not having their community and their support network and their village around them. To me, that was a really compelling space to think about how can I be a part of that and how can I be a part of a solution to that? Cause of course I'm not coming in, like you, I'm not a medical professional. I haven't been a nurse. I haven't been a midwife. I haven't been doing this work for decades. And me thinking through, what can I be doing in a non-medical aspect, making sure that people are having more guidance during this time. I do think the world of postpartum doula is really, really interesting because it's specifically meant to just be support, you know, like the job can be anything. 

Some postpartum doulas spend all their energy cooking and cleaning and laundry and making sure your house is running. Some postpartum doulas really focus on emotional support of the family. Some postpartum doulas focus more on the baby and making sure their newborn care is being taken care of. You know, there's really endless possibilities of what this job can look like depending on the person and on the family they're working with. I think that's really compelling to be able to take your individual skill set and apply it to a situation where, you know, people need support. I ended up signing up for Erica Davis’s Whole body pregnancy, I believe is the name of her company. She does childbirth education for birth doulas, and she also does postpartum education for postpartum doulas. And I liked that it was specifically a postpartum doula class because I'm frankly just like not interested in birth doulas. It's not my space and not the world I'm interested in. And so I'll leave that to all the amazing birth doulas who are already out there. I really wanted something that would focus specifically on postpartum doulas and I love her course. We're almost done. We have a couple weeks left, but her course has been super, super great. If there's anyone who's interested in that world, I highly recommend checking her out. Cause, first of all, it's very people of color focused, right? There was a whole class on how to support trans and non-binary clients, how you can make sure that you are creating a welcoming and inclusionary practice, all that kind of stuff. We spend a lot of time talking about the emotional support of the family. It's not a course that's focused on… here's the best way to change a diaper. We're not talking about basic newborn care stuff. This is very lofty next level. What are we doing philosophically to support the family? It's been a really awesome course and I really enjoyed it. But yeah, it's just been great to think about what is it that I have to offer families? What is it that I have to offer birthing folks who are recently postpartum and, obviously twins, that's the first one, anyone with a multiple birth, I'm right there with you, absolutely. It's a very different world than a single baby. I can help you navigate that. And then anyone who is pumping, I’m your person. But I am not a lactation consultant, right? I have no certificate is as far as that is concerned. But the knowledge that I have of the world of pumping is, is very extreme, so I'm more than happy to help people with their pumping journeys because I know that that's a thing that even a lot of lactation consultants don't necessarily have a ton of experience in, or like are necessarily that helpful with.

Tanya: A lot of variation in lactation consultants when it comes to getting help with something other than putting the baby to the breast. And I happen to work with a team of people that are excellent at that and supportive of that, but you don't always see that. It's not a one size fits all approach.

Kristen: Yeah, absolutely. Obviously anything to do with pumping, I'm definitely there for support. And then I think I'm a very logistically minded person, I've worked on operations for most of my career. Think of how we can streamline your household and your systems and your process so that you are expending as little excess energy as possible. It’s very like Marie condos, right? Let's get rid of the stuff that isn't sparking joy right now. Let's make sure we're staying focused on the things that we actually, you know, want to be doing in these early days. Obviously I know our energy for organization and that kind of stuff is limited in our early days of postpartum.

But I think just being able to have a fresh eye come into your space when you are exhausted and sleep deprived and like not thinking straight, a fresh eye, being able to come in and say like, well, Hey, did you think about moving the drying rack over here and then you'd be able to have more space over here to prep your parts. You know what I mean? Like that kind of stuff. There's little things that can be done in people's households that can help streamline the process and help you move along, so that you can see what that looks like. I also think another thing that I am uniquely able to help support with, although not through my own doing is helping partners support their birthing partners. I think non gestational partners, whoever that is in your household, there is a serious lack of resources for them as well. For helping them figure out, who am I in this current space? Wwhat do I do? What is my purpose? Like I'm not producing milk. My baby doesn't need me to feed most of the time. I guess I changed diapers? You know, there's a lot of people out there who flounder in that space when you introduce a new life into this household and you don't necessarily have a clear role for yourself anymore. And I think my expertise comes not from me, but from a partner Blake who is just like dad extraordinaire and, and is the best and is amazing and kept us all alive for the past 16 months. 


Tanya: I have so many memories of the amazing things he did and for whatever reason, the one that rises to the surface for me always is picturing him bringing babies to work. I mean, within your own home. But as he transitioned back into work and your needs were still extremely great. I mean he obviously works with an amazing team. But he was literally working with at least one twin on his lap for a period of time. And you guys just, you guys did so much better than just survive.

Kristen: Yeah. Especially before they were old enough to sleep train. When I still wasn't comfortable with that. And you know, it took a lot of work to get them down for naps. During the day there were approximately half of Blake's meetings were conducted with him wearing a baby in a stretchy wrap that he was bouncing to sleep. And then, you know, sitting at his desk and working with the sleeping baby right here. God bless the stretchy wrap, those things really saved us.

Tanya: Well, you guys are amazing and I'm so happy for your part of LA to welcome you into the birth world. And you've given me so much to think about in terms of the ways in which midwives need to be working carefully and closely with the people who have boots on the ground because, I'm working virtually and that's one thing, but even midwives and OBs and anyone who takes care of birthing people when you're in the office and you're in the system, the structure that the system creates, you don't really have your boots on the ground either. And we just desperately need to be working carefully and closely with people who are willing to do the day in day out stuff because the vast majority of us, and this was me until about four years ago, we don't have all the answers to these day in/day out questions. I went on a massive quest to fill this gap, but it is not what most of us healthcare providers know deeply. And it's the doulas who are in people's homes who know this stuff. And so I'm super excited to have you be part of this world.

Kristen: Yeah, absolutely. So very quick plug. <y Instagram, if you wanna follow is @twin.postpartum.doula

Tanya: I'll put it in the show notes.

Kristen: That's my professional Instagram. You can go ahead and find that one. And then same for website, I know it's really long, but you know, there are a lot of doulas out there.

Tanya: But yours is long or not. It says exactly what you need it to say. Exactly. The audience knows exactly who they are. It's perfect. I love it.

Kristen: Exactly. So you know exactly what you're getting when you go to either of those locations. Feel free to check me out at either of those. And if you're in the Los Angeles area and you any know any folks who are postpartum recently or not recently that's actually been a topic of conversation in our postpartum course recently about how Erica, the person who runs the course, she is, I believe 10 months postpartum right now. And she's like, I need a person now more than ever, postpartum is forever man. Like it's a forever period. And thinking about my 16-month-olds right now and you teething with molars, yeah, I could use someone right now. I love it. Any birthing people in your lives who could use some at home support? Definitely. Feel free to send.

Tanya: I love it. Postpartum is forever and welcome to the birth world, Kristin Ross.

Kristen: Awesome. Thank you.

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