A breast pump is a working, lactating woman’s best friend. Like your cell phone, you simply don’t leave home without it. One morning with my last baby, I was in a rush to feed the baby, get ready, get kids dropped off to school, and make it on time to work. I got to clinic and realized I had forgotten my pump. I was filled with dread. Going home would put me way behind (and running behind drives me crazy), but the prospect of not pumping all day is like being told you can’t go to the bathroom all day. You know at some point in the near future, you’re going to be beside yourself with discomfort. Pumping for your baby while working is a lot of work (and sometimes filled with mishaps), but the benefits for your baby are huge. So here I am again, 2 weeks post baby, and I’m in full prep mode.

Before baby:

Get the pump. If you’re serious about pumping when you go back to work, you must have a good double-electric pump. If you’re going to try and have your insurance cover it, work on the details BEFORE the baby comes (the delay can take weeks).
Figure out how it works BEFORE the baby comes. When your boobs are sore and you’re exhausted is not the time to be trying to make sense of the instructions. (The pic of my pump is typical of most pumps; the milk goes through the funnel like cup directly into the bottles, never going through the long tubing).

In the first 1 to 4 days post baby:

If the baby nurses well do NOT pump those first few days. Just allow the baby to stimulate/drive your milk production. Besides, in the beginning, your baby should be feeding every 1-3 hours. You won’t really have extra time or milk to pump.
If the baby does NOT nurse well, then pump every 1-3 hours. Always pump AFTER breastfeeding your baby and make sure you get lactation help/support. Don’t allow those first few days to pass without giving your breasts appropriate amounts of stimulation. Milk production is completely a supply and demand thing. If there isn’t enough stimulation, your body simply won’t make milk later. Make sure you consult with your pediatrician about appropriate amounts of feeding for your newborn if breastfeeding isn’t going well.
Pump right away if your baby isn’t able to feed. There are lots of situations where your baby may be unable to breastfeed initially (e.g., your baby is premature, sick, or has a problem). Again, you’ll need to artificially create the demand for the supply to be there. You will need to pump as often as your baby would feed, if he/she were able.

4 days to 2 weeks post baby:

Pump to increase supply and for relief. Hopefully, your milk is well established at this point and your baby feeds frequently. When you plan on going back to work, getting a really robust milk supply is important (because pumping at work and maintaining milk can be difficult). Having more milk than your baby initially needs is ideal for a working mom. Pump occasionally between feeds (right after breastfeeding is ideal) to relieve pressure and help build milk supply.
Introduce a bottle. Once your baby is a good breastfeeder (can latch within 5 seconds and stay feeding), introduce a bottle. Don’t be afraid of “nipple confusion.” If you’re going to be going back to work, you need your baby to be able to take a bottle. Introducing it early, can save a lot of grief later. Have dad (or anyone besides the breastfeeding mom), feed the bottle. Do this once a day to once every few days (just to ensure your infant has the skills to go back and forth between breast and bottle).

2+ weeks to during the rest of maternity leave:

Pump 1 to 4 times a day. This is the time to help build a store of frozen milk. Choose a time that is convenient for your life. For me, I find it easiest just before I go to bed and in the morning after I get the other kids off to school (these are the quietest moments at the Wonnacott household). Always feed your baby first; you are essentially pumping off the extra.
Get your baby weighed. Typically, after having a baby, you will go to the pediatrician a couple of days post hospital discharge and again when your baby is 2 weeks old. These are great opportunities to ensure your baby is growing well, gaining weight, and getting plenty of milk. All of my suggestions of pumping are dependent on you having enough/extra milk and not taking milk at the expense of your baby’s current needs.
Continue giving a bottle. During your entire maternity leave, you will need to continue to give occasional bottles. While directly breastfeeding is often easier, it is important your child learns to be able to go back and forth between breast and bottle.

When you’re back at work:

Pump at least as often as your baby feeds at home. If your baby feeds every 2 hours, you can’t pump once during lunch in an 8 hour day and hope to maintain your milk supply. In the first few days, you’ll make tons of milk and pump big volumes, but after a short time, your body will stop creating so much milk and start weaning. You have to prevent your body from thinking it’s weaning the baby. Depending on your work environment, this is often easier said than done.
Pump for 3 minutes beyond when milk stops flowing. Pumping dry boobs helps stimulate them and, moreover, there is often a little extra burst that will come with the extra few minutes of pumping (this is the hind milk which is nutritionally awesome).
Coordinate (as much as possible) breastfeeding at the beginning and end of the work day. Typically, I will get fully ready and then breastfeed the baby just before I leave for work. I will also call my sitter just as I’m getting ready to leave work for the day to let her know I’m on my way home to feed the baby. That way, she can calm the baby without giving a bottle and then I can breastfeed the baby right when I get home. This approach saves me a couple of times of pumping, helps maintain breastfeeding, and encourages bonding. In complete disclosure, this is easier said than done (especially as I have more children and the other children have increasing needs).

Pumping for your baby when you go back to work is time consuming. Rotating milk, storing milk, finding places to pump, and learning all the ins and outs to safe storage and usage, etc., is difficult at best. But so much of what we do for our children is not what is easiest, but best for our children. Hang in there. Every ounce you can give your baby (even if it isn’t exclusively breast milk) is good for your baby.

See related posts:

BREASTFEEDING BENEFITS

HOW TO INCREASE YOUR BREAST MILK SUPPLY

SHOULD I BUY A BREAST PUMP?

CAN I TAKE THIS MEDICATION IF I’M BREASTFEEDING?

Most women at some time during the breastfeeding experience question how to increase or maintain breast milk supply. The short answer is that breastfeeding is a complete “supply and demand” experience. The body is an amazing machine; if you feed a lot (that is, breastfeed a lot), it will make a lot. How else can we explain women that make enough to feed twins or triplets? So to make more, you have to feed more. As simple as that sounds, there are a few tricks to try.

Timing

The key time to establish a good milk supply is at the beginning. Frequent, effective feeding will really drive your milk to come in. You must stimulate the milk to come in. This is ideally done within the first few hours after birth. If your baby isn’t a great feeder, has problems, or is otherwise unable to eat (e.g., a premie in the NICU), you can “trick” your body after birth into making lots of milk by pumping. Typical newborns feed every 1-3 hrs for 20 or so minutes. If you are going to pump, you must do so as often as a baby would feed. If you want to make milk for twins, you must feed/pump twice as much.

Pumping

Sometimes, when a mom experiences a dwindling milk supply or experiences a problem (e.g., mom or baby got sick) that affects her milk supply during the breastfeeding experience, I will recommend something I call power pumping. Once again, it is the concept of trying to trick your body into making more milk. Know in advance that it is a lot of work/time commitment and doesn’t always work. This is how to do it: pump an extra time for every time your baby eats. Take for example a baby that feeds every 3 hours. First, breastfeed your baby. About an hour later, pump both sides of your breasts (the key is to pump for 3 minutes beyond when there isn’t any more milk coming out, to get any remaining hind milk). Then two hours after that, feed your baby again. The cycle just repeats itself. I typically recommend doing this for 24-48 hours. If your breasts will respond to extra stimulation, you will see an increase in the amount of pumped milk throughout the power pumping.

Drugs

Drugs or medications can increase or decrease milk supply. The most common medications that lactating women unknowingly take which can decrease milk supply include: combination birth control pills (it is usually the estrogen component that creates problems) and antihistamines/allergy medications (esp. those with pseudoephedrine). As for which drugs increase milk supply, there is a drug called Reglan (a.k.a., metoclopramide) that is sometimes used. However, the drug does have a black box warning on it, so I tend not to recommend it. There are also a few other drugs (not commonly accessible in the U.S., so I will not elaborate here). Some women have success with an herb called Fenugreek. If I were to use an herb, this is probably the one I would use (it has a good safety profile and is fairly effective). There are other herbs of note like alfalfa and blessed thistle (I have less experience with them and the safety profile is a bit less established).

Taking Care of Mom

Probably the most important aspect of milk production is appropriate care of the woman producing the milk. Lack of sleep, stress, and not eating well (doesn’t this sound like all new moms) can all contribute to less milk supply. I acknowledge that it is easier said than done, but try to get sufficient sleep. Eat well (especially high-protein foods). Consume enough calories (moms eager to lose baby weight may have strict diets that inhibit their body’s ability to make a good milk supply). Drink lots of water. Decrease your stress load. Stay healthy. All of these things will increase your milk supply.

Age of The Baby

Most babies start solid foods around 6 months of age. Since breast milk production is a supply and demand thing, most babies “demand” less milk as they eats solids. Consequently, most women gradually start to make less milk. You can help offset this effect by having other care givers feed more solid foods when you are not around, so you can breastfeed more when you are around.

Relax

Ultimately, relax. If you don’t make enough milk to feed your baby, it is ok. Many women have this “all or nothing” approach to breastfeeding. The truth is, any amount of breast milk you can give your baby is good. Certainly, something is better than nothing. Do what you can and use formula for the rest. It’s ok, you’re doing great.

Tag: breast milk

Pumping Tips For The Working Mom