Breastfeeding, Returning to Work and Pumping

Oh My!

By popular demand, we’re going to have one more breast feeding post, this time focused on tips/tricks and just plain survival being a breastfeeding/pumping/working mom.

Jennilyn asked me for this post in general terms and I wrote her back asking what specifically she had questions about, here’s what she said:

I guess my pumping questions are pretty basic- what did others find worked
best to keep supply up? Just pumping a lot, teas, straight up fenugreek? How
much tea should I be drinking a day? Is it better to pump more often (I
still get WAY less if I pump often) or wait a while to get more milk @ once?
I’m completely paranoid about my supply dropping, and since Rowan will not
take frozen milk I don’t really have a back-up. My BIGGEST concern is my job
is not a typical set up- I work at Starbucks and am finding it hard to
figure out WHERE to pump. The back room is open to the front area, and the
real only place is the bathroom! Yuck! So I know I’m entitled to an actual
place to pump, but they obviously cannot remodel the store for me! So as of
right now I am pumping in my car. I’m wondering if any of your readers have
had a similar situation and figured something out. Pumping in a car is not
the most comfortable situation!

I’m going to address a few of these concerns, but I don’t have any experience pumping in a car or bathroom, so we definitely need to hear from those of you that do/did!

1) Most important tip of all:  If you plan on continuing breastfeeding, you MUST get a good double electric pump (I have the Medela Pump In Style.) Anything less will not only keep you out on break pumping for ever, but will also not be efficient enough at removing milk from the breast to keep up your supply.

2) I read this online somewhere and it has been a lifesaver: If you have a fridge at work where you can store your pump parts, you can pump and then just store them in between pumps in the fridge and pump using the same parts again without washing/sterilizing inbetween! Obviously you wash and sterilize at the end of the day, but not having to do it multiple times during the day saves so much time.

3) Get an extra pair of horns/collection bottles – makes things easier all around. Worth the investment if you plan on BF for any length of time.

4) Some of you asked about schedule & when to pump: I always pumped when baby would normally be breastfeeding if with me. That’s what I read to do and that always worked for me. To build my stash and/or make up for the fact that I may pump a little less than baby eats I pump at night after he’s in bed at 11pm. Some people pump in the morning, but he always drains me in the morning so the nightime pump is what worked for me.

5) Always give baby the oldest frozen milk you have stored so that you are constantly rotating the supply so it doesn’ t go over the 3 month mark! The exception to this rule is when baby is sick and you should give fresh milk so baby benefits from the antibodies your body is producing to combat the illness.

6) As far as bras go, I wear a sports type bra that isn’t very tight and doesn’t have a ton of coverage, it’s not a specialty nursing bra but it has no underwires and actually allows me to sort of flip the bra part over the horns of the pump so I can effectively be hands free! (The suction assists in them staying on).

7) If you have problems letting down for the pump, bring a picture or even a recording (on your phone for example) of your baby, this should help. Also, bach flowers rescue remedy taken a few minutes before pumping is said to help.

8) Fenugreek is a great galactogogue, but please be aware that up to 20% of babies reportedly get VERY gassy in response to mommy taking fenugreek, so be sure to watch for the signs of tummy distress. If you have a serious supply problem and want to continue breastfeeding, domperidone is a wonderdrug (obviously consult your LC about that first.) Other small things  personally do to ensure my supply is eat oatmeal everyday for breakfast (or a cereal with oats as primary ingredients), drink 1 beer a day (this is my favorite!) and Caffix, which is a natural instant barley based hot beverage that tastes incredibly yummy.

That’s all I can think of at the moment, I’m sure the rest of you breastfeeding/working mommies have lots of your own tips and tricks to share, so please do!

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kelly says:

i started a new job when i returned to work when my daughter was 10 weeks, and am exclusively breastfeeding. unfortunately my only pumping location options are the bathroom or my car. I have just been using the bathroom, and just try to be super quick with capping the milk when im finished which i like to think is preventing any contamination. i wish i had a better circumstances, but i dont mind dealing with it, the worst part is the sound of the pump and people coming in being like ‘do you hear that? what is that?’ but whatever! im happy to be able to bf my little girl!

Bradi says:

OMG my boss walked in on me while I was pumping… a scene out of an Austin Powers movie I assure you. She suggested I put a sign on my door. (my closed door was clearly not sign enough). I thought perhaps it should read “Pumping in Progress!”

Advice, lock your office door or get out the sharpie!

Jen says:

Just wanted to ditto Ava’s point on water intake. I’ve been able to keep up with my hungry man’s intake as long as I drink a lot of water. A lot. As soon as I slack, i find myself coming up short and having to do an extra nighttime pump so I don’t go ‘negative’ on the freezer stash.

Also, I’m pretty sure Ariana mentioned this before, but starting a bottle early was key for us. We started giving him expressed milk at 4 weeks or so, but since it was going well, I was bad, and only gave him one every few days. All of a sudden he totally rejected it at 10 weeks. Thankfully he was *ok* with it around 12-weeks, when I went back to work, but those two in the middle were not fun. I suspect it would have been better if I had been better about giving him a pumped bottle every day on leave. It was just so much easier to feed the fussy kid directly, but I paid the price in the end.

Lastly, I commend anyone who takes on pumping at work under not-so-ideal circumstances. I’m lucky to have a supportive workplace, a private office, access to a refrigerator, etc. And it’s *still* a challenge a lot of days. But I’m committed to making it work. He may be away from me during the day, but it helps to know I’m still providing for him the best way I can. So keep it up ladies : )

Jennilynn says:

Thank you everyone for the extra info! I do have a double pump that works very well, and use a hooter hider in my car. I take pictures to work but have not been taking them w/ me when I go pump!

I AM in CA, so we do have very supportive laws about breastfeeding & pumping at work. I have considered pumping in the lobby- I don’t think the Starbucks Partners would care, they all know I’m breastfeeding and go pump on my breaks. Its the creepy, staring customers I keep thinking about. I am rotating around to different stores as of right now, so once I get into my permanent spot I will be able to figure something out, but it seems like a bigger hassle to do it for every store I’m in! I should just suck it up though & talk to someone to be less cramped! I also don’t know the people at my permanent store as well as I know the people where I’m at right now, so I’m just NERVOUS about the situation when I get there.

Oh- and I do think I have a high lipase issue- and if I am not able to keep up w/ my supply during my work week I will have to try scalding the milk. Up until now I haven’t really needed backup, so once I realized there was an issue I haven’t wanted to mess with it. I’m hoping Rowan will be able to use my freezer stash for cereal if its mixed w/ fresh stuff.

But thank you again for the extra tips and what have worked for all of you!

Laurie says:

I teach high school and am exclusively breastfeeding my 6 month old. I pump in my classroom, which is especially wonderful when I can hear my 16 year old male students arrive early to class and rough-house in the hallway OR when my principal unlocks my door and barges in on me (yes, he is a man).

I pump when my daughter would be eating, and I usually keep up pretty well with her demand, unless I have evening commitments that keep me away from her during the usual 8-5 workday.

I have not had problems with clogged ducts thus far, and both of my nursing bras have underwire. (I just couldn’t give the underwire up.) I went to a maternity and nursing shop and found a bra that fit really well; the saleswoman told me that fit is the most important thing. Underwires are definitely more risky, though.

Something that has helped me with let-down is keeping a video of my daughter taking a bottle on my phone. Watching her and hearing her happy eating sounds has helped make my pumping sessions both faster and more productive.

This was mentioned in the previous breastfeeding post, but I really loved the book _Unbuttoned_. I really connected with the discussion of the emotions that accompany breastfeeding, both positive and negative. I read _The Milk Memos_ and didn’t like it quite as much, though it was the best source of information for nursing moms who work outside the home.

Finally, I have become very forward about my pumping needs with colleagues. I refuse to be apologetic for wanting to breastfeed my baby!

Sarah says:

Lots of good tips and I don’t have anything to add to that.
I will say that I no longer pump when DS gets a bottle at work (I’m only pumping once now at 14 months) and we are still able to nurse on demand on the weekends. He doesnt’ nurse as often during the day on the weekends but it is certainly more than the amount I pump at work and we’ve had no issues (like I’m not engorged M-F and he’s not pissed at a lack of milk on Sat/sun).

Kimberly says:

Ariana,
I’ve found in the month or so that I’ve tried not to pump, that he’s actually replacing nursing with solid meals in many cases… although I have to say my supply is not nearly as sensitive as yours seems to be. So the 3 days I work (T/W/Th), I’m pretty full by the time I get to feed him at lunch time, and I usually try to make him nurse both sides to empty. There have been a couple of days when he was just not in the mood to really nurse, so I did give in and pump to release pressure, and to protect my supply. On my days off, he normally nurses just one side at a feeding, and I alternate. So I guess it balances out somewhat. Now that he’s slept through the night the past 2 nights and we’ve dropped the mid-night feeding, we’ll see what happens. My hope is that he’ll continue to nurse right when he wakes, then before naps (2x a day) and then before bed. If he wants extra nursings I always let him… but he’s getting plenty of solids now, and taking some whole milk, so my hope is that everything will regulate… if that makes sense. I’ll let you now how it progresses! :)

Tracy says:

Use a hospital-grade electric pump, they work better. Also buy a hands-free setup for your pump to make things easier for yourself.

Using hand massage and hand compression while pumping increases milk volume, it also drains the breast better and faster.

Hope this helps! ;-)
More tips on any breastfeeding problems:
http://www.breastfeeding-problems.com

Justina says:

I’m not a full time working mum, but I do have to be away from baby often thanks to my research and I have to pump during lecture breaks, so in my case, useful tips will be:

1. Yup, must must must get the double electric pump! No manuals, and get batteries so that you are not dependent on finding an electrical socket to plug your pump.

2. Perhaps for mummies who don’t get access to a nursing room, get a nursing cover that allows you to see what’s going on underneath it while still being all covered up. That way, you can pump in the corner of Starbucks and the only weird thing will be the “zwong zwong” noises coming from under the cover. In that case, wear tops and nursing bras that are easy to undo under the cover.

3. Get a insulated carrier bag with those chiller packs that you can freeze so you can store the milk temporarily.

4. And I agree with Ariana, pump as often as you would feed the baby, cos supply depends on the demand.

Westwood says:

If you’re going back to an office-type setting, I think everyone would appreciate reading The Milk Memos, http://www.amazon.com/Milk-Memos-Learned-Business-Babies/dp/1585425443. It provided encouragement to keep it going when I was most discouraged by pumping.

Great advice above. I have the Medela Freestyle, and I think it’s great. It runs on a battery, so you don’t even need to plug in anywhere. The Easy Expressions bra is another must-have. Mother’s Milk tea was really helpful for my milk supply, but I think if I wanted to really keep it up, I would have to pump at least 1x more than the baby was eating. That was too many times for me. I know a few moms who were able to get away with not pumping during the week and nursing on the weekend, that never worked with me (I was engorged every Monday), but everybody is different.

Kristina says:

Ariana:

Oh how interesting! I guess I take for granted how progressive California is on a lot of these issues. I’m sorry to all non-Californian women! Check that website for your local laws, it is really helpful.

ariana says:

Kimberly, question for you: If you don’t pump for a feeding he’s getting while away from you are you able to feed him at that feeding when he’s with you say on the weekend? My supply is too sensitive for that I’m afraid, though in theory I would LOVE to do that!

Kimberly says:

I realize I have been VERY lucky when it comes to successfully breastfeeding, since I never had ANY issues or problems beyond the first couple of months of just figuring the whole thing out. We’re still going strong at 13.5 months, with no end in sight, and James has never had formula (well except the 20ccs they forced me to give him in the hospital at 2 days old, but I digress). When James turned 1, I pretty much gave up the pump and replaced those breastmilk bottles at my mom’s with whole milk.

I have worked full-time since he was 12 weeks old, but am very fortunate to have my mom/sisters taking care of him, and I have been able to go home at lunch almost every day to nurse him. James does readily take my milk from a bottle, and pretty much always has… I had to pump and introduce a bottle in the hospital, so there was never any refusal of either breast or bottle. On the other hand, I have NO freezer supply and haven’t had since he was probably 5 months old. We live day to day. ;) All that being said, here are my tips…

1. It can’t be stressed enough… get A REALLY GOOD DOUBLE ELECTRIC PUMP. Mine is also a Medela Pump in Style Advanced, and I’ve been very happy with it. I started off pumping in my office with the door closed wearing my nursing cover, but I pretty quickly moved to pumping in my car… I know this sounds crazy, but I do just one side at a time, I have a car adapter, and I’d pump a couple of times a day (mid-morning and late-ish afternoon) in my car. (Never in heavy traffic or adverse weather conditions.) Nurse in the morning, at lunch, and after work. I’d leave my late-afternoon bottle at my mom’s for the following day, then bring my morning pump when I went at lunch. By the end of the week, I was usually 5-10 oz. ahead of him, which was good because by Monday after a weekend of no pumping, my supply had dipped a tiny bit and I’d get less pumping. But we always stayed just a little ahead of the game.

2. I also eat oatmeal most days for breakfast, and the couple times we had supply issues (like after a 10 day vacation during which I didn’t pump AT ALL) I drank Mother’s Milk tea and popped some Fenugreek capsules for a few days and that pretty much bounced my supply back to normal.

3. I agree with Ariana re: extra supplies… I have 7 or 8 pump assemblies / horns with extra membranes and maybe a dozen bottles. This way, I just bring enough for the day, (plus I always have an extra one in the car, just in case Mommy Brain strikes) then I don’t have to worry about cleaning or refrigerating them between pump sessions. I run them through the dishwasher to clean and disinfect.

4. Avoid underwire bras – I have several nursing bras from Target and one from VS that I love… and now I’m even back to wearing some regular, non-nursing bras, but all without underwire (this is possible even if you’re well-endowed). Underwires and very restrictive / tight bras are notorious for causing clogged ducts, and I’ve never had one, so I swear by this.

5. Just try to RELAX. Drink LOTS of water. And eat well… you need more calories to produce breastmilk than you did when you were pregnant. So be healthy but mindful of getting sufficient calories. All these things will contribute to good supply. And remember it’s supply and demand… if your supply dips, try just lying skin to skin with baby in bed for a day or a night, nursing frequently in a side-lying position. We co-slept until James was 11 months old, and he nursed on demand through the night, and I am convinced this was a key to our success and my supply. Not to mention my ability to get enough sleep.

ariana says:

Great stuff guys, thank you!

Kristina, I just want to say that I *think* the laws that govern employers and places to pump other than bathrooms etc vary by state. I found this webpage that has a listing by state of the laws:

http://www.ncsl.org/IssuesResearch/Health/BreastfeedingLaws/tabid/14389

Kristina says:

I commented about pumping at work on the last breast feeding post, but it is so important I thought I would comment some more!

1) I second (and third and fourth!) the need for a double electric pump. If you are going to be pumping for a significant period of time this is a must. They are spendy, but definitely a worthwhile investment.

2) My OB suggested this, and it has worked for us. She told me to bring a bunch of pictures of the little guy into work into work – I basically have a collage of pictures on a computer print out. I bring it with me when I am pumping and just try to relax and think about the little guy. It seems to help with my supply (and my sanity!)

3) Try to relax! When I went back to work my whole world was consumed with pumping, I was obsessed with whether I was pumping enough. I think my stress caused my supply to suffer and I found myself pumping all day just to get enough for the next day. It was extremely exhausting and really upsetting. My husband finally convinced me that we should get some formula to have in the house just in case. I fought him forever because I really wanted to EBF, but in the end it was more important that the little guy just have enough food. We feed him formula probably once every couple of days (sometimes less sometimes more) and it has been a huge weight off my mind. And consequently my supply has gone back up! Feeding the babe formula is not something I wanted to do, but I think the stress of trying to pump enough (along with the stress of being back at work) was just too much.

4) Finally, speaking as a lawyer, your place of work HAS to accommodate you, and give you a private place to pump. The bathroom is NOT a reasonable accommodation. I don’t have any advice for the woman in the email, but Starbucks has an enormous HR department, and even though it is an awkward subject, she should really talk to someone about it. That is really my advice to all pumping women. This is a hard conversation to have. I work at a law office, they know have to give me a place to pump, and the HR department filled with working moms, but I was still really uncomfortable asking. But you just have to do it. And your work has to give you a place to pump.

Love this topic, so so important for working moms!

Ava says:

Wait… one last thing — will your baby not drink your frozen milk because you might have high lipase content? To know if you do, when you defrost, does your milk smell soapy? Some kids can’t handle high lipase. If this is the case, scald your milk prior to freezing. Yes, it won’t be as high in nutrition content vs. non-scalded, BUT it gives you a shot at giving frozen stuff.

Ava says:

For anyone who pumps regularly, I HIGHLY recommend getting a hands-free pumping vest. This one is what I use and love: http://www.amazon.com/Easy-Expression-Bustier-Hands-free-Pumping/dp/B000MFVOGW/ref=sr_1_1?ie=UTF8&s=apparel&qid=1251081322&sr=8-1 . It really makes you feel more comfortable not having to hold onto the flanges the whole time. You can read, take a phone call, play with a laptop… If you have a back-pack style pump, you can even walk around the house and do chores, or play with your baby.

I cannot stress enough how important water intake is to a pumping mom. What my supply does is directly correlated to how much water I’ve been drinking, and it’s an instantaneous response: not enough and we’re in drought city.

For me, personally, pumping more often actually produces more overall. I might get 2oz/session if I pump every 2.5-3hrs, but only 3.5 if I pump every 4hrs. I guess everyone is different here.

There are many tools to maintaining and increasing supply. Kellymom.com is a good resource: http://www.kellymom.com/bf/supply/index.html . They mention oatmeal, beer, Fenugreek & Blessed thistle, and discuss the various prescription medications also issued to nursing moms. If you’re also into baking try making some lactation cookies (link on my blog here: http://gnluv.wordpress.com/2009/02/08/yum-cookies/). If nothing else, you’re healing yourself with something sweet ;p

I have had experience pumping in the car or bathroom, but only if I had to go to an appointment or we were on the road for extended hours and I couldn’t nurse. It’s difficult and I felt really vulnerable/anxious, because people could see what I was doing in the car, or be in line for the bathroom. If this is your only option, I would suggest two things: 1) OWN your space and feel proud over what you’re doing. Don’t let the presence of any person make you feel uncomfortable. 2) get the little sanitation wipes sold at BRU/Target. When you’re in a vehicle or bathroom stall, it’s hard to clean up some of the drip-page on the flanges. The wipes will help. Cap your milk as soon as possible to prevent contamination.

Ok, I’ll stop invading Becoming-mom’s post. I swear we can mutually write a book on this topic :)

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