If breastfeeding
is going to be combined with working, there are some things to consider
that will give you greater success. A working mom can provide breastmilk
for her baby without having to resort to the use of ABM (artificial
baby milk). She has many balls in the air and every trick that makes
any aspect of pumping a bit easier is worth consideration. Whether
you're planning on returning to work, or you've hit a bump in the
road, I hope you'll find a tip here that will make life easier and
the milk flow. Pumping
Routine
Establishing a routine schedule for pumping is one of the best
ways to consistently get an excellent MER or milk ejection reflex
(letdown). Think of it as teaching your body a pattern that you
would naturally fall into if you were with your baby all day.
One of the favorite tricks of many working moms is to rise prior
to baby waking and pump with a plentiful morning supply. Your
breasts will kick into action and continue producing milk so that
your baby will achieve plentiful MER's on his own during the first
nursing. Another good trick is to pump on one side during that
first morning nursing while nursing the baby on the other. This
takes advantage of the baby establishing MER for you and is often
the best way to get maximum ounces in a brief period of time.
Pumps
Your choice of pump will be crucial to your success as a working
mom. There are many options available that are excellent. For
a fulltime working mom, a double electric pump that has adjustments
available both for the strength of the suction, as well as the
speed of the cycle, is a must. Take a look at what is out there,
talk to other successful nursing working moms, and don't be afraid
to spend a little money to get a good model. You will be spending
many months using it and a quality pump will make your life much
easier. There are pumps available for rent if you'd like to have
an opportunity to use a certain brand before purchasing it. Your
local LC (Lactation Consultant) or IBCLC (Internationally Board
Certified Lactation Consultant) should be able to assist you with
renting one if you so desire.
It's a good plan
to have a few extra pump parts stashed at work, in case a small
but crucial piece gets lost in the shuffle. File this under something
else that a working mom does not need to have to deal with, and
prepare for it so it never happens to you. Another little tidbit
is to be careful where you put your parts in the dishwasher. Dishwashers
are great for "eating" pump parts. It would be a good
idea to get a basket designed for small pieces for your dishwasher
if you plan on using it regularly to wash your pump parts.
Pumping on Days
Off
The last thing that a working mom wants to see on her day off
is her pump. There's a distinct love/hate relationship with the
pump. The love comes from this machine that allows you to provide
your wonderful breastmilk for your baby even though you are separated
while you are at work. The hate comes from the pump being a poor
substitute for your precious baby at the breast. It may be necessary,
in order to maintain a good supply for your work days, to pump
even on your days off. Some mothers have no trouble maintaining
a supply while only nursing on their days off. Some mothers at
least pump the early morning session while home.
Supply Dips
I often receive the panicked contact from a nursing mom whose
freezer supply is running low and fresh supply isn't meeting the
baby's needs. The assumption is often made that there is a dip
in the milk supply. I propose that the supply itself may not be
a problem at all, but rather the reaction to the pump. Using a
pump instead of the baby is already a matter of "fooling"
your body. Sometimes the pump calls your bluff and you have to
find a new trick.
Some tricks that
may work when your reaction to the pump isn't:
- Massage your
breasts prior to beginning a pumping session
- Massage toward
the nipple while pumping
- Lean forward
and "shake" your breasts to encourage MER
- Look at a favorite
photo of your baby that provides warm fuzzies
- Smell an item
of clothing that your baby wore the previous day
- Bring a bottle
of shampoo or lotion that you use on your baby to smell while
pumping
- Breathe deeply
and imagine that every breath flows into your lungs and out
your nipple as milk. Another one that works well is to have
a glass of water and take a swallow of it and imagine it flows
right down and out your nipples. I know that imagery can
sound strange, but just try it. They are merely relaxation
techniques and using the imagery to help your body relax and
work with you.
- Rock your shoulders
gently forward and back. Then stretch your head forward and
gently roll to relax the muscles in your upper back.
- Hand express
for a couple of minutes prior to pumping
- Find some soothing
music or nature sounds that relax you
- Read and take
your mind off of the task at hand
- Twiddle your
nipples between your forefinger and thumb until you achieve
letdown and then begin pumping. Use imagery to assist you by
closing your eyes and imagining your baby is nursing.
Freezer Supply
Providing your baby with fresh breastmilk should be your ultimate
goal. Fresh breastmilk maintains nutrients at optimal level. Cooling
milk will reduce those and freezing will further reduce them.
Regardless of the manner in which your breastmilk will be stored,
it is definitely a far superior choice over formula. I consider
a freezer stash to be a matter of "insurance" and a
bit of a stress reducer for mom in knowing that there is an "extra"
stash in case it is needed. If your caregiver is not in your own
home, consider leaving a small stash in their freezer for emergencies.
The last thing that a mom needs to be worried about at work is
whether the EBM (expressed breastmilk) she left is going to be
enough. Alleviate this concern with a small freezer stash. Once
you've returned to work, a good way to create a freezer stash
is to pump on your days off during baby's naps.
Storage
Consider storing your breastmilk in a variety of increments, some
in two ounces and some in four or more. The caregiver can then
become accustomed to approximately how much your baby takes at
different times of the day. It is never a problem to warm an extra
two ounces of EBM, but it is a true shame to waste the same amount.
Mom has worked too hard to pump it to risk not using it. It's
important that the caregiver is on your team with this concept.
If it's possible
to have a standing freezer unit, EBM is stored for longer periods
than when in a freezer unit attached to a refrigerator.
EBM is good for two weeks in a freezer compartment located inside
a refrigerator, for 3 to 4 months in a separate door refrigerator/freezer
and for 6 months or longer in separate deep freeze at a constant
temperature of 19 C (0 F). When storing your EBM in the
freezer compartment attached to a refrigerator, you have to bear
in mind that many new units have a frost-free cycle that periodically
turns the freezer off. To help identify if your unit goes
through such a cycle, put an ice cube in a small dish and allow
it to sit in your freezer compartment for several days and observe
any changes. Many frost-free units use a periodic heating
of the walls of the freezer to defrost. In that case, do
not store EBM against the walls of the freezer, but stack them
in a container kept in the center. It's also a good idea
to keep an ice cube in a small ziplock bag in the freezer to identify,
in the event of a power outage, if defrosting has occurred.
For further tips
on storing EBM, see
Common Concerns When Storing Human Milk.
The Flavor of
EBM
A crucial element to using expressed breastmilk for your baby
is to take the time to do a taste test. This may seem strange
to you, if you've never heard that upon expression some women's
milk takes on different flavors. Some women notice that their
EBM has an unpleasant smell or flavor. This can be caused by vitamin
or mineral supplements, or some medications including strong antibiotics
or nasal sprays, but typically they do not cause this effect.
However, there is a situation involving the lipase in a mother's
milk that does alter the flavor. Lipase is what breaks down the
fat in breastmilk, and the presence of high lipase content can
cause the milk to take on a soapy flavor. It can be noticed not
long after expression, after cooling or after freezing. It is
for this reason that I recommend a taste test prior to returning
to work. If you happened to be one of these women with high lipase
content, you wouldn't want to find out after having accumulated
a large freezer stash.
Setting up a simple
taste test will let you know if lipase content is an issue for
you and your baby. Experiment by expressing some milk and letting
it set at room temperature for thirty minutes. Express some fresh
EBM and compare the taste. If there is no difference in taste,
refrigerate the EBM. After the EBM is cooled, repeat the taste
comparison with fresh EBM. Continue in this manner through the
process of freezing and thawing. The predominance of women will
find that the milk may taste slightly different, but does not
take on an unpleasant flavor. Much in the way that a vegetable
cooked fresh has more in depth flavors than the same vegetable
after having been frozen.
If you find that
your milk takes on a very soapy flavor at any step along the process,
there are a couple things you can further experiment with. It
may be as simple as cooling the milk before placing it into the
freezer, or allowing the EBM to thaw in the refrigerator prior
to warming it in a cup or bowl of hot water. Alter the process
in these simple ways to see if it will bring about the change
needed. If the milk still has a strong soapy flavor, you may need
to give your EBM a very, quick scald prior to cooling. Be careful
not to bring it to a boil. Heat it quickly to just this side of
boiling and take it off the stove immediately, pouring it out
of the pan into a heat safe glass container to cool. When the
EBM is cooled, you may place it in the storage container of your
choice and put it into the refrigerator to cool further, before
transferring it to the freezer if needed.
Lunch Breaks
If it is at all possible to leave work and be with your baby during
your lunch break, it will make life much easier for you. Not only
will you not have to provide milk for that session, but the stimulation
of even one nursing during the long day you're at work will make
a big difference in your supply. When making arrangements for
care for your baby, this is something to keep in mind. The closer
to home you can be employed, the easier this will be to accomplish.
Think outside the box and see what you can arrange. If it cannot
be set up for your family, you will still be able to maintain
a supply regardless. It is truly a matter of effort and commitment
and can be accomplished even in less than perfect circumstances.
Caregivers
It is crucial that whomever is the caregiver for your baby while
you are at work understands that feeding should not be used as
the first option when baby seems fussy. Sit down and have a serious
discussion with them about how hard it can be to pump and provide
the EBM for your baby. Encourage them first to hold, rock, sing,
dance, walk or play with the baby. If baby is merely bored or
in need of loving arms, one of these will fit the bill. If baby
is truly hungry, they will not. In this way, there is never a
precious drop of breastmilk wasted. Make sure they understand
that you are not asking them to schedule your baby, but rather
to learn to recognize baby's needs rather than presume each cue
is one of hunger.
Bottles or Cups
The most difficult initial decision to make as the time draws
near for your return to work is what to use to feed your baby
when you are not there to nurse. If a bottle can be avoided by
using a sippy cup, soft-feeder or other feeding methods that do
not utilize an artificial nipple, it will eliminate the risk of
nipple confusion/preference. Even very young infants can learn
to use a sippy cup with some patience both in experimenting with
different kinds and in teaching the caregiver how to tip it back
and forth to assist the baby. If a bottle is used, it is best
to consistently use a newborn or slow flow nipple regardless of
the age of the infant. This will help to reduce the risk of nipple
confusion by keeping the flow of the EBM from the bottle at a
slow pace. Graduating up to older infant nipples will provide
a very fast flow which runs the risk of baby choosing the faster
flow over nursing and exhibiting a full blown strike to go along
with it. When you are with your baby, always nurse. You need the
stimulation for your supply that a baby at the breast provides.
Nurse Often
at Home
Remember on your days off that you are maintaining and stimulating
your supply. Take it one step further than you would normally
and nurse more often than if you were with your baby fulltime.
You need the opportunity not only to provide stimulation for the
sake of your supply, but also to love, snuggle and cuddle with
your baby while nursing. It helps to balance out the time spent
at the pump during work days. Resist the temptation of over scheduling
your days off. You need to make nursing a priority on those days,
particularly in the early months, to ensure that you have a long
and continued nursing relationship.
Watch What You
Drink
We all know that water is very important to our overall health.
It is even more vital to the fulltime working and pumping mom.
It may be from merely providing the adequate and excellent hydration
that sixty-four ounces provides any adult. There is controversy
on the impact of water consumption on milk supply amongst lactation
professionals. I may not stand with the popular opinion on this
issue, but I've seen the negative effect of too little water consumption
on the ounces at the pump and an almost immediate increase with
a minimum of sixty-four ounces of water consumed daily by the
pumping mom too often to not admit to the correlation. I also
caution against drinking too many dehydrating drinks, both due
to sodium content and caffeine. Any that are consumed need to
be counteracted with at least that much water to make up for their
dehydrating effect. I realize that a morning cup of coffee is
the mainstay of many working moms, but it does need to countered
with an equal amount of water. Other liquids, such as juice or
herbal teas, may not be a dehydrating problem, but should be consumed
in addition to your sixty-four ounces of water a day, not as part
of them. Water alone serves the ultimate purpose of keeping your
system flushing toxins and well hydrated. Staying well hydrated
assists greatly in keeping your body in optimal functioning order,
and optimal functioning order is definitely required for a fulltime
working nursing mom!
Rest
It is very important that any nursing mom stay well rested, because
her bodies is not only maintaining her own health, but spending
500 - 800 calories a day in the production of milk. That's a lot
for one body to do on less than optimal sleep. Make rest a priority.
Consider naps on your days off. Schedule one day a week with a
completely lazy morning. Make this a priority from the beginning.
It's crucial.
Your Diet
Maintaining a good, healthy diet is another important factor for
everyone, but particularly working moms. Candles are burning at
both ends and meals often suffer for it. Plan ahead. Cook large
meals on the weekend and freeze leftovers to use when you're in
a hurry. You need the good foods for energy to accomplish the
many tasks required of you.
Galactagogues
Should your reaction to the pump decrease and all the above methods
have been tried without success, there are galactagogues (herbs
or medications that stimulate milk production) that will assist
with increasing supply. There are many herbs that have a history
of success, however, you must use herbs carefully. They can cause
reactions that range from mild to strong and should be used under
the advice of a professional that is familiar with them. I would
recommend checking with an IBCLC (Internationally Board Certified
Lactation Consultant), a certified herbalist or doctor of homeopathic
medicines for guidance in selecting which herb is right for you
and in what form. There are also medications that a physician
can prescribe to increase milk supply. Again, there are side effects,
and every other tip should be tried before resorting to an herb
or medicine to increase supply.
For more information,
see: Increasing Milk Supply
Handling Managers
and Coworkers
Your commitment to pumping may be met with a variety of reactions.
You need to remember that you have made an excellent choice by
providing EBM for your baby and it is a choice that does not need
defending. Do not feel the need to educate your peers on breastfeeding
and why you pump. The best approach is to succinctly tell them
that you will be using your breaks to pump. Period. You aren't
asking permission. You're informing nicely. It is your right to
use your breaks in this manner, so there should be no argument.
The logistics of exactly where you will pump will have to be worked
out. Find the most relaxing environment for you that is available.
Whether it be in a private locked office, the break room or in
your car, the important thing is that you are comfortable with
the location. The more relaxed you are, the easier your task of
pumping will be.
Some mothers meet
with resistance in the workplace. La Leche League International
website has information on it pertaining to legislation regarding
the workplace. Many states offer incentives to employers for providing
a breastfeeding friendly environment. Should you receive pressure
regarding pumping, don't panic. Find the information you need
for your state and present yourself as a positive role model for
other mothers and your employer. Stand up for your rights in the
workplace in the gentlest way possible to get the job done. You
may be paving the way for many mothers behind you.
When it's time
to take the leap and return to work, consider starting on a Thursday.
That will give you an opportunity for a dry run that only lasts
two days as opposed to what may look like a very long week stretching
before you if you start on a Monday.
You may also consider
speaking with your supervisor about rearranging your schedule
to work four days a week. Working on Monday and Tuesday and then
again on Thursday and Friday would allow a much friendlier schedule
for a mom of a young nursing infant. It is not possible in all
work situations, but is certainly worth considering if there's
a possibility of a modified schedule as an option for you. Function
on the "it never hurts to ask" policy with this. The
worst thing that could happen is that you would be told "no".
It will be much
calmer for your return to work if you take the time to make all
pumping arrangements regarding where you will pump prior to returning
to work. Take the time to have a brief meeting with any superiors
if this is needed and get this solved ahead of time. The last
thing a mom needs when she is making the transition to returning
to work is to spend a moment worrying about exactly how pumping
is going to play out for her. Step back into work with the confidence
that these plans are set.
Additional Information:
05/2003 |