By Cheryl Taylor, CBE
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.
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.
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.
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.
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.
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.
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.
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!
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.
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.
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.