Working and Breastfeeding

MomNursingDesk_CDCPBFMNDK.jpg

photo from the CDC Media Center

Table of Contents for all blog posts

Returning to work or school and balancing breastfeeding/lactation can be stressful! I hope these resources make it a bit easier for you.

Overall Return to Work/School Ideas

  • NJ law relating to breastfeeding and employment - your employer must give you time and an appropriate space to pump.

  • Sample schedules for nursing/pumping:

    • If you want to nurse when home and pump at work - try nursing shortly before leaving the baby, pump every ~2.5 - 3 hours, then nurse at pick-up (or when you get home). When you are home from work - nurse as you normally would.

    • If you are exclusively pumping - continue the pattern you have already established and see how that fits in with your work schedule.

    • Over the first days/weeks, adjust the timing based on how things are going. Ultimately, you want the amount of milk you need for your baby and a bit more as a buffer. If you are making too much or too little milk - the plan can be adjusted.

  • It’s normal for your baby (and you!) to need time to get used to the new normal.  Some babies need time to reliably bottle feed, or want to feed more at night to get extra time with you, or anything in between.  As long as both of you are happy and healthy, it’s all good!

  • If stash is running a bit behind, sometimes a bit of pumping over the weekend is helpful (but work with your IBCLC to figure this out, and see below for more pumping ideas - ideally you shouldn’t need to do this).

  • Plan for the baby to drink about 1 - 1.5 oz per hour that you are away as a starting point. Adjust volumes depending on how things go in first days and over time.

  • Store different amounts for different feeding situations (1 oz, 2 oz and 3 oz bags or bottles, for example). Adjust based on how things are going over time.

    • If you have a bag of milk that has more than you want to use, cut it up into frozen chunks with a clean/sharp knife. Then re-store the smaller portions in new bags.  This can help prevent thawing more than you need.

  • Talk to your caregiver about your timing/ desires - so you can pump/nurse when you want to, avoid wasting milk or avoid overfeeding the baby while you are away.

    • For example, too often parents are told to pump more and more - and the baby is given a higher percentage of milk for the time you are away (always remember babies feed 24 hours a day!). Overfeeding the baby causes them to nurse less when you are home, and puts more pressure on you to pump milk when you are away. Your body may not be made that way - you too, are meant to make milk 24 hours a day - not most of it in the 10 hours you are away.

    • If you want to nurse the baby at pick up/getting home, but the baby is hungry shortly before you arrive - have the caregiver provide a small “snack” bottle to tide them over (the 1 oz portions are perfect for this). This way the baby will still want to nurse when you get there

    • If you want the baby fed before you arrive, have the caregiver provide a full bottle, and pump on your way to picking them up/getting home.

Pumping

  • Flange fitting is critical - milk flow is better, faster and more comfortable if you are sized correctly! Most people need smaller sizes than those that come with the pump - work with your IBCLC!

  • Portable pumps are convenient but not always strong enough for full-time use. They also need to be fitted with silicone inserts for best fit (see point above). It may be helpful to have a portable pump for when you need portability, and a stand-alone/stronger pump for other times.

    • There are also very light/portable pumps that are very strong - they don’t fit in your bra like a wearable pump, but you can wear then on a lanyard - an example is the Baby Buddha (here’s a 10% coupon - LACTATIONPRINCETON10).

    • There are flange cups that are like the portable pump shape, and work with any stand-alone pump - such as Freemies, Cara Cups or Legendairy milk cups (as with wearable pumps, you need proper inserts for best fit)

  • Pump both breasts at the same time to save time. Typical sessions if your flanges fit correctly should be around 10-20 min.

  • Get a nursing/pumping bra or camisole rather than a pumping-only bra - it’s much easier to wear a bra all day, rather than change each time you pump. Pumping bras allow you to pump hands-free, or have your hands available for massage (instead of having to hold pump parts).

    • Hacks for pumping bras:

  • Manual pumps are inexpensive and portable - great for quick sessions (or some people just like them more than electric pumps). Again - make sure the flanges fit properly.

  • Massage while pumping can be helpful to get more milk.

  • Hand Expression is a good alternative to pumping if you have to miss a session or don’t have enough time for a full session.  It can also be used after pumping to get extra milk, if needed.

  • Many more ideas on my pumping page.

Cleaning/Storage

  • CDC storage guidelines

  • 2 helpful articles on milk storage - one by Nancy Mohrbacher and one by The “Milk Meg”

    • They were written before the CDC updated their guidelines (above), so some of the times/days they give are different (defer to the CDC numbers), but the overall info is still very helpful.

  • Store freshly pumped milk in a cooler with ice-packs, or in refrigerator during the day while you are at work.  Combine milk once they are the same temperature.

  • Milk storage bags stack better if you freeze them while laying flat (make “milk bricks”)

  • The CDC recommends washing/drying pump parts every time, and to always use good hygiene for washing/storage to ensure safety (seea bove link)

  • Possible time-saving ideas (but always keep CDC guidelines in mind for safety):

    • Have multiples of each item (bottles, pump parts and valves, etc) to save time by batch cleaning (or to have replacements if something breaks).

    • Pump sterilizing wipes

    • Quick rinse/dry throughout the day and thorough hot/soapy wash each night.

    • “Refrigerator hack” - not endorsed by the CDC because there are too many steps where contamination could occur - but very commonly used since the basic rules indicate milk is safe a cooler with ice-packs for 24 hours or a refrigerator for up to 4 days.

      • After pumping, store the milk in a cooler with ice-packs or refrigerator, and put the other parts (flanges, valves, etc) in clean storage bag with a good seal. Keep the parts in a cooler with ice-packs, or refrigerator between pumps.  Then use them for your next pump. Repeat and then wash everything thoroughly when you get home.

      • Always evaluate your situation for cleanliness, and smell/taste the milk to check!

    • Sterilization of bottles and pump parts is not necessary for a full term healthy baby as long as parts are thoroughly clean.  However feel free to sterilize if needed/desired - boiling water bath, commercial sterilizer, commercial microwave sterilizer bags, etc.

Bottle feeding

  • Paced bottle feeding - prevents overfeeding (and overuse of your hard-earned milk), slows feedings down for less tummy upsets, and is nice communication/interaction between the baby and the caregiver.

  • Bottle refusal - if this occurs, see ideas on my paced feeding page (link just above). Also work with your IBCLC to figure out why the baby is refusing bottles!

  • For the caregiver - start with less in the bottle and add more, if needed. This will waste less milk and avoid overfeeding. Note the CDC (see storage guidelines above) indicates that, unlike formula which must be discarded, pumped milk can be used up to 2 hours even after a baby has drunk from that bottle (human milk has components that inhibit bacterial growth).

Related topics/resources

<—— Oral Exercises — Weaning ——>