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Optimizing your Milk Supply

Optimizing Your Milk Supply After Returning to Work or School

There are three critical components necessary for successfully maintaining milk supply when reentering the workforce or returning to school:

A high quality breast pump that removes milk quickly and effectively

A place to use a breast pump at work/school that is clean, private, and with access to electricity, if needed

Time to use a breast pump at work/school at least every 3 hours

The information provided on this page will help you understand how to manage working and breastfeeding.




Selecting a Breast Pump

When assessing the performance criteria of a breast pump, the breastfeeding baby should set the standard. When a baby nurses he creates approximately 200-250 millimeters Hg negative pressure and sucks approximately once every second (45-55 times/minute).

breast pump suction pressures range from 20-650 mm Hg negative pressure. Pressures above the high 200s often cause pain. Pressures below 150 are reported to be ineffective at extracting milk. A breast pump that is similar to a nursing baby creates 200-230 mm Hg negative pressure and cycles about once every second. Two Medela pumps meet both criteria for suction pressure and cycles (sucks) per minute: the Lactina and the Pump In Style. Both of these pumps are also designed for frequent, long term use and their simultaneous double pumping action may help maintain milk supply more effectively.

If only working or taking classes part-time - less than 4 hours a day or 2 eight-hour work/school days - the Medela Mini Electric or Avent Isis are other options. Although these pumps do not meet both criteria for performance, they are still acceptable when used in this limited and short-term fashion.

When choosing a breast pump, you should consider where at work/school you will be using it. Will you have access to an electrical outlet? If not, does the pump convert to battery operation or can it be used in your car? Both the Lactina and the Pump In Style are electrically operable and can also be powered by a vehicle lighter adapter or battery pack. The Mini Electric can be powered with an AC adapter, 2 AA batteries, or manually. The Avent Isis pump can be operated manually without the need for additional power sources or worry about wear and tear on motor parts.




Breast pumping in the Weeks Prior to Your Return to Work/School

During the time after your baby is born and before you return to the workplace or classroom, your primary goal will be to establish your supply. This is best done through frequent day and night feedings and the avoidance or limitation of supplemental bottles.

Also during this time you will want to select or purchase your breast pump. This will allow you time to become familiar with the operation and cleaning of your pump, enabling you to determine if you need extra parts, etc. and to remedy any pumping problems.

This is also a good time to begin stockpiling your milk reserve and introducing your baby to an alternative feeding method, usually a bottle. Be advised that you will want to avoid bottles unless medically indicated for at least 4 weeks if possible in order to lessen the risk of nipple confusion. Plan to pump milk to stockpile whenever the opportunity arises:

In the early days when the milk supply may be more than the baby needs, often referred to as the engorgement period.

On the other breast when the baby only takes one side.

A few minutes (5-10) after feedings.

In the morning hours when milk supply is most plentiful.

When pumping during these days, expect to only be able to pump small amounts as your body adjusts to a different type of stimulation and while your baby is nursing frequently throughout the day and night. You may have to pump several times in order to acquire the amount needed for one bottle. Once you return to work or school, however, and begin missing feedings regularly, you will be able to pump greater amounts.




Managing breast pumping in the Work or School Setting

Frequency of pumping: Ideally you should plan to pump at least 3 times during an 8 hour work/school day, 2 times during a 6 hour day, and at least once during a 4 hour day. If pumping opportunities are extremely limited,brief pumping sessions of 5 minutes are better than no pumping. If there is no pumping for prolonged periods; i.e.. 8-9 hours or more, expect milk supply to drop. Supply can be increased through frequent nighttime and weekend (days off) nursing sessions.

Some mothers resort to reverse cycle feeding if pumping is not an option at work. This is simply feeding your baby at least as frequently during the night hours as he would normally feed during the day. It is made easier by bringing the baby to bed with you so that you can obtain the rest that you need.

Possible locations for pumping: a women's restroom, lounge, locker room, or break room, an unused conference room or office, an employee health office, your vehicle, or a designated employee breast pumping room. Wherever you decide to pump, make sure that you have access to electricity (if needed for pump operation), the location is private and comfortable (not too hot or too cold; comfortable place to sit), and there is sufficient cleanliness for collecting milk. If using a public restroom wash area to wash pump parts after collecting milk, consider bringing your own wash basin from home in order to maximize hygiene.

Consider doing a "practice run" the week before you return to work/school. Leave the baby with the caregiver and go to your workplace or school a couple of times during the day to pump when you normally will be pumping. This will give you the opportunity to identify any problems; i.e.. With the pump, location of pumping, whether or not your collection/cleaning/storage options are adequate, and the estimated time required for pumping.




Strategies for Maintaining Milk Supply

The number of breast emptying (nursing or pumping) sessions per every 24 hours is critical:

8 times is optimal

7 times is minimal

6 times - expect milk supply to decrease

More frequent feedings can be encouraged by increasing skin-to-skin contact and co-sleeping.

Avoid bottles and pacifiers whenever you and baby are together. This will ensure that all the baby's sucking needs are met at the breast and that you receive vital stimulation to maintain your supply.

Minimize any stress in your life and delegate responsibilities when you can.

Optimize your physical status by going to bed earlier, increasing rest times on off days, getting moderate exercise (increases Prolactin levels which in turn increase milk supply), and consume adequate fluids (many busy moms do not take the time to drink enough, so make it a point to have something nearby that you can sip throughout your work/school day).




A Typical Work/School Day for the Breastfeeding Mother

Set your alarm clock 20-30 minutes early. Nurse your baby during this time even if you have to awaken him.

Dress yourself and the baby.

Eat a well-balanced breakfast including something to drink.

Nurse again before leaving.

Plan to pump around midmorning.

Have something to drink and a snack.

Plan to pump again - or nurse if possible - at midday/lunchtime. Eat a well-balanced meal with something to drink.

Plan to pump around mid-afternoon. Have a snack With something to drink.

Pick up baby after work/school and nurse as soon as you arrive home.

Eat a well-balanced dinner with adequate fluid.

Nurse on demand throughout the evening. This is beneficial to increasing your supply and it helps your baby reconnect with you.

Work in some moderate exercise as this increases the hormone that is responsible for milk production.

Have a bedtime snack with something to drink.

Nurse on demand throughout the night. Bring baby to bed with you to allow for adequate rest.




Is it Worth All This Effort?

Using a breast pump at work/school takes a real commitment. Some mothers make this effort so that they are clearly distinguishable from their baby's caregiver. Only a mother can breastfeed. Others decide to pump at work or school simply because they enjoy breastfeeding and want to continue it for as long as possible. Pumping while at work/school makes this more possible.

There is no doubt about the continued health benefits of breastfeeding to you and your baby even after you return to work or school. Even with the cost of a breast pump and related supplies and the added burden that pumping brings, the cost of NOT continuing to provide your baby with breastmilk after your return to work/school is HIGH! The cost of formula ranges from $48 - $190 per month and specialized formulas required by some babies cost even more. Additionally, formula-feeding is associated with more frequent doctor's office visits and hospitalization, prescriptions, and parental absenteeism from work/school in order to take care of an ill baby. Breastmilk cannot be purchased. Only YOU can provide it!




Guidelines for Storing Expressed Milk for Moms of Healthy, Full-term Babies

The following are some guidelines for storing expressed milk for moms of healthy, full-term babies. Moms who are storing milk for a baby who is in the hospital should follow any guidelines required by the hospital.

Before expressing milk, always wash your hands and make sure the containers you plan to store the milk in have been washed in hot, soapy water and thoroughly rinsed, or have gone through the dishwasher.

Always date the milk before storing it.

If you are expressing or pumping milk to be given to your baby in the next 30 minutes, the milk can simply be kept at room temperature - there are no special storage guidelines.

Milk can be stored in a normal refrigerator with other food items. The US Occupational Safety and Health Administration and the US Centers for Disease Control say human milk does not require special handling or storage in a separate container.

Breastmilk can be stored at room temperature (66-72 degrees Fahrenheit) for up to 10 hours

Breastmilk can be stored in the refrigerator that maintains a temperature of between 32 and 29 degrees Fahrenheit for up to eight days.

Breastmillk can be stored in the freezer section of your refrigerator that has a separate door for up to 3 months.

Breastmilk can be stored in an upright or chest freezer at a constant temperature of 0 degrees (Fahrenheit) for 6 to 12 months.

Containers

Use plastic or glass containers With tops that fit well or special bags designed for storing breastmilk (many pump manufactures make milk storage containers). Thin bottle liners are not recommended. They tend to rip and tear easily.

Freezing

Milk stored in the freezer should be placed in the middle of the freezer and not kept on the freezer door.

If you plan to add milk to an already frozen container, cool the milk in the refrigerator first. Adding warm or room-temperature milk to a frozen supply could thaw the frozen milk.

Milk that has been frozen and thawed can be refrigerated for up to 24 hours, but should not be refrozen.

Freeze milk in two-four oz. servings. This will allow you to thaw one serving at a time to help avoid wasting the milk.

Whichever container you choose, don't fill it to the top -allow room for expansion when freezing.

Warming

Thaw frozen breastmilk under warm, running water. Do not boil! Heating the milk will destroy its nutrients.

Shake before testing the temperature or serving it to your baby (it is common for the cream to separate from milk in storage).

Avoid microwaves. Breastmilk heated in a microwave tends to have "hot spots" that could burn your baby.

OTHER RESOURCES

La Leche League

La Leche League provides phone support from experience mothers, accredited by La Leche League International. Monthly support meetings for information and support are also available.

Arizona Dept. of Health Services Pregnancy and Breastfeeding Hotline (bi-lingual)
Contact #: 1-800-833-4642

Breastfeeding National Network (Medela)
Contact #: 1-800-835-5968

Ameda Helpline
Contact #: 1-877-992-6332, Option #2

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