Working & Breastfeeding - Tips for Success
Going back to work after having a baby can be challenging.
You may be feeling a lot of emotions, including worrying about how your baby will do without you by their side. If you are planning to breastfeed, you may also be worried about how you will find time to pump at work so that your baby can have your milk for the next day of childcare.
This article offers tips for breastfeeding mothers who will be returning to work and expressing milk for their babies to have with their caregivers. It is dedicated to encouraging each mother to find what works for her, and to give support to those with supply issues or questions about pumping. It is also a great resource for mothers who will be expressing milk for their babies even though they are not working outside of the home.
You can start pumping as soon after your baby’s birth as you feel ready. There isn’t a prescribed time that you need to start or a time when it is too late (I pumped for the first time when I was still in the hospital). Many moms don’t pump until they are home and preparing to go back to work.
Don’t be discouraged by this! The little bit of yellow-clear liquid that you do get is LIQUID GOLD! This is your colostrum—you’ll want to make sure your baby gets every bit of it! Your mature milk doesn’t actually come in until four to six days after giving birth—and this is completely normal! Your baby doesn’t need anything except your colostrum in the early days.
Prior to going back to work, I recommend starting to pump on a regular basis so that you can build up your frozen milk supply for when your baby is with the caregiver. Every mother is different, so you will need to figure out what works best for you and your baby. Below are some tips to help you build up your milk supply and your frozen stock of breast milk before you go back to work.
Remember that some of these tips may work for you and some may not. Please use the ones that are helpful and ignore the others. Every mom is different and some tips will be helpful for some moms but not for others. This list is to give you different options to try —you don’t have to do all of them and you can do a few, some or many. You will quickly figure out what works for you and your baby.
- Add in an extra pumping. You have the most milk in the morning, so if you can pump then (after feeding your baby first), you will probably get the most output, but anytime is fine—just do what works best for you and your baby (For me it was 10:00pm!). If possible, try to pump at the same time each day. You won’t get very much milk the first few times you pump because the pump isn’t as efficient as your baby and because your body isn’t used to having this extra feeding time. But do it consistently and your body will adjust.
- Try pumping on one side while your baby nurses on the other. Having your baby nursing on one breast will actually stimulate the other breast to make more milk.
- If you need to increase your milk production, try pumping right after you nurse your baby. You won’t have much milk left, buy every little bit helps and the added stimulation is good for helping to increase your milk supply.
- Make sure that you have the correct size breast flange. Many women need a different size flange than the ones that come with your breast pump. Having the correct size flange will increase your milk output, as your breast will be getting the proper stimulation for milk expression. The size of the flange you need has nothing to do with the size of your breasts; rather, it has more to do with the size of your nipples and how they are being pulled into the flange by the pump. You want to make sure that your nipples do not touch the sides of the flange while you are pumping and that they are evenly and consistently being pulled into the flange when the pump is in use. It is also important that your aerola is not being pulled into the flange, as this could be a sign that the flange you are using is too large. If your flanges are too small or too large, you will not get the best use out of your pump, so make sure that the ones you are using are the correct size.
Storage and Freezing
Once you have started pumping and building up your milk supply, you will need to make sure you store the milk properly so that it can be used when your baby is ready for it. I strongly recommend storing your milk in bags or milk trays, not bottles—especially anything that you want to freeze. If you are just going to keep it in the refrigerator for a few days, then bottles are OK, but you will want to transfer your milk to storage bags or milk trays when freezing it to prevent freezer burn. Below are some tips for storing and using your breast milk:
- A general rule of thumb is that freshly pumped milk can be stored for 5-10 hours at room temperature, 4-5 days in the refrigerator, 3-6 months in a regular freezer and 6-12 months in a deep freezer. Some women’s breast milk may spoil more quickly than others—everyone is different and you will need to figure out what works for you and your baby (I could only store my milk for 3-4 days in the refrigerator, but it was still fine after 12 months in the freezer).
- Since breast milk can only be stored for a limited amount of time, you will want to make sure that you are using your oldest milk first. Be sure to clearly label your bags with the date that the milk was expressed (One trick that worked for me was to use the milk that I pumped one day to give to my caregiver to feed to my son the next day. If I had any extra, I would freeze it. If he needed more than I left, my caregiver would take it from my oldest freezer stash. At the end of the week, I would freeze whatever I pumped, and at the beginning of the next week, my son would get milk from my oldest freezer stash—this way my son got mostly fresh milk, but my freezer stash was also turned over regularly).
- Depending on how much you pump and when you pump, you may only get a little bit of milk. For this reason, it is a good idea to pump into the bottles and then transfer the milk into bags or milk trays for storage. You can combine the milk from a single pumping session or multiple pumping sessions on the same day before you freeze it.
- After pumping, you should first cool the milk in the refrigerator, then transfer it to the freezer. This will help your milk to last longer.
- If you are combining milk from the same pumping session before freezing, just mix them together. If you are combining fresh milk with milk from a previous pumping session, you will want to cool the fresh milk down before combining them. Before freezing any milk, make sure you cool it down in the refrigerator first, and then transfer it to the freezer.
- To thaw your frozen breast milk, place it in a pan of warm water. It will take just a few minutes to thaw. Do not microwave or boil the milk, as this will scald the milk and you take a chance that there will be “hot pockets” that can burn your baby.
- Once your milk is frozen and thawed, it can only be kept for 24 hours in the refrigerator before it needs to be used or thrown out. So it is important to freeze your milk in a variety of different sized bags. You want your caregivers to have the “right” amount to give your baby and not to have to thaw more than they need. I recommend 1 oz., 2 oz. and 3 oz. per bag. That way if the baby just needs a “tide-me-over” until you get there, your caregiver won’t have to thaw more milk than is needed. It is also a good idea to tell your caregiver to try not to give the baby any milk for at least an hour before you are due to pick up your baby—that way the baby is hungry and you can nurse as soon as you get there.
- If your child is being cared for outside of your home, take some frozen milk to store in the freezer at the caregiver’s house. This way if you don’t have enough fresh milk from the day before, your caregiver will always have extra frozen milk.
When can you start giving your baby a bottle?
Nurse your baby exclusively as long as you can before returning to work. Most experts recommend waiting four to six weeks before giving a bottle, so that you have established a good nursing routine with your baby. This will help your supply and it will also help avoid nipple confusion. Below are some tips for giving your baby a bottle:
- Every baby has different preferences for which type of bottle or nipple they will accept, and some babies are pickier than others. Consider buying one each of a few different kinds of bottles so that you can determine which type your baby likes best. Once you figure that out, then you can stock up.
- Use a newborn, slow-flow nipple on your baby’s bottle. Milk is much easier to drink from a bottle than it is from the breast, and you don’t want your baby to develop a preference for the bottle. Also, it is very easy to over-feed a breast-fed baby with a bottle since the milk comes out so much more quickly. Using a newborn nipple will make the milk come out slower so that your caregiver doesn’t accidentally give your baby more milk that they need.
- Use a technique called ‘Paced Bottle Feeding’ when bottle feeding your breastfed baby. This technique allows the baby to determine the ‘pace’ at which they eat— similar to how they would if they were breastfeeding. To do this, have your caregiver hold your baby in a slightly upright position. Touch the nipple of the bottle to the baby’s chin until the baby opens his/her mouth to accept it. After the baby sucks four or five times, pull the nipple out slightly while keeping it on the baby’s lower lip. This will allow the baby the ability to draw the nipple back in when he is ready for more. You can also tip the bottle to slow/stop the flow of milk instead of pulling the nipple out. This will allow your baby to feed more similarly to how he would feed at the breast and will prevent your caregiver from accidentally giving him too much.
- The first few times your baby receives a bottle, have someone else give it—either your caregiver or your husband/partner. Your baby may not want to drink from a bottle, and if you are the one giving it, they may refuse to take it. Babies are very smart: even if you are in another room, they may know you are close-by and may refuse to take the bottle. Try leaving the house and going out to run errands while your baby is fed. Don’t worry: your baby will take the bottle when they are with your caregiver.
- Many babies change their schedules after their mother goes back to work. They either don’t like the bottle or they just miss the closeness of nursing. Don’t be surprised if your baby begins drinking less during the day and waking up more at night.
- Make sure you have a good pump. The Ameda Purely Yours or Hygeia Enjoye breastpumps are the only personal pumps that use the same high quality components as hospital-grade pumps.
- Get a hands-free pumping device. There are several different kinds available. This will allow you to type e-mail or do other things while pumping and you won’t feel like you are “wasting work time” while you are pumping.
- Bring in a photo of your child and maybe even one of their outfits or a recording of their voice. These will help your milk to let-down and will give you more milk per pumping session.
- Pump both breasts at the same time; they help each other to let-down.
- Make sure you pump until your milk stops letting down and then for a FULL 5 minutes after, even if you have stopped getting anything. The added stimulation will be good for your milk production and it may even stimulate another let-down. One thing that always helped me was to pump for ten minutes, then turn the pump off for 2-3 minutes and pump again for another 5-10 minutes. For me, this ALWAYS gave me a second let-down.
- Buy extra breast flangesso that you don't have to wash them after each pumping. You can also put the bottles and the flanges in the refrigerator, so you don't have to wash them between each pumping and can just continue to pump with the same bottle and base each time. I recommend several breast flanges because you don't want to put the cold flange from the refrigerator against your breast.
- If you can, buy your own “dorm-style” refrigerator to have in your office. This will allow you to store your milk and nursing supplies without having to put them in a shared refrigerator.
- Stay hydrated. I kept a case of water in my office at all times. My husband and I would refresh it every weekend.
- Nurse your baby at home before you leave for work (even if you have to wake them up!) and as soon as you return home in the evening. This will be a great way for you to bond with your baby after a long day at work and it will also ensure that your milk supply stays strong.
- If needed, you can try taking a supplement to increase your milk supply. Fenugreek is one that many mothers swear by (ask a lactation consultant how much to take.) Other things that help to increase milk supply are oatmeal (the kind you cook, not the instant ones) and some of the "mother’s milk" style teas.
- Don’t compare how much milk you should be pumping to how much magazines say your baby should be drinking. Most of these magazines are measuring what formula fed babies drink and they are certainly not measuring what your baby needs. Don’t forget that your baby is also nursing before and after you go to work. As long as you are pumping enough for your baby to drink while you are away, you are doing fine. I typically only pumped 10 ounces per day (2-3 ounces per session) and this worked out great for us. You may pump more or you may pump less; the specific amount isn’t what is important.
- Don’t compare what you pump to what you think your baby is getting while nursing. Your baby is much more efficient at getting your milk out than a pump is—so your baby may get the same amount in five minutes that you get by pumping for 15 minutes. Never use the amount you can pump as an estimate for how much your baby gets while nursing.
Pumping at work
When you first go back to work, don’t worry if your baby drinks a lot more than you pump. You will both be going through a stressful time. It is easier to get milk from a bottle than from the breast, so the baby may just gulp down more because it comes out so easily. You are also going to be a little stressed with the new job and being away from your child; stress tends to decrease milk supply. You don’t have to be concerned: as you both settle into your new routines, the supply and demand will even itself out. It is a good thing to be prepared for this so that your lower-than-expected output or your baby’s higher-than-expected consumption doesn’t add to your stress level. (When I first went back to work my baby drank 17 ounces and I pumped 10 for the same time period! But over time, I ended up with a whole lot of left over milk in the freezer, so it all worked out well).
Pumping and working can be stressful, so try to find some things that help you relax: play some music; kick off your shoes; use your hands-free device so that you feel “productive” while pumping; close your eyes and think about your baby’s smiling face. And don’t forget to take pride in what you are doing: you are taking good care of your baby! Both you and your baby will benefit from your efforts to pump at work!
Judy P. Masucci, Ph.D.
A Mother's Boutique, LLC dba Levana Bratique
© 2005-2017, Judy P. Masucci, Ph.D., A Mother's Boutique, LLC dba Levana Bratique. All Rights Reserved. No part of this document may be reproduced without express written permission from the author.
Published in the Expectant Mother's Guide 2007-2011, on-line and print editions.