Going Back to Work – Easy as 1-2-3

Many mom’s are returning to work after having a baby. When should you begin pumping? When should you introduce a bottle? How much milk do you need to have stored? These questions and more are answered below in this month’s newsletter.

Step 1: The Beginning

When mom brings a new baby home from the hospital, she should concentrate on enjoying baby and getting as much rest as possible. If need be, mom can pump due to engorgement making it easier for baby to latch on. Definitely save that milk but no need to stress out about pumping this early to prepare to return to work. Once the baby is a couple of weeks old and things settle down with the new routine, mom can begin pumping milk to save for her return to work. If there has been a previous issue with low milk supply, start pumping sooner.

Morning is when breastmilk supply is most plentiful, making it the best time to pump. Pump right after nursing so the breasts are emptied but won’t take away from the next meal. Even if it’s only an ounce, by the end of the week, she will have 7 ounces stored. Pump more than once a day if desired. When baby is sleeping for longer stretches at night, the breasts will become much fuller and allow for more milk storage after baby feeds. Do not mix warm milk with refrigerated milk, but add together once both are chilled. This will take up less space in your freezer than 50 one ounce bags!

Step 2: Preparing for Work

Once breastfeeding is well established (after at least 2 to 3 weeks), start giving baby a bottle of breastmilk so he or she will take it when you go back to work. It’s better if someone other than mom gives baby the bottle so baby continues to associate breastfeeding with mom. Baby doesn’t have to have a bottle every day to know how to eat from it; once a week is enough. Short nipples with a fat base are best for breastfeeding babies so avoid long, skinny nipples and pacifiers. Pacifiers should also be avoided until breastfeeding is well established and baby is back up to birth weight.

Breastfed babies will often take more breastmilk from a bottle than if they are breastfeeding. Make sure the caregiver takes the bottle out of baby’s mouth to burp after each ounce and slow down the feeding. A slow flow nipple is preferred otherwise baby can gobble down a full bottle of milk before their brain has registered their tummy is full.

Since you don’t know for sure how much baby gets at each feeding, it’s helpful to have different amounts of breastmik frozen in bags. Anywhere from 2 to 5 ounces may be what baby will take depending on baby’s age, how long since the last feeding and baby’s size. Medela’s milk storage bags are nice since they attach directly to the pump saving the step of pouring it from the bottle and into the bag. If you spill some of the milk in the process, you probably will “cry over spilled milk”!

It’s also a good idea to freeze some of your breastmilk in a clean ice cube tray. Once the cubes of milk are frozen, put them in a freezer strength Ziploc bag. One cube is about an ounce. Maybe baby has taken 3 or 4 ounces of breastmilk and is still hungry. You don’t want your caregiver to unthaw another 3 or 4 ounces and waste some of your precious breastmilk, so they can just unthaw one cube and top your baby off. Or maybe you are on your way home from work, baby is getting hungry and you want to breastfeed when you get there. Baby can be held off by warming up that cube of milk and then you can still nurse baby.

Breastmilk should be warmed up in a bowl of warm water or under warm tap water. Never, never microwave! It can break down some of the protein nutrients or give it hot spots that burn baby’s mouth. Make sure bottles are BPA free. Medela’s products were BPA free before any of us had even heard of BPA. Breastmilk can be stored in the refrigerator for 5 to 7 days but freeze it if you aren’t going to use it right away. You can freeze them for 3 to 4 months. Place the bags in the back, not in the door where it is exposed to warmer temperature changes. If you have a deep freeze, it can be stored for 6 to 12 months. Put your milk storage bags in a freezer strength Ziploc bag if you are storing them long term and always date your bags so you can use your oldest milk up first.

Step 3: Back at Work

Milk pumped today at work should be what baby eats tomorrow so you don’t need to have a freezer full of milk. It’s good to have extras on hand and will be less stressful knowing there is back up milk available. This piece of mind means mom is more likely to pump more. A lot of what happens in your brain, affects what happens in your breasts. Stressing about not having enough breastmilk pumped may actually produce less milk. Positive thoughts translate into more milk. Have a picture of your baby near by while pumping or even a recording on your cell phone of your baby’s noises or crying to help your milk to let down. Also try thinking of a dam bursting or a flood of water rushing through a narrow canyon. Imagery can be very helpful with pumping. Again – positive thoughts!

Ideally you should pump at work to match your baby’s feeding schedule. This may not be possible for all moms so do the best you can. If you work a 6 hour shift, you should pump at least once, twice for an 8 hour shift and 3 times for a 12 hour shift. Try to nurse your baby right before you walk out the door to go to work so baby empties your breasts and you don’t need to pump as soon as you get to work.

Having a good double electric breastpump is very important. Pumping both breasts simultaneously gets a nice, fast flow of milk from both breasts. You will be able to get a lot more milk over a shorter period of time than if you were only pumping one breast. Medela makes the Advanced Pump InStyle and the Freestyle double electric pumps for moms to purchase. You can also rent the Symphony which is an excellent hospital grade double electric pump. This is especially helpful if you have a hospitalized infant or issues with milk supply.

If you get tired of holding the breastpump in place, the Freestyle is hands free or you can purchase the Easy Expression hands-free bra that is worn on top of your nursing bra while using the Pump InStyle breastpump. Some moms have limited time so this frees up her hands to eat lunch, work at a laptop or read a book. All these products are available for purchase at Breastfeeding Support & Supplies of Omaha with a free demonstration of products by a Lactation Consultant.

All Medela breastpumps have the two-phase expression that mimics baby’s sucking pattern helping stimulate your let down. If you can, put a warm moist towel over your breasts before you pump or if you are home, pump after your shower. You can also massage your breasts then begin manual expression—roll your nipples between your thumb and finger which triggers your brain to think baby is latching on. If you get more milk from one breast (which almost all moms do), pump that side that makes less milk for a longer time and/or put baby to that breast at the beginning of feedings more frequently to produce more milk. Remember to have positive thoughts while pumping!

It’s important to eat well and drink plenty of water when you are at work. Foods with malt and oatmeal are good for milk supply so an oatmeal cereal bar and glass of milk with Ovaltine are a good snack at work. If you are having problems pumping enough at work, Breastfeeding Support & Supplies has a variety of herbs to help increase milk supply. You can also make an appointment with Diane for a consultation. There are many suggestions she can give you to help increase your milk supply. She also has a detailed handout on ways to increase milk supply that she can review with you.

Still have questions? Don’t hesitate to call or email me anytime with your concerns. I am here to assist you in any way I can.

(402) 707-1696 or contact me.