Making It Work
Getting Enough Milk?
From: NEW BEGINNINGS, Vol. 17 No. 5, September-October 2000, pp 183-85, 189
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.
I just gave birth to a beautiful baby daughter. I will be returning to work full-time when she is two months old. I am committed to continuing to breastfeed, and I have a pump that will work well for me. However, I am worried about how much milk I need to pump. How do I know how much milk to leave for her each day? I cannot measure how much she nurses right now. What if the milk I express at work each day isn't enough for her the next day? Any suggestions would be welcome.
I, too, returned to work after two months and have been successful with breastfeeding (my son is eight months old). Two of the obstacles I encountered were how to know how much milk to send for my son daily and the constant worry of whether it would be enough. I found that I would always pump enough for his needs and sometimes had milk left over. The first month or so I would send exactly what I pumped each day and request that the remainder be frozen for future needs.
In addition, I gave my son's caretaker a copy of the La Leche League tear-off sheet on Storage of Human Milk. She was very thankful to read about how to store and prepare human milk. After about a month, I was able to gauge how much milk my son needed and began storing milk at home. I still leave an extra bottle or two with my son's caregiver in case something unexpected happens. Once a month, I remind her to use up the oldest milk in her freezer and replace it with a fresh supply. This way, I can ensure that the milk is always fresh. I always freeze milk in bottles so it is easier for my son's caregiver to thaw the appropriate amount and have a bottle ready.
As far as pumping at work and frequency, I had to maintain a strict two-to three-hour pumping schedule. I struggled with my milk supply and still am fighting the battle. Even though some days it seemed as if I had not pumped much milk, it always seemed to be just the right amount for his needs. It is very stressful counting ounces as you pump and worrying if you will make your "quota" for each day. I finally realized that I would always have the right amount for his daily needs. His intake has fluctuated and so has my milk supply. I continue to pump on the weekends when his nursing doesn't coincide with my pumping schedule. I'm home for the summer as I am a schoolteacher and have continued my pumping schedule. I feel more comfortable with extra milk in the freezer and will use it on his cereal in the future, if needed.
Stone Mountain GA USA
I have a beautiful daughter who is six months old, and I have been back to work since she was three months. I am pumping and our nursing relationship continues to be rewarding for both of us. Before I returned to work I read Nursing Mother, Working Mother by Gale Pryor and the advice in that book helped me to pump with confidence. It may be available in your local Group Library. I highly recommend buying a copy. I also received some wonderful advice from the board-certified lactation consultant from whom I purchased my pump.
I began to pump when my daughter was four weeks old so that I could stockpile my milk in case I had some difficulty when I went back to work. This eased my mind because I knew that there was plenty of milk for her. I received literature from the lactation consultant on the average intake of babies at various ages and weights so that I could estimate how much she needed at each feeding. This was very helpful when I was preparing her bottles. I never wanted to waste any milk. When you are pumping, milk becomes liquid gold and you don't want to waste an ounce! Now that I have been at work for a while, my husband knows when my daughter is especially hungry, and he makes the bottle according to her needs.
My best suggestion is that you make pumping a priority and schedule it into your day. I work 12-hour shifts as a critical care nurse. My job can become very time-consuming at the drop of a hat, but I knew that I wanted to pump every four hours. Just as my patients are given their medications on time, I pump on time every day. I believe that this schedule has ensured my milk supply and has also given me perspective. I know that every time I pump I am providing for my baby and giving her the milk she needs even when I cannot be with her. My co-workers have become accustomed to my schedule and are extremely supportive. I think that is because I spoke honestly and directly about my needs from my first day back to work.
At one point, my frozen milk supply began to diminish and I panicked. I called my LLL Leader and she told me to start pumping once a day when I was home to increase my supply. My daughter was sleeping longer at night so I pumped just before I went to bed, and before I knew it I had a freezer full of milk again!
Your body is an amazing machine and you need to put faith in it. You will produce the amount of milk that is right for your baby as long as you continue to stimulate your breasts. Pumping will become like second nature and your baby will reap all of the benefits even when you cannot be there in person. I wish you the best of luck!
Morrisville PA USA
Like you, I worried about my daughter not having enough bottled milk during the hours I was at work since I had no idea how much she would need. My advice is to start pumping ahead of time so you'll have plenty stocked in the freezer. Pump whenever your baby is napping; just an ounce or two at a time quickly adds up.
Once you return to work, you'll be pumping at the times she is taking a bottle (twice a day for us), so the milk will be replaced as it is being used up. Even with this strategy, I felt I was sometimes close to falling behind. My solution was to stay committed. Sometimes I would pump from one side first thing in the morning when my breasts were fullest and then nurse her on the other; or occasionally I would get out of bed in the middle of the night to pump. It was worth it! We never ran out. I found it difficult to discard remaining milk when I picked her up at the end of the day. But over time, I realized that since there was leftover milk, she must have always had enough.
Wolcott CT USA
I went back to work in my job as a police officer when my older daughter, Jessie, was 8 weeks old (now 4) and when my twins, Jamie and Ryan, now 20 months old, were 12 weeks old. Jessie weaned herself at two-and-a-half years. Jamie, Ryan, and I still have a wonderful nursing relationship.
In my experience, the key to pumping was to start at least two weeks before my anticipated return to work. Don't worry about not having enough milk to nurse your daughter with pumping. Mother Nature is a genius! I found it best to pump either immediately after a nursing session or about halfway through the baby's long nap. With my older daughter, I was away from home up to 12 hours on some days, but never had to worry about running low on milk. Good luck!
Waterbury CT USA
I returned to work full-time when my son was four-and-a-half months old. I also had questions about how much milk to leave and found no straight answers. Yes, all babies are different and each working mother needs to find out what works best for her situation, but I was frustrated. I felt I needed a number to shoot for. I was so worried that I would not leave enough milk and my son would go hungry! He eats frequently during the day; he sleeps through the night from about 8:30 pm to 6:30 am, but takes few naps in the daytime, sometimes even skipping naps entirely.
Fortunately, I returned to work part-time for three weeks before going back full-time, and this gave me an opportunity to see about how much milk I needed to leave for a whole day. Before returning to work, I pumped before going to bed for about two weeks and stocked up milk in the freezer. I am so glad I did this because on my first half-day back to work, my son drank 10 ounces! At that rate, I was worried I would never be able to keep up with his needs! By the end of the third week, he was still consistently drinking 10 ounces. Once I returned to work full-time, I planned on him drinking 20 ounces a day. While working part-time, I only pumped at night before I went to sleep and in the morning before jumping in the shower. I limited my morning pumping to no more then two ounces per breast, as I knew I would be nursing within an hour and wanted to be sure to have plenty of milk. I continued to pump on weekends, giving myself a break if I was too tired to stay up to pump. My son actually drinks anywhere from 16 to 20 ounces a day while I am at work full-time. I pump once at work and at home following the same routine as when I was working part-time. I am keeping up with his demand, and continuing to pump during the weekends helps me not to panic if I am too tired to pump some morning or evening. I always try to keep an emergency supply of 20 ounces in the freezer.
Higley AZ USA
I can still remember the apprehension (okay, fear!) I felt when I needed to return to work when my first daughter was only 12 weeks old. I, too, wondered whether I would pump enough milk to meet her needs.
Here's what worked for me. I began to pump fairly early on (at about three weeks) to "practice." I knew that pumping was not the same as a baby and my body would need to learn to let down milk for the plastic pump flanges. I would pump once every other day or so at first, and save every drop in the freezer. I made sure to freeze in small quantities (two ounces or so), so that the frozen milk could be thawed faster and not wasted. By the time I went back to work, I had quite a supply built up—enough that she could be fed frozen milk exclusively for three to four days if necessary. Having an emergency supply helped me relax about pumping enough at work. Relaxing, in turn, helped me pump more effectively and get more milk!
It also helped to schedule enough pumping sessions during the day. Pumping more often (at least three times in an eight-hour day) really helps to keep up my milk supply. I also started back to work on a Thursday. That way, I had only two days of work (because the first days back are extremely stressful, no matter how well prepared), and could then rest, nurse, and build up my milk supply again on the weekend. Also, if I had discovered I couldn't pump enough during the day, I could have squeezed in a pumping session or two on the weekend to stimulate my breasts to make more milk and put a bit more milk in the freezer.
Unfortunately, the only way to know if you'll pump enough milk while at work is to actually go back to work and pump. However, practicing pumping ahead of time can be reassuring. It lets you know that your body can learn to let down milk to the pump as necessary so that your baby can still be fed your "liquid gold" while you are away.
One real challenge to mothering and working away from the home is that it is hard to relax and enjoy the baby during a maternity leave. So, the most important helpful tip I could give you is to enjoy your baby! The pumping will take care of itself; really, it will. There are many ways to work on supply difficulties if necessary. But your maternity leave will flash by in the blink of an eye—although it may not seem like it some days!
Good luck to you!
Hibbing MN USA
I returned to work when my daughter was six weeks old, but began planning when she was two weeks old. My first purchase was an electric pump that allowed me to collect all the milk from both breasts at the same time in about ten minutes. Ten minutes was the amount of time ordinarily allowed in a work break, and me being away from my work station for this length of time would not greatly inconvenience my fellow workers.
I started pumping about two weeks before I was to return to work, in order to build up an adequate supply of milk and get used to pumping. It took time for my body to get used to producing milk with this different form of stimulation. My second purchase was a supply of four-ounce baby bottles and, by the time I returned to work, I had about eight in my freezer, each filled and labeled with the date on which I had collected the milk.
My third purchase was a special container for storing the pumped milk at near-freezing temperature until I could get it from work to my freezer at home. That way I never had to use the refrigerator at work and my pumping could be kept private.
Some days I would pump more and other days less. Because I had a reserve of milk in my freezer, the amount I pumped on each individual day was not as critical. My daughter's caretakers would retrieve the milk from the freezer in the order it was collected.
I found that it was important to drink lots of water and always to use the air conditioner in my car, even in mildly warm weather, so I would not sweat. I found that the amount of milk I was able to pump was directly related to my body's hydration level and that sweating caused too great a water loss.
As my daughter got older and my milk supply decreased, I had a more difficult time getting milk with the pump. I found that a good technique was to nurse my daughter on one side while pumping the other side simultaneously. My daughter's nursing stimulated the other side to produce milk even with the pump's less powerful suction.
Cherry Valley CA USA
I went back to work when my daughter was seven weeks old. I began pumping when my daughter was two weeks old in order to build up my supply of milk. I too was unsure how much my daughter would need while I was working.
I was very fortunate that I was able to visit the daycare every day at lunchtime for a nursing session. In addition, when I arrived at the daycare in both the morning and afternoon I nursed my daughter.
In the beginning, I sent four 4-ounce bottles and took home anything my daughter didn't use. After several weeks I noticed my daughter was on a regular schedule and using only two bottles a day. I spoke to my daughter's caregivers who told me that she didn't seem to need any more than those two bottles. I always sent an extra bottle just in case. My daughter really only drank two to three ounces at the beginning. As she got older, she progressed to four, then six ounces.
I never had any problem getting enough milk pumping. I pumped twice a day while at work (once in the morning and once in the afternoon). When my daughter was 10 months old, my milk supply started to diminish. I started pumping three times a day, trying to increase my supply. When that didn't work for me, I decided to use a supplement.
Dedication to nursing and the willingness to pump is all that is needed to be able to work while nursing. My daughter is 14 months old now; she is still nursing, and I am still working.
Rochester Hills MI USA