Breast Feeding, Pumping, & Being a Working Mom

I wrote a similar post when the girls were about 4 months old and I had just gone back to work:

How Does She {Breast Feed Twins}

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"Where do you see yourself in 5 years?" 

Parker and Jolie | 10 days old

When I was going through school, internship, and finding a job as a dietitian, I was always asked this question.  Never did I ever say or admit that I would eventually be a stay-at-home mom.  Everyone around me was geared to work, and work for what seemed like forever.  Becoming a dietitian is no easy task and it is my proudest accomplishment after becoming a mother to Parker and Jolie. My job isn't something I could decide to walk away from and expect to go back to in five years after the girls were in school- there are too many new, determined, and up and coming dietitians that could take my place.  I had only been licensed and registered for about three years when we got pregnant and I wasn't ready to hang my hat just yet.  I am so blessed to have help and (free) childcare from the twins' grandparents, and a hubby that is home a lot during the days I work.  

So, it is for all these reasons I decided that I would continue to work after the girls were born.  I'm not justifying my reasons for working, just explaining why I work, as it is a question that I get asked on a near daily basis.  I have twins, so I MUST stay home.  It's just not for me at this stage in my life.  What is for me?  Being on bed rest for nearly five months and still getting paid.  I could totally do that.. but that's for another post.

Make a commitment.

My first day back to work | February 20th 2013

Juggling working and breastfeeding is not easy. There will be days when you wonder if it’s all worth it. Working and caring for a couple of babies is a juggling act. Knowing I would be returning to work just 10 short weeks after the girls were born, I needed to get in the mindset of a transition from breastfeeding the girls full-time to pumping part-time and nursing whenever I could.  

You may be on the receiving end of less than supportive comments from ignorant co-workers - I was.   There will be days when you’re ready to toss in the pump and reach for the formula - I had them. But in the end, I made a commitment to continue to breastfeed, and I found a way to do it.  Forget the “what ifs.” “What if he won’t take a bottle?” “What if she won’t take a nap without nursing?” “When I pump milk at home I can pump only a little bit. What if I can’t pump enough milk when I’m back at work?” Don’t let these worries intrude on your decision to make the commitment. 

Get breastfeeding off to a good start.

This is number one.  Getting off on the right foot with your littles will encourage ample milk supply and  fall in sync with your baby’s needs. I found that Parker and Jolie needed a lot of practice nursing.  They had small mouths, and worked really hard at the breast for the first couple of weeks, but eventually they figured it out and they were 'sucking' pros! Babies with effective sucking skills aren't often affected by artificial nipples. The more you and your babies can learn about breastfeeding at this early stage, the easier you will be able to solve any problems that might occur later on.  Once I became confident in my supply, my ability to nourish, and Parker and Jolie's satiety, I was more confident in facing any issue (low supply, supplementing with formula, or a nursing strike) I would have had later on.

Increasing & Maintaining Milk Production

Some things I've tried that didn't do much for me:

·         Mothers Tea- To me it tastes and smells horrible.  I didn't seem much change at all in my milk supply.

·         Fenugreek- smells of maple syrup (it is the additive that is actually added to pancake syrup) and I didn't see too much of a change in my milk supply. I was taking 4+ pills a day and decided after finishing a bottle that it wasn't worth it to purchase again.

What worked for me:

·         Multi-grain Cheerios. No joke! I ate a bowl of Cheerios every night before bed and notice a huge change in my milk supply for the next day. There are studies that say oatmeal is helpful and since Cheerios are and oat based cereal I can see why it works for me.

·         Stay hydrated. I could tell in my milk supply when I didn't drink enough throughout the day. I drank at least 100mL/day of water alone. Not counting the water I get from fruits, vegetables and other food sources. 

·         Eating a balanced diet.  Occasionally, a mother’s calorie or fluid intake can affect milk production.  Excessive dieting can reduce milk supply, but sensible dieting is generally not a problem.  I have read that it’s best not to do anything consciously to lose weight until after the second month. This gives your body enough time to successfully establish a healthy milk supply that is less likely to be adversely affected if your caloric intake is restricted. I had no problem dropping the baby weight, but I wasn’t doing so with effort. 

o   Breast feeding a singleton baby you need an additional 300-500 calories/day.  Breastfeeding twins  you need upwards of an additional 1,000 calories/day  

o   There are no foods that you should avoid simply because you are breastfeeding. It is generally recommended that a nursing mother eat whatever she likes, whenever she likes, in the amounts that she likes and continue to do this unless baby has an obvious reaction to a particular food.

The main thing that I personally needed to maintain an ample milk supply is simple –The more often and effectively my babies nursed, the more milk I had.

Be the time the girls were 4 months old,  I needed to pump almost 40 ounces for my 8 hour work day.  I couldn't help but have a twinge of anxiety every time I would increase each feeding amount.  The fear of not being able to keep up with them is real.

Formula Supplementation
At birth, my little girls were pretty petite at just 4 pounds, 8 ounces and 5 pounds 14 ounces.  The main focus became making sure they were getting enough and gaining weight.  The smaller baby, Jolie Grace, missed the NICU for her weight by just 49 grams (a just about a tablespoons worth), so I became determined to keep her weight up so that they both could come home with me when I was discharged.  In the beginning while I was attempting to build up my supply and weight was of major concern I supplemented with about 1-2 ounces of formula.  I would nurse for just 15 minutes at a time so that they wouldn’t burn too many calories working to get the milk.  The bottle was much easier of an effort and after 15 minutes at the breast, I would offer the bottle and they would eat just a little more. After the first month the girls improved at feeding, my milk supply became efficient to feed them both, and my life got so much easier.  It was tough feeding them once, and then feeding them both all over again.

To some breast feeding mothers, formula isn't ideal, but unless you are producing enough milk for your baby or babies, it might just be the only option. That was hard for me to accept, but finally I came to grips that it wasn’t about me at all- it was all about making sure my babies had enough to eat and grow. With this realization my confidence increased and my anxiety levels dropped and I knew they were getting enough and that's all that matters.  Formula is OKAY, great, actually.  If you choose not to, or circumstances prevent you from being able to breast feed, formula is perfectly fine and will produce healthy and happy babies.

Get to know your breast pump.

One thing I can promise is you’ll develop a love-hate relationship with your pump.  I was hooked to that machine 8-10 times every day during the first six weeks or so. Because the girls’ mouth were small and were not successful in emptying my breasts during a feeding, I had to make my body think that they were so that the supply and demand theory would kick in and increase production.  Pumping while I was still at home not only helped with my supply, but it also helped to build a small stockpile of milk in the freezer. This helped my confidence during the early months after returning on the days that I didn't quite get enough milk to fill the bottles for the next day. 
Don’t panic if you get only a small amount of milk the first few times you pump. There were several times when I would pump at home and I could hardly get a half-ounce (or even less) in 20 minutes of pumping. 

For peace of mind:

• Don’t worry that your baby is not getting enough to eat. Your body does not respond to a pump the way it responds to your baby. Plus, your baby is more efficient at getting milk out of your breasts than the pump.  
• With more practice, your milk ejection reflex will become responsive to the pump. Normally, your milk lets down after your baby sucks for a little while, or maybe in anticipation of your baby sucking. Your body will learn to react in a similar way to the pump and the routine that surrounds pumping.  I have a close girlfriend that exclusively pumped for her twin daughters and she recently told me that she couldn't even be in the same room with her pump without the let down sensation occurring.  I can officially say that never happened to me, but it just goes to show that your body will get to that point of acceptance.

There are a ton of theories and ideas out there for how long you are supposed to pump.  I've heard to pump five minutes after you notice the 'last drop', some say to pump at least 20-25 minutes and no less, others say just 10-15 minutes is enough. Personally, I would make sure to pump until your breasts feel soft and empty. For me, it was at least a 30 minute pump session every three hours during my eight-hour work day.  

There are several options when choosing a pump.  I would recommend the Medela Pump-in-Style breast pump.  I carried that thing everywhere, or so it felt like.  Your pump will come with one set of pump accessories, but I would suggest getting a second set (membranes, valves, shields, and 5-ounce bottles with lids).  I have six (5oz) Medela bottles that I pumped into and occasionally used as storage in the fridge.  I would also highly recommend getting 6-8 of the pumping bottles. I often didn't have time to pump and immediately wash the bottles so I'd have them for use next pump session.  Going back to work and pumping multiple times a day, I found that the larger 8oz Medela storage bottles are helpful.  

Feeding twins, I was typically pumping about 30 ounces while at work, and its easy to store my milk in three larger bottles rather than 6 smaller. For the most part, what I expressed the girls used up pretty quickly, so I never had a whole lot of extra to store, but I did have a stash of Medela Storage Bags in case I came to need them.  They are kind of expensive so unless you are putting milk in the freezer for storage, I'd stick with the Medela bottles.
   
For quick clean up while at work use the Medela Quick Clean Wipes.  Really easy and convenient for cleaning up post-pump session and there isn't a sink available.  Lastly, don't forget the Medela Quick Clean Micro-Steam bags for sterilizing once every day!  You can use these 20 times before you have to toss it.

An Employer Discussion.

Being a working mom is not only about you.  Its success is driven by your commitment, but is also determined by the support of your employer.  Before returning to work I had a serious phone discussion with my boss letting her know of my plans to breastfeed when I returned to work.   I explained what I would need, the time it would take, and respect that I expected. You don’t want to be desperately looking around for a place to pump on your first day back to work, when your breasts are full and you’ve just realized that the ladies lounge has no outlets for plugging in your electric pump.  Be sure to have a plan for when you will pump, where you will store milk, and most importantly where this will all take place. 

Some things to think about:

• You will need to pump about as often as your baby nurses, every two to three hours. If you work an eight-hour day, this means pumping at mid-morning, at lunch, and at mid-afternoon. My lunch hour was typically spent pumping.
• Ideally, the place where you pump will have an electrical outlet, so that you can use an electric pump, if that is your choice, and a sink to rinse off the parts of the pump that come in contact with your milk. You’ll need a comfortable chair and a table for your equipment, your lunch, or any light reading or work you might want to look at while you’re pumping.
• Where will you store the milk? A refrigerator where you can store expressed milk is handy, though you can substitute ice packs and a cooler.  I always kept mine in a lunch bag and our office fridge.

Keeping Up Your Supply.

Squeeze in as many breastfeeding sessions as you can.

image credit: Google

Depending on your work hours, most working mothers can get in three to four breastfeeding sessions in the hours they are home with their babies.  I personally was able to get in three. I always started the day with and early feeding before work, a feeding right when I walked in the door around 4:30p, and a before- bed feeding around 7pm. 

In order to maintain and build-up your milk supply, you need to have days when you breastfeed more often to make up for the times when you and your babies are separated. My suggestion is to make sure your little ones are only given a bottle while you are at work or away.  This will not only help to maintain a good milk supply, but it will also keep the mother-baby connection strong.  Pumping does not stimulate your body to produce milk as well as a nursing baby does, so don't pass up the opportunity when you can. After nursing Parker and Jolie all weekend, I was always really 'full' on a Monday morning when I returned to work.  It 'refueled' my supply to nurse them for three days in a row. After the first few weeks of juggling breastfeeding and working schedules, you will be amazed at how your body adjusts to making just the right amount of milk for your babies.

One thing that I was told when I went back to work was that breastfed babies who are away from their mothers during the day often nurse more frequently at night. This happened to me and Jolie.  I went back to work when the girls were almost four months old, and around that time Jolie started waking through the night, and would not be soothed unless she nursed.  This lasted about a month- I would wake to feed her just once a night around 2am.  I had no idea my going back to work could have altered her sleep-eat habits, but surely it had.

One last tip: You can combine breastfeeding and formula feeding.  

Breastfeeding is not an all-or-nothing deal. While many of us who work and attempt to solely breastfeed find success, others resort to using formula as a back-up when they are unable to pump enough milk - and that it completely fine!

Parker and Jolie | 13 months

I successfully nursed my girls for 13 months (before Parker said NO MORE)- and carried my pump for 10 of those months to and from work.  If I had to count up the hours I spent connected to that machine, I would probably feel sick, but it was all worth it.  Every single minute.  

Bottom line:  It is 'do-able' to successfully breastfed while being a working mom!  Don't feel intimidated or self-conscious- give yourself a chance, and I think you will be surprised. 

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Breastfeeding While Traveling HERE