Breastfeeding and Working

Updated on September 27, 2006
S.R. asks from Twin Falls, ID
17 answers

Hello there! I just moved to the area and am a RN in the emergency room here at SLMVRMC & I have a six month old daughter. Working in the ER makes it very difficult to maintain my milk supply. Since I started work, I have noticed a gradual decline in my milk supply, to the point where I can't keep up with her needs anymore. I do pump when I can, which is usually only on my dinner break for 15-20 minutes and then as soon as I get home, about 4-5 hours later. I can't pump more often then that due to the demands of the job (excuse me sir, I know you're having a cardiac arrest, but I need to go pump...LOL, don't think so!) On my days off we nurse as much as possible, I have tried Fenugreek and Blessed Thistle supplements & pumping after I feed her to increase my milk supply but I still haven't noticed a difference in my supply (I have been doing this for 2 weeks now, doing everything reccommended by LLL and still no noticable change, still can't keep up!). My husband and I have made the decision to supplement her with formula until I can get my supply back--she only needs one, maybe two feedings of formula and she is still primarily breastfed. I was pretty upset about doing that, I wanted her to be exclusively breastfed, but we kinda had no choice. My daughter and I aren't ready to wean yet, and I would be absolutely devastated if I had to wean her this early. I think part of the problem is that my orienting to the new job in the ER requires a schedule that is pretty irregular. Here in a couple weeks it should start calming down and becoming more regular. Any suggestions as to what to do or tips on increasing milk supply would be fabulous, I really want to continue breastfeeding my little one, it's such a unique and rewarding experience!

Also, I would be up for playdates after my schedule calms down a little!!

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J.H.

answers from Eugene on

You might be able to rent a hospital grade pump from the nicu. I havent used them personally but the LLL told me they are effective in building a milk supply.

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K.

answers from Rapid City on

HELLO. I AM ALSO A RN AND I HAD COULD NOT GET MY 9 MONTH OLD TO NURSE. EVEN AFTER 3 LACTATION CONSULTANTS AND TRYING FOR 2 MONTHS. MY MOM IS ASLO AN NICU NURSE AND TRIED, AND SHE CAN GET ANY BABY TO THE BREAST. I ENDED UP PUMPING FOR 6.5 MONTHS ENTIRELY. AFTER ONLY BEING ABLE TO PUMP, YOUR MILK SUPPLY WILL DECREASE! AND AFTER I WENT TO WORK I COULD NO LONGER PUMP EVERY 3 HOURS, SO MY MILK SUPPLY REALLY DECREASED. I WENT ON REGLAN, AND IT DEFINITELY INCREASE MY SUPPLY. I KNOW IT IS AN MEDICATION, HOWEVER I HAD NO SIDE EFFECTS, NEITHER DID MY LITTLE GUY. I WAS TAKING 10MG 2-3 TIMES A DAY. THE LACTATION CONSULTANTS HERE DO RECOMMEND REGLAN IF SUPPLY CAN NOT KEEP UP. ANY WAY WORKING WITH THE PEDS AND NEOS THEY HAVE SAID THAT THE FORMULAS NOW DAYS ARE BETTER THEN THEY USED TO BE, SO HOPEFULLY IF YOU DO NEED TO CONTINUE WITH FORMULA THAT EASES THE MIND! GOOD LUCK

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C.M.

answers from Salt Lake City on

S.,
My sister is going through your same predicament. She also works as a nurse, has a crazy schedule and has tried to juggle pumping for her daughter who I take care of 50 hours a week.
Due to time limitations, she just couldn't do it. Now when she drops the baby off with me she'll give me the one or two bottles that she was able to express and formula for the rest of the day. She felt guilty about it initially but there was just no other way. The baby adjusted to it beautifully and all is well.
So, if you do have to go the formula route, don't beat yourself up too much because sometimes the only other alternative is working less and not everyone can do that!
Good luck.

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A.J.

answers from Salt Lake City on

Hi S.. I am also new to this area and also a nurse! My daughter is 19 months old and I breastfed her for her first year. I pumped at work as often as I could, 2 times in a 12 hour shift at first and then just once. The funny thing was, as much as I pumped I NEVER got as much as she was drinking while I was working. I tried to pump on my days off in the morning and at night to stock up, but eventually I just gave up and she took formula when I was working. Amazingly, I always had enough for her on my days off, I just didn't get as much pumping. It's odd but if you have to supplement with formula just go with it! As good as those pumps are (mine almost jerked me off my chair the first time!) they just don't work as well as the babies do! My guess is that you will be able to keep breasfeeding even if your supply seems low at work. Best of luck to you! I am new to the area so I am not quite sure where you work..right now I work at the LDS hospital in Salt Lake but I am agency so maybe I will run in to you somewhere! A.

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K.P.

answers from Omaha on

I just want to say hang in there. When I had my daughter I was able to breastfeed longer because I supplemented with formula. My husband and I worked it out so that we both got to spend time feeding her & we both got to sleep. I wasn't working, but I have bipolar and what I needed was more sleep, so maybe supplementing will work to help fit your needs too. Best of luck, it is well worth it.

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B.T.

answers from Provo on

Hey there, I thought I'd write because I have a 14 month old daughter who I had to stop breastfeeding before she was a year which was not how I'd planned it. I had to go back to work when she was only two months old, I was a waitress, but much like your job I never knew when a customer was going to come in and I had no set breaks so finding enough time to pump was tricky.At first it didn't seem to affect my supply but after a while I had a definite decrease and by four months we already had to supplement with formula. When I asked my doctor for suggestions she pretty much said the best thing to do was to make sure I was constantly taking in fluids. She also said that for some women, no matter what they do, their milk supply will naturally dry up before the baby may be ready to wean. My milk was gone by the time she was ten months. It was a bummer for me but she did great. She's 14 months old and only had one small cold since she was born which her pediatrician said is almost unheard of and most certainly do to the fact that she was primarily breastfed the first 6 months. So don't feel too bad. Your daughter will love you just as much no matter how long you breastfeed and there are pleanty of other ways for you to continue connecting with her. Also, I'm from Chicago so I don't know if this exsists here in Utah but try contacting the La Leche League. It's a helpline/support group for nursing moms. Good luck!

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R.A.

answers from Portland on

I just wanted to offer some pump advice. I have a five year old and a 2 month old. With my first and for a little bit with the new baby I used a manual pump (Medela, which is a really good brand) that was completely useless. I would pump for a half hour and maybe have 2 ounces. The lactation consultants at my local hospital told me that WIC provides double electric breastpumps to women on WIC who breastfeed exclusively and will be away from their babies for more than 20 hours a week. With an electric breast pump, I can pump 2 ounces in five minutes from just one breast! It is so much easier than manual. Since your milik supply is generally more in the morning, for my son's first morning feeding, I feed him on one side and pump on the other. (It takes a little juggling with pillows and practice). Letdown is quick because my baby is nursing, compared to pumping without my baby present. I am using a double electric pump from Medela. Good luck.

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H.B.

answers from Las Vegas on

Hi S.,
My name is H. B., I am a certified lactation consultant. I have over 12 years breastfeeding education and 4 years bf, 2 children. I don't think I have done something as hard as pumping. I had never been able to exclusively bf either of my children. I was lucky enough to be able to bring both children to work with me until they were 6 months old. Yeh, Good and Bad! Though I never had any problems bf in public and what comes in handier than latching your own infant on the breast for examples of positioning, while teaching bf classes. I had tought BF for 2 years prior to having my first child. I thought everybody should bf and if they don't they are either selfish or uneducated. WOW! What an eye opener. I believe everything happens for a reason. I worked with my first infant for 3 weeks feeding with an eyedropper, and crying at my work place( my lactation consultant) because my baby wouldn't bf. I also had the problem that no matter what kind of pump I used, It just said" who are you kidding?" I have rented the medela and have used the hospital grade pumps. Both of my children had problems with failure to thrive. Both were supplimented with formula, both bf till the age of 2, I chose to wean at that point.

I think the metoclopramide or reglan, or dopermine is another option. I have used mediclopramide to induce a milk supply for adoptive moms and for low milk supplies for children going into surgery. I took it for 3 weeks and wow did my supply increase. This is usually a last effort due to the possible side effects. I had a chioce at the time. I could take it or my infant could due to her failure to thrive. She gained amost a pound in the month it was used but I suffered terribly due to the side effects. If you can find a physician to prescribe it ( your in the right place and you probably know people ) and you can deal with the side effects than this should work. I still would try to recommend a bathroom break, well maaybe not in the bathroom but even if you can find 2-5 minutes to pump if you are feeling full. When you get engorged, this tells your body to stop producing milk, then with decreased stimulation decrease of milk supply. My heart goes out to you! But, You have done so much, so far. Alot of mothers want to breastfeed and are not able too. 6 months, wow!!!!!!!!!!
I'm so proud of you! I did continue pumping at work for 3 months and what a waste of time, most people would say.(Including my bosses who promote breastfeeding.) I would double pump 3 times a day with an electric medela and I would get 1 oz each time. 3 oz. of milk, is it really worth it? It was to me. I increased my breastfeeding on the nights and weekends. Don't be surprised if your infants starts waking more frequently in the middle of the night. They have a way of changing thier Bf times and amounts to suit thier needs.If your child is not getting enough pumped bmilk, your at a really nice age to start supplimenting with food, go slowly if your just introducing. Formula (I have been forced to learn) is a safe, alternative, effective way to feed your infant. Or just suppliment with. You have nothing to feel guilty about! You sound like a greeat person and a hard worker and thats what makes a great mom. Also, this may make you alot more simpothetic(sp) when a nursing mother comes into the emergency room needing help. Some medications may not make it possible to bf. So, take into account your situation and realize where you can learn something that may help someone else in the future. You may not be able to change the fact, that sometimes it is not recommended or possble to breastfeed and it will allow you to empathize about what your patient may be feeling. Even if its just engorgment, or loss of being able to continue breastfeeding. If you need additional info. I can fax you a sheet about the medoclopramide/reglan. Dr. Jack Newman is an excellant source of info and support. He also has info on dopermine as another medical chioce. You can get alot of info on him or sources from the internet. I have a phone number from 1997, probably has changed but if you want to try to contact [email protected]____.com would be a great choice to start getting medical info in case you decide to take this route and run into resistance. Not everybody is supportive of breastfeeding. Good luck and email me a personal note if you need extra info or help! Good luck and thanks for being a nurse! There are not enough of you out there!

H. B.

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M.S.

answers from Spokane on

I am also an RN and returned to my nursing job at 6 weeks pp. I nursed until my son was 7 months old, b/c my milk supply diminished to the point where it wasn't worth my time to pump it. We don't drink enough while working, we have anxiety at work, fatigue, we're not smelling, touching and looking at the recipient of this labor of love when we're at work. My feeling is this: nurse her for the bonding, but make the decision that her main nutrition will come from formula. Lots of babies out there have done great on formula and so will your baby. The other option would be to work less. You need to decide what's most important. Your lunch break is supposed to be just that: a break. Not a stress session to pump as much as you possibly can while scarfing down a sandwich. Good luck.

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T.

answers from Las Vegas on

S.,

I pumped at work for my son until he was 16 months old and I nursed him until he was 23 months. It is hard but not impossible to maintain or even build a milk supply around working but it takes some time, patience and persistence. Since you can't pump more at work, you will likely have to pump outside of work. I ended up needing to pump 4 -5 times a day to get enough milk to feel my son while I was gone and I could only do 2 of those sessions at work. So I started pumping first thing in the morning, twice a work and then before bed each day when I had to work and I started pumping twice a day on each weekend day so I'd have a little "breathing room" on the days I didn't quite pump enough. I started out just pumping twice a day on the days I was at work and I was producing about 8-10 ounces a day that way and my son was eating close to 20. I was able to get to the point where I was producing 20-25 ounces a day but it took about 3 weeks of following my new schedule of at least 4 pumps a day (in the meantime, I'd throw in a pump session any time I could - like when I got home from work and maybe an extra session or two on the weekend days). Within 3 weeks, I was producing enough for my son.

Some things that definitely help: double pumping with a hands free system (I had an Easy Expressions Halter that I got off ebay for $17 plus shipping from Elite Breastfeeding Supplies but you can find them from other people too), using a good quality pump (I had a Medela Pump in Style Advanced but some women do better with a hospital grade rental pump), and making sure you are pumping for at least 20-30 minutes per session.

I belong to a yahoo group called "PumpMoms" and it was really helpful to have access to other women go through the same struggles.

I'm currently 34 weeks pregnant with my second child. I fully intend to pump and breastfeed again for at least a year. I do think it will be easier this time because I'll have a better idea of what works for me. Good luck to you. If you want to chat about more specific ideas, email me.

[email protected]____.com

T.
mama to Cole 9-11-03
and someone new due 11-2-06 (boy!)

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T.C.

answers from Portland on

You probably have already tried this, but try drinking more water and milk. I know from experience that you will not produce more milk if you do not drink enough liquids. While at work, do you get engorged? Try using a small pump while at work, every time you go in and use the rest room, pump, even if it's only 5 minutes.
I worked my daughter's first 6 months, I found that at first I wasn't producing enough, my husband was a stay-at-home dad and tried so hard to get her to take a bottle, she refused and would just cry herself to sleep, then when I'd get home all she wanted was to be cuddled in my arms and nurse... He ended up bringing her to work, knew when my breaks were and I would nurse her, even if it was only 5-10 minutes. After the first few weeks, he started only bringing her to me twice a day, by the time I got home I would be engorged and needing to express the milk.
It's not easy nursing and working at the same time.
T. C

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A.M.

answers from Bismarck on

My supply started to slow when I got my BC. I was told to try oatmeal (not instant) and molassas. I'm not a fan of oatmeal so I made quite a few cookies. With the molassas I would take a large spoonful and mix it in a glass of milk a couple times a day. It made the milk taste almost like maple syrup but my supply increased alot!!

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E.B.

answers from Omaha on

Hi S.. First off, congratulations on wanting to give breastfeeding a chance. Sounds like you have done a great job for six months. That is incredible! When our first son was six months old, I had to be hospitalized for gallbladder surgery. I pumped every four hours around the clock while in the hospital, but my milk supply diminished anyway. I never really got it back. I only work part-time, but every time I'd pump, I was so stressed out about making enough milk for the next day. We managed to make it last until he was eleven months and then switched to formula for a month. Even that was devastating to me, but he just lost interest when there was no more milk there.

With our second son, I was more prepared, so I started pumping every morning after he'd nurse when he was one month old. This really helped and I ended up throwing breastmilk away when we stopped nursing at 14 months. I know you can't go back to when your daughter was a month old, but there are some things you can do similar to what I did the second time around. For awhile, anyway, pump after every single time you nurse her. You may not get much (if any) milk for several days, but eventually, your supply should increase. Make sure you are nursing and/or pumping immediately before work and immediately upon your return. The key to this is consistancy. If you skip pumping even once, it could affect all you have been doing.

This method worked well for our second, but not for our first. Unfortunately, it is not a fail proof method. Most importantly, don't feel like a failure if it doesn't end up working out. Your daughter benefits from every drop of breastmilk she gets and the six months worth you have already given her is wonderful. Many moms make supplementing work along with nursing. The stress you're feeling about it may very well be affecting your supply, too. If you try for a month and it's just not working, maybe you could nurse her before bed and one or other convenient times for you each day and give her formula the rest of the time. I know how bad I felt the first time my first baby tasted formula, but I shouldn't have.

You have done a great job and I hope you can make it work and feel happy with whatever happens. Good Luck!

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A.H.

answers from Boise on

Welcome to the wonderful Magic Valley! I too work (although I'm off due to maternity leave) at SLMVRMC in the Transport department. I'm working there on a PRN basis while attending the RN program at CSI. I've finished my first year, and will be picking up with the second year in Aug. 2007, after this baby is born and a bit older. I am 35 yoa, mother of 3, almost 4, wonderful kids. Being a mom is my #1 love in life.

On the breastfeeding and working, I did the same and found it very difficult to just take a break to pump...(excuse me sir...I know you need to go to CT, but I need to go pump) It is very hard to keep your milk supply up while you're away from baby, as pumping just doesn't seem to empty the breast as well as a nursing baby. I did, however, talk to the nurses in the NICU and was able to use the pump they have up there during my break time. It was much quicker, and seemed to empty my breasts much better. I would then save any pumped milk and use it to supplement, rather than using formula. That way my son remained exclusively breast fed, even if the breast milk was from a bottle. There were also times when my husband would bring baby in for a feeding when he could...which also helped.

Best of luck to you and I hope everything works out for you! I know how very rewarding and special breastfeeding is. I've nursed 3 babies for the entire 1st year of their lives, and have very healthy happy kids. The bond is incredible.

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T.H.

answers from Chico on

My lactition consultant said that a baby could get milk from you even if you thought you were dry. Though it is true that your milk roduction will slow if there is no demand for it. I've also read somewhere (don't remember where) that once a woman has breastfed, she could start again if there was a need. That is how some adopted babies can be breastfed. It's something about the way a baby sucks...not sure.

Anyway! As long as your baby is growing normally and not loosing weight drastically, then most of the time they say don't worry about it. Just pump when you can.

Where as I don't know the stress of a working mom, especially an ER RN...I do know that I used to worry I wouldn't have enough to feed my large baby boy. But he's fine, grows like a weed and was excuslively breastfed til 6 months, then we added in solids and water. He's about 9 months now and is about 25 lbs. and I think about 30-31 inches long/tall.

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M.

answers from Las Vegas on

I had the same problem when I went back to work when my daughter was 4 mo., only for me there was light at the end of the tunnel. Unfortunately my milk supply dried up completely somewhere around 9 months. It was very hard on me emotionally, as I wasn't ready to wean.

Looking back, I wish I had seen a lactation consultant rather than just researching online. Also, in hindsight, I realize I nursed as long as I physically could & I'm proud of that. My daughter is now over 2yrs. old & is one of the healthiest babes I know. She's only been truly sick 2 times. So while I encourage you to do everything you can to continue nursing, you need to realize that if you should have to cut back or wean that you did the best you could & should be proud of yourself!!!

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M.M.

answers from Las Vegas on

I breast feed my twin girls too. I had so many obsticles but it was well worth it. My first obsticle was one of them had latching on problems and did not want to breast feed. I was supplimenting with formula for her. The second was going back to work the girls were 6 months old I was trying my hardest to pump but it was too hard I was a 911 operator. I decided to go to the natural food store and they gave me somethings to help, gosh cant think what it was i know one was fish oil pills, but there is something eles, cant remember. I then decided to stop pumping because it was stressing me out and cutting my supply even more because of the stress.
So once I cut it off, I would get off from work and breast feed strickly. Low and behold it worked my body did it, it roduced milk when I needed it too.
So I breast fed at home, but while at work they had formula.
Then I stopped at 9 months but started back up at a year again because the Isa the baby that was not latching on properly at first wanted to breast feed again and somehow doctor cant figure out how but my body began producing milk again and I successfully began to breast feed the twins for another 4 months.
Then I met the things called teeth WOW!
I had a hardtime with my breastfeeding the twins, honestly it was more stressful then anything eles, and honestly I wish I wasnt so convinced that it was the only way if I could change it I would. I would have not gone through all of it and once my milk started going low I would have stopped.
I guess what I am saying is good luck but if it because too stressful decide if it is right for you, because remember you are a working mommy is a demanding high stress field already.
Aloha

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