Pumping, Going Back to Work

I went back to work--which included multi night business trips--when my daughter was 10 weeks only and managed to keep her exclusively on breastmilk until she was almost 9 months old when she started showing interest in solid foods.

I would definitely pump before nursing in the morning and try to get in 1-2 sessions during the work day. If your place of employment doesn't have suitable facilities for pumping in a clean environment, pumping and dumping will help keep your supply up. I had to do this a lot when travelling when I didn't have clean facilities or a place to store milk over several days.

I also sometimes would nurse on one side and pump the other--then switch. I seemed to get more out of the pumped side when I was nursing the other.

While I am a huge proponent of exclusively breastfeeding as long as humanly possibly AND doing everything you can to secure it...formula isn't poison. Do what you can within your means to keep up with the breastmilk and then use some formula.

I never pumped when my son was at home. I only nursed him. When I started going back to work at 6 weeks, I would send formula with him to daycare, freeze the milk I pumped at work, and nurse at home. This worked for me because I had to travel for work, so my son needed to be able to rely on formula and someone else giving him a bottle. I saved the frozen milk for my parents when I would gone for a week at a time. He never had any digestive issues switching back and forth. If you find you aren't pumping enough, this might be an option for you.

When I pumped at work, I would pump twice a day. I would nurse in the morning before I left for work (7AM), pump during a morning break or at lunch (10-11AM), pump in the afternoon (2PM), and nurse as soon as we got home (5-6PM). I had a Medela Pump in Style, which was a dual pumper. The sitter tended to feed him as needed, which would usually be 3 bottles of 3-4oz each over about 9 hours. When he was going through growth spurts, his normal eating pattern could vary wildly, which was another reason the formula at daycare worked since he wouldn't run out. I breastfed/pumped for about 11 months, so doing the formula at daycare did not affect my supply at all.

I have been back at work a month now and breastfeed my baby. My son goes to daycare so I nurse him right before he leaves the house with my husband for drop off. I pick him up in the evenings and feed him as soon as we get home. I do not use any bottles at home. I think my supply has kept up fairly well but my son does receive formula at daycare because I simply cannot pump enough. He is now about half breastmilk and half formula at daycare but all breastmilk/nursing at home.

I pump three to four times per day while at the office. You don’t ask the following but I’ll volunteer it anyway. The pumping bra is the way to go for sure so your hands are free. I use the Medela Pump in Style and it works well. Make sure your breastshields are fitting properly so you aren't impacting your results from pumping. A poor fit can hurt your results. Also drink tons of water/fluids. I notice a significant dip in pump output when I don't drink enough. Monitor any medications you may take as those can hurt your supply too. When I pump I get between 2.5 to 4 ounces total. Kellymom is a great resource and on that website it mentions those pumped amounts are reasonable. It also talks about breastshield fit, pump types, etc. That website is a tremendous resource and I highly recommend it as have others to me.

Before going back to work I pumped about an hour after my baby ate twice a day (once in the morning and once at night) per my lactation consultant. This ensured I didn’t have to bottle feed him if I pumped beforehand and he didn’t have enough to eat. It also gave me a stockpile. I don’t see why the order of pumping and nursing matters. Whatever works for you is what you should do. I pumped and nursed alternately for about one week before I went back to work. I could have added extra pumping sessions (at noon or overnight) and I could have started sooner but with a newborn and a toddler I did the best I could. When I went back to work, I did have a frozen reserve. However, my well-meaning MIL fed it all to my son the first day I was back at work. I posted a question about that situation and people had great advice for me. She fed him way too much in response to every whimper. A good care provided will not do this by the way.

When I switched my son to his daycare, the daycare does feed on demand BUT they read the cues better and they work with me to avoid overfeeding my baby. They ask my husband every morning when was the last time our baby ate and then they follow my son’s cues from there. It works out to approximately the same pattern as at home. We do not use a pacifier at home but they use one at daycare which helps I think. Instead of pacifying with a bottle they can use a pacifier. Recently my son was eating the bottles I sent him with very quickly and still was hungry. The ladies were great about talking to me about the situation. We came up with a plan (more food in the bottles but the same time apart) and for now we are back on track.
What you need to figure out is approximately how many times your baby eats in twenty four hours. Then you can determine how much you will need to leave for him while you are away. You don’t mention how old your baby is but I noticed my son settled into a pattern of eating after six weeks. My son’s eating pattern can vary but it is more predictable than when he was tiny. My son eats about every two and a half hours. So in a given day he eats nine to ten times (24/2.5 = 9.6). I think it through logically like this. My son eats once overnight, then again early in the morning, one more before going to daycare and then I feed him after pick up and finally once more at bedtime. That’s five feedings so he needs to eat four to five times at daycare. I send him with five bottles and he typically only eats four of them. As far as how much to give him I worked with my lactation consultant to determine a number of ounces. Her estimated number was 4 ounces while Kellymom predicted 3 ounces (link below). I don’t know how your childcare works but with mine I can leave one or two extra bottles with more formula as backup which is what I do. Some days my son just eats a lot and I don’t want him going hungry. This past weekend and others times recently my son has eaten very frequently. I worried about how that would work out at daycare but so far he sticks to his pattern at daycare. It seems like he reserves the frequent feedings for when he’s home with me. Good luck.

http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

I would actually pump before your LO nurses in the morning. Babies are much better at getting milk out of breasts than pumps are. So you'll pump more, and your baby will probably still eat enough too. Try it once. If your baby is fussy because he can't get enough, you can always give an ounce or two of what you pumped. And then you can give up on this idea. But I think it's worth a try.

Also, you may need to pump longer. I always had an initial letdown of milk, then right around the 15-20 minute timepoint, I had another letdown of milk.

As for childcare, I would plan on one 3-oz bottle for every 3 hours that you are gone. Then, give your childcare provider a few 2-oz packs of frozen breastmilk to keep in the freezer in case of a high-demand day.

I minimized the number of bottle I had to send by pumping at the daycare in the room immediately before I left for work. My schedule was something like this: nurse at daycare at 8:30, bottle for 11:00, bottle for 1:30, bottle for 4:00, pick up and nurse at daycare at 6. That meant I needed 9 oz per day to send in. If you have 60 oz right now, that means that you have a 6+ working days of milk in the freezer.

Right now you aren't pumping much because your baby is eating first, then you are pumping. I'm actually impressed that you are getting 2.5 oz on top of what your baby is eating. So if the baby wasn't eating at that time, you'd probably pump as much as 6 oz at that session (your baby is nursing out 3 or 4 oz, and then you are pumping 2 more oz). When you pump at work, you will get a LOT more milk from each pumping session, because your baby isn't eating at that time. Plan to pump at approximately the same times that your baby would be taking a bottle. You will likely pump enough to send in the next day, and the 60 oz you have in the freezer will be backup in case you are short an ounce or two here and there.

It really sounds to me like you are going to be fine.

And great job with the pumping and nursing!

If you can get the pumping bras that do both at one time, those are GREAT! You look totally goofy, but you are hands free and pumping twice as much at one time. Pumping before feeding may actually help, as your kiddo will get more from you than a pump can. Start your child on the non-favorite side when you nurse. That way, you'll build up the supply on that side. You can switch to the favorite side to "even out".

Also, if you can pump at work, during your lunch break in a private area, that's another time you can use. If you have the pumping bra, you can eat WHILE you pump.

Talk to a lactation consultant to see if there are alternatives we haven't come up with.

It's tough. I went back to work after 6 weeks with my son and 9 with my daughter. I pumped for the 1st year with both. I had the Medela Pump in Style. Expensive but so worth it. I EBF'ed on demand. My husband owns his own business so he works from home and he would also bottle feed the kids on demand. He was good at reading their hunger cues as opposed to them just being bored cues. I pumped after I fed my daughter in the AM, pumped at work around 10 ish. My husband would bring her to see me at lunch and i would nurse her, if not I would pump at lunch, then I would pump around 2ish and feed her around 4:15ish when i got home. So i was roughly pumping every 2.5 hours or so. I also had formula as a back up. My son got more formula than my daughter. For some reason I produced more with my daughter, don't know why. Only idea is I sucked down tons of Gatorade with supposedly helps supply. ANyway, the bottle pumped in the AM was her mid morning one which dh kept out at room temp. And what I pumped at work was usually one bottle more than she needed so if she was extra hungry she had backup if not it got frozen for my stockpile.

Unfortunately, there is no way to tell how much they will eat. They have growing spurts, sometimes dont want as much, etc. But I found knowing that I had formula as a backup, even though we never used it, took off tons of stress and made things easier.

But good luck. You can do it!