Sunday, December 8, 2013

When Maternity Leave Ends...How To Have Continued Success with Breastfeeding

Since this isn’t Europe, with extended maternity leave times of up to 12 months, most mamas return to work at least part-time between six and twelve weeks after the birth of their babies.  For those who are breastfeeding, this can be a daunting experience, but with proper preparation, it is absolutely manageable.  You can have continued success with breastfeeding and pumping, allowing your baby to continue to have breast milk for as long as the two of you both want it to happen.  That’s not to say that there still will not be tears; when returning to work myself, I definitely cried.  As time passes, though, it becomes easier, I promise.

Above all else, I recommend getting a good breastfeeding relationship started prior to attempting to use the pump, unless there is a medical necessity for pumping sooner.  To illustrate this, my first child was born early at 37w5d.  She was jaundiced, and a sleepy nurser.  She would latch, nurse for thirty seconds or so, and fall asleep.  The key to removing her jaundice, though, was to nurse.  So, to help her with getting milk, I started pumping for her at 5 days old, and gave her 1 ounce of pumped breast milk at the end of every nursing session.  Pumping that early on, though, eventually lead into an oversupply situation for me, which will be discussed in a future article.

Let’s start with the most basic of questions, one I hear frequently, that being some variation of how much milk needs to be frozen ahead of the “the big day.”  A lactation consultant that I worked with after the birth of my second child gave me this wise piece of advice, “Not much.”  Ideally, the milk that you are making is exactly what your baby needs at the specific age and stage of development.  That’s not to say that milk pumped when he was 3 months old won’t be useful to him at 6 months, but it is definitely different in nutritional value and fat content. 

When pumping, ideally, you’d like to just keep up with your baby.  For that first week back, you’ll need a “starter stash,” but again, it may only need to be a day or two of frozen breast milk.  Presuming that you return to work on a Monday, you could use frozen milk on Monday to provide for your baby, but on Tuesday, you could use a combination of milk that was freshly pumped on Monday, and through the week, use less and less frozen milk.  Sometimes, by the end of the week, you will have excess milk, and that would restock your freezer supply.  In other words, there is no reason to stress out if you have a small freezer stash prior to your anticipated return to work date. 

Now with that established, let’s rewind a bit to discuss pumping, and what you’ll need to be as efficient and comfortable as possible.   When you decide you are ready to try pumping (ideally plan to do this about 4-6 weeks before you return to work), get out your pump and its instruction manual.  Read through the instruction manual, and set things up to make sure you are comfortable with the parts and the function of the pump.  If you were not sized at the hospital with a lactation consultant, definitely check out this link ( first from Medela to figure out which size breast shield fits you best.  Not all women will be comfortable using the included (with Medela pumps) 24mm breast shield.  Having the wrong size breast shield can sabotage your success at pumping before you ever get a chance to get started!

While you certainly can simply hold the breast shields against your breasts during the pumping process, many mamas find that it is more comfortable to invest in some type of hands-free device.  While not all women can multi-task during pumping, for those that can, taking time from the workday to pump does not decrease productivity.  I have used two different options for hands-free pumping.  The first is a bra that goes over your nursing bra (with the clips undone), and has an opening in the fabric to slip the breast shield into that holds it in place.  One such brand name of this type of product is Simple Wishes (  The bra is highly adjustable with both Velcro sizing and a front zipper, allowing for a customizable fit. 

A second option is a device that goes fully within your nursing bra, and collects breast milk in a slightly different manner.  In some ways, it almost looks like the funnel part of the breast shield was turned “inside out,” and set inside a cup.  As there is not a traditional breast shield, there is also not a traditional collection pouch or bag!  With the Freemie (, the milk collects inside the cup, inside your bra, and the only exposed portion of the device are the two thin hoses that come out from underneath your shirt to attach to the pump tubing.  When finished pumping, you simply remove the collection cups from your bra, and pour the milk from the collection cup into a pouch or bag for storage.   

When you begin pumping, prior to returning to work, I personally recommend pumping once daily, or even every other day, depending on the length of your maternity leave.  Typically, you will feel the fullest, and have the most milk, after the first morning nursing session.  This can vary if your baby wakes several times during the night, of course.  Waiting 30 minutes to one hour after that first nursing session (long enough to change a diaper, cuddle a bit, and set up the pump) will also increase the amount that you may be able to pump.  It’s important not to focus necessarily on the ounces that you pump initially.  That can be a significant hang-up to pumping mamas, and a stressor that may ultimately negatively affect milk production.  Pumping should last usually about two minutes after you stop seeing milk flowing freely into the breast shields (after the end of the let-down), but some women will have a second let-down in any given pumping session.  These pumping sessions may not initially result in an entire extra feeding of expressed milk, but will be the beginnings of what you use for your “starter stash” described above. 

Returning to work can be a daunting process for a new mother; there is so much emotion involved in the actual separation from your baby in addition to the desire to continue to provide breast milk.  However, with the right pump, properly fitting breast shields or other collection device, and some way to pump hands-free, pumping at work is entirely doable and can be done without much interruption to your regular workday.  In the next part of this series on returning to work, more information will be given on collection, storage, and usage of expressed breast milk.    

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