photo from the CDC Media Center
Returning to work and balancing breastfeeding/lactation can be stressful! I hope these resources make it a bit easier for you!
Overall Return to Work/School ideas:
NJ law relating to breastfeeding and employment - it is the law to give you time and an appropriate space to pump your milk!
Sample schedules for nursing/pumping can start by roughly mimicking the times that you have been doing prior to returning to work (as long as those times have been working for you in terms of your comfort, milk output, baby’s weight gain, etc)
If you would like to nurse the baby at home and pump at work, a sample schedule could be to nurse just prior to leaving baby, pump every ~2.5 - 3 hours, nurse at pick-up (or when you get home). Then nursing when you are home any other time you normally would.
If you are exclusively pumping, then start by continue the overall pattern that you have already established prior to going back to work.
Use the first week or so as a trial for your schedule and adjust your timing depending on how things are going. You are looking to have the amount of milk you need to feed your baby and maybe a bit more to have a cushion. If you are making too much or too little milk - the plan can be adjusted (or your flange/pump settings, etc)
It’s normal for your baby (and you!) to take time to get used to this. It might take time to reliably bottle feed, or babies sometimes want to feed more at night to get extra time with you, or anything in between. As long as you are both happy and healthy, it’s all good!
Plan for the baby to drink about 1 - 1.5 oz per hour that you are away. This is a reasonable estimate to start with, and adjust volumes depending on how things go in first week or so.
Store different amounts for variety of bottle feeding situations (1 oz, 2oz and 3 oz bags or bottles, for example. Adjust the amounts depending on how things go in the first week or so, and as you get to know your baby’s pattern. For the caregiver it’s good to start with less in the bottle and add more if needed go - this will hopefully allow less waste of your milk if there’s leftover milk. NOTE - the CDC (see storage guidelines below) says that for pumped milk, which has components that inhibit bacterial growth - it can be used up to 2 hours even after a baby has drunk from that bottle.
Talk to your caregiver about your timing and desires - both to be able to pump/nurse when you want to, and also to avoid wasting any of your milk. For example, let’s say you want to nurse the baby at pick up (or getting home) at 5 pm, but the baby is hungry at 4:45 pm. The 1 oz portions are perfect for that scenario! Alternatively, you could also tell the caregiver to give the baby a full bottle, and you can pump on your way to picking them up/getting home.
If you have a bag of milk that has more than you want to use, you can cut it up in frozen chunks with a clean/sharp knife - and then re-store the smaller portions in new bags. This can help prevent thawing more than you need.
Pumping ideas:
Make sure to have a flange fitting with your IBCLC! You will get milk faster and with more comfort if you are sized correctly! Most people need smaller sizes than those that come with the pump.
Also work with your IBCLC on the type of pump to use - for example, portable pumps often need to be fitted with inserts to work well for you. And, many people find they still need to use their regular pump to get the most milk.
Pump both breasts at the same time to save time. Typical sessions if your flanges fit correctly should be around 10-20 min.
Massage while pumping can be very helpful to get more milk.
Hand Expression is a good alternative to pumping if you have to miss a session or don’t have enough time for a full session. It can also be a good thing to do after pumping to get extra milk, if needed.
A manual pump is inexpensive and can also be a good thing to have for quick sessions and/or the need for extra portability. Again - make sure your flanges fit properly!
Sometimes it’s needed to pump over the weekend if stash is ever running a bit behind (work with your IBCLC to figure this out - and ideally how to not need it).
Several good pumping episodes on the podcasts “The Boob Group” and “All Things Breastfeeding” (and great episodes in general!). There are more podcasts that I like if you want more - check my blog post on evidence-based resources for more on this.
It’s good to have extra items on hand - bottles, pump parts and valves, etc. This can save on cleaning time (because you can just clean everything when you get home), act as replacements if something breaks, or just be available if needed.
Pumping Hands Free (or allowing your hands to be free from holding the bottles so you can massage at the same time!)
Use a nursing/pumping bra or camisole (it’s much easier to have a bra that can be worn all day, as opposed to a pumping-only bra, so you don’t have to change your bra to pump)
Hacks for hands-free pumping:
Homemade pumping bra - cut a small hole in an old bra and wear a pad between the hole and your breast
Try using the bra or camisole you already have by just pulling it to the side to hold the flanges - sometimes stretchy sports bras work well this way
Ponytail holder trick for holding flanges - works with most bras or camisoles
Hands-free pumps - Willow and Elvie are two examples - but they only work well if they fit you properly - a silicone insert will be needed to accomplish this, so make sure to have a pumping visit to assess your correct size!
Light/portable pumps - Baby Buddha is currently the best on on the market (and much less money than the Elvie or Willow), and can be used with your existing flanges. If you want to get one they gave me a 10% coupon (LACTATIONPRICETON10)
Hands-free pump parts that work with standard pumps like Spectra - examples include Freemies, Cara Cups or the Legendairy milk cups. As with wearable pumping, you will need the proper insert for them to fit you correctly.
Cleaning/Storage:
Storage guidelines
Here are 2 other articles that are very helpful - one by Nancy Mohrbacher and one by The “Milk Meg”. They were written before the CDC updated their guidelines (above), but I’m including them because the overall info is very helpful. The main difference is that they used to say milk was good in the fridge up to 8 days, and some articles used to have room temperature guidelines that were longer than 4 hours. Many still find that they can go beyond the CDC guidelines (as we did for years!), but it’s always wise to smell/taste to check the milk no matter what!
Store freshly pumped milk in the cooler or in a refrigerator during the day while you are at work. You can combine milk from one pump to the next once they are the same temperature.
Milk storage bags stack better if you freeze them laying down flat (make “milk bricks”)
The CDC recommends washing/drying pump parts every time but here are some time-saving “hacks” to consider (evaluate your situation to determine if any of these may not be right for you):
Use pump sterilizing wipes
Quick rinse/dry throughout the day and thorough hot/soapy wash each night.
Having extra flanges and other parts is great if you don’t want to wash but want to use clean parts for every pump. Then you can wash everything one time at home.
Some people use the “refrigerator hack” - after pumping, store the milk in a cooler or refrigerator, and put the other parts in clean ziplock-type bag. Keep those parts in a cooler or refrigerator between pumps. Because milk storage rules (see CDC link above) show that milk should be safe in a cooler for 24 hours or a refrigerator for up to 4 days, this is generally considered safe. But, of course please evaluate your own situation for cleanliness, and smell/taste the milk to check!
Sterilization of bottles and pump parts is not necessary for a full term healthy baby as long as parts are thoroughly clean. However it’s always good to check on overall cleanliness and sterilize if needed or desired. This can be with boiling water bath, and there are also commercial sterilizing microwave bags.
Bottle feeding ideas:
Paced bottle feeding - prevents overfeeding, overuse of pumped milk, slows feedings down for less tummy upsets, and it’s a nice communication/interaction for the person giving the bottle too!
Bottle refusal - if this occurs, see ideas on my paced feeding page (linked just above). Also work with our IBCLC to figure out why the baby is refusing bottles!
Other helpful related topics:
Cold and Allergy Medications Compatible with breastfeeding article on KellyMom (and, any article on KellyMom is helpful!)
Infant Risk center for asking questions about medications, also excellent for looking up medications, supplements, etc is the website e-lactancia
IG pages