Working and Breastfeeding

Jul 18

Written By Leslie Kowalski

Returning to work or school, and balancing that with caring for your baby can be stressful!

I hope these resources make things a bit easier for you.

Table of Contents for all blog posts

To get ready for returning to work or school you need the following:

A baby who is feeding well (breast and/or bottle) and a good supply (work with your IBCLC if supply is not where you want it to be).
An good quality pump and flanges that fit you well so that sessions are comfortable, timely, and effective.
Enough milk to feed the baby on day 1 (~1-1.5 oz per hour that you will be away is a good starting point)

This might be surprising info because the internet is full of photos of freezers full of milk! But this can be deceiving - the amount you really need is how much your baby will drink on the 1st day that you are away - plus whatever amount of overage/buffer (stash) that helps you to feel comfortable. Also a freezer full of milk usually pairs with breasts that are overly full and uncomfortable (an oversupply). A typcial helpful stash is just a few days worth of milk - good for those days when things do not go to plan (you miss a pump session, the milk spills (😢), the baby takes more milk than usual while you are away, etc).

Ideally once you start work - the amount you pump while you are away will be the amount of milk the baby needs the next day. So, on day 1 you pump for day 2; on day 2 you pump for day 3, and so on. So let’s say you need 12 oz on day 1 - then your goal can be ~36 oz in stash. With that goal in mind, if you were to pump 1 oz extra per day for 5 weeks then you will meet your goal!

The law requires that your employer give you appropriate time and a clean/private place to pump (not a bathroom or a storage closet!). Here’s NJ law relating to breastfeeding and employment (or search for info about the state where you live).

It’s normal for your baby (and you!) to need time to get used to the new normal. Some babies need time to reliably bottle feed (your IBCLC can help here!), or may want to feed more at night to get extra time with you, or anything in between. As long as both of you are happy and healthy, it’s all good!

Index for this page (scroll down for each topic)

Sample schedules
Working with your baby’s caregiver
Pumping tips
Cleaning/Storage
Bottle feeding
Caffeine, alcohol, and medicines while lactating; and more

Sample schedules for nursing/pumping

If you want to minimize pumping/maximize nursing - try nursing shortly before leaving the baby, then pump every ~2.5 - 3 hours while you are away, then nurse at pick-up (or when you get home). When you are home the rest of the time - nurse as you normally would.
If you are exclusively pumping - continue the pattern you have already established and see how that fits in with your work schedule.
Over the first days/weeks, adjust the timing based on how things are going. Ultimately, you want the amount of milk you need for your baby plus a bit more as a buffer. If you are making way too much or too little milk each day - the plan can be adjusted. Work with your IBCLC on this - you may need to adjust the timing of when you pump, adjust flange fit/pumping settings, how much the baby is drinking, and more.

Working with your baby’s caregiver

You want to pump/nurse when you want to, avoid wasting milk and avoid overfeeding the baby while you are away.

As a starting goal - plan for the baby to drink about 1 - 1.5 oz per hour that you will be away. Depending on how things are going, these volumes can be adjusted over time
It’s helpful to store different volumes for different feeding situations (1 oz, 2 oz and 3 oz bags or bottles, for example). This will help your caregiver to customize how much the baby is getting depending on how the day is going. If you happen to already have a frozen bag of milk that has more milk than you need - you can either thaw it and split it into two bottles for the day. Or, if you want to keep it frozen you can cut up the frozen milk with a clean/sharp knife, and re-allocate the milk to new bags.
Avoid overfeeding the baby. Too often babies are fed more than they need while you are away by well-meaning caregivers. Keep in mind that babies feed 24 hours a day, so let’s say your baby takes 30 oz per day and you are gone 10 hours, the baby may only need 10-15 oz while you are away. If your baby is overfed during the time you are at work, it puts more pressure on you to pump extra milk, and your body may not be made that way! You too are meant to make milk 24 hours a day - not most of it in the 10 hours you are away.
- Start with slightly less in the bottle than you think the baby will drink - and then add more, if needed. Once you have more of a routine this is less likely to be needed.
- CDC (see storage guidelines below) indicate that, unlike formula which must be discarded after drinking - pumped milk can be used up to 2 hours even after a baby has drunk from that bottle (human milk has components that inhibit bacterial growth). So if the baby doesn’t finish the bottle, it can be finished in the next 2 hours.
Timing feeding/pumping for when you are about to pick up the baby:
- If you want to nurse the baby when you get to them, but they are hungry shortly before you arrive - have the caregiver provide a small “snack” bottle to tide them over (smaller portions described above are perfect for this!). This way the baby will still want to nurse when you get there.
- Alternatively, if you want the baby fed before you arrive - have the caregiver provide a full bottle, and you can pump on your way to picking them up/getting home.

Pumping Tips

See also my pumping page for milk storage, flange fit and more.

Flange fitting is critical - milk flow is better, faster and more comfortable if you are sized correctly! Most people need smaller sizes than those that come with the pump - work with your IBCLC for a custom fit!
Portable pumps are convenient but not always strong enough for full-time use. They also need to be used with silicone inserts for a custom fit (see point above).
Pump both breasts at the same time to save time. Typical sessions if your flanges fit correctly should be around 10-20 min, and you should get the amount of milk you want/need.
Pumping while driving can be a great hack for getting 1-2 of your pumps accomplished. This can be with a portable or standard pump. Helpful tools are car chargers and a scarf to cover the pump parts if you are concerned about fellow drivers seeing you pump.
Pumping bras allow you to pump hands-free, or have your hands available for massage (instead of having to hold pump parts). Get a nursing/pumping bra or camisole rather than a pumping-only bra - it’s much easier to have a bra that you can wear all day, rather than have to change your bra each time you pump.
- Or you can try these pumping bra hacks:
  - You may be able to use a stretchy bra or camisole (pull the cup to the side to hold the flanges).
  - Ponytail holder trick for holding flanges
  - Items like these bra extenders
  - Homemade - cut a small hole in a bra you like, use a pad to cover the hole
Manual pumps are inexpensive and portable - great for quick sessions (or some people just like them more than electric pumps). Again - make sure the flanges fit properly.
Massage while pumping, if needed, can be helpful to get more milk (note sometimes if you have to use this excessively it may mean that your flanges do not fit you well enough).
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 used after pumping to get extra milk, if needed.

Cleaning/Storage

CDC storage guidelines
2 helpful articles on milk storage - one by Nancy Mohrbacher and one by The “Milk Meg”
- They were written before the CDC updated their guidelines (above), so some of the times/days they give are different (defer to the CDC numbers), but the overall info is still very helpful.
Store freshly pumped milk in a cooler with ice-packs, or in refrigerator during the day while you are at work. Combine milk once they are the same temperature.
Milk storage bags stack better if you freeze them while laying flat (make “milk bricks”)
The CDC recommends washing/drying pump parts every time, and to always use good hygiene for washing/storage to ensure safety (seea bove link)
Possible time-saving ideas (but always keep CDC guidelines above in mind for safety):

Have multiples of each item (bottles, pump parts and valves, etc) to save time by batch cleaning (or to have replacements if something breaks).
Pump sterilizing wipes
Quick rinse/dry throughout the day and thorough hot/soapy wash each night.
“Refrigerator hack” - not endorsed by the CDC because there are too many steps where contamination could occur - but very commonly used since the basic rules indicate milk is safe a cooler with ice-packs for 24 hours or a refrigerator for up to 4 days.
- After pumping, store the milk in a cooler with ice-packs or refrigerator, and put the other parts (flanges, valves, etc) in clean storage bag with a good seal. Keep the parts in a cooler with ice-packs, or refrigerator between pumps. Then use them for your next pump. Repeat and then wash everything thoroughly when you get home.
- Always evaluate your 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 feel free to sterilize if needed/desired - boiling water bath, commercial sterilizer, commercial microwave sterilizer bags, etc.

Bottle Feeding

Ideally we want to prevent overfeeding (overuse of your hard-earned milk!), slow feedings down for babies have more comfortable digestion, and have bottle feeding be a nice communication/interaction between the baby and their caregiver. My page on paced bottle feeding is very helpful for all of this!
Bottle refusal - if this occurs, my bottle feeding page (link just above) has many ideas to work with. Bottle refusal, though, is not normal (beyond a short time of the baby mabye being a little fussy/getting used to the new normal). If your baby is having issues taking bottles, work with your IBCLC for help!