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Dr Carol's Advice
   
Breastfeeding and Working  
By: Carol Chamblin, DNP, APN, RN, IBCLC  
   
Going back to work and breastfeeding can happen! There are ways to help you.

First, start to collect and store your expressed breast milk as early as 2-3 weeks after having your baby, or at least 2-3 weeks before you plan to return to work.

Pump effectively 1-2 times a day and store your milk in collection bags made for breast milk storage. If you have trouble with keeping up your supply to have enough for your baby, I would recommend you use a Medela Symphony breast pump. If you get enough milk collected and stored with the use of a Medela Advanced Personal Double Pump, then continue using it.; Store your milk in quantities of 2-4 oz until you have about 20 bags. Then begin to store 4-5 oz per collection bag.

Many mothers I encounter who have returned to work for 3-4 weeks notice that their milk supply has decreased since beginning to go to work. In these situations, they think that the stress of work, or lack of a good diet, or being away from their baby has caused them to lose their milk supply. They feelthey can’t do anything about it, but to continue to use their frozen milk and then begin to use formula. If using a pump other than a Symphony pump, I highly recommend getting one. I have helped many mothers fulfill their goals of expressing enough milk to continue to breastfeed for an entire year. Frequently, mothers even purchase deep freezers to store the huge quantity of expressed breast milk.

It is important to start to give your baby a bottle early. If breastfeeding is going well, and you feel tired, a reprieve of someone else giving your baby one bottle so that you can sleep is not necessarily going to cause you to not be able to breastfeed. Certainly, it would be best to have pumped once earlier in the day to have expressed milk instead of formula for your baby. But, it’s emphasized to you here that you will continue to breastfeed if you want to continue. Then, if you didn’t need to give a bottle in the early days of breastfeeding, indeed begin to offer a bottle by the time your baby is 2-3 weeks old. You don’t have to give a full feeding by bottle. Even an oz. given by bottle every 3-4 days will maintain your baby’s willingness to take a bottle.

Many times moms that I have worked with to establish breastfeeding without lingering problems will forget to give bottles. Do not forget to give an occasional bottle once breastfeeding is going well and bottles are not needed for your baby’s weight gain.
When giving a bottle, please pace the feeding.
Paced bottle feeding is done by letting your baby take 3-6 sucks on the bottle and removing the bottle to allow your baby to pause and breathe.
Your baby will be less apt to over-feed, and be more apt to feel full. If babies feed too fast, like if adults eat fast, then we all over-eat and don’t realize our stomachs are full. Bottle confusion doesn’t exist, but flow-confusion may exist. Pacing the bottle causes the flow to mimic closer to breast feeding flow which is controlled and regulated by your baby. Usually babies do not feed too fast at breast.
 
Here’s a snapshot of a work day and breastfeeding/pumping:
Either pump or breastfeed your infant prior to going to work. You choose which method works for you. In some situations baby may be cared for in your home and asleep when mom leaves to go to work. This mother may choose to pump instead of breastfeed. Another mom may need to take her baby to an off-site daycare setting, and therefore, she may choose to breastfeed before leaving home. Which feeding/expressing style is best for you is okay.; Just make sure you do one or the other.

Then, while away at work, you do not need to pump your milk at the exact time your baby feeds. Just make sure that you pump twice. This means you do not pump every 2 hrs. Nor does it mean you need to pump three times. If you can’t get enough milk expressed for your baby’s feeding needs with pumping two times, then I’d highly suggest that you call to get a Symphony pump. Why? Because the Symphony pump empties the breasts most effectively, and therefore, you will produce more milk.

Once home from work, you should try to breastfeed your baby soon thereafter. If possible you can offer your breast to your baby again within 1-2 hours. This type of feeding routine can help you to maintain a good milk supply. Do not miss your opportunity of your baby’s impact on your milk supply by not breastfeeding often enough in the evenings. Strive to breastfeed at least 3-4 times in the evenings. This looks like: breastfeed at 5 p.m., again at 6 p.m., and then at 8 p.m. or at 10 p.m.. If your baby continues to wake-up during the night to feed, you can breastfeed at that time as well. If you prefer to have your husband give your baby a bottle during the nighttime, you can do so. But, if you notice your supply decreasing and you don’t want it to decrease, then I would suggest that you don’t give your baby the bottle feed. If this is not agreeable to you, I’d suggest you contact me to discuss a personal plan that works for you. There is a lot of flexibility.

On the weekends, or days off of work, do not continue to pump as if away at work. Breastfeed your baby at feeding times. The impact of your baby being put to breast will keep your supply stimulated. You may also pump 1-2 times during the day, or you don’t need to pump if you have enough stored breast milk for your baby’s needs.
 
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