Great information for breastfeeding moms working full time

I e-mailed some questions about storing expressed breastmilk and low milk production to La Leche League. I received a fantastic response from one of their leaders and thought I would share it here. It has so much helpful information for anyone who is pumping at work and/or breastfeeding at home.

*Warning: this is very long but well worth the reading, IMO.

"Most working and pumping moms report that they are able to pump out the most milk in the morning and that as the day goes on, that amount decreases. The important thing is that you pump out at work the TOTAL amount by the end of the day that he needs at day care.

Are you supplementing with milk form the freezer? If so, take a look at this article: WISE USE OF A FREEZER STASH

Also, feeling "empty" at the end of the day is typical even for mom who are home with their baby all day. Although he is usually satisfied after nursing on only one breast, in the evening he may need to nurse on both breasts to be satisfied. He may also need to "cluster feed" in the evening, nursing off and on for a few hours. Allow him to nurse as long as he likes on the first breast, then offer the second. If he still seems hungry after the second breast, offer the first again. You can keep going back and forth between your breasts until he seems content. If he wants to nurse again a short time later then encourage that. That will increase your supply.

Keep in mind that your breasts are always producing milk and are never truly empty. Also, the more the breast is drained, the more quickly it "refills". From How Mother's Milk Is Made
"The emptier the breast is, the faster it tries to refill - similar to an automatic icemaker. Hartmann says the rate of milk synthesis in women ranges from 11 to 58 ml/hour/breast, or about 1/3 of an ounce to 2 ounces per breast per hour. Emptier breasts make milk faster than fuller ones. When milk is regularly and thoroughly removed from the breast, milk synthesis is unrestricted."

I do have some suggestions for increasing the amount of milk you can pump. First of all, the pump you are using can make a huge difference. Some pumps are much more effective at extracting milk than others. An automatic double action pump made by a reputable company is usually needed by mothers who are away from their babies on a regular basis. The pump should cycle-suction 40 to 60 times per minute.

Secondly, the key to getting a good amount of milk when you pump is being able to stimulate let-downs (that is when the milk sprays out, not just drips out). Stimulating let-downs is very individual, and mothers often need to experiment to come up with a strategy for letting down easily to a pump.

Some moms find that after pumping has been going well for a while, they suddenly experience a dip in output. Mothers often call this the "6 month slump." It often happens in the 6-9 month range, after a mother has been working and pumping for 3-6 mos. One mother had a slump at 9 mos, and she discovered she needed to use a different pump. She had been using a Lactina Select, but she had to switch to a Pump-in-Style. Another mother had no luck with the Pump-in-Style, but she had great success with using two Avent Isis hand pumps. Some mothers have rented a hospital-grade breast pump, just for a month, when they have had supply crisis, and this has gotten things back on track.

These mothers have said, “When there is a problem with pumping, first check the pump!” Pump parts wear out, some pumps are better quality than others, and different pumps work differently for different mothers. Once you are sure the problem is not the pump, check what you're doing during pumping. Many mothers who had a slump in pumping production found that they were trying to do too much while pumping: multitasking, answering emails while pumping, or whatever. It can help to try to leave distractions aside for those 10-20 minutes and focus on your baby.

It can help to find a private, comfortable place to pump, free from distractions. Many mothers begin with a pre-pumping ritual, such as putting on a warm sweater, doing relaxation-breathing exercises, massaging their breasts, and imagining nursing their baby. Some mothers find warm compresses before the pumping session can help with letdown. A disposable diaper run under warm tap water can make an excellent compress, and if not filled too full it won't leak. Some moms bring a picture of baby or an item of clothing that smells like baby. Others bring recordings of baby's cooing.

After doing their pre-pumping ritual, mothers put the pump on and pump until the milk sprays out. When the milk stops spraying and slows to a trickle, they take off the pump, massage their breasts again, again imagine nursing their baby in as much detail as possible (how it feels, how their baby smells, how much they love him), put the pump back on and pump until they produce another letdown. This sequence can be repeated for however long you have available to pump. Some mothers find that when the milk slows, they can turn the pump down to very low suction, low speed, for a minute or two, then turn the speed up, keeping suction low (on those pumps that have both settings) - mimicking the flutter-suck that a baby does. This can lead to a second letdown. Once the milk lets down, the speed can again be decreased and the suction power increased.

Mothers often get the most milk if they nurse the baby on one breast while pumping the other breast. If you are currently only pumping on breaks at work, you might add a pumping session at home, while your baby breastfeeds. This often works best first thing in the morning, when most mothers' supplies are greatest. When mother switches the baby to the other breast, she pumps the side where he nursed first.

You can do this in the evening as well. You might be able to pump a good amount of milk during the first nursing after you get home from work, because you may be more full at that time. You could also try pumping after baby nurses, and adding pumping sessions on weekends.

Adding an extra pumping session is a good idea for a mom whose pumping output has gone down. Try to add it at the same time each day. Many moms find it can be helpful to nurse the baby before getting out of bed, then shower and pump immediately after (benefit of warm shower water and early in the day naturally high milk supply) - leaving that milk for caregiver that day. These extra sessions don’t have to be long. More frequent, shorter duration pumping sessions can boost output. Some moms find that breaking up 20- or 30-minute pumping session into 2 or 3 10-minute sessions can boost supply.

Many mothers arrive at childcare a little bit early, so that they can breastfeed one more time before leaving for work. This helps to reduce the amount of pumped milk baby needs while you are away.

Here is an column from our monthly magazine for members, New Beginnings. It has several suggestions for pumping more. http://www.llli.org/NB/NBJulAug96p118.html
and
WORK AND PUMP MAINTAINING SUPPLY

If possible, try a “nursing vacation” on a weekend to boost supply. You might want to add an extra pumping session on the first few days back at work. Often a mom just needs a couple GOOD days of breastfeeding or pumping to get over a pumping slump or temporary supply dip. Sometimes it just takes mom being able to add a few ounces to the freezer stash to feel less worried, which leads to better output (when you're stressing over every drop, it gets VERY hard to relax to let down!)

It’s also possible that your caregiver is giving your baby more breast milk than he truly needs. It may also be helpful for your caregiver to know what to expect when feeding a breastfed baby. According to La Leche League's Breastfeeding Answer Book, 3rd edition, on average most breastfed babies take between 2-4 ounces about 8-12 times per day, consuming about 28-32 ounces total per day. (Your baby is getting much of this amount directly from you, by breastfeeding when you are together. He only needs a portion of this amount at daycare. The amount depends on how many hours at a time he spends there.) Some babies will take more milk than they truly need if coaxed. Your caregiver might appreciate learning the soothing techniques that you have found helpful with your baby that don’t involve feeding.

Along with this, buy enough bottles/equipment to be able to send MANY small bottles with your child to childcare. Many mothers find that making up many 2-3 oz bottles leads to less waste than having fewer larger bottles. Work with your childcare provider to make sure that breast milk isn't being wasted. Sometimes childcare providers don't have any idea the stress breastfeeding mothers are under to pump enough, and with some gentle guidance from the mom may be able to adjust so that they aren't wasting much breast milk.

Sometimes when we're working and caring for a young child we forget our own needs. It's important that the nursing mother stay hydrated and is eating well. Several small meals can suffice if making time for large meals or meal prep is difficult to manage. Salads, oatmeal (there are anecdotal reports that OATMEAL helps to increase milk supply), granola bars, dry cereal, cheese, carrot sticks, whole fruits, yogurt, etc. are some examples of healthy nutrient-dense snacks mom can carry with her to always have a mini-meal on the go."

Very good info!

I exclusively pumped with my daughter.  She NEVER received one drop of formula and she had breast milk for over 15 months. 

Best decision and best use of hard work ever!

Thanks for posting this! I'm still prego but this is awesome info to have. Definitely going to tag this.