Exclusive Pumping and Returning to Work

April 15, 2016 10:52 AM

I am exclusively pumping for my 8 week old little guy due to poor latch early on. I currently pump 9 times per day (on the even hours, from 2 am - 6 pm) for half an hour each session. I go back to work in three weeks and obviously won't be able to pump that much. Any exclusive pumpers out there who can advise me?

Almost everything I can find online is for nursing mothers who are adding pumping to return to work. I have read the Exclusive Pumping blog and found it helpful, but I'm looking for more input.

How should I decrease my pumping sessions? Do I need to do a gradual decline, maybe starting now? Any suggestions for a pumping schedule once I'm back at work? I'm thinking I'll pump 5 times a day: before I leave for work, in the mid-morning, at lunch, in the afternoon, and at home after dinner.

Have you done this? Did you have a big decrease in supply? I haven't been able to build a surplus. I took fenugreek and was making just enough to get him through the day, but my period came back this week and we're back to using formula to make up the difference. I'm taking Motherlove More Milk Special Blend to try and get my supply back. Given my supply issues and the prospect of less pumping overall, I expect that we might have to give him formula during the day at day care and use the breastmilk at home. I'm okay supplementing with formula, but I don't want to give him all formula if I don't have to.

(As a side note, I've put him on the breast twice this week and it was not terrible. If nursing him some of the time can be a solution, I'm open to trying again.)

posted by erloteiel to Health & Fitness (13 answers total)

This is the sort of thing that varies wildly with each person. Although I did not exclusively pump, I did go back to work full time starting when each kids was 8 weeks old, and did not supplement with formula. So there was a lot of pumping.

What I found was that, in the morning especially, it didn't matter whether I pumped mid morning and at lunch, or just at lunch: I got the same total volume either way. I found that by pushing the morning pumping a bit later I could get more. I was somewhat uncomfortable by pumping time, but I managed fine.

I always got less in the afternoon. This is the sort of thing that may vary a lot between exclusive pumping and workday pumping, so take it with a grain of salt. But it may be worth an experiment where you try cutting out one pumping session and see how it affects total daily output.

I only pumped 3x during the workday when my supply was dropping and needed to be boosted back up. But the extra pumping was usually 15 minutes, half the length of the main two.

If you're open to continuing to try to breastfeed I would ABSOLUTELY do that. Who knows, it might work! Even if you don't want to make it into a Big Thing, a session or two with a lactation consultant might give you a few ideas to try. And I really feel that that actual real nipple stimulation from the baby will be good for the hormones that keep your supply up.

Finally, you might as well eat oatmeal. It's supposed to work; who knows if it actually does, but it's reasonably healthy and maybe it'll contribute a bit?
posted by telepanda at 11:31 AM on April 15, 2016

I did this and pumped 2x a day at work for about 20m per session. I would also pump once in the morning when I got up, once right after getting home, once before bed.

Drink more water, keep the stress levels down, keep taking the fenugreek/motherlove, but if you can't keep up, it's ok. I quit pumping when I could only do 50-75% of what she actually needed.
posted by schnee at 11:35 AM on April 15, 2016 [1 favorite]

So I wasn't exclusive but did pump. It is very difficult to maintain supply with pumping. General tip is hand expression at the end can significantly increase supply. I would pump 3x at work, around your normal break times. Your child has already received a lot of the health befits of your milk. If you can't

I would try 2x a day, everyday to get your LO to nurse. There's health benefits in the action for both of you. For most women, supply drops drastically a few months after birth without consistent actual nursing.

Pupping is hard. No way I'd go every two hours for an extended period, even just on the weekends. Actual nursing will increase your supply with less effort. Otherwise I'd be looking to taper down the pumping starting at week 12.
posted by Kalmya at 12:09 PM on April 15, 2016

From my understanding, fenugreek is a blood thinner, so I've seen it not recommended for long term use (or any use, too). Oatmeal for breakfast has helped me, as anecdata, have a successful supply (and at times in the beginning, over-supply). I really trust KellyMom.com's stuff, and here is their information page on pumping.

If you would like to try to bring the baby back to the breast, I would recommend searching for a local IBCLC (international board certified lactation consultant) to help. They can identify if the baby has lip or tongue ties or other transfer issues, and can help with latching.

FWIW, my mom *cough* years ago breastfed me evenings and weekends and I had formula at daycare. That worked for us just fine. I've been successful at breastfeeding my 2.5 year old, where the first 8 weeks were some of the toughest. The IBCLC and leaders from my local LLL really helped me.

Good luck! You are doing great so far being your kiddo's mama. Just keep that baby fed in whatever works best for you. :)
posted by jillithd at 12:32 PM on April 15, 2016 [1 favorite]

Congrats on the little guy! You are doing great :) You might find it helpful to get in touch with a local La Leche League leader for practical advice and support with this, especially if you are open to nursing.

Some women in the breastfeeding support group I am in (not LLL) find that challenging latch issues resolved as their babies got older (and their mouths got bigger!). Three weeks is a long time at this tiny stage, so a lot can change before you go back to work. Bear in mind that since milk is generated on the principle of supply and demand, reducing the frequency of pumping is more than likely also going to decrease supply, as will supplementing with formula (which your boobs will interpret as decreased demand!), as will the return of your period.

If I were in your situation, I would talk to a lactation consultant/LLL leader/breastfeeding support group about the latch issues (have you tried the "flipple technique"?) and then, once confident latch is not causing nipple damage, offer the baby the breast as much as possible before you go back to work. I would also continue to pump for 2-5 minutes after last drops, and consider renting a hospital grade pump. You might find KellyMom.com helpful in general - I think it is the gold standard of all things breastmilk related!

Disclaimer as I feel sensitive about this issue and you might be too: This reply is not intended to pressure you into breastfeeding if you don't want to, but to give as much support as possible to women who want to breastfeed, which you seem to want to do.
posted by bimbam at 12:39 PM on April 15, 2016 [3 favorites]

Bear in mind that since milk is generated on the principle of supply and demand, reducing the frequency of pumping is more than likely also going to decrease supply, as will supplementing with formula (which your boobs will interpret as decreased demand!), as will the return of your period.

Well.. this is true and not true. Between 8 and 12 weeks most babies start spacing out their feedings and become more efficient at nursing. So, instead of eating 2oz at a time 10 times a day, they're eventually eating 4oz at a time 5 times a day (or whatever - the ounces aren't necessarily accurate but the point stands - I think EBF babies eat about 25oz a day). A 2 month old who nurses 10 times a day is eating about the same number of ounces as a 6 month old who is exclusively breastfed, despite the 6 month old eating far fewer times per day. Your body adjusts and produces more milk at each feeding as the baby's capacity for eating more each feed increases.

If you just kept pumping as you are now but dropped it to pumping 3x or 5x a day, your body would probably get confused and think there was no demand anymore. But, if you shift to pumping longer for fewer feedings, your body should figure out what you are doing, and produce more milk at each feeding. I also think that, if you can, nursing in the morning/evening will probably help accomplish this more easily.

And nthing the others that you are doing awesome. I cannot stand pumping and massively respect anyone who puts in this kind of effort.
posted by gatorae at 1:52 PM on April 15, 2016 [1 favorite]

I pump but do not exclusively pump. I pump 3x per day: once mid morning at work, once mid afternoon at work, and once after the baby goes to bed. She takes 2-3 bottles at daycare (I visit at lunch to nurse) and nurses (basically) 6 times a day. My baby is 6.5 months old, I went to work full-time about 6 weeks ago.

Here are my notes:

- My pumping supply ebbs and flows - anywhere from 2oz to 5oz in 15 mins. At first I thought it was dropping but really it just lowers and raises fairly regularly, probably for all the reasons anyone suspects (timing, water intake, emotional state, rest, ebbs and flows in demand, etc).
- I would get more if I pumped in the am after waking up, but I nurse twice before leaving the house, so I just can't fit it in.
- I usually get more in the mid morning than in the afternoon or evening pumping.
- A friend made lactation cookies, and when I was eating those in the morning for breakfast I really noticed the supply difference, particularly in the mid-morning feeding.
- As someone else mentioned, I don't necessarily get more milk if I pump more often (ie, if I pump 2x in 4 hours I don't necessarily get more in oz than if I pump just one time in that span), but I think pumping more often does increase the overall supply, so you may want to do it when you can.
- Watch your letdowns - you're pumping for 30 minutes - I'm curious if you're getting that much more in 30 mins than you'd get in 15.
- Smart thing I did was get a pump to keep at work, so it was one fewer thing to lug around.
- I am currently part of an informal breast milk exchange (Human Milk 4 Human Babies) to donate my backup freezer supply that I haven't needed, so that could be an option for having a backup, supplementing, or extending out the time the baby is on breast milk if you are unable to keep up your supply.
posted by vunder at 3:02 PM on April 15, 2016 [1 favorite]

(As a side note, I've put him on the breast twice this week and it was not terrible. If nursing him some of the time can be a solution, I'm open to trying again.)

Just to respond to this portion, I had the same experience of my son not being able to latch when he was very little, and I did a lot of pumping and was able to exclusively breastfeed. We kept trying the breast, though, and around the two month mark it he got stronger and was really able to get a good latch, and I was able to reduce the amount I pumped. I still pumped about once a day to have some extra milk for when I was out of the house or whatever, but gradually got less and less output from the pump (even though my supply was still there; I breastfed through until his 3rd bday).

So if you do want to keep trying your baby on the breast, it may work more and more as he gets bigger.
posted by JenMarie at 3:36 PM on April 15, 2016 [1 favorite]

Also came in to mention Human Milk 4 Human Babies - check out their FB group for your area.

(And thank you vunder for being a donor!)
posted by vignettist at 3:44 PM on April 15, 2016

When I exclusively pumped for my daughter (from 3 weeks to when she was 4 months old) my supply was pretty much fixed around 40 oz regardless of how many times I pumped during the day as long as it was a regular schedule. 8 times a day or 6 times a day was irrelevant, it took a few days for my supply to adjust but it always evened out. Even when, at the end, I went down to 4 times a day (6am, 10am, 2pm, 6pm) my supply remained unchanged. I quit because I hated it, not because my body couldn't figure it out.
posted by lydhre at 4:20 PM on April 15, 2016

I exclusively pumped for my oldest, and I still pumped every three hours around the clock when I went back to work after eight weeks.

The way I maintained the schedule at work was, first, to be unapologetic about it. My daughter was a preemie and was still in the hospital when I went back to work, and breastmilk is basically medicine for babies as sick as she was so it was crucial that she get it. Second, I also was capable of pumping while working - I had a cubicle with high walls and just put a big sheet on a tension rod over my "door" and would pull that closed while I pumped. I didn't care if people could hear the pump going. That doesn't work for every woman or for every office, but it helped me not feel bad about the frequency with which I was puming - I really wasn't losing much work time. If you need to use a lactation room, consider whether working from a laptop or cell phone will allow you to have a letdown (as opposed to needing to concentrate on your baby's smell or picture).

However, I probably could have scaled back a little at that point, but I didn't know - months later when I began dropping sessions, my production always evened back out to around 36 oz per day regardless of how many times I pumped, like lydhre. And with my son, who was able to nurse, it was around the 8-10 week mark that he started dropping sessions on his own, nursing for a little longer at each session. So it's a good time, in a way, to experiment to find what will work for you.

And yes, HM4HB is a great alternative! I donated a lot of milk to moms through there, and later collected from donors for a friend whose wife did not survive delivering their daughter.

Not that you want to be pumping even more, but if you can manage it, try pumping with a hand pump while nursing him or letting him nuzzle - babies are way more efficient at getting a let-down than a pump, and I was able to build a good stash with my second child simply by pumping once or twice a day while he nursed the other side. I could get three oz in about two minutes, compared to twenty or thirty minutes.
posted by peanut_mcgillicuty at 6:25 PM on April 15, 2016

You and I are in the same boat. I exclusively pump for Baby Kitty who just turned 8 weeks. I have been pumping since he was one week old (he is not a good latcher). I started pumping every 2 hours when I needed to get my supply up, but eased back to 3 hours once i was making more than he was eating in a day. To scale it back, I just started going every 3 hours. When you say you're pumping 30 minutes a session - is that just a set 15 minutes each side regardless if milk has stopped? I always try to pump at least 5 minutes after "the well has run dry" to make sure my body will ramp up the supply side. Sometimes this means i pump for 15 minutes, others it can get closer to 20 or so. I average about 43 oz a day right now with this approach. I try to pump at 7am, 10 am, 1pm, and 4 pm during the work day. This way one of my pumping breaks falls during lunch and my absence not as noticeable. However - i work from home when i'm not on the road, so my schedule is a little easier to stick to. At night i do 7 pm, 10 pm, and 3 am when he wakes up to eat.

Oatmeal, fenugreek, and what not have been helpful to me. Have you tried flax energy bites? I found those to be helpful as well. Here is a recipe i use - although i usually leave out the coconut.Energy Bites . Absolutely drink a 16 oz bottle of water at each pumping session. Staying hydrated is the difference between a 5 oz pumping session or a 6 oz session for me.

Good luck to you!
posted by Suffocating Kitty at 7:53 AM on April 16, 2016

One other thing: Apologies if this is obvious to you but I pumped an entire year for the first without knowing it, so -

You can use the letdown cycle on the pump more than once per pumping session. This was such a revelation the second time around. When the milk stopped flowing, I'd press the letdown button, and hey presto - another round! This definitely made pumping more efficient.
posted by telepanda at 11:11 AM on April 18, 2016