Breastfeeding when returning to work or school

Managing Milk Supply

Basics of milk production:

Milk removal = milk productions

Milk accumulating in breast over time tells breast to make less milk 

Storage capacity in breast varies among mothers and is significant pumping

No set answer for how often to pump - depends on length of work day and commute and mother's storage capacity

2 to 3 times per work day is average

Ideal: one for each missed feeding (approximately 10 to 15 minutes double pumping) : provide all milk for next day

Real: as often as you can manage

once is so much better than none, 7 minutes is better than 0

pumping may help you avoid problems and sick time because a very full breast can lead to a plugged duct, unrelieved plugged ducts can lead to mastitis

avoid choice of all or nothing- any pumping will help you preserve breastfeeding

Increasing pumping yield -- relax don't stare at bottles, hands-free pumping, protein snack

Potential Problems 

plugged ducts, engorgement, mastitis, breast infection 

Best approach is prevention and early attention to avoid doctor's visits, sick time (nursing/pumping as soon as possible is the first action to resolve plugged ducts) 

Decreasing milk supply

add pumping sessions (e.g. nurse-shower-pump; pump then nurse upon return home; pump on weekends; more night nursing: bread feed when you're with baby) 

When dipping into freezer stash -- try to replace each week

Address things that reduce supply : fatigue, stress, ineffective pump (old, worn out pump or wrong size breast shield on pump -- many women need 27 mm breast shields rather that 24 mm which comes with pump) 

Avoid pseudoepherine or certain foods (sage, parsley, peppermint, soy) 

consider galactogogues eg. Herbs (fenugreek, blesses thistle) foods (oatmeal, malt, almonds, sesame seeds)) medications (domperidone) 

Managing Bottles

Overfeeding requires more pumping 

Leave milk in small (2-4 oz) increments, depending on age/weight of baby. 

Care giver use other comfort measures (pacifier is better than overfeeding) Slow flow (newborn) nipples are fine for all ages

Breastfeed whenever you are with your baby