The Boob Group
Back to Work: Pumping Strategies

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Robin Kaplan: When a breastfeeding mother returns to work, she often has questions about the type of pumping schedules, she should use, how much milk her baby will need while away from her and strategies for promoting a strong milk supply. Today, I’m thrilled to welcome back to the show Wendy Wright, a private practice International Board Certified Lactation Consultant and founder of Lactation Navigation, a business based in the bay area in California that help support breastfeeding moms and the businesses they work for. Today we are discussing maintaining milk supply while back at work. This is the Boob Group Episode 50.

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Robin Kaplan: Welcome to The Boob Group, Broadcasting from the Birth Education Centre of San Diego. I am your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre. At the Boob Group we’re your online support group for all things related to breastfeeding. Did you know that we have an entire panel of experts who’d love to answer your breastfeeding and parenting questions, all you have to do is go to our website and send them an email from the expert’s page. Your question will be answered in an upcoming episode. Today in our studio, we have three lovely panelists. Ladies, would you please introduce yourselves.

Elizabeth Flandreau: Hi! My name is Elizabeth Flandreau. I am a research scientist, I have one daughter and she’s nine and a half months old.

Lisa Howe: Hi! My name is Lisa Howe, I’m a social worker and I have one daughter who is ten months old.

Kate Lane: Hi! I’m Kate Lane, I am a paralegal and I have two kids. I have a two and half-year-old boy and a seven-month-old little girl.

Robin Kaplan: Fantastic! Well, ladies, thank you for coming to the show and welcome.

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Rebecca: Hi, this is Rebecca, I’m calling from San Diego, California. And I'm a flight attendant and I have got a question for your experts. I am due to go back to work in April, and I have a four-month-old son and I’m wondering how I’m supposed to pump on the plane. I contacted my airline and they told that my option is to pump in the lavatory and I’m not too comfortable with that and I didn’t think that they could do that because of the law. So, has anyone come across this and what are some options, I would love to hear some responses, so thank you so much.

Veronica Tingzon: Hi, Boob Group listeners, this is Veronica Tingzon, International Board Certified Lactation Consultant, and also the owner of the Original Comfort Food Lactations which is in San Diego, California. Rebecca, I know that you’ve called in or written in to your HR to find out about pumping while you’re actually on flight and they gave you the response of pumping in the lavatory which doesn’t sound too groovy and it doesn’t sound too hygienic either. I do know some people who have done it before, I have a friend who was a flight attendant and she’s been pumping in the lavatory and she had no problem with it. Firstly myself, I would not find it to be the best situation, I know that, I have also, you know, had to be on a flight where I did pump and the flight attendants were nice enough to set me up kind of in the corner of the galley area, you really have to feel it out and see if there is may be a portable one-sided pump that you can pump, somewhere in the galley or may be on a private row if it’s not too jam pack of the plane. But probably what’s going to end up having to happen for you is that, you’ll probably have to pump prior to boarding in one of the lounges or maybe pump on the plane prior to when the passengers start filling the plane in, may be in the back of the galley or maybe the pilots will allow you to use the cockpit to pump in prior to them getting in, something like that. And then maybe pumping once again in that same situation, either the cockpit or the galley area. It really all depends on if you’re going to be flying a domestic flight or an international flight that’s going to take a whole day to fly or it’s just going to be a couple of hours. Hopefully, you don’t have to take too many flights though, and it can be home with your baby just nursing away. Have a great day Rebecca and I hope this answers your question.

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Robin Kaplan: Today on the Boob Group we’re discussing maintaining milk supply while back at work. Our expert Wendy Wright is an International Board Certified Lactation Consultant and founder of Lactation Navigation in the bay area in California, which focuses on supporting and advising working breastfeeding moms as well as setting up corporate lactation programs. She is also the creator of the Working Pump iPhone app. Thanks so much for joining us Wendy and welcome back to the show.

Wendy Wright: Thanks Robin, it’s great to be here.

Robin Kaplan: Well Wendy, one of my first questions at I’m always asked when I teach my breastfeeding for the working classes. How will I know how much milk my baby will need while I’m back at work and how can a mom easily figure this out and does this change over the course of time that she’s breastfeeding?

Wendy Wright: You know, that’s the question that I’m asked the most often as well. So, I’m glad we’re starting out with that because we certainly don’t want to talk about this topic at all without touching on it. But the basic rule of thumb, Robin and all panelists is just one ounce per hour that you’re away from your baby. So, it’s great to think about your work schedule probably an either nine hour a day and then add your commute to that one hour maybe on each end or 30 minutes on each end. So, that’s nine or 10 hours absence from baby.
So, then I would drink approximately nine to 12 ounces with me to the daycare provider or leave that for the nanny and that ought to do it regular periodic small feeds are best for breastfed babies. And then, of course, you’ll always want to have one, two or three ounces just tucked away in your freezer for those times when maybe there is an accident on the freeway, or you’re called into an emergency meeting and you can’t return home as quickly as you’ve thought.

Robin Kaplan: That’s great advice. And I mean I think that a lot of moms and myself, in particular, I remember when I was at work was I had this unrealistic expectation of how much my baby needed to feed, I mean my kids were getting like eight ounce bottles while I was away and I was like wow my supply isn’t keeping up and now with this research as well as listening to what you’re saying, our babies actually, well they are not transferring eight ounces from the breast, so why would they need it from the bottle and maybe that makes moms feel a little bit more secure that their babies are actually getting you know, what they need and the moms are able to produce what they need when they’re away from their baby.

Wendy Wright: Yeah, that’s absolutely right and some babies even, you know, as we talked about will take less when they’re not with their mothers. Because they do prefer to actually get milk from the breast so, I even won’t be surprised if you sent eight to 10 ounces, for an eight to 10 ounces on work day and came home and there might be two or three ounces left. Now, what that means of course is the baby is going to be on the breast a little bit more maybe at 1:00 a.m. and 3:00 a.m. but what a tremendous way to keep up your milk supply.

Robin Kaplan: Okay. Ladies, will you remind us when you answer this question, how old your baby is and then I’m curious to know how much is your baby taking while you’re at work, Elizabeth?

Elizabeth Flandreau: My baby is nine months old and she takes three five-ounce bottles while I’m gone, one every three hours. Actually hearing the advice from Wendy I could cry hearing that because before I went back to work, I asked my pediatricians that exact questions and she said, oh! I don’t know, try pumping one day and just giving her bottles and see how much she eats. But obviously, that was not at all practical for me to be doing. And so, I just sort of wing in that, I initially brought like two ounce bottles as many as I could to take care and they weren’t feeding her very often so there were always coming home with them and then I was doing three, three-ounce bottles and that may be the four month mark or something I finally asked the day care worker, well, does she seem hungry still and she’s like, oh yeah! After she drinks the bottle she seems hungry. I don’t know why she didn’t just tell me that anyway.
But, so then for a while I was trying to do four-ounce bottles, 4 four ounce bottles and I couldn’t produce 16 ounces a day. So, it has been just trial and error and we settled down this every three hours, she gets five ounces and that seems to do the trick and helps her to get enough during the day but she’s now waking me up all the time at night.

Robin Kaplan: And it’s a good point too. Okay, Lisa how about you?

Lisa Howe: Well, my daughter is 10 months and it’s been kind of trial and error. My work schedule is – it changes on a daily basis. And so, for the longest time, I would leave four, four and half ounce bottles for her every day which could be a challenged on some days to pump that much. She doesn’t typically eat more than two of the bottles a day. In the last few months, she’s gotten super into-solid, she’s crazy for food, so she’s eating even fewer bottles. So, now I’m realizing that I can pump and leave two four or five-ounce bottles and that’s more than enough for her which has been a real relief. So then – you know much less stressful trying to pack in that third pumping session during the work day.

Robin Kaplan: Absolutely! How about you, Kate?

Kate Lane: Yeah, same here. So, my daughter is seven and half months and she’s been doing about two bottles of about five ounces each. And then sometimes a little bit less depending on what she eats for the solid foods during the day but I have been noticing when I’m pumping away from her I just pump twice and I’m getting about eight ounces. So, it’s pretty much even out like that but I feed her before I drop off at daycare and then she will eat two bottles and then as soon as I pick her up, I breastfeed her and that works out great because I’m only pumping twice and she’s only getting two bottles a day.

Robin Kaplan: So, equals out?

Kate Lane: Yeah, so far.

Robin Kaplan: Wendy, how does the amount a baby is consuming guide a mother’s pumping schedule?

Wendy Wright: So, the amount that the baby its drive -- that definitely can drive the pumping schedule. It kind of depends on the stress level and on how frequently you are allowed to get away from your desk at work in order to pump. So, if we have a baby consuming nine, 10, 12 ounces, ideally if mom could pump three times during her work day divide that over with the three times three or four ounces per pumping session, that would be ideal. However, we do have those moms who just cannot let down for the pump as easily as they can let down for their infants, and some moms may only get one or two ounces when they pump at least initially. Those moms are going to need to do some supplemental pumping. So, again just three times at work, because they just don’t seem very many individuals able to get away from work more than that during the work week or work day. However you could add in morning pumping session, you could pump at night or you could add a couple of sessions on the weekend. One of the great recommendations I’ve heard too is that very first morning breastfeed is a great thing to do is perhaps put the baby on the left breast and use the pump on the right breast to get really, really emptied before you start your day and that way too you’re capturing and taking advantage of the babies let down to get more in one of those bottles.

Robin Kaplan: That’s a great trick for any mom who’s having a hard time letting down for the pump, I love that idea.

Wendy Wright: Yeah, yeah.

Robin Kaplan: And then, so you mention, two to three times during this time period at work, so how long should this pumping sessions take and again does that change as the baby gets older?

Wendy Wright: You know, it can change as the baby get’s older just like anything we get better at it. So, we can only recommend to starting off at about 15 minutes pump session, but really test your own body and your own pump. So, when you sit down to pump and you wanted, if you can’t, try this out at home, when you’re more comfortable than at work for the first few times. But put on hands-free pumping bra if at all possible strap on the pump and then use hand massage and compression. Breast compression while you’re pumping that will really maximize that flow and then I also like to when I see that flow really begin to slow down just to a dribble or slight trickle. I’d like to turn off the pump, stand up, do a good stretch massage my breast, sit back down, deep breath and turn that pump back on and overtime you can train your body to get a second let down. Now, that may take the 20 minutes instead of 15 but you’re going to get several more ounces. So, it’s a fantastic way to go. So, anywhere between 15 to 20 minutes generally, I’d like to block off 30 minutes on the calendar if possible, the nice thing about that is then you’re never late getting back to your office. Because if you only block off 15 you’re going to the lady right, who is always late for meetings if just something happens so, yeah, give yourself plenty of time, but you may not be pumping that whole time.

Robin Kaplan: Okay, sure. Ladies, what does your pumping schedule look like, Kate?

Kate Lane: And so before I went to work I started pumping about 9:30 in the morning when my baby was two weeks old. And I have been able to maintain that schedule so, at work I’m pumping at around 9:30 and then around 1:30. And, what Wendy was just saying about the second let down, it’s funny because I’ve notice that the more I pumped, the faster I get my second let down. And so, I’m able to get more ounces and I’m only probably actually pumping milk for about nine to 10 minutes and the whole ordeal from when I sit down and get my pump out and get it all set up and start pumping to when I’m washing my bottles out and back at work is about 15 minutes.

Robin Kaplan: Okay.

Kate Lane: So, I’ve definitely streamline the process, which is great, good for me and I’m more productive at work.

Robin Kaplan: So Lisa, what does your pumping schedule look like?

Lisa Howe: All right. So, typically what happens is where we will nurse on one side during the night and the other side fills up and so when I wake up in the morning I pump that side and that’s one of her bottles for the day at one plus, I usually get five or six ounces. And then my job is unique, I don’t work in an office, I worked in the field. So, my schedule depends on the day when I’m seeing patients. So, I pump in the car while I’m driving in between seeing patients. So, typically I try and pump between 12:00 and 1:00 depending on the day. But usually I just let my body dictate when it’s time.

Robin Kaplan: And how long do you pump for usually?

Lisa Howe: About 15 minutes, usually about 15 minutes.

Robin Kaplan: Very cool! And you’ve mastered the pumping while driving?

Lisa Howe: I have, yes.

Kate Lane: Like you’re actually driving and pumping?

Lisa Howe: I’m actually driving and pumping and I’d like to say, I've only been noticed twice. Never on the road, only in parking lots as I’m getting ready for the process and it’s been kind of fun to watch peoples’ reaction. But I keep waiting for like a trucker to drive by and honk his horns but everyone’s too busy on their phones.

Robin Kaplan: Elizabeth, what does your pumping schedule look like at work?

Elizabeth Flandreau: Well, so my daughter wakes up usually around six in the morning and then I try to feed her and get myself ready and go as soon as possible so that I beat the traffic and then as soon as I get to work I pump. So, sort of what Wendy was suggesting except for instead of pumping at home, I pump first thing when I get to work. So, that’s usually around 7:30 or 8:00. And then I pumped again at 11:00 and then again at 2:30. And then depending on what her schedule has been during the day I try to nurse her right when I pick her up but sometimes she won’t.

Robin Kaplan: Sometimes the timing is off, I remember that too where I’d walk in and then the bottle is being pulled out of Ben’s mouth and I’m like, no, I have to go and pump this thing. And how long do you pump for typically?

Elizabeth Flandreau: It takes me a while. So, I have lately mastered getting the second let down, I do turn off the pump and then turned it back on and if I don’t get it, I do that again. Because I have to have the second let down in order to get enough milk. And I don’t use the hands-free bra at all, I just do like, constant massage or I will literally get nothing, like especially if I’m full nothing will come out unless I start massaging.

Robin Kaplan: Like a baby’s mouth would do. Wendy, here’s a question from one of our Facebook followers. Rachel posted, ‘I haven’t started work yet, but even at home I seem to be able to pump less and less and I’m worried about this trend. My pump always leaves me feeling sore and I think realizing this makes me not want to do with which may lower my supply. Any tips on how to deal with this?’

Wendy Wright: Yeah, that’s so challenging. So, the fact that she hasn’t started work yet means she’s really breastfeeding, very, very frequently, most likely. So, because she’s breastfeeding and the baby is very, very capable of emptying that breast so completely we do get less when we pump following a breastfeeding session. So I’m pretty confident that once she starts working, she’s away from her baby, her milk flow and will be adequate and will be fine. She also may have an expectation that it should always be increasing and of course it won’t. It’s always going to relatively similar throughout her breastfeeding career. So, we just have to stream that out. And then I am worried about this painful pump. Most likely it’s a flange stick issue and what we’d really like to see is when that nipple elongates into the flange, we want to be able to see the skin all around the nipple, not touching the plastic flange. It’s that constant rubbing over and over on the flange that can cause some breast pain and even abrasion. So, in the meantime, if this is the problem, I would take a little melanin or olive oil, coconut oil and coat the inside of that flange so that the breast can move easily in and out and then I would get a larger size flange or a softer flange for this woman. The other thing we might want to consider is she turning the pump suction onto high. And there is nothing wrong with going with the absolute lowest pump suction and pump frequently, not a problem at all. And then just work up to – you know when you can pump a little bit more vigorously. I always sound, personally at the time of my period I would have to turn my pump way, way down, because I was just much, much more sensitive on my nipple tissue and then a week later I was back but I would still get to see the manner of milk out. So, that is the important thing. So I hope it’s just one of those issues with her pump.

Robin Kaplan: All right. Well great! Well, when we come back, Wendy will discuss tips for milk storage, how to keep up your supply once you return to work and how to make sure that your caregivers aren’t over feeding your baby. We’ll be right back!

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Robin Kaplan: Today we’re talking about maintaining your milk supply while back at work. We’re here with Wendy Wright, an International Board Certified Lactation Consultant and owner of Lactation Navigation. So, Wendy here’s a question from one of our Facebook followers. Kay, wants to know what is the easiest way to store pumped milk?

Wendy Wright: Great question. So, what I like to do is store pumped milk as much as possible in the refrigerator. As a working mom, it’s very, very important that we get all the immunology from our breast milk right into our babies as quickly as possible or within the next 24 hours or so. So, that we protect them from any illness that might be exposed through a day care or through their nanny or through their caregiver. So for example, pumping on Monday that would be the milk that we feed baby on Tuesday, Tuesday’s milk on Wednesday, Wednesday’s on Thursday for example. Friday’s milk then can be frozen in the freezer and rethaw out the oldest milk from the freezer Sunday night to provide for the baby on Monday. That way babies only getting eight hours in one week of frozen milk assuming you’re working an eight-hour shift and the rest of the time the milk is all fresh. So, in that case, I would just store in the bottles or bags, whatever is easiest for you. I personally like bottles, glass bottles because of all the plastic concerns lately. And I just like the way they feel in my hand. So, that’s a very, very nice and almost any nipple will fit on the majority of the glass bottle that are out there now. It’s very easy to wash in the dishwasher as well. So, that’s how I would store the fresh milk in the freezer, I would definitely store in milk bags or breast milk bag and what I like to do when I freeze milk is freeze it in very, very small containers. Remember the breast milk bag will hold five or six ounces in each bag, however, only once in a while did we actually need to thaw out five or six ounces because that’s pretty much enough for a half day or half of our workday. But you might want to fill in that pipe, but I would freeze mine in one ounce, two ounces and three ounces small containers, that way if I fell short during the week and I just need to pull out one ounce. I’m just defrosting one once at a time rather than defrosting six ounces when I only need one. And then I’d like to freeze them in flat in the freezer, so I lay the bag down flat with freezers so it looks like a pack of cards for example, and then you can keep them up just in a cardboard box or shoe box, just something like that. Nice and compartmentalize in your freezer as little cards in the sense and then you can always just pour your oldest one out. So, that’s my tip for storage. But again the smaller the better, because once we defrost that milk it must be utilized within 24 hours and I would hate for you to be utilizing frozen milk that you’ve defrosted when you have fresh milk right there. So, freeze that milk in a really small compartment.

Robin Kaplan: Okay, that’s great. Those are great tip. Ladies, how do you store and transport your pumped milk, Lisa?

Lisa Howe: Well, some time on the road I’ve got a couple of insulated lunch bags that have a whole collection of ice packs in my freezer. So, that’s what I do throughout the day and carrying it in the bottles and then place those in the fridge and then transfer them to the bottles that she eats out of every day.

Robin Kaplan: Okay, fantastic. How about you, Elizabeth?

Elizabeth Flandreau: So, when I work in the same building all day I have my little freezer pack that came with my pump and I keep the whole thing in the refrigerator or I’ll put the freezer pack itself in the little freezer and I keep the milk in the refrigerator and transport it that way. And as far as storage I usually am feeding the baby in the same bottles that I’m pumping into so, I just pour like both breast into one bottle and then I usually will have a five-ounce bottle. And then I will freeze it actually in a one bottle size and if I’m short a day, I usually thawed out enough for a whole bottle and save the partial bottle for the next day. So that over the week it get better and that works out better for my daughter anyway because she’s not as big as fan of thawed milk, so if she gets just three bags of thawed milk on Monday she is maybe not going to eat very much. But if she gets one thawed bottle or one thawed bag every once in a while it’s a little bit easy on her.

Robin Kaplan: Okay, cool. How about you, Kate?

Kate Lane: So, my daughter has only got thawed milk so far from daycare and now I feel self-conscious about that. Because I started pumping when she was so young, I built up pretty much a three-month stash before I even went back to work. And so, my routine has been to take the pumped milk from work and then I immediately bring it home at night and throw it in the freezer and then I sent the daycare the oldest frozen milk and then they keep it frozen and then thaw when needed. But I thought that’s okay.

Robin Kaplan: I was going to say, this is so going along with the judgment free breastfeeding support, you do have to remember too that although you’re pulling out the frozen milk that you pumped months ago, she’s still breastfeeding multiple times on the times that you’re home as well. So, she’s still getting all of those antibodies and everything, so don’t stress.
But I do think Wendy has a very good point about it and just keep taking out the oldest milk maybe once a week or once a couple of times a day, or once a couple of times a day -- I can’t say that once a couple of times a week, couple of days a week. However, again, keep in your mind she’s breastfeeding in time so she’s still getting all those antibodies from all that the fresh straight from the tap that she’s getting every single day. Wendy, what if a mom notices a dip in her supply or pumping output when she returns to work? First of all, why would this happen?

Wendy Wright: Well, a dip in supply immediately following returning to work is probably emotional. You could say it but stress and exhaustion, trying to get use to the new schedule plus remember, it’s not as easy to let down for a pump as it is to let for the baby. It’s hormonally driven and if you’re not feeling 100% confident and secure where we’re pumping, a car for example as one the panelist mentioned, there may be a day when that’s just a little bit threatening, our milk supply won’t be as strong that day. We are also probably pretty tired and just maybe not taking 100% care of ourselves because that can happen. And again, somebody mentioned most women will start work three, four months after having baby, if your period returns at that time, that can also cause a slight dip in your supply as well as birth control, a lot of women will again start taking right around the time, right when they return to work and so that can’t be blamed on the work, but it also might just be birth control. So, lots of different reasons can impact milk supply. But again, just sticking to it and then breastfeeding and skin to skin contact as much as possible on the weekends and when you’re at home in the evening is the sure way to, you know recover from that.

Robin Kaplan: Okay. And I was going to say too, one of the things that I noticed not only with myself, but also with a lot of the moms that I work with is, sometimes when we go back to work because you’re wearing so many hats of mom, wife, a partner and working that I found I forget to eat a lot as well and I think that my calories were dipping way below the 15,000 calories at least that I needed. And so my supply tended to go down as well just because I wasn’t focusing on myself as much as maybe I should have.

Wendy Wright: Yeah.

Robin Kaplan: So, Wendy what are some strategies to keep up a mom’s milk supply while pumping at work and what if she needs to actually increase after a dip in her supply?
Wendy Wright: Right, so and favorite thing before I would recommend any supplements or anything like that, will just be the baby noon, get that baby with mom as much as possible. And even if that means we need to take off early on Wednesday for a couple of weeks and just make some baby mommy time, sleep together at night. You know, different things like these where baby and mommy can be together. And then always remembering to pump and take care of yourself as much as possible. Very, very important just like you mentioned, I love the idea when you’re putting a bottle of breast milk into your storage bag, make it so that there is fruit or granola bar or handful of nuts in there that you actually have to physically take out in order to fit the milk in and that way it will make you eat something to at least stay a little bit nourished.

Robin Kaplan: That’s a great tip.

Wendy Wright: Yeah, yeah. And then, of course, there are thistles, fenugreek, cheese, you know all sorts of things that moms if they really having a serious supply issue may want to consider. But again I’m hesitant to go to those at first, I really like to just try the skin to skin, baby noon, get mummy and baby real comfortable is what I would recommend first because I find that, just usually does seem to do the trick.

Robin Kaplan: Okay. And something you’ve mentioned earlier in the episode also was maybe adding in that pumping session, pumping on one side, breastfeeding baby on the other in the morning or also adding a pumping session on the weekends or at night, do you find that can also help with increasing a mom’s supply if she’s had a little bit of a dip?

Wendy Wright: I definitely think that can, although we have to keep in mind adding pumping if it’s, again, if it’s replacing our sleep, you’re certainly not going to do it. So, if you’re up anyway I would go for it or you’re breastfeeding anyway, yeah, take advantage and pump the other breast. But yeah, it’s sleep again, it’s going to be one of our friend in terms of keeping that supply high.

Robin Kaplan: Absolutely. Ladies, have you noticed a dip in your supply at all since you’ve returned to work and if so, were you able to increase it and how? Kate, how about you?

Kate Lane: So, yes, occasionally if I’m really stressed out at work or if I have a big deadline coming up or if I have a big presentation to give, I do notice that my sessions prior to that I get a little bit less. So, I really just learned to stop looking at how much milk I’m getting because, well, counting the fractions of the ounce that are adding up in the bottle were just stressing me out too much. So, I don’t need to be watching it, so I try to keep that covered so I can’t see how much I am getting. And I really just try to have it be totally relaxing and I’ll flip through photos of my daughter on my phone and I’ve recorded videos and stuff of her actually breastfeeding.

Robin Kaplan: That’s a good idea.

Kate Lane: So it’s more of a like I'm the mom in taping. Yeah, I mean I really, I train myself to – this is my pumping time, and I need to pump and I need to not stress about it and I’ve noticed that my milk supply is maintaining because of that.

Robin Kaplan: Very cool. How about you Lisa?

Lisa Howe: About two months ago, I had a couple of days when I actually called Robin in tears that my supply dropped so low that I was so afraid and it turned out that I was ovulating and so, I was able to see -- I went to acupuncture and took some herbs and then it bounced back. But I also wanted to kind of piggyback on what Kate said that if I watch it, I feel like it, I’ve just produced less, I become stressed out about it and then I start thinking, oh! I’m not going to have enough and then I just work myself up. And so, it actually is helpful when I’m driving because I’m usually listening to public radio which I find really relaxing and I’m focusing on what I’m listening to and not on that. And plus since I’m driving and it’s not really safe to watch.

Robin Kaplan: That’s awesome! How about you Elizabeth?

Elizabeth Flandreau: So, I have found that if I get sick, which I have gotten sick a lot since Vivian went to daycare, I end up with horrible milk supply not right away but like the next week and for a full week. So, that has been really rough. And the other thing was that Vivian wasn’t sleeping well at night, so we’re trying to co-sleep and I was feeding her like every hour and thinking, oh! I’m going to have this awesome milk because she’s eating constantly. And it was the exact opposite. I was getting nothing like drops. And I think it’s because I was tired and dehydrated and stressed out, I definitely do not have a problem eating enough. But I think I probably don’t drink enough water and Lisa actually has been one of the people saying, drink more water, drink more water and that definitely does make a difference. And for me, I sort of do the opposite of what these girls say, I’m always looking at like how much is coming out and I’m thinking like, yeah boobies go, go! And that does seem to help and I also flip around on like the Facebook breastfeeding support page or look at pictures of my daughter on the phone and I also have a video of her breastfeeding.

Robin Kaplan: Very cool! Wendy, do you have any comments for our panelist about what they’re doing to keep their supply up?

Wendy Wright: You know Lisa, I would have mentioned it as well they’re looking at their iPhone for pictures and videos, what a great tool. And remember, we’re all mammals so even if you have little one day that your babies slept in last night and while you’re pumping at work to give good, good smell of that one week, can really, really enhance let down. So, taking advantage of things like that. The other great tip is if you have a nanny or someone who could bring baby to work, have lunch with your baby once a week. Again, that’s a direct breastfeeding session, middle of the day on Wednesday, it kind of prevents that slippage that we see Monday through Friday where the milk supply slowly, slowly goes downhill. You know, it’s smaller a little bit on Friday because we’re not with our baby all week. So, come over for lunch, bring some sort of leftovers which you brought and then just nurse for an hour. Great way to go!

Robin Kaplan: Absolutely. Wendy, what strategies do you have for when a caregiver is giving the baby more than he or she needs or more than the mom is able to pump?

Wendy Wright: Yeah, this is a huge problem. I mean we look around the room where you are and everyone is breastfeeding and so we forget those that in the State of California by the time you are three and four months out of delivery, very, you know, less than half of the population is actually breastfeeding. So, that means less than half of the caregivers are used to feeding breast milk and they’re feeding formula. So, it’s a very, very different experience from the caregiver perspective. If the baby is acting hungry and they’re on formula is much, much easier to just whip up another bottle, right? But we don’t always have that supply of the breast milk. So I really, really like to go back just to the baby cues to the caregivers. And teach the caregiver when my baby does this, and show the ruding face, or show the little fist coming up the mouth or whatever your baby does to signal to you that she’s hungry, that’s the time when we feed her. And if we take a bottle out of her mouth and she’s done eating, but maybe she’s acting slightly agitated or a little bit of crying make sure that we’re seeing those feeding cues at the same time. It’s not unusual for a baby to drink a full bottle, maybe relatively quickly, have a little bit of tummy discomfort, she may be a bit agitated, caregivers often interpret that as hunger and will add more milk when actually that’s only going to make the situation worse. So, really working closely with the caregiver, to tell, slow down those bottle feed address hunger cues that when we feed the crying stiff baby with her arms away from her mouth is not a hungry baby, right. But oftentimes, anytime the baby is crying, food goes directly in that mouth. And that’s going to lead to this obesity issue that we’ve already got in this country. So, yeah, just really, really working on the cues, the caregiver is trying her best, right. She’s trying to satisfy this infant but maybe just needs a little bit more training about what your infant is actually trying to say.

Robin Kaplan: That’s great, that’s great! And we’ll also be discussing this more in our next episode with you, Wendy, about what are we looking at for the baby’s cues and helping our caregivers understand what those cues are in and paying attention to them. So, thank you so much Wendy for your insight into maintaining milk supply while back at work and thank you so much to our panelists as well and for our Boob Group Club Members our conversation will continue after the end of the show as Wendy will discuss what you can do if you pumped more from one breast than the other. For more information about our Boob Group Club, please visit our website at theboobgroup.com.

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Before we wrap things up today, here is Denise Altman with some nursing basics for the new mom.

Denise Altman: Hey there! Boob Group, my name is Denise Altman, and I’m a private practice IBLC, otherwise known as the Registered Lactation Consultant. Private practice means I have my own business and I specialize in prenatal education of breastfeeding support. This session is about prenatal prep for breastfeeding. Something I definitely have an opinion about. One thing you, as the expected mama and her partners should be considering, where are your resources? In the hospital or breast centre or out? Your professional resources are your lactation consultant or breastfeeding specialist typically beginning in the hospital or as I said, birth centre. In many cases, most hospitals or birth facilities don’t have an access of breastfeeding support staff. So, the best to utilize your lactation consultant when she comes to visit you, ask her to watch a full feeding. If the baby is already in nursing, when she walks in the door, remove the baby from the breast and ask her to watch you latch and observe the full feeding. Your staff nurse and caregivers that are at your bedside for at least a full shift are also an excellent resource while you’re immediately postpartum. Staff nurses are often trained and expected to assist with feeding and while they may not have the same level of knowledge as a lactation consultant, most of them are very willing and able to help you at least get through the basic. After discharge, it helpful to know what’s your resources are in the community. While you’re pregnant, contact your local La Leche League or peer counselor support network WAKE if you are WAKE eligible, but also find out where your outpatient resources are. Sometimes a hospital offers outpatient breastfeeding support services, sometimes support groups and most communities have a private practice lactation consultant like myself. Private practice LC often do home visits, which is very convenient if you’ve had C-section or a difficult birth or if the baby has to be on Billi lights, so you’re spending a lot of time back and forth to the pediatrician’s office. And let’s not discount the pediatrician’s office. Many now are hiring lactation consultants to function as fact members, but when you’re choosing your pediatrician, this is something to ask about as well. I hope that the information in this session can get you started on exploring your options. For additional tips on choosing a breastfeeding class, please visit my website, feedyourbaby.com and keep listening to the Boob Group.

Robin Kaplan: Well this wraps up our show for today, we appreciate you listening to the Boob Group, don’t forget to check out our sister show Preggie Pals’ for Expecting Parents and our show Parent Savers for Moms and Dads with Newborns, Infants and Toddlers. Coming up next week, we have JonaRose Feinberg from Twins in Mind consulting, discussing positioning and scheduling of Twins. Thanks for listening to the Boob Group, your Judgment-Free Breastfeeding Resource.

[Disclaimer]

This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in these areas are believed to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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