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Friday, July 31, 2009

Maintaining My Milk Supply

One of the most common questions I get asked on breastfeeding and working is how I maintain my milk supply. Naima is almost 20 months old and she still takes expressed milk at home. I also still have excess milk which we donate (if substantial) or use in cooking Naima's food.
I went back to work when Naima was 7 months old. At that time, my biggest fear was that I would not be able to express enough milk at the office for Naima’s next day feed. Happily, that has never happened. Naima’s daily milk intake has remained to be fresh (refrigerated, actually) and we’ve never had to dip into our freezer supply. In fact all my freezer supply gets donated every time my cook complains that we don’t have space for our frozen food (which used to be every 2-3 weeks but my intervals have lengthened into a month or so).

To maintain milk supply and successfully pump at work, here are some tips:

1) Prepare for your return
Check your office’s policies on breaks. Look for places where you can pump and store your milk at the office. Talk to your boss or supervisor about getting some time off to express milk. And of course, work efficiently – you’ll already be taking extra time to express milk so cut the idle time – chitchat, etc.
I’d also recommend that moms bring 2 or 3 sets of flanges/horns so they don’t have to wash in between pumps. In my case, since I have a refrigerator near my pumping area, I just bring a clean plastic food case. After each pumping session, I put the flanges in the case and stick them in the refrigerator immediately. So for my subsequent sessions, I just attach new bottles and pump away. WARNING: The horns are cold! Also, there is a concern about mixing the cold drops of milk with the warm freshly expressed milk. If you are worried about this, then you can just rinse your flanges with water from your office dispenser or bring your own water cooler.
2) Maintain a regular pumping schedule
When I first went back to work, pumping schedule looked like this:
  • 630am – wake up and pump
  • 9am – 1st pump at the office
  • 1130pm – 2nd pump at the office
  • 230pm – 3rd pump at the office
  • 530pm – 4th pump either at office or at home, depends if I’m working late
When Naima was younger, she doesn’t ask for milk immediately when I get home. So I still get to express milk before I directly nurse her at about 6pm or so. After Naima turned 1, I dropped a pump and my pumping schedule changed to:
  • 630am – wake up at pump
  • 930am – 1st pump at office
  • 1245pm – 2nd pump at office
  • 4pm – 3rd pump at office
I dropped the last pump which I used to do just before nursing Naima. Sometimes the last pump gets extended to about 5pm, depending on whether I’m rushing work. I’m able to drop the last pump occasionally but get really engorged.
For a short while, I followed this pumping schedule:
  • 630am – wake up at pump
  • 1030am – 1st pump at office
  • 230pm – 2nd pump at office.
I started on this schedule a month ago but discovered that the 3-day pump at office schedule works better. I would have wanted to keep the 2-day pump at office schedule. However the pumping times usually coincided with the busy office times, unlike the other schedule (3 pumps at the office), where my pumping breaks are scheduled during break times. So I reverted to my 3x a day office pumping schedule.
I also pump during the weekends. I never miss the 630am pump whether it is a weekend or holiday. I usually get the most amount of express milk during that 1st morning pump. I also pump a couple of times during the weekend, usually after Naima nurses. The extra milk serves as buffer in case I am unable to express enough milk during the work week.

3) Eat the right foods and stay hydrated.
My daily breakfast consists of a bowl of oatmeal, 1 malunggay capsule and a cup of native cocoa drink. The oatmeal and malunggay are said to be galactagogues. The native cocoa was just carried over from my ge-lai days. I also have a bottle of water on my office table. As one lactation consultant told me – stay hydrated but don’t drown yourself in water. Drink every time you feel thirsty.
It is also important to eat well. In my various yahoo groups, nursing and pumping moms recommend eating eat enough protein and good saturated fats (such as olive oil, flax oil, avocados, coconut oil – I assume this is VCO!). Aside from the galactagogues, I also try to eat healthy foods and avoid eating out as I don't know what goes into my food. I take extra calcium and continue taking my prenatal vitamins.
Oatmeal is known to promote lactation and there is a popular recipe for oatmeal lactation cookie, which I’ve copied and pasted below with notes on some of the ingredients’ local availability.
  • 1 cup butter
  • 1 cup sugar – we’ve reduced this to ½ cup
  • 1 cup firmly packed brown sugar – we’ve reduced this to ½ cup
  • 4 tablespoons water
  • 2 tablespoons flax seed meal – available at healthy options
  • 2 eggs
  • 1 teaspoon vanilla
  • 2 cups flour
  • 1 teaspoon baking soda
  • 1 teaspoon salt
  • 3 cups oats - You can use the “quaker oats” brand – choose quick cooking not instant. You can also buy oats from Healthy Options
  • 1 cup chocolate chips – Some moms replace this with toffee chips or chopped-up pieces of Heath bar.
  • 2-4 tablespoons brewer's yeast – available at Healthy Options. I also sprinkle brewer’s yeast on my daily oatmeal bowl.
Preheat oven to 350°. Mix the flaxseed meal and water and let sit for 3-5 minutes. Beat butter, sugar, and brown sugar well. Add eggs and mix well. Add flaxseed mix and vanilla, beat well. Sift together flour, brewers yeast, baking soda, and salt. Add dry ingredients to butter mix. Stir in oats and chips. Scoop onto baking sheet. Bake for 12 minutes. Let set for a couple minutes then remove from tray.
4) Stop milk wastage by knowing how to properly bottle-feed the breastfed baby and knowing how to properly handle breastmilk.
Sometimes, the reason why working and pumping moms think that the milk they produce is not enough is because their yayas or babysitters overfeed their babies or waste the milk by not handling it properly.
KellyMom has a terrific guide by Eva Lyford on how to bottlefeed the breastfed baby. There is even a printable guide which you can give to your caregiver. You can also compute how much milk your baby will need when you are away by using the milk calculator here.
It is also important to teach your caregiver how to properly store/prepare milk. I’ve heard horror stories of dads or caregivers thawing out too much milk, only to throw them away because the baby couldn’t finish the milk. Since these caregivers do not express the milk, they don’t realize how difficult it is to squeeze those extra drops out just so you can make a full bottle. I trained my yaya how to warm Naima's milk and how to store (in small amounts) milk to avoid wastage. I guess I was also lucky that my yaya recognized the importance of breastmilk and readily learned how to handle and serve it to Naima.
There are also several other internet resources working moms can check for more information. There is even one site specifically addressed to breastfeeding and working mothers. I am counting the months until I wean from the pump. My goal is to stop pumping for Naima at the end of the year but still continue nursing her whenever we are together. Balancing work demands and time required for expressing milk is not easy BUT it can be done as long as the mother is determined and disciplined to focus on her goal of being able to bring home expressed milk for her baby at the end of her workday.


Pat Grace said...

hi! what kind of pump did you use and did you express from both breasts a work?

Jenny said...

Hi Pat! I use a double electric pump and express both breasts at the same time at work - i find that it saves me time to double pump. Thanks for dropping by!

linggerts said...

a friend linked your page to me, coz she encouraged me to continously breastfeed my almost 2-month old baby. i told her that I thought it wasn't possible for me to continue coz im running out of milk supply, inspite of my effort to sustain it. tnx to your blog that it helped me realize that it really was possible. tnx to my friend as well :)

Jenny said...

@linggerts! thanks for reading and yes, i'm sure you can sustain! :) keep visiting

Mrose said...

Thank you for this wonderful entry! I'm excited to try your oatmeal recipe. I've been on a daily diet of soup and malunggay capsules so I'm excited to try something new! Good timing also as I've started learning to bake yey!!! Recently I've been having trouble maintaining my milk supply...went back to work a week ago and it's hard to catch up with work demands and still find time to pump. Thanks to your blog entries, I'm inspired to keep on breastfeeding my baby. Will read more of your entries :)

Cheeeryl said...

Will definitely try the oatmeal cookie recipe once our oven's fixed hehe. Would Quaker Oats for breakfast help me with my milk supply for the meantime?

Jenny said...

@Cheeeryl - yes, i eat quaker oats daily. - choose the quick cooking and not the instant one

dinna said...

Hi, Ms. Jen! I find your blog really encouraging... I may not have read all your articles, but I get the impression that you gave birth in the US? (I did, too.) And that Naima was jaundiced with an alarmingly high bili level (my little boy was, too, and underwent phototherapy for 30 hours at 8 days old, with a 24.4 level, scaring the wits out of me.).

Anyway, I just want to ask how many ounces of milk you were usually able to pump given the two-hour interval in your schedule. I know that pumping increases milk supply but I get the feeling and observation that I don't get to produce milk fast enough to satisfy my son about 2 hours after I had pumped.

Jenny said...

hi dinna! i was pumping barely 1 oz from both breasts then!

Armi said...

Hi Ms. Jenny! Been following your blog since I was preggy. Thank you for the very informative articles, they helped me a lot. I'm now exclusively breastfeeding my 2-month-old little girl but is going back to the office soon.

Could you kindly give me an estimate of how much expressed milk my baby may need for 12hours while I'm away? I've already started building my frozen milk supply, but I want to give her refrigerated milk expressed the previous day as much as possible. Thank you very much!

Jenny said...

hi armi! thanks for reading.  check out these milk calculator links:

Armi said...

Thanks a lot! ^_^

peppermint artist said...

Hi ms jen I'm a n@wie and is currently following ur blog:) I'm soon going back to work and is now starting to build frozen milk for my baby. I am just wondering because I still keep on pumping milk every 2hrs and just get about 50ml to 2oz only. And sometimes I feel incapable to produce enough:( is produced milk I get every 2hrs is normal?

YME said...

Hi! How much time do you consume for pumping sessions in the office? Thanks!

YME said...

Btw, the pumping schedule you mentioned was when you started how about a week or 2 before, how did you handle nursing and pumping? I am exclusively nursing now, my baby will be 2 months old in a week, I read a lot about preparation but I dont know when to start as I feel that my baby is always hungry and he nurse for 45 mins or more.

Jenny said...

pumping sessions are 15 minutes. when i was trying to build milk supply, i pump in between feedings. 

Jenny said...

i think i wasn't able to answer it is 12-15 minutes. i pump in our pantry now for my 2nd baby :D

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