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Question from first time breast feeder..

Posted by on Nov. 2, 2013 at 10:32 AM
  • 10 Replies
So I have a son due in march.
I tried bf my first born but I was young and just didn't try hard enough.
I plan on going back to work about 6-8 weeks after baby is born.
I work 8 hour days.
My question is, if I'm pumping during the day...how will my milk be what it needs to for baby?
They say pump ounce for every hour...what about growth spurts?
Also, why is it the same? I've heard whether baby is 10 weeks, or 10 months, it's still only ounce an hour?? Doesn't seem to make sense.

We really can't afford for me to not go back to work...but I REALLY want to give baby ONLY bm..NO formula!

Thank you!!
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by on Nov. 2, 2013 at 10:32 AM
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Replies (1-10):
MusherMaggie
by Platinum Member on Nov. 2, 2013 at 10:38 AM
1 mom liked this
Look up "Bottlefeeding the Breastfed Baby" on kellymom.com for the answers to all those questions. Breastmilk constantly changes itself to meet your baby's needs, which formula cannot do. The baby himself regulates how much he takes in at a time when nursing, so the amount varies. The1-1.25 ounce per hour rule protects your supply. It's enough to get him through the time you are apart so that he will nurse more when you are together.
Y2kmomma
by Member on Nov. 2, 2013 at 10:44 AM
But how will it change for babies needs, or regulate when I'm manly pumping?

Quoting MusherMaggie:

Look up "Bottlefeeding the Breastfed Baby" on kellymom.com for the answers to all those questions. Breastmilk constantly changes itself to meet your baby's needs, which formula cannot do. The baby himself regulates how much he takes in at a time when nursing, so the amount varies. The1-1.25 ounce per hour rule protects your supply. It's enough to get him through the time you are apart so that he will nurse more when you are together.
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Cruz-s-mommy
by Amanda on Nov. 2, 2013 at 10:44 AM

This! And congrats on your pregnancy! :-)

Quoting MusherMaggie:

Look up "Bottlefeeding the Breastfed Baby" on kellymom.com for the answers to all those questions. Breastmilk constantly changes itself to meet your baby's needs, which formula cannot do. The baby himself regulates how much he takes in at a time when nursing, so the amount varies. The1-1.25 ounce per hour rule protects your supply. It's enough to get him through the time you are apart so that he will nurse more when you are together.


iSMILEheCRIES
by Bronze Member on Nov. 2, 2013 at 12:35 PM
Congrats! You can do this! Feed from the breast when at home and that will help with the "what kind of milk" question. And you only need to pump every 2 hours while away (not every hour). Check the law to see what work is required to help with (breaks, pumping room). Just stick to it!
maggiemom2000
by Ruby Member on Nov. 2, 2013 at 1:20 PM

Preparing for Your Return to Work: The Breastfeeding Mother’s Guide

When a family is expecting a baby, it’s a time full of wonder and happy expectation. For months, a mother feels fluttering and quickening, the soft movements of her baby. For many families, it is also a time for making plans to welcome a new family member. Parents may also use the time of pregnancy or the waiting period for adoption to investigate how to support the breastfeeding relationship in the workplace or in school. This article addresses some common questions breastfeeding mothers have about preparing for a return to work and includes the concerns that mothers who do not have a pro-breastfeeding workplace or school may face.

Talk to your employer

This article, Pumping 9 to 5, provides some information on how to talk to your employer about breastfeeding and how to make a plan for expressing your milk at work. Being ready for this conversation, with an idea of what you will need in terms of space and time, will help make your points clear and concise. Take the time you need to make a plan before you speak with anyone at your school or job. Other workplaces, tribes, and many places of higher education have set up lactation rooms; think about bringing them up in your conversation to support your requests. It may also be important to mention the ways your workplace or school will benefit from setting up a lactation room for other families. This booklet explains some of the possible concerns that a business or institution may have about setting up a lactation program for individuals that either work in or attend the facility.

Know your rights

There are State and Federal Laws in place to support breastfeeding mothers. For example California Labor Code 1030-1033 stipulates:
Every employer, including the state and any political subdivision, shall provide a reasonable amount of break time to accommodate an employee desiring to express breast milk for the employee's infant child. The break time shall, if possible, run concurrently with any break time already provided to the employee.
Additionally, the IHS and many Government agencies provide pumping breaks for their employees, and many institutions already have supportive programs in place for breastfeeding mothers. The Affordable Care Act of 2010, states that:
Effective March 23, 2010, the Patient Protection and Affordable Care Act amended the FLSA to require employers to provide a nursing mother reasonable break time to express breast milk after the birth of her child. The amendment also requires that employers provide a place for an employee to express breast milk.
Consider all of your options

Are you able to change your work schedule or delay returning to work or school? Some mothers have worked out job shares or found other ways to minimize separation from their babies. Talk to your employer about what might work for you.
  • Some companies offer on-site day-care or allow a mother to bring her baby to work with her so that she may continue to breastfeed. This arrangement eliminates the need to express milk because the mother can breastfeed her baby throughout the work day. Plan ahead: many on-site day-care facilities have long waiting lists.
  • Working from home part or full time is an option in some situations.
  • If you are not able to bring your baby with you or visit him during the day, consider a day-care situation that would allow a care-provider to bring him to you.
  • Split the work week with a co-worker who is looking for extra hours or a partial shift.

When should I start expressing milk? 

Babies grow so fast! They are newborns for only a few weeks, and before you know it, they are smiling, cooing, and reaching for your face while you are nursing. In the first several weeks after birth, take all the time you can to relax, get to know your baby, and just enjoy being his mom. Unless you have to return to work right away, it is recommended that mothers wait until breastfeeding is well-established before they begin expressing milk for returning to work: for most mothers, somewhere between 3-4 weeks. If you have to return to work earlier than 4-6 weeks, you might wish to begin pumping milk two weeks before you plan to return to work.

Learn how to express your milk

Preparing for your return to work or school can begin with learning to express your milk.
  • You can express milk by hand, with a breast pump, or by using a combination of the two. 
  • Learning how to remove milk without your baby requires both developing your own expression technique and conditioning your milk ejection reflex (MER) or “let down” to respond to it. 
  • Most mothers experience MER in response to the sensation of their babies suckling as well as other stimuli like the sound of a baby crying. If you are having trouble eliciting MER during expression, try visualizing your baby at the breast or listening to a recording of your baby's cry. Looking at pictures of your baby or smelling your baby's clothes or a blanket may also be helpful. If you have a video feature on your phone, try recording your baby breastfeeding so you can play it back while expressing. One study indicated that mothers who replicated their babies’ sucking patterns by adjusting the cycle settings on their pumps expressed more milk (Meier, et al, 2012). 
  • Warming the breast before expressing and gentle breast massage (working from the armpit towards the nipple with a soft kneading touch or in a circular motion with flat fingers) has been effective at increasing the amounts of milk removed during expression (Jones, Dimmock & Spencer, 2001). 
  • Combining hand expression and massage with a pumping routine has been shown to assist with increasing milk production and output (Morton, Hall & Wong, 2009).

How do I hand express?

Hand expression requires no special equipment and can be an effective way for you to remove milk when separated from your baby. Some mothers find that hand expression is more effective for them than pumping because it is more comfortable, and they can feel for areas of fullness and apply pressure with their fingers exactly where it is needed. Once you have success with a method of hand expression, you may feel that you are able to meet your baby’s needs without a pump.

What type of pump should I use?

A high-quality, full-size, double-electric pump is recommended for a mom who plans to pump milk every day. A pump that is made by a manufacturer specializing in breastfeeding equipment will be of higher quality than cheaper pumps made by a company whose primary products are bottle-feeding equipment or baby food. A breast pump is an item for which the old adage, “You get what you pay for,” often rings true. Another option for many mothers is renting a multiple-user pump from a trusted source such as a Hospital, Tribal Health Clinic, or local IBCLC. Most WIC offices provide pumps to moms who are returning to work or school; contact your local WIC office to see if you qualify. Many families have health insurance that is willing to cover the cost of renting a hospital-grade pump. If you are able, call your insurance provider for the details of your own coverage when you are pregnant. Recent 2011 news from the IRS states that electric pumps are now tax deductible, so keep your receipts for your tax records.

In our opinion, the top three single user pumps on the market today are:
Pump Brand/Model
Cost range
Warranty
Mechanics
WHO-CODE
Hygeia Enjoye*
$180-300
3 year
Closed system
Compliant
Ameda Purely Yours
$150-180
1 year
Closed system
Compliant
Medela Pump in Style
$250-350
1 year
Open system
Non-compliant
*Sold in the category commonly referred to as single-user pumps; Hygeia is the only pump company that has sought and received FDA approval for their pump to be used by more than one person.

What is the difference between an open and closed system pump? 

With an open system, if milk or condensation makes its way into the tubing, it is possible for mold to begin to grow in the motor. There is no way to clean the pump motor, and any mold spores present could come through the tubing and possibly into contact with the expressed milk. Furthermore, if the pump is second-hand or was used by another mother, germs from one mother or her milk could contaminate the milk in the same way. An open system is built to be a single-user system only.

Closed system pumps are just what they seem: there is no way for the milk to come into contact with the motor. Theoretically, any closed system pump could be safely used by more than one person (each with her own tubing and other external pump parts). 

What is the WHO CODE, and why is it important to consider when buying a breast pump?


The “WHO CODE” is short for the World Health Organization’s International Code of the Marketing of Breastmilk Substitutes. Part of the purpose of the WHO CODE is to protect breastfeeding by preventing aggressive marketing of breastmilk substitutes and artificial nipples. Many people prefer to purchase a breast pump from a company that is supportive of and compliant with the WHO CODE.

More information on both the breast pumps, the WHO CODE, and open and closed systems can be found at: The Problems with Medela

How often should I express milk?

Once a day is usually plenty at the beginning. Most moms find that they are able to express the most milk in the morning hours. You can nurse your baby on one side while expressing milk on the other side. Or you could pump both sides about one hour after your baby’s first morning feeding. Don’t worry if you don’t get very much milk at first. It takes practice, and your body needs to “learn” to make milk for that extra “feeding.” When milk is removed, your body responds by making more milk at a faster rate. It can take a few days for your body to increase production (Daly, Kent, Owens et al.,1996). Any milk collected during these practice sessions can be stored in the freezer.

How much milk should I have stored in my freezer?

Many mothers find that they feel less stress if they to know that they don't need to create a large freezer stash of milk before they return to work. Instead, they can use their maternity leave to focus on being with their babies and getting breastfeeding well-established. If you have enough milk to send with your baby on your first day, then you have enough in the freezer.

It is important to express as much milk while you are at work as your baby needs during that time. If your baby needs 10 ounces while you are away at work, then you need to pump at least 10 ounces each day.
For example:
If you were to only pump 8 ounces and send 2 ounces from the freezer each day, you would not be expressing the amount of milk your baby requires. Your body will “think” that your baby needs 2 fewer ounces each day than he really does, and your production will not match his demand. If you start to run out of milk in your freezer, you may face the difficult decision of how to meet your baby’s needs. Many mothers learn too late that increasing their milk supply to meet their baby’s demands is more complex than it seems. Meeting your child’s daily needs for expressed milk during separation is the best way to avoid difficulties later.

Using the simple system described, you pump each day what your baby would need the next day. This way you only use the small freezer stash for emergencies, such as dropping and spilling a day’s worth of milk, or other milk-related calamities.

If you need information about returning to work or expressing your milk, a Breastfeeding Counselor La Leche League LeaderNursing Mother’s Counsel or International Board Certified Lactation Consultant may be able to help. Accessing a community support system can help you reach your breastfeeding goals.

You may also be interested in these articles:
Returning to Work: The Breastfeeding Mother’s Guide
Are There Differences Between Breastfeeding Directly and Bottle-Feeding Expressed Milk?
Breast versus Bottle: How Much Should Baby Take?
Facts Every Employed Breastfeeding Mother Needs to Know
I’m Worried My Milk supply is Drying Up, What Can I Do?
maggiemom2000
by Ruby Member on Nov. 2, 2013 at 1:20 PM

Returning to Work: The Breastfeeding Mother’s Guide

Returning to work after giving birth can be stressful for many mothers and their families. It is often hard to adjust to being both a mother and an employee, and you may have mixed feelings about leaving your baby. Mothers often report that they are sad to leave their children, and it is normal to feel hesitant or reluctant to part with the small person who holds a lion’s share of your heart. Both new and veteran parents worry about childcare for their new infants. You may be wondering how your baby should be fed when you are away and how milk you should leave at daycare. This article will address some common questions breastfeeding mothers have about continuing to breastfeed and providing breastmilk for their babies after returning to work or school.

How much milk will my baby need while I’m away?

Breastfed babies need, on average, 24 to 32 ounces of milk per day (Kent et al., 2006). If you spread that amount over a full day it equals 1-1.25 ounces per hour. With that information in mind, plan on leaving about 1-1.25 ounces of milk for each hour of separation. Most breastfed babies need no more than 2-4 ounces at each feeding (Kent et al., 2006). Breastfed babies need less milk than formula-fed babies do, and unlike with formula, the amount of breastmilk your baby needs does not increase as he grows bigger. When you return to work, your baby will need only a portion of this daily amount of milk from the care provider, because he will still be getting much of it by breastfeeding during the hours of the day and night when you are together.

Offering smaller bottles, of no more than 2-4 ounces, means there is a smaller chance that your baby will not finish his bottle and leave milk that must be thrown away bylicensed daycares. 


How many times do I need to express milk at work?

How many times you pump at work will depend on a few factors: how long you are away from baby, how well you respond to milk-expression, and your work situation. Many working moms plan to pump milk at least as often as every 3 hours. If you are becoming engorged between pumping times, you may need to remove milk more frequently. Every mother has her own “magic number” and will differ in how frequently she needs to express her milk to both maintain milk production and provide enough expressed milk for her baby. Try to remove milk as often as it takes to collect enough for your next work day.


What if I can’t stop to pump as frequently as I would like?

When it is challenging to find enough time to pump your milk, here are some time-saving options:

  • Breastmilk can be kept at room temperature for 6-8 hours (ABM, 2004). With this guideline in mind, you do not need to take time to wash out your pump parts after every use. Keep your pump parts and bottles of milk in a cool place, and cover them with a cool towel; a small cooler or insulated lunch pack is another option.
  • Some mothers place all of their pump parts in the refrigerator along with their bottles of expressed milk each time they pump. At the end of the day, they take all of the parts home to wash.
  • Consider arranging your schedule so that you can arrive at work 15 minutes before you need to “clock in” and pump before you start work. 
  • If you don’t have enough time to completely drain your breasts, it is still valuable to stop and express some milk, even if it you only have 5 minutes.
  • If expressing in your car could help you save some time, consider purchasing a car adapter for your pump and a hands-free pumping bra (or you can make your own) so that you can pump with your hands free. For your safety, we recommend that you do not express milk while driving.
  • If you are mobile during your work hours, a cooler for your milk will help preserve your milk at a lower temperature, and you can save time by expressing milk whenever you have an opportunity.


How should I store the milk I pump at work? Do I put it all in the freezer?

In order for your baby to get the most anti-infective properties from your milk, it is best to offer it fresh whenever possible. Freezing has been found to denature some of the antibodies and kill some of the living cells in milk (Orlando, 2006; Buckley & Charles, 2006). Whether fresh or frozen, your milk provides all the nutrition your baby needs, and you can count on your milk to support your baby in all areas of growth and development.

Here is a schedule many working mothers recommend for using frozen milk. With this system, your baby gets more fresh milk and therefore the best possible nutrition and immune factors to protect him from illness:

  • Pump on Monday; give this milk to your babysitter to use on Tuesday.
  • Pump on Tuesday; use this milk on Wednesday and so on until Friday.
  • Pump on Friday, label with the date, and freeze this milk; put it in the back of the freezer.
  • Use the oldest milk in the freezer for Monday.
  • Use your freezer stash only when you have an unusual need for extra milk, for example, when your baby is going through a growth spurt or you accidentally spill all of your freshly-pumped milk.
This system prevents the frozen milk from getting too old and needing to be thrown out. Another option would be to refrigerate Friday’s milk over the weekend and let your babysitter use it on Monday. This practice would preserve more of the antibodies in Friday’s milk but would not use up your frozen milk before it goes out of date.


What if my baby’s caregiver says my baby needs more milk?

With bottle-feeding, there can be a tendency for the person feeding to encourage the baby to finish the bottle. Milk flows easily from a bottle nipple, even when the baby is not actively sucking, and the faster flow can cause a baby to continue feeding after he is full. Caregivers may believe that a baby needs more milk than he actually does, and many childcare workers are accustomed to the larger amounts of formula they feed many babies. Make sure that your caregiver has the correct information about how much breastmilk a baby needs and understands the difference between bottle-feeding breastmilk and formula. 

You can offer some tips to your baby’s caregiver on how to bottle feed in a way that supports breastfeeding:
  • Use a slow-flow soft bottle nipple that has a wide base and a shorter, round nipple (not the flatter, orthodontic kind).
  • Start by resting the tip of the nipple on the baby's upper lip and allow him to take it into his mouth himself, as if he were nursing.
  • Keep the bottle only slightly tilted, with the baby in a more upright position, so he has to work to get the milk out. If you hold the bottle straight down, the milk will come out too fast, and he may feel overwhelmed by the flow (Kassing, 2002).

What if my baby is refusing bottles?

If your baby is refusing bottles, or you prefer not to use one, there are other options available:
  • You can try cup or spoon feeding. If you use either a cup or spoon, make sure your baby is fed while sitting in an upright position and that the feeding is “paced” (slow).
  • If your baby continues to avoid any type of feeding while you are away, despite offering your milk from a spoon or cup, you may want to investigate slow-flow sippy cups (avoid ones that encourage babies to bite the tip to get milk).
  • Some mothers have said that offering frozen milk in a mesh feeder worked for them; babies may respond favorably to the new texture and temperature of the milk.
  • Investigate whether you can have your baby brought to you by your care-provider during a break so that you can nurse.
  • Another option, when your baby is refusing expressed milk, is offering to make up missed feedings when you are together. This is often called reverse cycling.
  • If your baby is over 6 months, and ready for solids, you can send foods for him that have a higher content of water such as melon. Your baby will ideally be able to get an amount of your milk in some way, but there are other ways to cope with hydration issues if your baby is unwilling to take your milk in a liquid form.

What if I’m not expressing enough milk?

Here are some tips to increase the amount of milk you are expressing:
  • Go back to the basics of learning how to express your milk.
  • Relax. Take a few deep breaths and get comfortable before you begin expressing your milk.
  • Avoid watching the bottles to see how much milk is coming out. Instead, focus on your baby, listen to music, or try some relaxation methods. Many mothers find that watching how much milk is coming out reduces the amount they are able to express. Try covering the bottles with a cloth or towel, so they are not visible. There is evidence that music can be soothing to mothers while they are pumping and improve milk-removal. Music-based practices have been shown to encourage better milk production in mothers who have babies in the nicu (Keith, D.R. et al., 2012).
  • Add another breastfeeding session, especially if your baby is sleeping 5 or more hours in a row at night. 
  • If you are unable to express more frequently at work, another option is to express milk at home first thing in the morning.
  • Try more frequent, shorter sessions of expressing milk. Many mothers have said that several 20-minute sessions will yield more total milk than a couple of 30 minute sessions.
  • Send what you are able to express. Nurse at drop-off and pick-up to decrease the total amount of milk needed while you are separated. Remember that your baby has 24 hours in the day to get all of the milk he needs. If he does not get enough in the time you are apart, he can nurse more when you are together in order to get the total amount he needs.
  • If you are using a pump, check its condition. Some pumps need parts replaced frequently to maintain full suction.
  • Rule out any health-related complications to milk production with your health-care team; there are many reasons that mothers experience a dip in supply.
  • Try “hands on pumping” when you are expressing milk to empty the breast.
  • Use some gentle massage before you express: starting in the armpit and work toward the nipple in gentle, circular motions. 
  • Update the pictures of your baby that you are using when you are expressing. Bring some worn baby pajamas and try smelling them to help you mentally bring your baby into the room with you. Some mothers have said that recordings of their babies are also helpful. One mother reports that creating a sound file of her baby’s sounds and favorite lullabies together was most effective for her.
If you need more information about returning to work or expressing your milk, aBreastfeeding Counselor La Leche League Leader, or International Board Certified Lactation Consultant may be able to help. Accessing a community support system can help you reach your breastfeeding goals.



You may also be interested in these articles:

Preparing for Your Return to Work: The Breastfeeding Mother’s Guide
Baby-Led Bottle Feeding
Breast versus Bottle: How Much Should Baby Take?
Facts Every Employed Breastfeeding Mother Needs to Know
Y2kmomma
by Member on Nov. 2, 2013 at 1:32 PM
Thank you all!
Posted on CafeMom Mobile
aehanrahan
by Group Mod - Amy on Nov. 2, 2013 at 5:40 PM
The baby's saliva on your breast tells your body what is needed and the milk will change to meet those needs. Growth spurts don't actually change the amount of milk. They change the milk to meet the baby's changing needs. Formula can't change, so the amounts have to increase to meet the growing nutritional needs of the baby. If you stick with the. 1-1.25 ounces per hour while you're separated, you'll still be nursing plenty to make the perfect milk at the right amount for your baby.
Have you read the nurshable article about this? If not, google nurshable one ounce per hour.


Quoting Y2kmomma:

But how will it change for babies needs, or regulate when I'm manly pumping?



Quoting MusherMaggie:

Look up "Bottlefeeding the Breastfed Baby" on kellymom.com for the answers to all those questions. Breastmilk constantly changes itself to meet your baby's needs, which formula cannot do. The baby himself regulates how much he takes in at a time when nursing, so the amount varies. The1-1.25 ounce per hour rule protects your supply. It's enough to get him through the time you are apart so that he will nurse more when you are together.
Posted on CafeMom Mobile
Junebaby18
by Nannerz on Nov. 2, 2013 at 5:50 PM
You don't literally give 1 oz every hour to the baby. You give them in bottles of 3 oz every 2-3 hours. If you're gone for 9 hours, you can nurse before dropping off at 6 for example. Sitter gives bottle of 2-3 oz at 8-9. Bottle at 10-11, bottle at 12-1 and you get there at 3 ish and nurse when you pick up. That would mean baby only really needs 6-9 oz while away.

While away, pump 3 times. Morning break, lunch and afternoon break or even save the afternoon break until you get to baby if you want.

Of course, this will change slightly if you're gone longer than 9 hours.
gdiamante
by Group Mod - Gina on Nov. 2, 2013 at 7:44 PM


Quoting Y2kmomma:

So I have a son due in march.
I tried bf my first born but I was young and just didn't try hard enough.
I plan on going back to work about 6-8 weeks after baby is born.
I work 8 hour days.
So you'll need 8-10 ounces per day.
My question is, if I'm pumping during the day...how will my milk be what it needs to for baby?
Because you're still nrusing at night. It's fne. No worries.
They say pump ounce for every hour...what about growth spurts?
STILL 1 - 1.25 ounces per hour. That's a forev er number. He'll nurse more when he's with you.
Also, why is it the same? I've heard whether baby is 10 weeks, or 10 months, it's still only ounce an hour?? Doesn't seem to make sense.
Because the bottle is "tide him over." That's all it is. If he needs more he takes it at the breast.
We really can't afford for me to not go back to work...but I REALLY want to give baby ONLY bm..NO formula!

Thank you!!

Then stick with the rules. No worries here for you. The guidelines are to allow you to keep it breastmilk only. Baby will be FINE.

Mine never took more than three ounces in a feeding and rarely more than 9 ounces in my ten hour day. He made up for it when I was home.

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