The pitfalls of pumping we tend to ignore

I was going to start off this blog post with a statistic. You know, ___% of working mothers pump breastmilk, or something like that. So I was plugging search terms into Google Scholar, and this paper published in American Family Physician popped up: Returning to Work While Breastfeeding. It’s not terrible: I like how it mentions that many women can’t take extended leave, that support and resources are so important, and, one of my pet ideas, that “the best long-term approach to improving the breastfeeding continuance rate may be to help communities establish lactation support programs for local businesses.”

On the other hand, it presents a two-dimensional view of the problems faced by working moms who breastfeed. Certainly, having the time and space to pump, as well as an employer who is sympathetic and family members who are supportive, are a big part of the equation, but there are a lot of seemingly small things that are often overlooked when talking about working and pumping. Here are some of them, which are not constrained to this article.

The kind of pump you have—manual or electric, single or double—is just one part of the pump equation. The standard-size flanges that come with pumps may or may not be the right size; larger or smaller ones can be purchased. Other replaceable parts of a pump may need to be replaced periodically; failing to do so may negatively impact pumping output and milk supply maintenance. And, although it may seem economical and Earth-friendly to purchase a used breastpump, most pumps are meant to be used by a single woman and for the duration of breastfeeding of one (or more, if we’re talking about multiples) baby. The motors can, and do, gradually lose their power. From Medela’s website:

Another consideration when deciding to borrow or even lend a previously owned electric pump is the pump’s motor life. A high quality electric double pump might last through the breastfeeding of your second child, or even several children. However, like computers or other electronic products, an electric breastpump has a limited lifetime. Medela guarantees its pump motors with a one year warranty. If you use an electronic pump that has been used for more than one year, there is no guarantee that it will generate as much speed and vacuum as it did earlier in it’s life. By using your own pump, you can compare the pump’s performance with each child. However if you borrow a pump, you cannot gauge its performance to ensure it is operating at full capacity.

You do not need to “stockpile stored milk.” Many mothers who are returning to work have heard of the “freezer stash.” Everyone needs a freezer full of milk by the end of her leave, right? Nope. Here’s more about that.

Your baby is the best way to build and maintain your milk supply. You don’t need to pump to “create a milk supply”; your baby is doing that for you, while you are together and feeding from the breast. Pumping in addition to nursing, especially if you take this article’s recommendation to pump every three to four hours, may be a recipe for plugged ducts and mastitis caused by oversupply. You need only feed one baby, and your pump is a substitute baby. Avoid making milk for two “babies” while at home, and then going to work and pumping milk for one.

Pumping can be flexible, and can be worked around the needs of a mother and her job. Some pumping is better than no pumping. You may not get a chance to sit down for a half an hour to leisurely express milk, but you might have time to pump for five minutes, set your equipment—without disassembling it—in a cooler, and come back later for another quick five-minute pumping session. You don’t need to do X number of minutes for each side; you just need to remove milk. You can get creative about how you do it, such as by wearing a hands-free pumping bra or using hands-on pumping techniques. And, for those moms for whom pumping is not an option at all, you can still breastfeed when you’re with your baby. Your milk supply will not be as robust as that of someone who is providing 100% breastmilk, but some breastmilk is better than none, truly. Whatever your individual challenges, there are ways to work around them, if breastfeeding your baby is part of your goals.

The amount of milk you pump doesn’t need to be extreme. In fact, it probably won’t be. On average, pumping will yield one to three ounces per session—NOT per breast—and this varies over the course of a day (many moms pump a large amount in the morning and smaller amounts as the day wears on). Keeping in mind that babies eat, on average, 25 ounces per day, and that you are pumping once every three hours or so, it makes perfect sense that a few ounces should be the maximum you can expect. Furthermore, a baby is better at removing milk from a breast than a pump is, and pumping output is not a good way to measure how much milk you make. Not being able to pump a large volume of milk does not automatically mean you have a supply problem.

Caregivers absolutely, positively need to know how breastfed babies eat from bottles, in terms of technique and quantity. As I see it, the #1 pitfall of pumping that is frequently overlooked is that so few caregivers have experience with bottlefeeding a breastfed baby. Breastfed babies tend to eat smaller meals more frequently, and this doesn’t change if their food is coming out of a bottle instead of a breast. A good rule of thumb is that a baby needs one ounce of milk per hour away from her mother. For reasons as varied as not being able or willing to soothe a baby who is not content without a bottle or being beholden to USDA food program guidelines, caregivers may request more milk than a baby actually needs, and it may take some work to get them on the same pro-breastfeeding page as you’re on. You’re in luck if you’d like concise and accurate information to share with caregivers; Nancy Mohrbacher just wrote a blog post on the topic.

Pumping at work can be straightforward, or not. Not everyone stumbles into roadblocks, but if you do, there are resources to help. Yes, IBCLCs and CLCs and La Leche League/Breastfeeding USA groups and so many other lactation supporters can and will help you with your pumping questions. We want to see you succeed, and helping moms pump at work is one big component in helping them achieve breastfeeding success.

About Tipper Gallagher, IBCLC

Tiffany (Tipper) Gallagher, BA, IBCLC, RLC, is an International Board Certified Lactation Consultant serving the Minneapolis-St. Paul, Minnesota, metro area. In her private lactation consulting practice, she provides in-home visits for families experiencing breastfeeding difficulties as well as prenatal and postnatal education in private and group settings. Tipper melds her passions for writing, advocacy, and sharing evidence-based information by blogging at www.theboobgeek.com, presenting at conferences, and actively participating in professional organizations.

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