The decision to leave your baby to return to work is hard, regardless of the feeding method.
But as the many advantages of breastfeeding become understood, more moms are choosing to continue to nurse after they re-enter the work force.
Developing a good routine for home and work may seem tricky at first, but plenty of moms successfully combine the two with a little planning.
Becca Mades, certified family nurse practitioner at Allina Health Clinic - Buffalo, offers tips to help make the adjustment easier.
Selected Podcast
The Breastfeeding Mom’s Return To Work
Featured Speaker:
Learn more about Becca Mades
Becca Mades, CNP, -Family Medicine
Becca Mades is a certified nurse practitioner specializing in family medicine at Allina Health Clinic – Buffalo. A mother of two, Becca is an advocate of breastfeeding because of its many health benefits to both baby and mom.Learn more about Becca Mades
Transcription:
The Breastfeeding Mom’s Return To Work
Melanie Cole (Host): For all new mothers, the decision to leave your baby to return back to work is very hard regardless of the feeding method. But, as the many advantages of breast feeding become more understood, more moms are choosing to continue to nurse after they re-enter the workforce. Developing that good routine for home and work may seem a little tricky at first but plenty of moms successfully combine the two with just a little bit of planning. My guest today is Becca Mades. She’s a Certified Nurse Practitioner specializing in family medicine at Allina Health Clinic, Buffalo. Welcome to the show, Becca. So, first of all, tell us a little about some of the benefits of breastfeeding moms and the things they should consider before re-entering the workforce.
Becca Mades (Guest): You know, the benefits of breast feeding have just been becoming more and more known both for mom and baby. For mom and baby, there are advantages in that there’s a reduced lifetime risk of cardiovascular disease, diabetes, multiple kinds of cancers. For mom’s breastfeeding, it helps to reduce stress, helps to improve weight loss and helps recovery from birth for baby. It also reduces lifetime risk for obesity and, in the here and now for while baby is little, it reduces risk of ear infections, breathing infections and stomach infections. It just keeps baby healthy long term. One of the other things that’s pretty cool about it is that breast milk is a natural pain medication in some ways for babies. It’s not actually medication but helps to produce that comforting effect for babies. It’s just so great for so many reasons and really helps baby to really thrive early in life and later in life.
Melanie: As hard as it is, Becca, for new moms to go away from their baby for even ten minutes, when they are thinking about returning to work and what would you like them to consider? What kind of planning should they be doing?
Becca: I think that the best planning for returning to work starts, really, as soon as you have the baby. So, if you know that you’re going to be returning to work, starting to pump early and often really makes a huge difference and just really helps to reduce that stress level. So many moms have so much anxiety about, “Will I be able to produce enough milk?” and “Will I have enough stockpiled?” Starting early and just being consistent with your pumping makes a huge difference. I have a couple little kiddos that I breast fed myself and, for me, I literally--as soon as my milk starts coming in, that day I start pumping, usually two to three times a day is what I’ve done. By the time that I’ve returned to work, I’ve had hundreds, even thousands, of ounces ready and just waiting for them so that when I get to work I’m not just so stressed about do I have enough and will this work.
Melanie: Okay, so we’re starting to pump and getting all these things kind of in order and getting our minds in order, too, which is really a big deal. Are there different kinds of breast pumps women should look at? Or, generally, they’re kind of all similar?
Becca: There are actually a lot of different kinds of breast pumps. There are single pumps. There are double pumps. There are manual pumps. There are electric pumps. There is a huge variance in different brands. Price points tend to be all over the board. I would say, for the most part, what most people recommend is a double, electric pump. Most things say that that’s how you produce the most milk. Brand to brand, women respond differently. I’ll say, for me, I have had really good luck with the Medela brand. They’ve done a lot of research on how babies actually do suck and have tried to mimic their machine after that. Babies will always be able to get more milk than a pump but a double, electric pump makes a difference. Flange size--the part that actually goes onto the breast itself--can also make a fairly substantial difference. A lot of women find that a slightly larger flange actually helps them to get a little bit more milk when they pump.
Melanie: What about storing? Can this be frozen? If you’re going to pump a lot and you know that you’re going to an eight hour day, you’ve got a caregiver that’s going to be feeding, can it be frozen? Is it refrigerated? Do you leave it at room temperature? What do you do with it?
Becca: So, breast milk, the rules actually vary a little bit. Most people, you can actually go up to 10 hours at room temperature and up to about eight days in the refrigerator and you’ll see anywhere from three to twelve months for the freezer. I like to just keep it simple for myself and I go with the rule of sixes. So, six hours at room temperature, six days in the fridge and six months in the freezer is how I like to remember that. If you have a deep freeze, people will say up to a year. I can say that I have stored breast milk for up to a year and it has still been just fine when we defrosted it. When you’re storing, you want to consider what you’re storing that in. For me, I’ve used, I’ve pumped into the BPH-free bottles and then I’ve stored it in plastic bags. If you lay those bags flat when you freeze them, they tend to store much nicer. You can kind of stack them like a book or all horizontally so that they lay nicely so that they don’t have that big chunk of milk at the bottom of the bag and an empty bag on top. So they take up a little less space ultimately.
Melanie: Do you recommend that women reuse what they haven’t used if they’ve put it into a glass bottle or they have their caregiver feed the baby every couple of hours, can they reuse what’s left in the bottom or do you just say chuck that out?
Becca: There’s actually research that says that it’s just fine that after baby has started to drink from a bottle, if they don’t finish it, you can use that last couple of ounces. If that milk has been heated, you only have about two hours to use it. Frequently, when babies are little they are eating about every two hours. If it has not been heated, you can use it for four hours at room temperature or you can stick it back in the fridge and use it within 24 hours. I can say that knowing that rule has saved me a ton of milk over the years with my kiddos.
Melanie: So, going back to work, speaking with your employer about this. So, if you’ve pumped before you’ve gone, do you feel the need to do that while you’re at work depending on the length of your work day?
Becca: Absolutely. Breast milk supply is all about supply and demand. Once you are back at work, you really still want to be pumping about every 2-3 hours to maintain your supply. You aren’t necessarily trying to grow your supply, typically, while you’re at work but maintaining your supply so that you can hopefully breastfeed for however long your goal is, is really important.
Melanie: How do you determine the right amount of milk that your baby will need while they’re away from you? Do you just leave a bunch out and hope the caregiver knows when the baby’s hungry and how much to give? Are there any sort of rules about that?
Becca: So, kind of rules for thumb for that are that the average 1-6 month old eats anywhere from 19-30 ounces. So, a pretty broad range. If you average that down to 25 and then you divide that by how many times your baby eats a day, most infants eat 6-8 times during a day total. So, that’s a full 24 hours that they’re eating that approximately 25 ounces. So, if you would go 3-4 ounces depending on how virulent your baby eats per bottle, you’re probably doing really quite well. Those rules are pretty consistent for all newborns.
Melanie: What about some tips, Becca, for maintaining your supply? Are there specific things that you would like new mothers to avoid or to make sure that they get in their bodies to help maintain that supply?
Becca: Yes. As far as maintaining that supply, making sure that you’re eating and drinking enough is a really big deal. I’ve seen a lot of new moms that they just so desperately want to lose that baby weight that then they don’t quite eat enough to maintain their supply. So, I do think that especially getting enough protein is a really big deal. I’m not talking about overeating. I’m just saying you can’t starve yourself to lose that baby weight. There are some supplements that you can take like fenugreek that kind of makes you smell a little bit like maple syrup but it can, for a lot of women, be a significant boost for their milk supply. Oatmeal can also be great. I ate oatmeal pretty much every day with my first child and I did actually feel like that made a big difference in terms of my supply. As far as things that you kind of want to avoid, there are some meds like decongestants that can cause some issues. Alcohol can decrease your supply some. Getting stressed or getting ill can decrease your supply and birth control with both progesterone and estrogen in them can significantly decrease breast milk supply for some women.
Melanie: Now, we’ve seen it in sitcoms, Becca, but people leak. They hear a baby crying down the street and they leak. What can women do to prevent this at work if they’re at work and in meetings or they are meeting with clients or something? Are there some tips you give them about that?
Becca: I think the best things to do to prevent that leaking, for me anyway, is just wearing breast pads. You slide them in your bra. I would just change them every time that I pumped. As baby gets older, I did find that I leaked less and less. I did have to be really religious about wearing those breast pads and then I never had any issues as long as I changed them regularly.
Melanie: So, in just the last minute or two, Becca, give your best advice for new moms that are breast feeding and returning to work and what you tell them every single day with what you do about the best advice about getting through this, the difficulties, even the psychology involved Just give us your best advice.
Becca: I think that with wanting to breast feed and be at work, just making sure that you are being consistent. That consistency is the key to maintaining your supply. I know that it can be so difficult to get away from work to go pump. There are actually laws in Minnesota, where I practice, that do help to protect that right. As long as your company is over 50 people, your employer is required to give you a space and time to pump. Just making sure that you are, indeed, taking advantage of that so that you are able to meet your goal, if that is your desire. Just start pumping early and then, once you’re back at work pump consistently. That consistency is the key. And, just relax about it. The more you stress about it, the harder it’s going to be on you and it can actually negatively affect your supply if you stress about it. Just kind of know that there are things that you can to do try to increase your supply at home but just try to not stress yourself out too much about it.
Melanie: It’s really great advice. Thank you so much, Becca, for being with us today. You’re listening to the WELLCast with Allina Health. For more information you can go to allinahealth.com. That’s allinahealth.com. This is Melanie Cole. Thanks so much for listening.
The Breastfeeding Mom’s Return To Work
Melanie Cole (Host): For all new mothers, the decision to leave your baby to return back to work is very hard regardless of the feeding method. But, as the many advantages of breast feeding become more understood, more moms are choosing to continue to nurse after they re-enter the workforce. Developing that good routine for home and work may seem a little tricky at first but plenty of moms successfully combine the two with just a little bit of planning. My guest today is Becca Mades. She’s a Certified Nurse Practitioner specializing in family medicine at Allina Health Clinic, Buffalo. Welcome to the show, Becca. So, first of all, tell us a little about some of the benefits of breastfeeding moms and the things they should consider before re-entering the workforce.
Becca Mades (Guest): You know, the benefits of breast feeding have just been becoming more and more known both for mom and baby. For mom and baby, there are advantages in that there’s a reduced lifetime risk of cardiovascular disease, diabetes, multiple kinds of cancers. For mom’s breastfeeding, it helps to reduce stress, helps to improve weight loss and helps recovery from birth for baby. It also reduces lifetime risk for obesity and, in the here and now for while baby is little, it reduces risk of ear infections, breathing infections and stomach infections. It just keeps baby healthy long term. One of the other things that’s pretty cool about it is that breast milk is a natural pain medication in some ways for babies. It’s not actually medication but helps to produce that comforting effect for babies. It’s just so great for so many reasons and really helps baby to really thrive early in life and later in life.
Melanie: As hard as it is, Becca, for new moms to go away from their baby for even ten minutes, when they are thinking about returning to work and what would you like them to consider? What kind of planning should they be doing?
Becca: I think that the best planning for returning to work starts, really, as soon as you have the baby. So, if you know that you’re going to be returning to work, starting to pump early and often really makes a huge difference and just really helps to reduce that stress level. So many moms have so much anxiety about, “Will I be able to produce enough milk?” and “Will I have enough stockpiled?” Starting early and just being consistent with your pumping makes a huge difference. I have a couple little kiddos that I breast fed myself and, for me, I literally--as soon as my milk starts coming in, that day I start pumping, usually two to three times a day is what I’ve done. By the time that I’ve returned to work, I’ve had hundreds, even thousands, of ounces ready and just waiting for them so that when I get to work I’m not just so stressed about do I have enough and will this work.
Melanie: Okay, so we’re starting to pump and getting all these things kind of in order and getting our minds in order, too, which is really a big deal. Are there different kinds of breast pumps women should look at? Or, generally, they’re kind of all similar?
Becca: There are actually a lot of different kinds of breast pumps. There are single pumps. There are double pumps. There are manual pumps. There are electric pumps. There is a huge variance in different brands. Price points tend to be all over the board. I would say, for the most part, what most people recommend is a double, electric pump. Most things say that that’s how you produce the most milk. Brand to brand, women respond differently. I’ll say, for me, I have had really good luck with the Medela brand. They’ve done a lot of research on how babies actually do suck and have tried to mimic their machine after that. Babies will always be able to get more milk than a pump but a double, electric pump makes a difference. Flange size--the part that actually goes onto the breast itself--can also make a fairly substantial difference. A lot of women find that a slightly larger flange actually helps them to get a little bit more milk when they pump.
Melanie: What about storing? Can this be frozen? If you’re going to pump a lot and you know that you’re going to an eight hour day, you’ve got a caregiver that’s going to be feeding, can it be frozen? Is it refrigerated? Do you leave it at room temperature? What do you do with it?
Becca: So, breast milk, the rules actually vary a little bit. Most people, you can actually go up to 10 hours at room temperature and up to about eight days in the refrigerator and you’ll see anywhere from three to twelve months for the freezer. I like to just keep it simple for myself and I go with the rule of sixes. So, six hours at room temperature, six days in the fridge and six months in the freezer is how I like to remember that. If you have a deep freeze, people will say up to a year. I can say that I have stored breast milk for up to a year and it has still been just fine when we defrosted it. When you’re storing, you want to consider what you’re storing that in. For me, I’ve used, I’ve pumped into the BPH-free bottles and then I’ve stored it in plastic bags. If you lay those bags flat when you freeze them, they tend to store much nicer. You can kind of stack them like a book or all horizontally so that they lay nicely so that they don’t have that big chunk of milk at the bottom of the bag and an empty bag on top. So they take up a little less space ultimately.
Melanie: Do you recommend that women reuse what they haven’t used if they’ve put it into a glass bottle or they have their caregiver feed the baby every couple of hours, can they reuse what’s left in the bottom or do you just say chuck that out?
Becca: There’s actually research that says that it’s just fine that after baby has started to drink from a bottle, if they don’t finish it, you can use that last couple of ounces. If that milk has been heated, you only have about two hours to use it. Frequently, when babies are little they are eating about every two hours. If it has not been heated, you can use it for four hours at room temperature or you can stick it back in the fridge and use it within 24 hours. I can say that knowing that rule has saved me a ton of milk over the years with my kiddos.
Melanie: So, going back to work, speaking with your employer about this. So, if you’ve pumped before you’ve gone, do you feel the need to do that while you’re at work depending on the length of your work day?
Becca: Absolutely. Breast milk supply is all about supply and demand. Once you are back at work, you really still want to be pumping about every 2-3 hours to maintain your supply. You aren’t necessarily trying to grow your supply, typically, while you’re at work but maintaining your supply so that you can hopefully breastfeed for however long your goal is, is really important.
Melanie: How do you determine the right amount of milk that your baby will need while they’re away from you? Do you just leave a bunch out and hope the caregiver knows when the baby’s hungry and how much to give? Are there any sort of rules about that?
Becca: So, kind of rules for thumb for that are that the average 1-6 month old eats anywhere from 19-30 ounces. So, a pretty broad range. If you average that down to 25 and then you divide that by how many times your baby eats a day, most infants eat 6-8 times during a day total. So, that’s a full 24 hours that they’re eating that approximately 25 ounces. So, if you would go 3-4 ounces depending on how virulent your baby eats per bottle, you’re probably doing really quite well. Those rules are pretty consistent for all newborns.
Melanie: What about some tips, Becca, for maintaining your supply? Are there specific things that you would like new mothers to avoid or to make sure that they get in their bodies to help maintain that supply?
Becca: Yes. As far as maintaining that supply, making sure that you’re eating and drinking enough is a really big deal. I’ve seen a lot of new moms that they just so desperately want to lose that baby weight that then they don’t quite eat enough to maintain their supply. So, I do think that especially getting enough protein is a really big deal. I’m not talking about overeating. I’m just saying you can’t starve yourself to lose that baby weight. There are some supplements that you can take like fenugreek that kind of makes you smell a little bit like maple syrup but it can, for a lot of women, be a significant boost for their milk supply. Oatmeal can also be great. I ate oatmeal pretty much every day with my first child and I did actually feel like that made a big difference in terms of my supply. As far as things that you kind of want to avoid, there are some meds like decongestants that can cause some issues. Alcohol can decrease your supply some. Getting stressed or getting ill can decrease your supply and birth control with both progesterone and estrogen in them can significantly decrease breast milk supply for some women.
Melanie: Now, we’ve seen it in sitcoms, Becca, but people leak. They hear a baby crying down the street and they leak. What can women do to prevent this at work if they’re at work and in meetings or they are meeting with clients or something? Are there some tips you give them about that?
Becca: I think the best things to do to prevent that leaking, for me anyway, is just wearing breast pads. You slide them in your bra. I would just change them every time that I pumped. As baby gets older, I did find that I leaked less and less. I did have to be really religious about wearing those breast pads and then I never had any issues as long as I changed them regularly.
Melanie: So, in just the last minute or two, Becca, give your best advice for new moms that are breast feeding and returning to work and what you tell them every single day with what you do about the best advice about getting through this, the difficulties, even the psychology involved Just give us your best advice.
Becca: I think that with wanting to breast feed and be at work, just making sure that you are being consistent. That consistency is the key to maintaining your supply. I know that it can be so difficult to get away from work to go pump. There are actually laws in Minnesota, where I practice, that do help to protect that right. As long as your company is over 50 people, your employer is required to give you a space and time to pump. Just making sure that you are, indeed, taking advantage of that so that you are able to meet your goal, if that is your desire. Just start pumping early and then, once you’re back at work pump consistently. That consistency is the key. And, just relax about it. The more you stress about it, the harder it’s going to be on you and it can actually negatively affect your supply if you stress about it. Just kind of know that there are things that you can to do try to increase your supply at home but just try to not stress yourself out too much about it.
Melanie: It’s really great advice. Thank you so much, Becca, for being with us today. You’re listening to the WELLCast with Allina Health. For more information you can go to allinahealth.com. That’s allinahealth.com. This is Melanie Cole. Thanks so much for listening.