Commenter Ariela shares her experiences as a nursing mother of five.
This is a picture of me and my daughter Noa nursing our babies. I am combining two of my greatest pleasures, reading and breastfeeding. One of the things I love about breastfeeding it that it “allows” a busy mother of 5 to take a few minutes “off” to sit down and read.
I have had the privilege of breastfeeding 5 children. I did this while working full-time. I am writing to tell other women about my experience and give hope to others trying to combine work and exclusive breastfeeding.
Some of my solutions are expensive. However, baby formula is also expensive. Moreover, breastfed babies are healthier; this means that you will need to take fewer sick days and that will save you money as well.
Before I had my firstborn (he is 15), I knew that I wanted to breastfeed him. I was also aware that my financial reality dictated that I return to work after 3- 4 months. I desperately looked for books or support groups on the topic, but found almost nothing. My sister already had a child and exclusively breastfed her while doing her PhD, so I looked to her as my guru. She expressed breastmilk by hand, so that is what I would do as well.
I was starting my PhD when my son was born and was able to stay home with him for four months. When I returned to work I hand expressed milk between classes in the rare women’s bathrooms at Hebrew University. The surroundings were unpleasant (to say the least) and there were usually people waiting outside for me to finish. You can imagine how relaxing and conducive to lactation this environment was! Nevertheless, I expressed milk for 10 months and he never had formula. We had a wonderful breastfeeding relationship until he was 13 months old. This was not easy: I had to do “makeup” milk expression sessions on the weekends and always felt like I was barely making it. I also developed tendonitis in my right hand.
When my daughter came along I learned a bit and bought a Medela electric breast-pump. It was battery-operated and did one side at a time. This was better than hand expression, because it gave me a free hand to do things like eat while I expressed milk (and did not give me tendonitis). Double-tasking is essential for a working mother! I also convinced an attending physician at the department to let me use her office to express milk. The surroundings were more relaxing and I was able to express sufficient milk, but not enough to avoid the weekend “makeup” sessions. I expressed milk until she turned 10 months and she breastfed for 13 months.
After my third child was born I did two helpful things: I bought the Medela pump-in-style and I started expressing milk when he was 4 weeks old. I expressed about 100 ml everyday and froze them so that I would have a backup supply of milk. This was fantastic for many reasons, most of all because having a backup supply ensured that I never felt pressured to produce milk. Of course, as in all performance anxiety, when the pressure was off I produced more milk. Also, pumping both sides stimulated my letdown so I got more milk than ever. There were no more weekend pumping sessions and I always had enough milk. I did use all the milk produced on my maternity leave, so I was not pumping as much as he needed, but we were OK. However, when he was 9 months old I got a killer breast infection and decided to stop pumping. He nursed for 16 months.
When Noa (see the picture) was two-and-a-half months old we moved to Seattle so my husband and I could do post-doctoral research. I schlepped my pump-in-style to America and started pumping and storing breast milk as soon as we landed. To my delight and surprise I found that the University of Washington has many lactation rooms. They are private, quiet rooms that provide hospital-grade breast-pumps. Each mother is required to buy adaptors and all pump parts that come into contact with her breasts. I had a long talk with the lactation consultant at the center about the pump-in-style vs. the hospital strength pump in the lactation room and she convinced me to try their pump. I was hesitant because I loved the Pump-in-Style (PIS) and had schlepped it across the ocean and a continent. All I can say is OMG — there is no comparison between the PIS and the hospital-grade pump (Lactina). I was always able to pump more than enough milk and never had to use the supply sitting in my freezer. I am sure the lactation room also contributed to my successful pumping. I had never felt truly comfortable in borrowed office. The lactation room had a cork board for pictures of babies, a place to wash hands and pump parts and was very comfortable. I pumped milk for Noa until she turned 13 months and breastfed her for two and a half years.
I currently nurse my 20-month-old son Ehud. I also have an academic position and an office of my own. When he was born I rented a Lactina pump from a local lactation consultant whose name I got from the Israeli distributor of Medela. The pump cost me 190 NIS/month and I figure that is less than formula. I did pump and store a supply of breast milk while on maternity leave, but much of it is still clogging up my freezer. I pumped milk for him in my comfortable office and was able to talk on the phone and work on the computer while pumping. I stopped pumping at around a years. I plan to continue our nursing relationship as long as it works for both of us.
I hope my story is helpful to other women and here is a list of practical suggestions: [MiI: My comments are in maroon.]
- Build up a supply of breast milk while you are on maternity leave. Wait until breastfeeding has been well established, at about 4-6 weeks (in my opinion pacifier use in the first few weeks can delay this process). At this time start by expressing milk before you feed your baby. Your body produces by demand so you will not use up your milk (he will just need to feed longer and/or more often for a few days). It is best to start early in the morning when you are the most rested. Rest is the best way to your milk supply. I stored the milk in special bags produced by medulla that have a ziplock closure. There is another company that makes similar bags that are half the price. Always label the bags in indelible marker with the following information: expression date, amount, baby’s name and expiration date. That way it is easy for the babysitter to defrost and use the milk. Store the milk in small amounts so that it doesn’t go to waste. Whoever said “don’t cry over spilled milk” obviously never expressed breast milk. [Usually two weeks is enough to build up a supply. After starting work, mothers will usually be expressing enough milk for the next day. There is no technical problem with starting early as Ariela suggested, but I often see mothers who are stressed over this issue throughout their maternity leave--instead of enjoying their baby they worry about milk supply, whether their baby will take a bottle, etc. Also, mothers who depend on their freezer supply, instead of making the effort to pump enough at work, may not have enough for weekends and vacations when they want a break from bottles. Of course you don't *have* to use up the freezer supply and you should have enough in case of emergency.]
- For me at least, the better the pump, the more milk I produced. Medela’s site has excellent information on this topic, with an interactive question and answer service. Some women prefer to manually express breast milk. The big disadvantage of this method is both your hands are in use and you cannot multi-task. Even the double-sided breastpumps leave you with a free hand. No matter what method you use, relax, look at a picture of your baby and think about her. It helps the letdown reflex.
- Buy at least one extra set of pump parts. If you need to pump twice a day, you can use each set at each pumping session and do not have to wash parts at work. For three sessions, buy three sets of pump parts. [If you can keep the pump or pump parts in a refrigerator, you only need to wash them once at the end of the day. For the record, sterilizing is not necessary when pumping for a healthy, full-term baby.]
- Buying a pump vs. renting. If I were a young mother at the start of my childbearing years I would buy a pump. The Medela distributor in Israel lets you try out the pumps to see which you prefer. Yad Sarah rents breastpumps. I have used the single sided pumps and find them painful. If you can’t tell by this point, I will state it explicitly – I am a fan of Medela. I have never directly heard Yad Sarah’s policy about renting out double-sided breastpumps. However, the rumor is that they save them for mothers with premature babies (rightfully so). [Currently, Spectra pumps are widely available at Yad Sarah. They are much cheaper than the Lactina, and mothers report that the difference in output isn't significant for a working mother. It might be significant for a premie or a mother who is exclusively pumping. Mamash in Tel Aviv lets you try out different brands of pumps as well.]
- A room of one’s own – try to find a comfortable place to express milk. I realize that many women do not have an office available to them. Try to “borrow” an office while a colleague is out to lunch. I believe it is worth trying to convince your employer about the advantages of expressing milk for your baby and giving you space to do so. If women express milk then they take fewer sick days. If your employer complains about taking off time for milk expression, ask whether smokers take off time to go out and smoke. Do other employees take lunch breaks? Suggest that you are not taking a lunch break or going out to smoke, just making food so your baby will be healthier. [Also, pumping is for a limited time period.]
- Make sure the sitter understands the differences between breastmilk and formula. She should also try to arrange that she feeds the baby your milk a few hours before you come to pick him up. [That might be too long for some babies.] That way, baby is hungry and ready to nurse when you show up. Nothing annoyed me more than coming to pick up a baby and find that she is just finishing off a bottle of my liquid gold and has no interest in me.
- Find a babysitter close to work. That way there are fewer hours away from baby and you need less expressed milk. I always nursed my babies immediately when I pick them up (even at the babysitter’s house). Some women can find babysitters that live close enough to their workplace that they can come over during the day and nurse baby. I never managed that, but my babies learned that pickup meant a relaxing session at the breast. [This is probably the most useful suggestion. It also saves on babysitting costs, because you pay less for the commute. But it may be less convenient when the father is the one to pick up.]
- The solution to not having enough milk – rest, rest and more rest. This is not the time to be super-mom. If you don’t have enough milk and are committed to breastfeeding you MUST rest. Consider using vacation days for well day with baby in bed. A great way to build your milk supply and enjoy some fun time with the little one. [While lack of rest alone does not generally affect milk supply, the combination of stress and fatigue is no good for anyone and especially challenging for moms combining breastfeeding and pumping.]
Thank you, Ariela, for sharing your valuable experience with us. I’m looking forward to readers’ suggestions.