Pumping for a toddler

The number one complaint I get my mothers going back to work is a drop in supply when they start to pump. They go from seeing tons of milk to very little. Pumping at work is a PITA. You have to be very committed to it and depending on your job it can be stressful or difficult to get away to pump. What most women don’t seem to understand about Breastfeeding is that the more milk you remove the more milk you will make. You can’t just will your body to make the same amount of milk whether you pump once or six times. The science doesn’t work that way.

Through the first year of life, I recommend mothers pump three times on an 8 hour shift and four times on a 12 hour shift. Remember, I recommend leaving the same number of ounces as number of hours you will be gone. If you’re gone 8 hours, you only need to leave 8 ounces. Make sure your caregivers are doing paced bottle feedings and not accidentally sabotaging your milk supply. Mothers can add in additional pump sessions by pumping in the car with the battery operated pump. Once your baby turns a year, and his or her milk needs decrease; as long as they are taking a healthy amount of solid foods mom can drop down to pumping twice or three times a shift.

As your Toddler continues to grow, you can make the decision to add in another milk/milk substitute, continue to pump, or just breastfeed when you are home and have caregivers give water depending on how much you are gone from your older toddler.

My last pump session at work. cheers.

Breastfeeding will working is a large commitment. I know this full well. These are the guidelines I followed with my own daughter. Up until she was 12 months, I pumped 3 times on my 8 hour shift. I had decided at 17 months to stop pumping while at work and just feed my daughter when I was home. However she had other plans 🙂 she constantly asks for May May, which is her word for my milk, while I am gone. So I was back to pumping just once a day and mixing my small amount of breastmilk with flax milk. She eats off of me like a barracuda when I walk in the door. (I think she just wants the snuggles). At 18 months I am now no longer pumping at work. She will nurse when she wakes up, when I come home, around bed time at 6:30, and every once in a while she’ll still wake up around 4am for an early morning snack. This is what my tiny human does. You have to figure out what works best for your tiny human, your family, and your health. Happy pumping!

Sabotaging your milk supply: working mothers who pump

The number one method to sabotage your milk supply when you go back to work is a caregiver who over feeds your baby. 

Scenario one: Baby is given a full bottle and takes 5 ounces in five minutes. Baby then spits up half the feeding and caregiver tries to give more to “keep it down”. Caregiver tells mom baby is fussy and has reflux. Baby gets put on Zantac and rice cereal.

Reality: there are several factors going on in that scenario that will sabotage a working mother’s milk supply. First, babies are not supposed to take five ounces in a feeding. Their stomach is the size of their fist and should only be taking 1-3 ounces per feeding through the first year of life. Their stomach can only hold so much and if it’s past capacity, the only place for it to go is up. I can eat a whole cake, but I shouldn’t. As an adult, if I overeat I get uncomfortable, too. I either take peptobismol or put on my stretchy pants to wait for the pain to subside. Then I don’t eat that much again.  Babies fuss and spit up for the same reason. We’re over diagnosing babies with reflux that are being fed too much or too fast.

Scenario two: Caregiver gives a baby six ounces every feeding, 3 times while mom is gone, every time the baby cries or wants to suck. Baby appears fussy and wants to suck all the time.

Exclusively breastfed babies should consume 25-35 ounces across each 24 hour day and approximately 20% of their calories should be taken over night. If you do the math, that’s a little over an ounce an hour, or 1-3 ounces every two to three hours. And in accordance to what the baby needs, mom will make that volume. So if caregiver is feeding 6 ounces three times in an 8 hour shift, you’re expecting mom to pump 18+ ounces. In reality, her body will most likely make 6-10 ounces which would be the amount she would make if she were home with her baby. In a few days of over feeding the baby, mom becomes discouraged that she’s not making enough and pretty soon she’ll start supplementing with formula

Babies also want to suck for a variety of reasons: comfort, pain, bonding, nutrition, pleasure, etc. Babies use mom as a pacifier without actually drinking. When babies are away from their mommies is very stressful, so their way to soothe is to suck.

Scenario three: Baby is given 4 ounces and chugs it down in five minutes. Baby is happy to chug down high volume and the caregiver thinks baby is just a piggy and really hungry. Baby occasionally coughs and chokes and milk comes out her mouth.

Reason: Babies have a swallow reflex that is with them at birth. When liquid reaches the back of the throat it triggers the swallow reflex. Babies are obligated to swallow otherwise they will choke or let the milk pool out of their mouths. When you see a baby chugging down milk really fast, it’s not usually because they are starving, but because they are trying to keep up with the flow of the bottle. As I said in an earlier post, there’s really no such thing as nipple confusion, but flow confusion. At the breast, other than during active let down in the first few minutes of active feeding, the baby controls the flow of milk by how they suck. In bottle feeding, the bottle will flow because gravity always wins. Caregivers need to be taught paced bottle feeding. Using a slow flow nipple, feeding baby in side lying, and frequently tilting the fluid away from the nipple to slow the baby from drinking so fast gives the baby more oral control and time to appropriately eat.

There are two kinds of receptors in the stomach: stretch and density. It should take a baby 10-20 minutes to eat from a bottle. This is also how long it takes the stretch receptors to tell the brain that the stomach is full. I can eat a whole pizza really fast, but I shouldn’t. Babies can eat a large volume really quickly, but they shouldn’t. Not only is it not developmentally appropriate, but pretty quickly the high volume needs will sabotage mom’s opinion of her perfectly healthy milk volume. She’ll turn to all kinds of milk makers: cookies, teas, herbs, etc and eventually if she’s discouraged enough she’ll turn to formula, when in reality if the caregiver would slow down feedings and give the rigjt volume, every one would be happy.

Happy pumping!!


Breastfeeding advice from social media: Buyer beware

Asking for medical advise from social media forums, especially mommy groups, is like asking a mother who’s had a baby to deliver yours. Just because she has experience in the field does not make her qualified to give technical advice in that area. She can give you her opinions or share her experience, but she did never be relied on as a trustworthy source when providing care to YOUR child.


Breastfeeding is especially one of those areas that we need to tread wisely into when asking for help and advice. Or culture has hidden breastfeeding from the norm and made it this mysterious, murky action where myths and misunderstandings abound. So much of the information found in quick Google searches are anecdotal, antiquated, or based off formula feeding data which is completely distinct and sometimes totally opposite of true breastfeeding. We should be seeking community support for breastfeeding, but not when medical advice is being solicited.

When mothers give out advice on social media platforms, they are not taking into consideration the whole breastfeeding picture and may inadvertently give advice that could care harm or actually negatively impact breastfeeding. For instance, when a mother of a two month old asks for advice on increasing her breastmilk supply and mother start giving advice on herbs, lactation cookies, or teas, they may not be considering WHY she is needing to increase her supply. Is her baby in the NICU? Is she going back to work and stressed with the pumping process? Does she have. History of sexual abuse that she actually needs to work through? Did her pediatrician have her supplement which impacted her supply? Is she trying to sleep train and sabotaging her own supply? Is she ALLERGIC to the herbs in those teas and supplements? How often is she feeding? Does she have a metabolic or hormonal disorder impacting her supply? Does she have enough glandular breast tissue to even produce sufficient milk supply? Does her baby have a tongue tie? Does the baby simply have a poor latch? These are the questions that are crucial in giving appropriate breastfeeding advice to protect the breastfeeding relationship. The best advice a mother can give on the social media platform is to have the questioning mother contact a lactation consultant.

The gold standard for breastfeeding advice is the International Board Certified Lactation Consultant (IBCLC). There are other forms of lactation consultants that teach and serve out of a variety of backgrounds. The IBCLC is the top most coveted professional because of the extensive education and rigorous testing they need to go through in order to be able to assist lactating mothers. In order to sit for the FOUR HOUR board exam, candidates must have extensive education in specific health science subjects, like nutrition, psychology, and childhood development; 90 college level credit hours of education in human lactation and breastfeeding, and hundreds to thousands of clinical practice in providing care to breastfeeding families. They must also maintain a high level of continuing education courses and continue to sit for the board exam every 10 years.

So when you see moms with questions related to breastfeeding in social media forums that are beyond opinions or personal experience, the best advice is professional advice.

Pumping Log: new guidelines for washing pump parts

According to the CDC’s new guidelines, here is how best to care for your pump parts:

  • Wash your hands before using your pump, and use disinfectant wipes to clean the outside of your pump.
  • After every use, take apart the pump parts and rinse them under running water. Don’t put them directly in the sink!
  • Clean your pump parts as soon as possible with hot, soapy water in a wash basin and brush used only for cleaning pump parts, or in the dishwasher.
  • Rinse in fresh water (don’t put them back in the same basin).
  • Air dry on a clean dish towel, but don’t rub the parts with the towel as this could spread germs.
  • Rinse your basin and brush, and leave them to air dry. Clean them as well at least every few days.
  • If you’re using the dishwasher, place on a hot water and heated drying cycle, or a sanitize cycle. Wash your hands before taking out the parts, and allow them to air dry.
  • Store items in a clean, protected area only after they’re completely dry.
  1. For the full article, click here.

Pumping Log: When to throw in the towel

I’ve never been a super pumper. I’ve diligently pumped three times a day at work for the last 8 months. I’ve almost always made just enough for the next day of feedings. Sometimes I’ve even had a conservative stash in the freezer for low pump days or when my husband and I want to go out. There are definitely times when I have to work on my supply to keep it up enough to feed my daughter. Oatmeal for breakfast, teas at lunch, a Guinness with dinner, more tea before bed. Pump. Breast massage. Pump. Repeat. It’s exhausting. Especially since my uninvited monthly visitor has me with a low supply. As I come up on my daughters first birthday, I’m torn.  Continue the schedule I’m on with the highs and lows of constant pumping? Drop the pumping and only breastfed when I’m home and offer something else while I’m gone? Or gradually wean all together? The professional side of me (the crunchy, granola, die hard side) says, “Stick it out!!! It’s not that bad!! Breast is best!!! Your baby needs your milk!!! Show your boobs who’s boss.” While the personal side of me screams, “Screw it! You’re working so hard! Give yourself a break. You went a whole year. You did the best you could with the support you had. Some other milk won’t kill your kid. She’s eating like a champ and she won’t even notice.” I get it now. I understand why some moms give up breastfeeding, especially working moms. I also get why mom’s push through and keep going. We all just want the best for our babies. I’m still on the fence. We’re T minus 1 month to the big one year birthday. I’ll keep you posted on what I decide. But for now, Happy Pumping!!

Fact of the Day

Babies are the best pump. They empty the breast better than either hand expression, manual or electric pumps. Even as the most efficient pump, babies never completely empty the breast. Breasts work on what could be called the “80:20 concept.” The 80 percent is the average amount of milk removed by your baby each day. The 20 percent is the residual amount of milk that remains in your breasts. If more than 80 percent of the milk is removed, supply increases to maintain the 80-20 ratio. If less than 80 percent is removed, supply decreases to maintain the 80-20 ratio. Even though this is an over-simplification of a very complex process, as new research emerges this core principle proves true.

Pumping Log

Everyday is a new day with its own stresses and joys. The more we can take time to enjoy each day, the less we are prone to worry and stress, the better it is for our overall health as well as our milk supply. The past few days I have been working in the neonatal intensive care unit at my hospital. It is my favorite place to work. I love coming alongside mommies and their new babies and helping them feed them in their most critical time. My job on the acute floors can sometimes be stressful. I am helping elderly patients and families make end-of-life decisions. I assess patients feeding skills and decide if the patients can still eat and the options they have for nutrition and hydration. This definitely impacts my milk supply. I always see more of my own milk when working in NICU. Of course when some of those hungry babies cry I can occasionally feel my mommy hormones stimulating my own letdown. Where is your happy place? Have you noticed certain aspects of your environment or work impacting your milk supply? Where do you find your peace when pumping? This really does make a big difference. Happy Pumping!!

I use whatever containers I have clean!! My pumping always decreases as the day goes on.

Product review

It finally came!! My Mrs. Patel’s mothers milk tea!!! I’ve used the grocery store brand but it didn’t really seem to have a big impact on my supply. In researching teas, I came across this brand. They’re Milk Water tea comes in two tasty flavors : herbal and Chai. The Chai has an amazing sweet taste and when I drink a cup consistently at night I do see an increase in milk the next morning. I just got the herbal blend and am so excited to try it!!! Check out the website here. Take note, the shipping is expensive, so if you have a friend or two who are also nursing it will help distribute the shipping costs.


Pumping Log: right vs left

Unfortunately breasts do not come with markers on them. When you are an exclusively breast-feeding mom you never really know how much your baby is getting. We teach in lactation to watch for the signs that tell you your baby is getting enough milk. You look at swallowing patterns, wet diapers, and the overall health and weight gain of your baby. When you are pumping mom though, we are meticulous in knowing how much milk comes out of our tatas. Have you ever actually stopped and looked at that milk? I’m sure you have. I’m sure you analyze every drop that comes out of your body. Did you know that the left and right breast can make different amounts of milk? One research study found that stereotypically moms always make more milk out of the right breast. Which is interesting in light of the fact that most women have a slightly larger left breast. (Click on text to read the research articles) It really goes to show that size does not matter for production. Size is related to fat in the breast tissue and not the actual glandular tissue that produces milk. I love breastfeeding. And I try really hard to rotate which side I start on when I’m breast-feeding my daughter. When I am at work or use a double pump to pump both of the girls at the same time. It has been always consistent for me. My right always make slightly more than my left. Usually not very much more, but enough to be noticeable. And science still doesn’t really know why!! Oh, our fascinating bodies!!! Happy Pumping!!!

Pumping Log: back to normal.

Us pumping mamas tend to freak out about how much we pump. Can I get an amen?!? When our supply drops we freak the freaky freak out.  But what if we weren’t pumping. Would we actually notice any of these drops, or what our babies just happily do what they do and not even give us education that something has changed? Would we even have periods because we would be exclusively nursing And supply changeseould be a non issue? Yesterday I took my deep breaths and talked myself off the “I have no milk” ledge. Today my period is officially over. And low and behold my milk supply is back up. Remember, hormones do funny things to our bodies. Do what you can but don’t freak out over every little change. Stay the course. Love yourself. Love your body.