Pumping Log: the pump room

I’m sure every workplace has their own unique style of pumping room. It is a place of sanctuary and safety for many nursing moms during the day. At the hospital where I work, we have an employee lactation room on the first floor. Inside are two somewhat comfortable chairs, each with its own table, two curtains to separate them, and a sink. We are actually very blessed to be in a baby friendly hospital  where they at least attempt to take care of their breast-feeding moms. I have read about pumping room horror stories, though, of “pump rooms” that are nothing more then broom closets or electrical rooms with folding chairs. The law states that all employers must provide a non-bathroom room for breast-feeding employees. But their definition of “non-bathroom” is occasionally taken liberally. The room in which you pump can definitely impact your milk output. If the room you are in makes you stressed, you will see a decrease in milk production. If you are in a calm environment and don’t feel rushed, your milk will have a higher chance of letting down. Do you whatever you need to do to make your pump room as comfortable as possible. Make sure to surround yourself with plenty of pictures of your baby and since it is your break, if you can FaceTime or Skype your baby.

My hospital’s employee lactation room

I do have a funny story about my work pump room. The tables are older and one of them had a broken table leg. The table looked like it was going to collapse at any second. I put in a complaint through the proper chains. I came in the next day and the table was gone. But the two chairs were facing each other with the table in the middle as if anyone pumping at the same time would have a pump off! I don’t Think the maintenance department quite understood the purpose of the room 🙂 with a quick phone call to HR we were able to get a second table and move the chairs back to the proper positions. What are your funny pump room stories? Feel free to share your pump room pictures.

Let’s have a pump off.

Happy pumping!

Make it a double

They say you can’t over feed a breast fed baby. They’re usually pretty good about taking what they need and stopping when they’re full. This is because of stomach and breast anatomy. Remember how sucking and milk flow rate at the breast are different than the bottle? This directly links to stomach anatomy.

There are two kinds of receptors in the stomach: density and stretch. Density receptors tell you how calorically dense or fat-rich your food is. It’s why at the Cheesecake Factory your belly starts to feel really full after about ten bites of Godiva chocolate Cheesecake but you can eat 3 bags of popcorn at the theater. Chocolate is much richer and calorically denser than popcorn. Stretch receptors tell you how full your stomach is from a volume perspective. Your stomach at rest is on average the size of your fist. That’s true throughout your entire life. But the stomach can stretch. Just like my stretchy pants at Thanksgiving. It can still only fill to a certain capacity. The only problem is, it takes approximately 20 minutes for your stretch receptors to tell your brain that the stomach had stretched to capacity. This is what I call the twenty minute phenomenon. You know, when a group of college boys order a pizza, they each eat a whole pizza in ten minutes and then twenty minutes later feel over full and sick. They as much as they could as fast as they could but paid for it in the twenty minute window. Exclusively breast fed babies don’t typically over eat because again, breast milk flow varies over a feeding. It starts slow, mommy goes into let down, then milk shows, mommy changes the baby to the other side, milk starts slow, mommy goes into let down, 15-20 minutes later the baby’s stomach tells the brain it’s full and the baby stops eating. Anatomy and physiology in perfect harmony.

Unfortunately bottle fed can be over fed. Bottles have these lovely ounce markers on them that tell us how much the baby needs to eat to be full. At every feeding my baby NEEDS to get a full 5 ounces of she will be hungry. She NEEDS to eat 24 ounces in a day or she will starve to death. And when baby stops eating at 3.5 ounces, I just jiggle the bottle or wait a few minutes and jiggle the bottle until baby takes that full feeding. Jiggle, wiggle, look at that she took the full feeding. Instead of listen to baby’s cuts that she’s full, we let the bottle dictate how much baby needs. And we wonder why formula feed babies have a significantly higher rate of obesity. Here’s the thing. Bottles are not the enemy. My daughter takes breast milk from a bottle five days a week while I’m at work. They are lovely devices that do an essential job. But we need to be mindful to not over feed our bottle fed babies.

Tips to not over feed a bottle fed baby (regardless of what’s in the bottle)

1. Always use a show flow nipple until 1 year of age. Slow flow most closely mimicks the flow at the breast. It also shows a baby down so the brain can keep up with the stomach (aka be mindful of those stretch receptors).

2. Watch your baby’s cues. Does he push the bottle away? Did he become sleepy? Do his hands and body relax? Does he release his iron grip on the nipple? These are signs he’s done. Over fed babies tend to spit up or vomit more because their tummies are at capacity. Don’t try to force in that last half an ounce. Respect your baby and stop feeding. Your baby will let you know if he’s still hungry.

3. In reality, babies only ever need 3-5 ounces of milk per feeding. In the first four to six months when your baby isn’t eating any solids, here’s a simple rule of thumb: Offer 2.5 ounces of formula per pound of body weight each day. For example, if your baby weighs 6 pounds, you’ll give her about 15 ounces of formula in a 24-hour period. Once a baby is six months of age and starting solid foods, offer the breast or bottle first (3-5 ounces), then offer well balanced, nutritious, solids. The solids will provide them the additional nutrition they need. (**Disclaimer : if your baby is not ready for solids at six months, that’s FINE. Your baby is ready to start solids when they can sit unsupported for a good amount of time, uses a pintcher grasp, and has the hand eye coordination of hand to mouth. If your baby is over six months and not taking solids, your baby may need additional milk per feeding.)

4. It is OK for volumes of feedings to be didn’t throughout the day. We take for granted that babies can know their bodies. They can tell us when they’re hungry and when they’re full. Sometimes I’m really hungry in the morning and I eat a Grand Slam breakfast. Other times I only want a piece of toast. It’s OK to have your baby eat a ton one meal and very little the next. Remember, there are no ounce markers on the breast. Exclusively breast fed babies do this all the time. And there’s no amount of nipple jigging that will get them to take more in a feeding.

Here’s the big take away: it’s OK to take the pressure off feeding, especially if your a working mom trying to keep up with pumping. As long as your baby is following their growth curve, making enough wet and dirty diapers, and happy, keep doing what you’re doing. If your baby is not getting enough nutrition, not gaining weight, or unhappy, please have your pediatrician write a referral to a pediatric clinic ASAP or give me a call and we can dialogue through a plan of action.

Happy feeding!!

Pumping Log: pumping is a full time job

I’m a lactation consultant. I’m also a first time mother. My daughter will be nine months old next week. I went back to work when she was just twelve weeks old. I’ve been pumping since then. No one told me how much work that would actually be. Pumping while at work is literally a full time job in and of itself. For most moms that plan to continue breastfeeding after they go back to work, you need to plan to pump when you would typically feed your baby. Feed the baby or feed the pump. That’s how you keep up supply.

But that can be tricky when you’re working. I try to pump three times in an eight hour shift. Every two and a half to three hours. For ten to twenty minutes depending on my break. I’m typing this over my lunch break as hard plastic suction cups suck on my tender bits.  It takes scheduling and planning. Some days are easier than others. Some days the milk flies better than others. The most important thing is to not give up and not get discouraged. In the end the benefits definitely far out weigh the risks. Like reducing my risk of breast cancer. Reducing the risk of allergies, eczema, respiratory and ear infections for my baby. Saving the environment from extra trash. Not to mention saving almost $3000 a year from formula costs. You definitely need to keep your goals and your humor about you to persevere.

This is a comparison of several days. My baby has always had enough. Every once in a while I will pump at night before bed to give me a little extra milk if I have a lower day. As you can see, first pump of the day (on the left) always gives me the highest amount with amounts dropping as the day goes on. That is normal for every mother whether she pumps or nurses.)

what have you found to be most helpful for keeping your supply up while pumping at work? Feel free to comment!!!

Pumping Log #3

Every pumping session is a new session. Calories in breast milk range from 13-35 calories per ounce. The average amount of calories in typical breast milk around 20-22 calories. This fluctuation is due to changing fat content. The amount of fat in human milk changes depending on the degree of emptyness of the breast (empty breast = high fat, full breast = low fat). The longer a mom goes between pump sessions, the more water is in the milk and the lower the fat content. This is because the mom’s body thinks the baby is getting dehydrated and the water content is to rehydrate the baby. A breastfeed baby can take in the same amount of calories from different volumes of milk. For example, 4 ounces of 15 calorie pumped milk early in the morning has the same calories as 3 ounces of 20 calorie breastmilk pumped only a few hours later. This is unlike formula. Standardized formula has 20 calories per ounce.

For more info on the nutrition facts in breastmilk, check out these websites!!

Children’s Hospital of Philadelphia 

Kellymom.com

Happy Pumping!!

Pumping Log #2

What’s in my pumping bag. A well stocked pumping bag is the most essential item you will need when you go back to work. Packing the bag efficiently and with necessities can help eliminate stress and worry while pumping at work. Here are a few of the things in my pumping bag. Obviously the pump is the most important piece. Make sure to check that you have all the pieces and parts in the morning before you leave for work. I had forgotten one or two pieces several times. I actually now keep a spare pump in my car that is always ready to go in the event that I forget something. I always keep instant oatmeal, mothers milk tea, and honey sticks ready for a quick snack on the go. When I know I am going to work the next day, I bring empty bottles to put my milk in. That way I can keep it in the fridge and handy for the next days feedings. If I know I am going to be home the next day, I use disposable milk storage bags. I’ve tried several brands and really like the Dr. DuDu. They’re sturdy and have a double zipper. Plus they come in a handy 8oz size for streamlining in the freezer. I can put my pumped milk in the freezer and it will be ready to go the next time I’m at work. I always keep extra nursing bra pads. I wear washable ones made of bamboo fiber. But you never know when you might need to change them. I keep it small stash of disposable ones in my bag at all times. Another necessity is my stash of essential oil’s. I use fennel to help keep my supply up. Serenity, lavender, balance, and citrus bliss help elevate my mood when I’m feeling down at work. What’s in your bag?