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Thread: missing pumping sessions

  1. #1

    Default missing pumping sessions

    I will be going back to work in the next few weeks. As a teacher, I won't be able to pump as often as my 5 (then 6 month) daughter nurses. It looks like I will be skipping one feeding session, going about 5 hours.

    If I skip a pumping session, supplementing with frozen breastmilk, and then formula, as needed, will my supply hold when I pump or breastfeed other times of the day? I know it's not ideal, but I think it's what I have to work with. Will I be able to nurse on the weekends still?

    I am also concerned because when I pump I don't generally produce as much as she eats, so I am concerned in general about pumping. I have been pumping at night to build up a stash, but a few ounces a day will go quickly.

    What's been your experience? I am trying not to freak out about it all.

  2. #2
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    Default Re: missing pumping sessions

    Hi teach48!

    So there are many things to consider when a mom is pumping part of the day and baby is getting bottles at that time due to separations. Having a good understanding of how milk production works and how bottle feeding can be done to minimize overfeeding will help you meet your goals of providing your milk for your child and protecting your milk production after you return to work.

    The lactating breasts are making milk all the time, 24 hours a day. Longer periods of 5-6 hours of no milk removal tend to happen around this age, in particular overnight, without it being any problem for milk production, as long as milk removal is still happening frequently and effectively enough overall. And milk can be removed from the breasts at any time. So there is really no such thing as a "missed" pumping session. If pumping break time at work is not optimal, if needed and if you choose, you could pump when you are home, or encourage your baby to nurse more often overnight/weekends in order to protect your milk production, or pump some other time during your work day even if that means two pump sessions are close together, or some combination of these.

    (If you are uncomfortable going that long without pumping, you may need to find a way to at least quickly hand express to relieve pressure, which will protect your health and your milk production, even if you are not able to save that milk.)

    My first suggestion is to make sure breastfeeding is going very well before you return to work. Generally this means baby is nursing with normal frequency (8-12 times a day) nursing both night and day, and any supplementing is kept to a minimum (such as just the little needed for "practice bottles.") Avoiding going overboard on practice bottles will also help you save up your back to work "emergency stash." Practice bottles are for practice and can be both small (an ounce or so) and infrequent (once or twice a week.)

    Many moms find they do not pump at one session what baby will take in a bottle at one meal. When this is happening, first it is important to make sure that bottles are being given in a breastfeeding supportive way that prevents overfeeding. I will link below articles and videos about this for you to check out below.

    The rule of thumb that is generally used is that during a separation, a baby should be drinking about 1 to 1.5 ounces per hour of separation. (This assumes baby is still nursing at least somewhat overnight as is normal for the first year at least.) So as an example, if you are separated from baby for about 8 hours total, and baby is getting more than 8-12 ounces over that time, that may indicate baby is being overfed with the bottles. Overfeeding is very common and easy to do, that is why it is important to learn how to not overfeed with bottles.

    Even if baby is being fed correctly, some moms have a hard time keeping up. Pumps are a very imperfect substitute for baby, and in some cases some moms just do not respond well when pumping. In such cases some moms find they need to pump more often when they can. Others choose to formula feed as needed. Obviously the latter is potentially more problematic for milk production in the long run, but with some precautions it can be a helpful, sustainable option.

    Of course last but not least it is vital to be sure that your pump is in perfect working condition. Even brand new, very good pumps can malfunction. Things that are easy to trouble shoot and usually easy to fix is making sure the flange size is always correct, (it can change) changing membranes frequently, and checking tube connections frequently. Many moms find adding hand expression to pump sessions help. There are many "tricks" for improving pump output when needed. But some moms do find they need to add pump sessions at other times to have enough expressed milk on hand and also to ensure their milk production is on good shape.

    You should absolutely be able to only nurse on your days off and any time you are home with baby, although you may need to pump as needed to ensure enough milk for baby when you are at work. It can all seem very complicated at first, but many working moms find they are able to pump and provide that milk for their baby and continue to have normal milk production for as long as they wish to breastfeed.

    Bottle feeding breastfed baby and safe milk handling (2 page document) http://www.llli.org/docs/00000000000...fyour_milk.pdf
    How much expressed milk will baby need? http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/
    For when mom is not pumping enough milk: http://kellymom.com/hot-topics/pumping_decrease/
    Paced bottle feeding videos: https://www.youtube.com/watch?v=UH4T70OSzGs and https://www.youtube.com/watch?v=dxpIzcitLc8
    Also the book The Womanly Art of Breastfeeding (8th edition) has excellent chapters on handling separations, pumping, etc.
    Last edited by @llli*maddieb; July 22nd, 2017 at 11:45 AM.

  3. #3

    Default Re: missing pumping sessions

    Thank you so much! I appreciate the resources you included and in the depth information you provided! Makes me feel a little better about it all!

  4. #4

    Default Re: missing pumping sessions

    MaddieB, I have another question for you concerning schedules. Right now, my daughter nurses every 3 - 4 hours during the day. At work, it looks like I'll go 4 - 5 hours between pumping (I'm working to see if I can shorten this at all). I know the body is amazing at knowing what it needs, and I'm wondering if I should start "to train" my body to go that long? I hope to nurse on the weekends (I hate pumping, and find nursing much more convenient), but if that's the case, are Monday and Tuesday always going to be a little uncomfortable? Just curious (trying not to overthink this all...but I don't think I'm doing very well. Thanks.

  5. #5
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    Default Re: missing pumping sessions

    Hmmm. I wonder, has baby ever gone 5 hours without nursing and was that very uncomfortable for you? Did you get engorged, or develop a plug, become ill with mastitis? Let me know if so, as that would change my answer somewhat.

    Generally, going from milk removal of 3-4 hour interval to a 4-5 hour interval once (?) a day for several days and back again does not seem like a big jump, so I am curious if your concern is discomfort, or leaking, getting plugs or?

    If you are not under a risk of severe discomfort or ill health, I would not suggest trying to train your body to "go longer." This would potentially be needlessly detrimental to your nursing relationship and your milk production.

    If you are going to be uncomfortable going 5 hours and it is not avoidable, I would suggest trying some other strategy.

    I think I mentioned going to the restroom and doing some quick hand expression - enough to get more comfortable.
    Another idea would be to pump just before this long stretch begins, rather than only have baby nursing. (baby still nurses if there, but pump also.) If this stretch is already after a pump session rather than nursing, can you make that pump session a little longer? Basically I am thinking, empty the tank at the start so it takes longer for it to fill up.

    I am basing my response on the following:

    1) The more often overall baby nurses, the longer baby nurses. This is why so often when mom goes back to work, and baby is nursing less often, baby tends to wean earlier than mom wished. We call it nipple confusion or bottle preference but that is an oversimplification of what can happen later on. The less baby nurses, even if baby never gets bottles, the more likely that baby will wean earlier. Basically the baby who continues to love to breastfeed is usually the baby who got to breastfeed a lot!
    So I would say that nursing when you are home with baby, as often as baby will, is not only much more convenient, it is also very important for breastfeeding longevity.

    2) Pumps are different than babies. Babies take as much milk as they need at the moment. Sometimes a lot and sometimes a little. So a mom may find she gets more full more quickly after some nursing sessions, or that and baby does not take much and mom worries about milk production etc.
    With a pump, as long as it is working properly and you have the time, you can basically "empty" your breasts. So if you are little fuller right before a pumping session, you can pump as long as you need to feel ok. Also if needed you can pump before a long stretch to "empty" the tank.

    3) What is really happening when a longer pause is taken between milk removal? It isn't that the body is learning to make less milk between (for example) 7 am and noon and more the rest of the day. Our bodies are smart but not quite that precise. Mothers usually find they can go longer at certain times of day (for example, overnight) without feeling full because nature makes milk production work this way...less milk production in the later evening/early night, and more towards morning. So when there is a longer stretch, what the body is learning instead is to make less milk, period. It might be slightly less, and it also might be offset if mom pumps long enough at noon to "empty" the breasts. In other words, it might not be a problem for your production. But longer stretches of not nursing (or pumping) tend to act to reduce production overall so generally moms do not want to do that more than necessary.

    Hope that made sense. It is late and I am loosing my focus a bit! Sorry!
    Last edited by @llli*maddieb; July 26th, 2017 at 11:32 PM.

  6. #6

    Default Re: missing pumping sessions

    Yes, that makes sense. I am mostly concerned about being uncomfortable or clogged ducts (although as a junior high teacher I am also concerned about leaking...I will have to be prepared since that would be beyond embarrassing). I have had a couple of clogged ducts (which were awful!), but I don't think it was necessarily related to going a long period of time, although both happened overnight, so I guess that could have been a factor. I am still nursing once at night, generally. (I tend to think it was from compressing a duct while sleeping - as a stomach sleeper. Trying to be more careful!)

    I REALLY REALLY appreciate your information and tips. I think I will try to squeeze in a pump session after my morning nurse, even if it ends up being right after, or pretty close after. I think I have a lower storage capacity (I can't think of the technical term for this), so the more often I can get any in, should help.

    Also, good to know about early weaning. I will just stick with breastfeeding at home and use hand expression if I'm desperate.

  7. #7
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    Default Re: missing pumping sessions

    Ok, if the plugs were not recent you may be fine, however if re-occuring plugs or some other issues do crop up with the return to work, and cannot be resolved another way, then in fact you may need to reduce your milk production just enough to be able to avoid this. It does happen that way for some moms who do not have optimal pumping at work situations...but usually if mom tends toward over production.

    Here are some leak tips:
    I used to put a disposable pad over a reusuable- the reusable was against my skin.
    Try very brightly or dark patterned blouses. The busy pattern was the key for hiding leak stains at least somewhat. Also unnatural fabrics show stain less and dry faster than cotton or silk. Wool might be ok but it is not sweater season yet! Actually where I live it is never very cold so I almost never wear sweaters, however the weave of a sweater or sweater vest might hide leaks pretty well now that I think about it. Especially if it is also patterned.
    Keep a spare blouse and bra as well as spare pads in your bag.

    For plugs, be careful about too tight bra or straps. If you prefer to wear an underwire, try shifting your position frequently if you find plugs are forming and only wear it when needed.
    Avoid as much as possible carrying heavy purse or other with a strap is across the breasts or pressing into the side of the breast.
    If you have to drive much, be aware that seatbelt placement can lead to plugs.

    I think I have a lower storage capacity (I can't think of the technical term for this),
    I think that is the technical term. But unlike "low milk production" it is not describing something that is not typical. Breast storage capacity varies mom to mom normally. And in fact can change baby to baby as well.

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