Tuesday, May 1, 2012

Pumping milk at work – a technical report

Recently, there were a couple of articles in the news talking about how breast feeding is not free at all, because women who breastfeed longer than 6 months earn significantly less, even five years after their baby was born, compared to women who breastfeed shorter than 6 months or women who formula feed their infants. It turns out that this difference in earnings is mostly because women who breastfeed longer than 6 months work a lot less than the other groups. In other words, women who (have to) go back to work sooner apparently have a hard time breastfeeding past 6 months.
To me breastfeeding is like walking; you do it because you can. And if you can’t, there are alternatives like using a wheelchair. However, very few people use a wheelchair if they are able to walk just because it is more convenient. That’s not to say that breastfeeding is easy: it’s a learned skill and the fact that we rarely ever see people nurse their babies makes it harder to learn. The same holds true for pumping milk; even though there are some great resources online, when you have to do it yourself you’ve probably never seen someone else pump milk, and perhaps you don’t even have women nearby to ask questions. That’s why I decided to write up what has worked for me over the past months.

Materials and methods
It’s very important to have a good double sided electric breast pump. I have the Medela pump in style , but if I’d have to choose again I would probably go for the Medela Freestyle, since it’s weighs a lot less, which is nice if you go to a conference. Save your receipt, because breast pumps can be tax deductible. The advantage of the black signature Medela bags is that it’s also an easy way to come into contact with other pumping moms who recognize your bag (yes, this happened to me multiple times). It is important that your breast shields fit well; you can ask a lactation consultant for advice. I also have one of these, so that I can pump hands free.

Before going back to work it is important that 1) your baby can drink from a bottle and 2) you have familiarized yourself with your breast pump. To do this, I started pumping one feed in the evening when BlueEyes was 6 weeks old (apparently there’s a window between 4-8 weeks when it’s best to teach babies to drink from a bottle. I have no idea whether that is true but it worked for us.) and Dr. BrownEyes would give him the bottle. I noticed that it takes some practice to pump a decent amount of milk, so don’t worry if you don’t pump a lot the first time. It is also nice to have about a week’s supply of milk in the fridge before you go back to work, so that if pumping doesn’t go well because you’re too stressed in that first week, at least you don’t have to worry about having too little milk to feed your baby. I built a supply in the freezer by giving BlueEyes a little bit less milk in the evening than the amount I pumped (don’t worry about the baby, he will drink whatever he needs during the night). If that doesn’t work: your supply is highest in the morning, so alternatively you can nurse your baby on one breast and then pump the other to build up your freezer stash. Also, make sure to figure out ahead of time where you can pump. I realize that having a clean room and a fridge available is a luxury, and that that’s probably why more higher educated women continue to breast feed, but no one should be afraid to ask for this. In some countries it is a right for women to pump milk for their baby during work hours.

So for the past 6 months I have been pumping milk at work for BlueEyes. Until a couple weeks ago I religiously pumped for about 15 minutes at 10AM and 1PM every day. This fit very well with my experiments, which I think is part of why it worked so well for me. I would cut brain slices, and while those were incubating I would pump the first time, and when I was done with my recording experiment I would pump the second time. I have two sets of breast shields, so I don’t have to bother about washing them in between. I pumped about 200-250 ml (6-9 oz) in total, and because BlueEyes drinks a bit more, I would also pump in the morning after I nursed him. In total I pumped about 300 ml (10 oz) and that’s exactly what he drank in daycare. Being a post-doc, I obviously don’t have my own office, but our department has an empty office that the pumping women can use to pump milk. Now that BlueEyes is eating solids and I have the feeling that my supply is pretty stable, I usually pump once or sometimes twice at work (my total yield is still about 250-300 ml per day).

What can you do when you are not pumping enough milk for your baby?
Your milk supply is a matter of supply (duh) and demand, so the first thing to do is pump more often or try to get multiple letdown reflexes during one pumping session. Also, make sure you empty your breasts well, because that will let your body know that more milk is needed. What I would sometimes do if my supply was getting low, was to ‘cluster pump’ at night. After BlueEyes had gone to bed I would pump according to the following schedule (pump 7 min – rest 7 min – pump 5 min – rest 5 min – pump 3 min – rest 3 min – pump 1 min). This did not yield a lot of milk at the time of pumping, because I had just nursed BlueEyes to sleep, but it does give a pretty good boost for your milk supply.
If this doesn’t work sufficiently, you can take various herbs, teas or foods to increase your supply . I’ve personally never tried that, but I've heard it works.

What can you do when it takes you very long to pump?
To me, the time it takes to pump depends for the most part on how long it takes me to get a letdown reflex. Some people like to look at pictures or movies of their baby to speed this up, but I usually just take a couple deep breaths (at home it even helps me to picture the empty office I usually pump in). However, if you still have problems getting a letdown reflex, and therefore need a long time to empty your breasts, you can consider using an oxytocin nasal spray.

I wrote this post to share my experience and to show that it is very possible to breastfeed for at least 6 months and work. Even though I couldn’t believe it at first, breastfeeding does get better and more fun and much less painful (even not painful at all) after 6 months.

Disclaimer: I’m not a lactation consultant or any other type of medical professional. However, feel free to comment or email me if you have any questions.


  1. Awesome post topic! I have another 7 1/2 weeks of leave to build up a milk stash in the freezer, and my own office at work to pump in (a real privilege), so I'm optimistic we can continue breastfeeding for a good while.

    Did you have any problems with overactive letdown/oversupply/foremilk-hindmilk imbalance? It's good in a way, because letdown while pumping is noooo problem, but I hesitate to even try him on a bottle because I'm afraid he'll prefer it since it will be less complicated than getting flooded at every meal.

    People say it will get better, so I'm still hoping (he's only 4 weeks old, it's got to even out eventually...but man, it is not easy right now).

    Anyway, thanks for sharing your experience. It's good to hear from someone that nursing/working can be done!

    1. Thanks for your comment! I had a bit of overproduction and a strong letdown, and I always made sure that BlueEyes would not be distracted while nursing, because when he was able to focus on nursing, he would do a much better job swallowing and not choking. When you have overproduction, you can try feeding in blocks. What that means is offer 1 breast for a block of 4 hours (so however many times you baby wants to nurse, he will just get that one breast), and then after that block give your other breast for the same amount of time. When the non-used breast gets engorged to a point that is uncomfortable, you can pump a little to relieve the pressure. This way, you baby gets to drink from an emptier breast, which means he will get more hindmilk and he should have less problems getting flooded with milk. Also what Anonymous says below: try to find a bottle with the same flow as your breast, however hard that might be. My experience is that these problems of overproduction get much better over time, when you supply is better suited for your baby and your baby will learn to swallow more milk when he gets older.
      I hope it works out well for you!

  2. Great post! I had some great breastfeeding role models who made it seem as easy and natural as walking, so breastfeeding wasn't even optional in my mind.
    Several years later when I had a baby I had a good friend who helped me get set up with pumping and great lactation consultants. Pumping was never much of a problem other than arranging my lab work and ducking out a few trips to the field. As it worked out my kiddo had some pretty major GI issues that led to me being on a very restrictive diet and not having the option of formula (other than prescription elemental formula that the insurance only partially covered). It my critter was 19 months old before I got the green light from the GI to give her dairy, so I pumped for 19 months. Sure it was a bit of a pain and somewhat inconvenient, but it really wasn't that big of a deal. I didn't feel like I had a choice, but I (usually) didn't feel burdened either.

    Llyn- I had overactive letdown and oversupply, and yes things were hard for us. The babe didn't start on bottle till 4 weeks old, but once she had it she wanted it more than me (easier to deal with slower flow from bottle than fire hose from mom). We had to deal with nursing strikes, and it took several weeks and lots of support from my lactation consultants but we got her to nurse again... and she didn't stop for 3 years. For a while I thought I would have to exclusively pump and it was very hard emotionally. If you know you have overactive letdown, then you might want to try a nipple with a larger hole to start with (ladies like us have the opposite problem as most nursing moms so need to break the rules a bit).

    1. Thanks for your comment. I'm glad you nursed and pumped without major problems for such a long time!

  3. Kim (Flabby Mommy)May 2, 2012 at 12:04 AM

    Wonderful article, and I love your idea about cluster pumping and I'm going to recommend that to moms who ask.

    Just one or two things I saw that I'd like to comment on. There isn't a need to get a baby used to a bottle or even to take a bottle. Many babies successfully cup feed either from a normal cup, a special feeding cup or from a sippy cup. There also isn't an ideal window for introducing a bottle - even a baby who has taken a bottle before may refuse one later.
    Generally though, babies are not suicidal, so if mom is not there, and they are hungry enough, they will take the milk however it comes - bottle, cup, spoon, slushy ice block. What helps with this is dipping the teat into some milk so that baby realises that milk comes out of the bottle.
    Its generally recommended that moms either don't introduce a bottle and let baby take it on her first day back at work (I did this successfully), or that a bottle with a small amount of milk is given as a plaything a few weeks (about 2) before mom returns to work. Care givers can heat or cool the milk and or the teat, wrap the bottle in moms shirt, or feed with the bottle under their arm so its ina similar possition to breastfeeding, or do the complete opposite and have baby's back to them while feeding (my sons nanny used to do this for my son).

    By giving a bottle when you are with baby, it reduces milk supply as baby is not stimulating more milk production from your breasts.

    There also isn't a need to build up a huge freezer stash. What is pumped at work today is left for baby for tomorrow. If there isn't enough, as you describe, pumping while feeding in the morning and evening will add to this, as will your wonderful cluster pumping suggestion:)
    A small freezer stash of milk frozen in ice cube containers is helpful though, as if there is a difficult pumping day mom can just add a block or two of the frozen milk to what she leaves for the next day. Friday pumped milk can be kept in the back of the fridge and given Monday.

    For those companies who won't give pumping time or in countries where it is not a legally protected right, mom can either negotiate time to pump by pointing out that she will be off with a sick child less often, that she is taking less time than anyone who takes a tea break or smoke break, or chats around the water cooler. Othser moms rather than have this fight, buy a small manual or battery operated "mini electric" pump, put it in a small bag in their handbag and just pump in their car or in a toilet stall (not ideal at all, but better than not pumping - yes, I have done this before).

    Also, pump flanges can just be run through water and stored in the coller pack if necessary, or washed out each time. I like your idea of two sets of flanges.

    Ideally a mom should pump for each missed feeding, but this isn't always possible, so pumping for a short bit every 2 hours is great, or a longer time every 3 hours. Moms can work during this time if necessary by reading reports or similar.

    Thanks for your excellent blog. It is so nice to see something written by a passionate breastfeeder that is not full of woo.

    1. Thanks for your comment! I agree with your that babies don't NEED to learn to drink from a bottle, but speaking from experience I think it really helps. To me the whole going back to work and putting BlueEyes in daycare thing was already pretty stressful, so for my peace of mind it was nice knowing that he could drink from a bottle. However nice our daycare is, they are not super patient when it comes to babies who don't know how to drink from a bottle... And the same holds true for the week's worth of milk in the freezer: my first days of pumping at work did by far not yield what I needed, but it didn't stress me out because I knew I had enough milk in the freezer. And as I said, when we taught BlueEyes to drink from a bottle, Dr. BrownEyes would give him a bottle at night when I pumped at the same time. We did this for about 2 weeks or so.

      And I completely agree with your comment below, that breastfeeding shouldn't hurt. What I meant to say was that all the discomfort and struggle to get everything right usually goes away between 3 and 6 months, which unfortunately is the time when most moms give up nursing. Even though I never had major problems, in the beginning I was pretty skeptical when people said that at some point I would really enjoy nursing, but now I know that's true!

  4. Kim (Flabby Mommy)May 2, 2012 at 4:34 AM

    sorry, one more thing to add. You mention that breastfeeding stops being painful. Pain in breastfeeding is always a sign of a problem - it could be thrush, it could be baby with a tongue tie, it could be a latching or positioning problem, it could be severe engorgement - many things really, but its not a normal part of breastfeeindg. Anyone who has pain when breastfeeding should seek help - it doesn't have to be that way. There are many IBCLC's and organisations like La Leche League who can help to resolve the problem. That said, some discomfort is pretty normal - a little bit tender in the first day or two, uhcomfortably full when milk "comes in" and so on. There is however a world of difference between pain and discomfort and pain should always be investigated. Once the problem is rememdied, in many cases there is immediate relief from the pain (not with thrush, that takes a while to clear).

  5. Thanks for the suggestions! We will keep at it. He's getting strong and chubby, so I know he's getting fed--we'll just have to work through the frustrating bits.

  6. Nice post. I personally had a very easy time pumping. I experienced oversupply early on and let my body run with it. I also had a very difficult time getting Monkey to latch on at first, so Hubby gave him a bottle at about a week old, not knowing that could interfere with breastfeeding. Turned out Monkey couldn't care less where he got his milk from, and as soon as he was old enough to latch on without a nipple shield (he was born a few weeks early), he became a nursing pro. My milk supply took a hit when I started back to work at 8 weeks, but I had a huge freezer supply and a convenient place to pump at work. After a few weeks, I was pumping more milk than we knew what to do with.

    However... I've known moms who never were able to establish nursing and instead pumped exclusively, and some moms never produce much milk at all, no matter what they try. For these women, no amount of convenience at work is going to make it worth their while to pump for 6 months or longer - this includes some faculty I've known who had an office with fridge, privacy, the works. My suggestion to any new working mom is to give the pumping and nursing thing a good try, and take advantage of the great advice here and around the interwebz. But don't hold yourself to impossible standards. If you're stressed or feeling overwhelmed every time you take out that black Medela bag, then stop. Formula is a fantastic alternative to breast milk - a feat of science if you ask me.

    I loved nursing Monkey for a year, I loved being able to provide him with my own milk instead of buying formula, and I loved the fact that I could eat full fat ice cream and yogurt and anything else I wanted for that first year. I even loved our quiet nursing sessions in the middle of the night - at least the ones that I was awake for. Nursing and pumping wasn't terribly difficult for me, yet the day I stopped pumping I felt liberated - after nearly two years, I took back ownership of my body. If pumping and/or nursing make you miserable, there really are better ways of providing nutrition to your child. Don't let guilt guide your decisions - do what's best for your own sanity.

    1. I totally agree that you should not try to breastfeed at all costs. However, I do think that there are a lot of women who do not succeed because of a lack of (good) information and because they don't have a network of other breastfeeding women. I think increasing the visibility of breastfeeding and pumping moms (literally and virtually) will help those women.
      Also, I never really understand the 'taking back ownership of your body'. In the end I am the one who decides whether BlueEyes gets to nurse or not. I don't feel like I am not the owner of my body. But that might be different for everyone.

  7. Here's our two posts on the subject:

    A really big point is: if suddenly it seems like your supply has dropped-- check your pump for cathair on the membrane or a hole in the membrane etc.

    1. Thanks for your comment and the links to your posts! And you're right about the valves; I had that happen once and wanted to mention it but forgot about it.

  8. Carolina (@braziliancakes)May 3, 2012 at 8:34 AM

    Thanks for this wonderful post!

    I had a very different experience. I started out with some pretty bad advice which made breastfeeding at the beginning extremely difficult. I had some major cracks and consequently got mastitis. Everything took a full 4 months to heal completely, but I was back to full-time nursing after 2 months. There was a point in the first 4 weeks were breastfeeding or pumping was so painful that I actually had to stop everything for 3 days to let things partially heal.
    The best help I finally got was through the la leche league where I got excellent support and ideas for helping everything heal. I returned to work after 3 months and since the baby had always been going back and forth from the bottle to the breast she didn't have much difficulty adjusting. Now I go home for lunch to nurse her, and pump during her afternoon feeding. I have found pumping to be annoying, but I am able to pump out more than she drinks in a bottle, so we haven't had any supply issues. My major issue is that I already feel super constrained for time in getting my experiments done and taking 20-30 min to stop and pump gets in the way sometimes.

    I assumed that breastfeeding was always going to be painful for me and that I would deal with that. I'm happy to say that the baby is now almost 6 months and breastfeeding is amazingly easy and actually a lot of fun. I'm also glad I can finally wear clothes without wincing in pain whenever a shirt shifted.

    And I completely agree with your comment above that had I gotten more (good) support and information about breastfeeding, instead of having people tell me it just wasn't going to work at all, I would have had a less stressful journey and probably a better time at the beginning with my baby.

  9. Thanks for your comment! I actually came up with the idea for this post after our twitter conversation ;-). I'm glad that after your rough start everything worked out and your enjoying breastfeeding now.
    I agree that it's hard to find time to pump sometimes, and I don't think I have any good advice on that, other than the fact that for most people their supply gets pretty stable around 9 months, so then it doesn't matter that much exactly when you pump. Or you might find that you can drop pumping at all and just feed in the morning, at lunch and at night. Be careful with your supply when you do that (provided you don't want to quit nursing just yet).

  10. Hi there,
    I see that this post is a good year old, but I am hoping you are still checking this thread... I am a neurobiologist too, but I work on degeneration. To be honest, I do not care about science that much now, all I can think about is that my heart is going to break when I need to leave my 16 week old little boy and go back to the .... lab :( As I am feeling so sensitive about this, if pumping did not work out that would be a total nightmare. I started builiding up my stash in the freezer and my little one takes the bottle, but I really want to avoid a drop in supply! Fingers crossed it is going to work out. It was great to read your post and I hope your boy enjoys day care (he must be well over 1 now...)