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Breastpump suction pressures range from 20-650 mm Hg negative pressure.
Pressures above the high 200s often cause pain. Pressures below 150 are
reported to be ineffective at extracting milk. A breastpump that is
similar to a nursing baby creates 200-230 mm Hg negative pressure and
cycles about once every second. Two Medela pumps meet both criteria for
suction pressure and cycles (sucks) per minute: the Lactina and the Pump In Style.
Both of these pumps are also designed for frequent, long term use and
their simultaneous double pumping action may help maintain milk supply
more effectively.
If only working or taking classes part-time - less than 4 hours a day or 2 eight-hour work/school days - the Medela Mini Electric or Avent Isis
are other options. Although these pumps do not meet both criteria for
perfomance, they are still acceptable when used in this limited and
short-term fashion.
When choosing a breastpump, you should consider where at work/school
you will be using it. Will you have access to an electrical outlet? If
not, does the pump convert to battery operation or can it be used in
your car? Both the Lactina and the Pump In Style are electrically operable and can also be powered by a vehicle lighter adaptor or battery pack. The Mini Electric can be powered with an AC adaptor, 2 AA batteries, or manually. The Avent Isis pump can be operated manually without the need for additional power sources or worry about wear and tear on motor parts.
Breastpumping in the Weeks Prior to Your Return to Work/School
During the time after your baby is born and before you return to the
workplace or classroom, your primary goal will be to establish your
supply. This is best done through frequent day and night feedings and
the avoidance or limitation of supplemental bottles. (See "Breast Babies and Schedules" for more on this).
Also during this time you will want to select or purchase your
breastpump. This will allow you time to become familiar with the
operation and cleaning of your pump, enabling you to determine if you
need extra parts, etc. and to remedy any pumping problems (see "Breastpumping Tips").
This is also a good time to begin stockpiling your milk reserve and
introducing your baby to an alternative feeding method, usually a
bottle. Be advised that you will want to avoid bottles unless medically
indicated for at least 4 weeks if possible in order to lessen the risk
of nipple confusion
Plan to pump milk to stockpile whenever the opportunity arises:
- In the early days when the milk supply may be more than the baby needs, often referred to as the engorgement period.
- On the other breast when the baby only takes one side.
- A few minutes (5-10) after feedings.
- In the morning hours when milk supply is most plentiful.
When pumping during these days, expect to only be able to pump small
amounts as your body adjusts to a different type of stimulation and
while your baby is nursing frequently throughout the day and night. You
may have to pump several times in order to acquire the amount needed
for one bottle. Once you return to work or school, however, and begin
missing feedings regularly, you will be able to pump greater amounts.
To determine how much milk to leave for your baby, take your baby's
weight in pounds and multiply that number by 2.5-3. Now divide the new
number by 8. The answer is the approximate amount of milk in ounces,
per every 3 hour feeding, that your baby will need while you are at
work or school. (See more on storage and handling of breastmilk here.)
Managing Breastpumping in the Work or School Setting
- Frequency of pumping: Ideally you should plan to pump at least 3
times during an 8 hour work/school day, 2 times during a 6 hour day,
and at least once during a 4 hour day. If pumping opportunities are
extremely limited, brief pumping sessions of 5 minutes are better than
no pumping.
If there is no pumping for prolonged periods; ie. 8-9 hours or more,
expect milk supply to drop. Supply can be increased through frequent
nighttime and weekend (days off) nursing sessions. See "How Can I Increase My Supply?" for more tips.
Some mothers resort to reverse cycle feeding if pumping is not an
option at work. This is simply feeding your baby at least as frequently
during the night hours as he would normally feed during the day. It is
made easier by bringing the baby to bed with you so that you can obtain
the rest that you need.
- Possible locations for pumping: a women's restroom,
lounge, locker room, or break room, an unused conference room or
office, an employee health office, your vehicle, or a designated
employee breastpumping room. Wherever you decide to pump, make sure
that you have access to electricity (if needed for pump operation), the
location is private and comfortable (not too hot or too cold;
comfortable place to sit), and there is sufficient cleanliness for
collecting milk. If using a public restroom wash area to wash pump
parts after collecting milk, consider bringing your own wash basin from
home in order to maximize hygiene.
Consider doing a "practice run" the week before you return to
work/school. Leave the baby with the caregiver and go to your workplace
or school a couple of times during the day to pump when you normally
will be pumping. This will give you the opportunity to identify any
problems; ie. with the pump, location of pumping, whether or not your
collection/cleaning/storage options are adequate, and the estimated
time required for pumping.
Strategies for Maintaining Milk Supply
The number of breast emptyings (nursing or pumping) per every 24 hours is critical:
- 8 times is optimal
- 7 times is minimal
- 6 times - expect milk supply to decrease
More frequent feedings can be encouraged by increasing skin-to-skin contact and co-sleeping. Avoid
bottles and pacifiers whenever you and baby are together. This will
ensure that all the baby's sucking needs are met at the breast and that
you receive vital stimulation to maintain your supply.
Minimize any stress in your life and delegate responsibitlies when you can.
Optimize your physical status by going to bed earlier, increasing rest
times on off days, getting moderate exercise (increases Prolactin
levels which in turn increase milk supply), and consume adequate fluids
(many busy moms do not take the time to drink enough, so make it a
point to have something nearby that you can sip throughout your
work/school day). For more tips on increasing supply, go here.
A Typical Work/School Day for the Breastfeeding Mother
- Set your alarm clock 20-30 minutes early. Nurse your baby during this time even if you have to awaken him.
- Dress yourself and the baby.
- Eat a well-balanced breakfast including something to drink.
- Nurse again before leaving.
- Plan to pump around mid-morning. Have something to drink and a snack.
- Plan to pump again - or nurse if possible - at mid-day/lunchtime. Eat a well-balanced meal with something to drink.
- Plan to pump around mid-afternoon. Have a snack with something to drink.
- Pick up baby after work/school and nurse as soon as you arrive home.
- Eat a well-balanced dinner with adequate fluid.
- Nurse on demand throughout the evening. This is beneficial to increasing your supply and it helps your baby reconnect with you.
- Work in some moderate exercise as this increases the hormone that is responsible for milk production.
- Have a bedtime snack with something to drink.
- Nurse on demand throughout the night. Bring baby to bed with you to allow for adequate rest.
Is it worth all this effort?
Using a breastpump at work/school takes a real commitment. Some mothers
make this effort so that they are clearly distinguishable from their
baby's caregiver. Only a mother can breastfeed.
Others decide to pump at work or school simply because they enjoy
breastfeeding and want to continue it for as long as possible. Pumping
while at work/school makes this more possible.
There is no doubt about the continued health benefits of breastfeeding
to you and your baby even after you return to work or school (see "Advantages of Breastfeeding").
Even with the cost of a breastpump and related supplies and the added
burden that pumping brings, the cost of NOT continuing to provide your
baby with breastmilk after your return to work/school is HIGH! The cost
of formula ranges from $48 - $190 per month and specialized formulas
required by some babies cost even more. Additionally, formula-feeding
is associated with more frequent doctor's office visits and
hospitalization, prescriptions, and parental absenteeism from
work/school in order to take care of an ill baby. Breastmilk cannot be
purchased. Only YOU can provide it!
Written by Becky Flora, IBCLC
Last revision: June 24, 1999
Sources:"Helping Employed Mothers Optimize Milk Supply"
by Linda Shrago, RN, MS, IBCLC as lectured at the La Leche League
Lactation Specialist Workshop Series VIII, "Breastfeeding: Overcoming
Challenges in Today's World", October 24, 1998.
La Leche League's, "The Breastfeeding Answer Book" (1997) by Nancy Mohrbacher, IBCLC and Julie Stock, BA, IBCLC
More info at other sites:
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