Maintaining My Milk Supply

One of the most common questions I get asked on breastfeeding and working is how I maintain my milk supply. Naima is almost 20 months old and she still takes expressed milk at home. I also still have excess milk which we donate (if substantial) or use in cooking Naima's food.

I went back to work when Naima was 7 months old. At that time, my biggest fear was that I would not be able to express enough milk at the office for Naima’s next day feed. Happily, that has never happened. Naima’s daily milk intake has remained to be fresh (refrigerated, actually) and we’ve never had to dip into our freezer supply. In fact all my freezer supply gets donated every time my cook complains that we don’t have space for our frozen food (which used to be every 2-3 weeks but my intervals have lengthened into a month or so).

To maintain milk supply and successfully pump at work, here are some tips:

1) Prepare for your return

Check your office’s policies on breaks. Look for places where you can pump and store your milk at the office. Talk to your boss or supervisor about getting some time off to express milk. And of course, work efficiently – you’ll already be taking extra time to express milk so cut the idle time – chitchat, etc.

I’d also recommend that moms bring 2 or 3 sets of flanges/horns so they don’t have to wash in between pumps. In my case, since I have a refrigerator near my pumping area, I just bring a clean plastic food case. After each pumping session, I put the flanges in the case and stick them in the refrigerator immediately. So for my subsequent sessions, I just attach new bottles and pump away. WARNING: The horns are cold! Also, there is a concern about mixing the cold drops of milk with the warm freshly expressed milk. If you are worried about this, then you can just rinse your flanges with water from your office dispenser or bring your own water cooler.

2) Maintain a regular pumping schedule

When I first went back to work, pumping schedule looked like this:

• 630am – wake up and pump
• 9am – 1^st pump at the office
• 1130pm – 2^nd pump at the office
• 230pm – 3^rd pump at the office
• 530pm – 4^th pump either at office or at home, depends if I’m working late

When Naima was younger, she doesn’t ask for milk immediately when I get home. So I still get to express milk before I directly nurse her at about 6pm or so. After Naima turned 1, I dropped a pump and my pumping schedule changed to:

• 630am – wake up at pump
• 930am – 1^st pump at office
• 1245pm – 2^nd pump at office
• 4pm – 3^rd pump at office

I dropped the last pump which I used to do just before nursing Naima. Sometimes the last pump gets extended to about 5pm, depending on whether I’m rushing work. I’m able to drop the last pump occasionally but get really engorged.

For a short while, I followed this pumping schedule:

• 630am – wake up at pump
• 1030am – 1^st pump at office
• 230pm – 2^nd pump at office.

I started on this schedule a month ago but discovered that the 3-day pump at office schedule works better. I would have wanted to keep the 2-day pump at office schedule. However the pumping times usually coincided with the busy office times, unlike the other schedule (3 pumps at the office), where my pumping breaks are scheduled during break times. So I reverted to my 3x a day office pumping schedule.

I also pump during the weekends. I never miss the 630am pump whether it is a weekend or holiday. I usually get the most amount of express milk during that 1^st morning pump. I also pump a couple of times during the weekend, usually after Naima nurses. The extra milk serves as buffer in case I am unable to express enough milk during the work week.

3) Eat the right foods and stay hydrated.

My daily breakfast consists of a bowl of oatmeal, 1 malunggay capsule and a cup of native cocoa drink. The oatmeal and malunggay are said to be galactagogues. The native cocoa was just carried over from my ge-lai days. I also have a bottle of water on my office table. As one lactation consultant told me – stay hydrated but don’t drown yourself in water. Drink every time you feel thirsty.

It is also important to eat well. In my various yahoo groups, nursing and pumping moms recommend eating eat enough protein and good saturated fats (such as olive oil, flax oil, avocados, coconut oil – I assume this is VCO!). Aside from the galactagogues, I also try to eat healthy foods and avoid eating out as I don't know what goes into my food. I take extra calcium and continue taking my prenatal vitamins.

Oatmeal is known to promote lactation and there is a popular recipe for oatmeal lactation cookie, which I’ve copied and pasted below with notes on some of the ingredients’ local availability.

• 1 cup butter
• 1 cup sugar – we’ve reduced this to ½ cup
• 1 cup firmly packed brown sugar – we’ve reduced this to ½ cup
• 4 tablespoons water
• 2 tablespoons flax seed meal – available at healthy options
• 2 eggs
• 1 teaspoon vanilla
• 2 cups flour
• 1 teaspoon baking soda
• 1 teaspoon salt
• 3 cups oats - You can use the “quaker oats” brand – choose quick cooking not instant. You can also buy oats from Healthy Options
• 1 cup chocolate chips – Some moms replace this with toffee chips or chopped-up pieces of Heath bar.
• 2-4 tablespoons brewer's yeast – available at Healthy Options. I also sprinkle brewer’s yeast on my daily oatmeal bowl.

Preheat oven to 350°. Mix the flaxseed meal and water and let sit for 3-5 minutes. Beat butter, sugar, and brown sugar well. Add eggs and mix well. Add flaxseed mix and vanilla, beat well. Sift together flour, brewers yeast, baking soda, and salt. Add dry ingredients to butter mix. Stir in oats and chips. Scoop onto baking sheet. Bake for 12 minutes. Let set for a couple minutes then remove from tray.

4) Stop milk wastage by knowing how to properly bottle-feed the breastfed baby and knowing how to properly handle breastmilk.

Sometimes, the reason why working and pumping moms think that the milk they produce is not enough is because their yayas or babysitters overfeed their babies or waste the milk by not handling it properly.

KellyMom has a terrific guide by Eva Lyford on how to bottlefeed the breastfed baby. There is even a printable guide which you can give to your caregiver. You can also compute how much milk your baby will need when you are away by using the milk calculator here.

It is also important to teach your caregiver how to properly store/prepare milk. I’ve heard horror stories of dads or caregivers thawing out too much milk, only to throw them away because the baby couldn’t finish the milk. Since these caregivers do not express the milk, they don’t realize how difficult it is to squeeze those extra drops out just so you can make a full bottle. I trained my yaya how to warm Naima's milk and how to store (in small amounts) milk to avoid wastage. I guess I was also lucky that my yaya recognized the importance of breastmilk and readily learned how to handle and serve it to Naima.

There are also several other internet resources working moms can check for more information. There is even one site specifically addressed to breastfeeding and working mothers. I am counting the months until I wean from the pump. My goal is to stop pumping for Naima at the end of the year but still continue nursing her whenever we are together. Balancing work demands and time required for expressing milk is not easy BUT it can be done as long as the mother is determined and disciplined to focus on her goal of being able to bring home expressed milk for her baby at the end of her workday.