Is this realistic?

[mamacolleen]

I am returning to work this week. My DD is 9.5 months old. I will be doing 12 hour shifts (out of the house for ~13.5 hours counting commute time). I will be working days only, 2 days in a row only and 6 shifts in a 2 week period. There will be at least 2 days off between my 2 days of work.

My DD has never taken a bottle of my BM. We've tried many times at different times in her life. She won't even take it from a sippy cup. It could be the taste?
Additionally, pumping at work will be problematic. I'm an RN and work on an extremely busy hospital floor. It's hard to get a bathroom break let alone a pump break. Plus, the only pump I currently have is a little manual Avent hand pump and the last time I used it was several months ago and I was only getting 1-2 ounces a session (I was getting at least 4-5 ounces when DD was young). I know I have good supply and this is just a pumping output thing. But for me to pump at work I would need a bigger electric expensive pump that we just can't afford right now.

So, our plan has been to give formula in a sippy cup a few times on the days that I work. Problem is that DD is rejecting that too. She takes it, spits it out, laughs and then gets upset when DH tries to give her more. He tasted it the other day and pronounced it "gross" and that we shouldn't be giving it to her anyway.

She is a very good eater.... has been on solids for 3 months. Takes 3 full meals and snacks and will drink water from the sippy cup very well. She is also a big baby... 22lbs 11oz at her 9 month WBV (gained 3 lbs. since 6 months)

She nurses probably 4-5 times during the day and 3-6 times at night. The only plan we can think of, now that EBM and formula are out of the picture, is to encourage even more reverse cycling on the days that I'm working. DH will be able to bring her to work to nurse her at lunch some days but not all.... but I'm not certain she'll actually nurse since she gets really distracted when I try to nurse her in public.

Is this plan realistic? What will it do to my supply? What can I do to keep up my supply? Is it okay for her to go 13.5 hours without milk for 2 days in a row?

TIA!

[goodygumdrops]

It may be ok for her to get by with formula and pumped milk but it certainly is not going to be ok for you. Your milk supply will be affected by going so long between nursing an not pumping. You will likely be painfully engorged.

From Kellymom.org
"Sometime between six months and a year (as solids are introduced and slowly increased) baby's milk intake may begin to decrease, but breastmilk should provide the majority of baby's nutrition through the first year. Because of the great variability in the amount of solids that babies take during the second six months, the amount of milk will vary, too. One study found average breastmilk intake to be 30 oz per day (875 ml/day; 93% of total intake) at 7 months and 19 oz (550 ml/day; 50% of total energy intake) at 11-16 months."

Therefore, assuming your on the low range...she would likely be consuming 10 - 15 ounces during the time your away. Is it possible for you to rent a breast pump? I appreciate that your a busy nurse but if you have a more efficient pump than you may be able to express more in a shorter amount of time. I can't imagine that you couldn't work something out with the hospital LC being an RN.

You can do it mama!!! Your baby is getting so big, you wouldn't have to pump for long....You can do it!!!!

[Llyra]

I would imagine going that long without pumping you'd be courting plugged ducts and mastitis. That's a long day, especially if you're going to nurse all day on the days you're with baby. You're going to be full to bursting-- won't it be painful? I only work four hour shifts, and I found that by the third hour I was SO FULL that I had to pump, even though my LOs were perfectly willing to wait until I got home.

The Avent pump is a good pump. It's possible, if you're getting reduced output from it, that the soft parts need to be changed. They wear out with time, and the pump doesn't work as efficiently because the suction is not as good. That might be cheaper than an electric pump.

[colsxjack]

Hi. Im mamacolleens DH.
If she pumps a bit at work to keep the pressure down, is it possible for a 9.5 mth old that eats a variety of solids really well to go 13+ hours without milk?
She wont drink EBM and she spits out the formula. I don't blame her as the formula tastes nasty!

We co-sleep and the baby feeds throughout the night. Is it possible to just encourage more night feeding and for her to go all day without eating for two days on and two days off and still be getting the right nutrients and benefits of breast milk?
We can technically go half way through Mama's shift to feed. But it isn't very practical in terms of time and money to do that all the time.

I will keep trying to get her to drink the formula and/or EBM. Im just not holding my breath as we tried with EBM everyday for a coule of weeks then took a break and tried again for a couple of weeks with no success. We have a very determined and strong willed baby girl. She is also pretty sensitive and so I dont want to push her too too hard.

[Llyra]

Will she drink water? You don't want her to get dehydrated, or constipated from not getting enough fluids. I would be okay I think at that age with no milk during the time you are talking about, as long as baby is taking water.

It's also possible that when the time actually arrives, she'll get thirsty enough to accept the milk. My DS refused the bottle, all the way up until I actually started working again, and then refused the bottle energetically that first day I was away, but within a day or two more he'd figured out that holding out on DH didn't make me appear any faster, and he relented. He still only took small amounts, but it was enough to keep him hydrated, and growing at a healthy rate. Sometimes babies will refuse when they realize mama is still nearby, or that you're not totally committed, or until they get REALLY thirsty, and it takes getting mama out of the house for a long period of time before they're willing to give the bottle or sippy a go.

Other things you might try: offering the BM in a little plastic open-topped cup, or even a little medicine cup, for baby to sip, or offering it in a medicine dropper. All of mine were able to sip from a little open cup at that age, with a lot of help and patience. You could also try freezing it until it's slushy, and offering it on a spoon, or thickening it with some kind of solid food and again spoonfeeding it. Breast milk yogurt is also very easy to make, and yogurt makers can be gotten fairly inexpensively.

I do think that you're possibly going to see a substantial decrease in supply, even with frequent night feeding, unless you're pumping on a regular schedule during the day. Some mamas are able to feed only when they're home, and the supply adjusts itself, but a lot of other mamas find out they have so much less milk when they ARE with baby that baby loses interest in the breast. If it were me, I would really think about how to make pumping work while you're away, to keep up your supply so you have enough for baby when you are home, just in case you're one of the ones who really need frequent feeds to keep up supply.

[crunchy_mommy]

I would be concerned, I have a 15mo and he's never gone more than 3 hours without nursing, I can't imagine a 9mo going 13+ hours.

Does she take ANYTHING in a bottle or sippy? (water, juice, coconut milk, smoothie, anything?) Have you tried an open cup? My DS will drink water/milk from an open cup (and has done so since 3mo or so) but he's not interested if it's in any other type of cup/bottle.

As far as the pumping issue, if you work in a hospital, do they have an electric pump on one of the floors? Could you use that, & then you'd just need to get your own... tubes & flanges or whatever they're called (sorry, I don't pump, I don't know all the technical terms).

If none of that works, I'd definitely bring the baby in to nurse once or twice during the shift & make sure she is eating a good amount of solid foods in between.

[colsxjack]

She does drink water from a sippy. But she wont drink milk from the sippy. And she will also drink water from a cup, we haven't tried the milk yet.

My DW can pump at work for supply. We are concerned with using that milk to feed the baby because hospitals are just really nasty dirty places and it would be hard to really feel secure about the sterility of the milk. But I may get over the germ factor.
Today was a trial day. My DW is/was a school for 7 hours. So far so good. Although I didn't try her on any formula. Tonight my DW can pump a bit and I will try to see if our DD will drink it out of a little cup tomorrow.

Thanks for all of the replies so far!

[physmom]

sorry, i didn't have time to read everyone else's response but I thought i'd add this. Would she eat foods with EBM in them? Like cereals or purees with it mixed in? Then she'd at least be getting something during the day.

We had a similar problem at that age (DD would take bottles when she was young but started refusing them after awhile). Fortunately, I could work in short 3-4 hour shifts at that time and go home and nurse or have MIL bring her to me. Maybe you could make the half-shift trips with other outs? Like when you need to get groceries or go to the park, etc.

[mamacolleen]

Thanks for the replies and suggestions.

Okay, so it seems a general consensus that my supply will suffer and I will be uncomfortable... kind of what I suspected. Do you think I can get away with pumping twice in that time period on the days that DD does come into nurse once and 3 times on the days that she doesn't? That's probably the max that I could get out of my day. And if I'm pumping solely for keeping up supply and preventing discomfort, how many ounces should I be pumping out? or how long should I be pumping?

I can try to get a hold of an LC at the hospital and see if I can use one of their pumps.... but I think doing it that way, I could likely only pump once a shift... on my lunch break. Because I would have to leave the floor to do it.
Thanks for the suggestion to switch out some of the pump parts... I will do a search for that. Could I just buy them off the Avent website?

I've also started taking fenugreek kind of prophylatically... good idea or dumb?

DD does drink water from a cup (both sippy and open), so I'm not terribly worried about dehydration... more my supply and her nutrition. We haven't tried BM or formula in an open cup. I think DH is going to try that tomorrow. I'm just not sure how to get her to swallow the milk... she consistently just spits it out!!! We can give it to her in all the different cups, etc. in the world but if she won't swallow, what can we do????
We have thought about making BM icecubes for her mesh feeder and about adding it to foods. She won't take purees... but maybe mixing it with yogurt or making a smoothie?

I think that my emotions about returning to work are making this stress even more difficult. I don't want to be going back to work. And to make it worse, I don't like the job I'm going back to... and I've been placed on a team of nurses who I don't particularly get along with and who don't function that well as a team. I know pumping at work is my right but I don't know how my co-workers will perceive it and, like it or not, I depend on their assistance to get my job done and my patients looked after. I am so stressed!!!!!! Not wanting to be at work and dealing with the stress of a baby who might not be getting the proper nutrition because her mama isn't there is nearly unbearable right now.

[Baby_Cakes]

Originally Posted by mamacolleen

Do you think I can get away with pumping twice in that time period on the days that DD does come into nurse once and 3 times on the days that she doesn't? That's probably the max that I could get out of my day. And if I'm pumping solely for keeping up supply and preventing discomfort, how many ounces should I be pumping out? or how long should I be pumping?

I think that's a really good plan. 3 times when she can't nurse and at least 2 times when she can. When I worked an 8 hour day, in the beginning (when my DD was only 4 mo) I pumped 3 times and then by 9 mos I was definitely down to 2.

Since you aren't sure she's going to drink/use the milk you're pumping, it's not as though you have to meet a goal in ounces. I *knew* that I needed 2 bottles with 6 oz each and any less wasn't going to cut it. With you, you want to pump until you have a good let down, collect some, and then -- no pressure. You can stop when the milk stops flowing. "Normal" is anywhere from half an oz to 4 (or more) oz per side per session! It varies so much from woman to woman, and time of day.

Originally Posted by mamacolleen

I think that my emotions about returning to work are making this stress even more difficult. I don't want to be going back to work. And to make it worse, I don't like the job I'm going back to... and I've been placed on a team of nurses who I don't particularly get along with and who don't function that well as a team. I know pumping at work is my right but I don't know how my co-workers will perceive it and, like it or not, I depend on their assistance to get my job done and my patients looked after. I am so stressed!!!!!! Not wanting to be at work and dealing with the stress of a baby who might not be getting the proper nutrition because her mama isn't there is nearly unbearable right now.

It is SO HARD to go back to work. I know how it feels. I'm hoping for your sake that once you get there it is nowhere near as horrible as it seems right now. Chances are it feels so much worse now b/c you're dreading going back.

As for the nutrition - she is still going to be nursing and getting so many benefits from your milk when you're together. You said she's doing well adjusting to solids. Whoever is watching her while you work will figure out their own routine, their own way of doing things. Provide the pumped milk (whatever you can) and let them sort it out. My MIL watches my daughter, and I used to freak out over all the when's and hows, and this-is-how-it-works-for-me's -- but soon they figured it out for themselves. I'm still shocked at how easily and quickly they found their own niche.

It'll be ok. <3