Expressing Breastmilk for 1 yr Old

[w1ldl1femama]

Most posts I have read about pumping at work are related to moms who are pumping for their younger babies. My question is related to pumping at work for a 1 yr old.  I have returned to work 4 days per week (M-Th) and want to continue my breastfeeding relationship with my now 1 yr old daughter.  I breastfeed often when we are at home together (i.e., every 2-3 hrs) and my daughter does not eat a lot of solids; she really seems to prefer the breast. On work days I breastfeed her 4 times per day (i.e., morning, late afternoon, night, middle of the night) and pump at work 2 times; I have to presume she is getting adequate calories from solids at day care.  I aim to pump 8 ounces so I can leave this amount in a sippy cup for my daughter at day care the following day.  My problem is that I can not pump enough milk and I need some advice from other moms who may be in the same situation and found something that works. I try to relax and look at photos of my daughter while pumping.  I also try using the massage, stroke and shake method but it doesn't seem to work for me.  I use a Medela Swing Pump so I realize that it is less efficient b/c I have to pump each breast seperately.  I try to pump long enough for 2 let downs on each breast, which sometimes equates to 30 minutes on each breast.  I need to be more efficient as I can't afford to take 2 hrs out of my work day to pump.  When I try to pump hands free so I can work at the same time, I find that it throws off my relaxation and output.  Is it realistic to try to pump 8 ounces from 2 pumping sessions each day with my current pump?  Should I try pumping more frequently but less time for each session?  I have also added a 3rd pumping session in the evenings after my daughter goes to bed and on weekends to try to get more milk but I am finding that I don't enjoy pumping and it becomes more of a stressful thing b/c I produce so little.  Are there other working mamas in the same situation?

[pedal_princess]

hi. kudos for you working & pumping mama!

i was in a similar situation. i work FT and my baby turned 1 today. we EBF and he does solids 3x/day. i was pumping for 20 minutes 3x/day at work just to pump enough, but now i'm going to cut down to 2x/day because i'm starting to wean him off BM during the day and only nurse in the early morning, evening and during  the night.

in order to pump enough, i tried these tactics:

1. i took domperidone. at first it didn't work alone, so i had to increase the dosage to 2 pills 4x/day (the max you are supposed to take). it's pricey but it finally worked. i found it worked best when i also took 5-6 caps of fenugreek and 3 caps of blessed thistle 1-2x/ day. sounds like a lot of pills but when your sweat or urine starts smelling like maple syrup, you know it's working. seriously.

2. i was having problems with supply at 6 months, so i added 2 extra pump times a day. and yes, it was a bitch. then i went down to only 1 extra pump time per day after doing that for about 3 months.

3. reduce your stress as much as possible. whenever i was rushed or stressed i totally couldn't pump. as hard as it is, try to relax and think about your baby at least right when you start pumping or do something you truly enjoy that is not stressful while pumping like reading something positive or about kids/babies. i try to return emails at work when i pump. when i try to write a presentation or work on a major deliverable, i just don't pump as much.

4.try mother's love supplement. i recently stopped the domperidone and started taking mother's milk plus along with fenugreek (6 caps) and blessed thistle (3 caps) 2x/day and it is working better than the domperidone was.

can/will your daughter take cow's milk? now that she's one, you could try supplementing what you can't pump with cow's milk. my son is allergic to milk, so we're doing coconut milk and oat milk. my pedi said at this age, just nursing at night is fine and that they'll do fine on solids and regular milk (or in my case, oat & coconut milk). it might help your stress level knowing that you have a healthy back up. i know for me, i wanted to avoid formula at all costs, but feel that the milk alternatives are nearly as healthy as BM at this for him.

good luck!

[CheriK]

I was working part-time and kept pumping until my children were about 2.  I've never been a good pumper (I was happy to get 3 oz when double pumping w/ a PIS and breastfeeding twins exclusively, and could never elicit more than one letdown per pumping session) and always struggled to leave enough milk for them.  I would pump twice at work (I was only gone 4 hours), once in the middle of my shift and once immediately before I came home.  I wasn't worried about having milk for my children when I got home since I knew I wasn't letting down well w/ the pump; clearly there was a lot more there!  I also added a pumping session every morning when they napped, even though I only got an ounce or so that made up the extra we needed.

I do have to say that by the time they were 1, I was less concerned about having "enough" pumped milk.  They would get what I had and would also get solids.  The recommendation for cow's milk, if you weren't nursing, is 16 ounces a day.  The recommendations I've read for nursing toddlers is that, as long as they nurse at least 4x a day, they're getting the nutrients they would otherwise get from cow's milk.  Your DD is already getting that from you, not even considering that she likely nurses more on the days you don't work.  And if you calculate from that 16 oz recommendation, you're aiming to pump 1/2 of her daily requirement of milk in 2 pumping sessions.  That doesn't seem realistic or even necessary to me, especially since she's probably getting plenty of milk directly from you. 

I would consider pumping twice at work, but limiting the length of the sessions so they don't become stressful, and just give her whatever you're able to pump.  You might try massage or hand expression to trigger a letdown (might be faster than the pump).  If it's fairly quick to trigger the 1st letdown, you might simply pump for that, then take a break and pump again in an hour.  It might be faster than trying to trigger 2 letdowns each session.  Since it's so frustrating for you, you might consider whether or not it's worth the pumping sessions at home.  Personally, I hated pumping and would prefer to fit in additional nursing sessions, perhaps by waking earlier in the morning and giving her a "dream feed" before you get ready for work, then nursing again before you leave, and/or by wearing her in a sling or carrier in the evenings so she can snack throughout your time together.

I do have to say that by the time they were 1 1/2 or so, all of mine refused pumped milk entirely.  I kept pumping for my own comfort, but they didn't want the milk any more.  So it simply stopped being an issue.  And my twins nursed for many many years, my current nursling is almost 3 and still going strong, so those hours away didn't affect the length of breastfeeding!

[Anna please]

At around 5 months after my LO was born I got sick and ended up on iv and almost completely lost my milk. Before that I was working full time and was bf ing when I was home with him. I didn't want to quit at 5 moths so I bought a double pump (made a huge dif for me both time wise and apparently if you stimulate both breasts simultaneously you produce more milk making hormones). I also took large amts of fenugreek and blessed thistle. But the main thing I did (and you need a dedicated partner for this) is took him off the breast completely so that I could pump every two hours 24 hours a day for about a week to 10 days. At first he was breast feeding as well when I could fit him in but he lost taste for the nipple preferring the bottle and never went back. But he loves milk and didn't start eating much till well after one year. Now he's approaching 2 years in february and I'm a SAHM and still pumping about 27 to 30 pounces a day for him and he still loves milk. My supply has gone up and down many times in the past two years but the main things I would recommend are get a double pump and try to add some power pumping into your weekends (where you pump 10 minutes on 10 minutes off for as long as you can, at least one our two hours).

PS. Sorry about the 13 posts! I submitted by phone and didn't see that it was posting. And I'm new - haven't figured out yet how to erase replies.
Edited by Anna please - 11/12/11 at 7:45am

[Megan73]

OP, I'd suggest getting a double-electric pump. I used a Medela Pump in Style when I returned to work at one year. It should really cut down on your pumping time. However I personally didn't have a problem with my one-year-old having cow's milk along with solids at daycare. I was mostly pumping so I'd have a decent supply on weekends when we were together. If you really want your LO to only have BM, you could try domperidone and pumping more often with a double electric.

Originally Posted by pedal_princess 

1. i took domperidone. at first it didn't work alone, so i had to increase the dosage to 2 pills 4x/day (the max you are supposed to take). it's pricey but it finally worked. i found it worked best when i also took 5-6 caps of fenugreek and 3 caps of blessed thistle 1-2x/ day. sounds like a lot of pills but when your sweat or urine starts smelling like maple syrup, you know it's working. seriously.

Are these the usual 10 mg pills? The usual starting dose is 90 mg a day and Dr. Jack Newman - who pioneered the use of dom as a galactagogue - says women can take 120 mg or even 160 mg a day if needed.

[remymom]

Hi everyone,

My son is 9 months and will be starting daycare in less than a month. He'll be starting progressively and only 3 days per week at first. I'm a bit concerned about how much milk he'll need. It's SO much work pumping and I find I only have the energy to pump 30 min. a day which gives around 4 ounces. I have a bit of stock in the freezer but maybe only for a few days. I'm afraid I won't be able to keep up with the supply. Any suggestions? My pump is only a single pump and isn't super efficient. Do teas work for me to produce more milk? Should I temporarily rent a better pump? I'm also wondering if I should give the daycare as a back-up either cow's milk or formula in case they don't have enough breast milk. It's so hard to judge how much he takes in a day. I'm guessing over an 8 hour period he'd probably drink around 12 ounces.... I seem to have heard bad things about starting cow's milk before 12 months.

As well, I'm guessing that if I give the milk to the daycare frozen, they can keep it in the fridge for 24 hours and just need to warm it before giving it to him. Am I correct?

[CheriK]

Are you pumping 30 min straight?  You might have better luck pumping for 2-3 shorter sessions, and it might be less stressful.  Also, are you switching back/forth frequently while pumping?  That can help when using a single pump.  You might also try pumping on one side while he nurses on the other, if he'll let you (it might be too much fun to play with the pump and try to figure out what Mom is doing).  His nursing will trigger a letdown, so you'll probably find it easier to pump.  Don't worry about not having enough for him; he'll still be able to get milk from the side you pumped if he wants to nurse on both sides.  You can switch the pump when he switches, too; you won't get much from the 2nd side, but every little bit helps.

Are you going to pump while at work?  You should be able to pump more milk when you're not trying to combine pumping and nursing.  Breast massage before and during pumping should help speed a letdown.  Of course, a double electric pump will be more efficient and likely more effective, but many moms do fine with a single pump.  Is your pump a manual pump or an electric?  I haven't heard good things about electric single pumps; you might actually have more success with a manual pump or even hand expression.

Does your DS still nurse at night?  If he's nursing frequently while you're at home, he will likely do fine with whatever milk you can send.  I know a lot of moms who went back to work w/ older babies who simply told the daycare that he gets what Mom can pump.  Is he eating solids?  If you can move his solids so he's eating most of them at daycare, then he'll be less hungry for your milk & the daycare can use what you pump for naptime bottles (when he's likely to really want milk).  An older baby can go for 3-4 hours without nursing, so if he gets one bottle at daycare, he should be fine, as long as he nurses plenty when you're together.

I would think that 12 oz in 8 hours is actually really high, unless he doesn't nurse at night anymore.  I'd think more like 8 oz.  An exclusively breastfed baby usually needs between 30-40 oz of milk a day.  Once solids are begun, milk consumption decreases.  If he's consuming 1/3 of his daily milk at daycare, then 12 oz would mean he's still consuming as much as an exclusively breastfed baby - unlikely.  If he's not nursing at night, then this might be a realistic amount, but you can reduce the amount he needs at daycare by fitting in more nursing sessions while you're together.  Some things that help - waking up early so you can fit in at least 2 nursing sessions in the morning.  One might be a "dream feed"  - waking him just enough to nurse right after you get up, then putting him back to sleep while you get ready, then nursing again when you drop off at daycare.  Planning on arriving at daycare early enough so you can nurse immediately before leaving means he won't be hungry for 2-3 hours, then planning on nursing at daycare when you pick up, and asking them not to feed him for 1-2 hours before pickup time so he's ready to nurse.  If he goes to sleep before you at night, fitting in another dream feed before you go to sleep.  Considering bedsharing & night nursing/reverse cycling if it wouldn't impact your own rest too much. 

As far as introducing cow's milk, I would avoid it.  Allergy risk is higher with early introduction of cow's milk. 

Teas might help - every woman has a different response to galactogues.  One potential problem w/ teas is that the dose of the herbs is highly variable, depending on the age of the herbs and how long it steeps.  Tinctures or capsules are more consistent dosing.  That being said, some women do just fine w/ teas (I still can't drink Mother's Milk tea without getting uncomfortably full and my currently nursing is almost 3). 

Yes, you can give them frozen milk and it can stay in the fridge for 24 hours, at least.  I would talk to your daycare about breastmilk handling.  Some daycares have "rules" that aren't necessarily helpful to pumping moms about how long they'll keep defrosted milk or whether they'll reoffer a bottle if baby doesn't finish it.  You can read the most recent guidelines for milk storage at: http://www.llli.org/faq/milkstorage.html.  You might want to send any milk that's already frozen as is and ask them to keep it in the freezer until needed, then defrost under warm water so it's not wasted if he doesn't need it.  And the milk you pump one day can just stay in the fridge until the next day you work; if it's only a couple of days, you're probably better off keeping it refrigerated since there will be less loss of live cells.  You'll probably want to send many smaller bottles until you know how much he'll drink and how often he'll need a bottle, so there's less waste. 

Good luck with your return to work!

[remymom]

Hi CheriK,

Thanks SO much for your advice. You've given me the motivation to persist on pumping until 1 year! 

I haven't gotten in to the habit of pumping several times a day yet. We have quite a few activities so are often out and most times when he goes down for a nap I have housework and catching up to do. I have tried alternating breasts and hopefully that's helping. I even pumped yesterday while he fed and that worked better than I would have imagined. I have a single electric pump. It cost $60 so you pay for what you get!

I'm not sure of my work situation yet. However he'll be starting daycare only progressively at 10 months so I don't think I'll have too much of an issue with not having enough milk. It's only 2 months - the holidays. I may need to start pumping more milk soon to get more stock in the freezer. I think if they can keep the milk in the freezer at the daycare we'll be able to avoid too much wastage. He still nurses during the night though we're trying to get him to skip his 1:30 am feed since the last couple of weeks. He wakes up and my husband tries to get him to go back to sleep without nursing. It works most of the time. Usually he nurses before bedtime at 7:30, then I nurse him at 10:30-11 before I go to bed and then he'll usually wake at 4:30 am. After 4:30 am he'll often stay in our bed and I'll feed him whenever he wants. So I think he's still getting a lot of milk in the night. He's eating three meals a day. I'm encouraging him to eat pieces on his own more and more which I feel means he's eating less than when he was eating purees. Maybe the ladies at the daycare will have tricks to helping him in this process.... Or maybe without the breast during the day he'll be more hungry for solids.

I might give the teas a try. I was wondering about milk preservation, does 24 hours mean from the time you take it out of the freezer? Or is 24 hours from the time it is thawed in the fridge?

Thanks again!