Category Archives: pumping milk

So is breast truly NOT best on the long-term?

Yesterday, a new study came out on the long-term effects of breastfeeding. The major limitation of this kind of research is that sociodemographic factors are so intertwined with breastfeeding behavior and long-term outcomes that it is nearly impossible to correct for this statistically. So Cynthia Colen did something smart: she looked at families in which one sibling was breastfed while the other wasn’t and in this way was able to circumvent all the unknown confounding factors. Her results have been highlighted on many news websites because they show that there are virtually no long-term benefits of breastfeeding. The most important findings are explained here by The Skeptical OB.

However, when I read the paper I couldn’t find one important piece of information: how long did these mothers breastfeed for? In this news article it says an average of six months, but those data (and the standard deviation) are nowhere to be found in the paper (or is it me and did someone else find them?!). The authors of the paper do report that there is no correlation between the long-term outcomes and the duration of breastfeeding, but since an average of six months is a lot less than the AAP recommended year, I still wonder if we can draw these conclusions from this study. Another piece of information that I missed is if in the discordant sibling sample, the first sibling was more likely to be breastfed than the second or the other way around. I want to know these things so I can judge this paper better!

An important factor that I’m missing in the current news reporting on this paper is that breastfeeding does seem to have short-term benefits for children and both short- and long-term benefits for mothers (well of course journalists aren’t known for their nuance, but still).

So don’t get me wrong: I think it is super important to have real and reliable data in order to create recommendations for breastfeeding and whether or not we should encourage women to do so. I recognize that starting to breastfeed can be a huge struggle and it is important to have the right information. But I feel that the societal debate that is happening following the publication of this article misses these points A LOT.

 

Reference:

Is Breast Truly Best? Estimating the Effects of Breastfeeding on Long-term Child Health and Wellbeing in the United States Using Sibling Comparisons. Cynthia G Colen, David M Ramey. 2014 Social Science & Medicine, available online Jan 29 2014

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Filed under attachment parenting, baby, breastfeeding, maternity leave, parenting, pumping milk

When do you stop pumping milk at work?


A while back I wrote about pumping milk at work and the other day I got an email from a reader asking me the following:

Hi Babyattachmode,
I came across your blog while looking for some guides to breastfeeding and pumping at work. I am about to go back to work as a postdoc, and I’m wondering whether it is possible to not pump at work at all and will my milk supply go down if I skip my work pump. Any advice is appreciated!
Best [anonymous]

Even though I’m not a lactation consultant, I do have some experience and heard a lot of advice and experiences from women around me, so I told her this:

It really depends on the age of your baby and on your supply. For most women, their milk supply starts to be stable between 9 months and a year. So if you baby is older than 9 months, I think you should be okay not pumping at work and just nursing him at home. However, if your baby is younger than that, I think not pumping will affect your supply and it’s up to you how much you don’t want that. If you’re okay with your supply dropping and slowly moving over to formula, then you can do it and any breastmilk he gets from you is something of course! However, if you plan to nurse longer and your baby is younger than 9 months, I wouldn’t advice not pumping at work.
Another thing to consider is your own comfort. When I stopped pumping when my son was 1 year, I still got pretty engorged at the end of a workday and had my handpump in my office to relieve the pressure on days when it got too bad. I’m sure my breasts could not have handled an 8+ hour workday without pumping in the first year, but I know this is different for different women too.
A last thing to add is that for me, pumping was not that much work. It’s another thing to add to your routine, but I was usually done within 15 minutes per session, and I pumped twice a day. I had an extra set of tubing and breastshields so that I didn’t have to wash those in between pumping sessions for example.

To which she replied that her baby was 9 months and that she had pumped twice daily since she went back to work when her baby was 2 months.
So I told her:

When your baby is already nine months, you’re likely going to be okay not pumping and continuing to nurse. I dropped one pumping session at 9 months and the other at 12, but you might be okay just not pumping during the day. Just see how it goes and if your supply drops dramatically you can always decide to continue pumping for a couple more weeks/months and then try again. For a while I pumped during breakfast to have an extra bottle and leave home with empty breasts for the day (especially when BlueEyes decided not to nurse a lot in the morning).

I thought I’d post this conversation on my blog too, as it might be helpful to others too!

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Filed under breastfeeding, parenting, pumping milk, working mom

On breastfeeding while pregnant.


Before BlueEyes was born I knew I wanted to give breastfeeding a try, but I didn’t have any particular goals in mind. I first wanted to see how things went and if I could even do it. Shortly after he was born he started nursing and it went surprisingly well. I was very lucky and never really had any problems. No clogged ducts, no mastitis, no nipples that were hurting. It was all smooth sailing. 
Before I had BlueEyes, I thought nursing a toddler, let alone a bigger kid, was a bit weird. I guess it doesn’t help that you rarely see people do it. But your own child becomes a toddler very gradually. So slow that you almost don’t realize that he’s not a little baby anymore. So there is no one day when all of a sudden he is a toddler and you ‘have to’ stop nursing. I’m still breastfeeding BlueEyes, because I really don’t see a good reason not to. What I didn’t realize before is that after about a year you can stop pumping at work, because your breasts slowly turn from milk storage units to milk making units (i.e. you make the most milk during a feeding instead of throughout the day). BlueEyes nurses shortly when we come home from daycare, he nurses (a lot) before he goes to bed, and then when he wakes up at night he nurses to fall back to sleep easily. And he nurses when he’s really upset and angry and when that is really the only way to get him to calm down.

And now I’m pregnant and again, before I had BlueEyes I didn’t even realize that that was a thing: breastfeeding while you’re pregnant. Well, it is. And now you know it too ;-).

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Pumping milk at work – a technical report

Introduction
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.
Results
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).
Troubleshooting
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 reflexesduring 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.
Conclusion
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.

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Filed under attachment parenting, baby, life in the lab, pumping milk, working mom

What I love about pumping milk

Expressing breast milk; it’s probably the least sexy thing I do on a daily basis, but I do it, just like I brush my teeth and do the dishes at night. It used to be in the category of things that just need to happen. And there are only few things as awkward as undressing halfway in an office at work, and walking around the university with your own bodily fluids in a jar on a daily basis. But now that BlueEyes is almost 9 months, and I think I can go from pumping twice to pumping once during my work day, I have come to realize how much I like it. 
It gives me the perfect excuse to sit in a quiet room for 15 minutes and relax. I don’t bring papers to read because when I relax I’ll pump milk much faster.  It gives me the opportunity to gather my thoughts, plan my experiments, think about my day, or just sit and fall asleep (okay that only almost happened once). And the release of endorphinswhen I’m pumping makes me feel even more peaceful.
Of course when I don’t need to pump milk anymore I could try and have those two small breaks in my day when I can sit and relax, but I just know that when I don’t need to do, I probably won’t do it. Normally I’m running around all day doing experiments and what not and the need to pump milk just makes me sit down, which I would otherwise probably not do.
It’s funny how I’ve come to love something that I used to dislike so much.

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To a conference in baby-attach mode

Last year’s society for Neuroscience meeting was right when I went back to work after my maternity leave. And since I had patched a whole bunch of cells while very pregnant, I even had something to present there. The meeting was right around the corner from where I live, which is why I decided that even though BlueEyes was only 4 months old, the whole family was going to the meeting (and in this case, with meeting I mean the actual science-part, and not so much the social and drinking part). So on Saturday and Sunday I put BlueEyes in a baby wrap (Girasol Chococabana for those of you interested), and walked around the conference.

Something like this, plus a couple thousand posters in the background

SfN turned out to be very baby-friendly, since they even had a specific room for infant care, where you could nurse and change your baby. The only disadvantage was that this was kind of far away from the poster hall, so after I had checked out a poster or two I had to walk back there to nurse a hungry baby or change a diaper. Oh well, most people walk around the poster hall to meet people they know instead of actually look at the posters anyway, right? A major unexpected disadvantage was that when you show up at someone’s poster with a baby attached to you, they automatically assume that you’ve come to show your cute baby instead of ask a serious science question. So not much science talk for me that weekend…

 
On Monday BlueEyes went to his usual daycare, and I traded the baby-in-wrap for my breast pump. This was potentially even bulkier and certainly more annoying to drag around all day. The same sort of thing as before happened where I would check out a bunch of posters (at least now I got to ask science-questions and have people answer them), and then have to walk back to the infant care room to pump milk. And after I presented my own poster I realized that whoever thought of four hour poster sessions had probably never lactated him- or herself….
A last thing to note is that the night after we took BlueEyes to SfN, he had his longest night sleep so far (a 6 hour stretch of sleep!). And mind you, this was in November… So I guess nothing puts our baby to sleep like a couple 1000 neuroscience posters!

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Filed under baby, babywearing, neuroscience, pumping milk, SfN, sleep