Breast Milk Management: Expression and Equipment

Continued, routine breast milk expression is important to maintain adequate milk production during the time spent away from your baby. When you return to work, plan to get up a little earlier than usual to allow time to breastfeed your baby before leaving. Many mothers find they maintain milk production more easily if they breastfeed before showering or getting ready for work and then breastfeed again just before leaving the baby with the care provider.

Choosing a Breast Pump

In most cases, mothers will need to rent or purchase an appropriate breast pump to help empty the breasts and maintain adequate milk production. It is important to use the right kind of pump when frequent milk expression is necessary. Also, not all breast pumps are alike. Hospital-grade, electric breast pumps are the only pumps built for frequent and prolonged milk expression to maintain full milk production. These pumps automatically cycle suction with release of suction—similar to a baby's sucking action.

Although there are many good, mini-electric, battery-operated and hand (manual) breast pumps on the market, none of these pumps were designed for frequent and long-term use. Most of these smaller pumps require a mother to invest more time and effort to obtain an adequate amount of her milk. Many do not cycle suction automatically, which often leads to complaints of breast soreness or tenderness. Frequent replacement of expensive batteries are necessary when battery-operated pumps are used frequently, and this type of pump becomes sluggish and less effective at milk removal as the batteries wear down.

Get a Routine

If possible develop a pumping routine based on when the baby would normally breastfeed, especially when first returning to work. However, you, your baby, and your milk production will adjust to a new routine if you are able to pump often enough.

Most mothers prefer to pump both breasts at once with a double collection kit about every three hours, for 10 to 15 minutes. Double pumping minimizes pumping time, but the frequent sessions are needed to "empty" the breasts for continued milk production and avoid any breast discomfort. Pumping less frequently, even for longer than 15 minutes, does not help maintain milk production as well. If unable to keep a regular pumping schedule at work, expressing small amounts of milk during quick bathroom breaks can help to maintain milk production better than going for longer periods without expressing any milk.

Do not pump just prior to leaving work for home (unless you learn your baby just ate a big meal). Plan to breastfeed your baby when you pick him up at the care provider or as soon as you get home. Ask your care provider not to feed the baby, or to limit the amount a hungry baby is fed, for one to two hours before you arrive. This will ensure that he/she will still want to breastfeed soon after your arrival. It may help to call the care provider when you are ready to leave work so he/she knows when you are on your way.

You may need to arrange your evening schedule so you can spend more time with your baby when you get home. Breast-feeding more frequently in the evenings and on weekends can help you better maintain milk production, plus you and your baby will enjoy the time together after separation.

Remember to Relax and Be Patient

Regardless of the actual time frame, the first few days or weeks after you return to work may be difficult until you and your baby develop a new routine. You can expect a period of adjustment as your body and your baby respond to the change. Some mothers experience a decrease in milk production the first week they return to work due to the stress and changes in schedule. If this does occur, it should quickly resolve and milk production should increase with frequent pumping sessions. Continue to breastfeed your baby as often as possible when not at work.

Should you have any questions, problems, or concerns about preparing to return to work when breast-feeding or at any time during the actual transition, contact your physician or a certified lactation consultant (IBCLC) for information, advice, and assistance.