Going back to work, expressing of breast milk
Women plan ahead, especially going back to work. Planning for going back to work starts already while you are pregnant. All mothers stress about going back to work, but with planning ahead you relieve a lot of the stress. You will think about a nanny or daycare, paced feeding, pumping and freezing of breast milk. Breastfeeding while back at work is possible.
Talk to your employer during your pregnancy. Confirm how long your maternity leave is and what your salary package is from the company during maternity leave. Ask your employer if there is a possibility for part-time work for the first few weeks. Find out about a clean, comfortable and private place to express breastmilk. Ask for two or three flexible pump breaks during your work day. South Africa’s Basic Conditions of Employment Act recommends two pump breaks of twenty minutes per day while the baby is under six months. Do not worry if it is not possible to pump at work, breastfeeding will still be possible when you are at home.
Before going back to work:
Advance planning can help smooth this transition back to work. Decide on your breastfeeding goals and your choices include the following:
Maintaining full milk production and supply
Supply as much as possible mother’s milk as needed and if needed supply formula to supplement with
The number of hours you will be away from your baby and how many feeds you need to send to the caregiver
Find a caregiver who is pro-breastfeeding
Build your supply of expressed breast milk
Make arrangements at work
Plan your daily routine as if milk production matters
Know how much milk your baby needs
Learn how to encourage milk flow when pumping
Things to look at when buying a breast pump:
Remember all pumps are not equal. Do your research about pumps and buy a pump best for your budget.
Cycling rate:
We need a cycle rate between 40 and 60 times a minute as this is the closest to baby’s sucking. A cycle less than 30 is too slow.
Suction strength:
A pressure of 220 to 230 mmHg is suggested. A pressure above 250 mmHg will hurt your nipples.
Open versus closed system:
Closed system pumps have a mechanism to prevent moisture from getting into the tubing and machine.
Warranty:
Is always a consideration when buying a pump
Flanges of the pump:
Check if there is only a standard size available or if there different sizes available so that you can have one that is suitable for your breast. It is advisable to measure the diameter of your nipple at the nipple’s base
Adapter:
Can they work with batteries and electricity? This is important to keep load-shedding possibilities in mind.
Car chargers:
A car charger can come in handy when you travel an amount of time to and back from work.
Noise:
Think about pumping in the office.
The following might have an effect on your pumping:
The baby’s age and weight determine how much you will need per feed.
Is your baby exclusively breastfed: you will need more breast milk per day compared to the baby who regularly receives top-ups with formula milk.
Time since milk removal: you will express half a feed if you pump in between regular feedings. If you missed a feeding you should expect to pump more or less 90 ml
The time of the day: milk production varies during the time of the day. Our baby will feed more often when the supply is slow. The suggested time to pump is early morning, your production is more early morning. Remember to pump when it suits you.
Your emotional state: stress, anger and upset mother will influence your pump volume of milk. Do some relaxation exercises and calm down before you start pumping.
Breast storage capacity: this capacity indicates the volume of milk in your breast during the fullest time of the day. This is based on the amount of space in your milk-making glands.
Pump quality and pump suction settings: not all pumps are equal. The highest setting which you can use is the one whereby you still experience comfort. After the milk flows, settings can be adjusted to a higher setting as long as there is no discomfort.
Hands-free or not: studies showed that more milk is pumped out when hands are used while pumping. You will do breast compressions while pumping thus hands compress and the pump sucks.
The number of milk releases: effective milk expression depends on muscle action known as the reflexes of let down or milk ejection. The number of letdowns/milk ejections affects the volume of milk expressed.
When pumping:
When you pump let your senses of feelings, seeing, hearing, touching, smelling and tasting help you.
Most pumps start with a stimulation setting which mimics the baby’s sucking and changes the suction rate when the milk starts to flow
Make sure that your nipple is in the middle of the funnel
The pump must form a good seal with the breast
If the flow stops at one breast change to the other breast and change back again
Pump another two minutes after the flow stopped to stimulate the production more.
Storage containers:
Any container is suitable but stainless steel is an exception. The reason is that fewer live cells in the milk survive. Avoid storing milk in containers which are not BPA free. Milk freezer bags are available. Make sure that your container won’t leak, we don’t want your “liquid gold” to spill.
Safe handling your breast milk:
Expressing your milk:
Wash your hands prior to expressing or handling your milk
Any container which is BPA-free is suitable, as mentioned above
Mark the container with the date and advisable before filling the container
Storing your milk:
Refrigerate or chill your milk right after expressing if it won’t be used in the next few hours
If milk separates, swirl (don’t shake) to redistribute cream before feeding
Combine several pumpings in one container by adding cold to cold. Freshly expressed milk needs to cool down before adding to already expressed milk
Milk does expand as it freezes so leave space at the top if you plan to freeze
To minimize waste fill containers only with 60 ml
Store milk in the back of the freezer away from the sides, where the temperature is most steady
Use the oldest frozen milk first to keep it from too getting too old
Thawing your milk:
Thaw frozen milk in the refrigerator or in a bowl of warm water
Don’t heat the milk directly on the stove or in the microwave
Some babies are satisfied to drink cold milk
Thawed can be refrigerated for up to twenty-four hours, then use or discard
Storage of express milk:
The guidelines for storing express milk change as new research emerges. The following will give you an indication.
Room temperature above 22 degrees Celsius for 4 hours, below 22 degrees Celsius for 6 - 10 hours
Cooler box: 24 hours
Refrigerator: 6-8 days
Deep freezer: 6 months
Chest freezer: 6- 12 months
Frozen milk thawed in the fridge:
Do not freeze
Refrigerator 24 hours
4 hours at room temperature
Thawed warm milk not fed:
Do not refreeze
4 hours in the refrigerator
Room temperature till feeds ends
Warmed milk fed:
Do not refreeze
Do not store it in the refrigerator
Only keep it till the end of the feed
For more information on breastfeeding preparation classes or a breastfeeding consultation contact Sr Elna 072 124 7455.
REFERENCES:
Breastfeeding and Human Lactation; Jan Riordan and Karen Wambach;
Breastfeeding Made Simple; Nancy Mohrbacher and Kathleen Kendall-Tackett
Born to breastfeed, born to be breastfed; Hettie Grove
Borsvoed jou baba; Marie-Louise Steyn
The womanly art of breastfeeding; Diane Wiessinger, Diana West, Teresa Pitman