Archive for the 'breastfeeding' category

Repost: pumping milk at work - a technical report

This week is World Breastfeeding week and this year's theme is combining breastfeeding and work, so I decided to repost this post from May 2012. But before I do that, I want to draw your attention to this Kickstarter that has only 7 days left to raise money for a new type of breast pump that uses compression instead of suction, and can be used very discreetly, which might be nice if you're traveling or have no access to a proper lactation room.

Disclaimer: I have no ties to Kohana, Inc and have never tried their breast pump, but I think this innovation is really cool and I hope they raise enough money to continue the development.

 

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 reflexes during 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.

Another 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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The thing that made going back to work after maternity leave a bit easier

I recently came across Laura Vanderkam's post about dealing with going back to work after your maternity leave.  It made me think about the one thing that I did when going back to work after BlueEyes was born and that was for my husband to take a week off to take care of BlueEyes the first week I went back to work (BlueEyes was 3 months when I went back). This was a great thing for us for a couple of reasons:

1. By being home for a week with BlueEyes my husband realized what it takes to be home with a baby and why some days when I was on maternity leave I would be ecstatic to have contact with another grown-up after being home with a baby all day. He realized how exhausting it was, how for some reason you get nothing done all day and by 5 PM you find yourself on the couch with a crying baby, still dressed in pajamas that may or may not have been puked on. After this, he would never ask:"what have you done all day?" on days that I was home.

2. For me, it was nice to go back to work and not have to worry about how BlueEyes was doing in daycare that first week. Instead, I only had to worry about pumping milk, being incredibly sleep deprived, not fitting in my old clothes yet, trying to remember what I was sciencing about before going on leave and adjusting to being this entirely different person who was mostly very alert whether somebody was crying or hungry.

3. I don't know if for BlueEyes it mattered whether he was home with my husband or at daycare. I like to think it was a nice transition for him, to have to drink from a bottle but still be in the house that he knew before going to daycare, but with such a little baby, it's hard to know.

I think my ideal situation would be to have some hybrid work-baby situation with a small baby: be able to bring them to work or be able to work a bit from home (which I did much more with Little Brother), or be able to have both parents work half days, but of course each baby (and parent) is different. What would your ideal transition back to work look like?

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Repost: To a conference in baby-attachmode

Yesterday, Potnia Theron wrote about why it is so important to go to meetings to hear new ideas and stay creative. In response, Christina Pikas wrote how incredibly difficult and expensive this is when you have children. I couldn't agree more after not having gone to meetings (other than our local neuroscience meeting) in the past two years because of being pregnant and having small children. There's only so many options: take your kid(s) to a meeting means either bringing enough support so that you can still go to social events in the evenings (which is expensive), or not going to social events which takes away most of the usefulness of going to a meeting, or being able to leave your kid(s) at home, which has its own challenges (ask my husband about not sleeping for a couple nights the first time I left without 15 month old BlueEyes to go ta a conference...). That's why I thought it would be fitting to repost my second blog post ever, about going to a conference with a small baby:

 

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.

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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Reverse cycling

No this post is not about anything related to bicycles (although I did sign up for my first spinning class in ages today). Rather, it's about Little Brother's breastfeeding habits. He's now 10 months and he used to drink 3 big 5 ounce bottles at daycare (5 ounce is 150 ml for everyone in the world using the metric system). Then he turned 9 months and all of a sudden he is only drinking about 1,5 ounce during an entire day at daycare. I already knew that this is called reverse cycling: he catches up on milk at night.

But where with BlueEyes around this age I was exhausted, now I'm actually pretty well rested. I think I finally mastered the art of co-sleeping. Little Brother is in a cosleeper next to me and most nights I wake up and find that he is already right next to me. So apparently I woke up just enough to pull him towards me and have him nurse and then immediately fall back asleep. It's awesome to not feel as tired as I was with BlueEyes and it makes me wish healthcare providers wouldn't scare the shit out of people with the movies they make you watch* about dead babies from SIDS. Rather, I wish they would tell people how to co-sleep safely.

*At least I had to watch this movie about SIDS and co-sleeping in the hospital hours after giving birth...

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Losing the 'baby weight' US vs EU

This morning I read this article posted by @wandsci describing a woman's struggle journey to become and stay a size 0. I had never really thought about this much, but apparently in the eyes of some men "taking good care of yourself" as a woman means being skinny to the point where it's no fun anymore (unless you really enjoy running 8 miles every morning and exclusively eating iceberg lettuce for dinner. I wouldn't enjoy this much). Also: yikes. I have never been a size 0 but I also have never really struggled to be the size 4-6 that I am. I do however, have some observations to share regarding how easy it was to lose the ~10 extra pounds (5 kilos) that I had gained during both of my pregnancies.

While living in the US when BlueEyes was born, it took me about a year of normal eating and breastfeeding to lose those 10 pounds and fit back into my old jeans. While living in Europe for the past two months (Little Brother is almost 6 months now), I am already almost at my pre-pregnant weight AND I fit in all my old clothes. I could have written a funny blog post about how a stressful transatlantic move is an excellent, but very expensive, weight loss strategy, but instead I think there are three important differences between the US and EU in terms of how difficult it is to lose weight.

1. Added sugar. The first morning back in Europe when I drank orange juice from the supermarket, I could almost not keep a normal expression on my face:"oh my god this was so sour!". This made me realize how much added sugar the supermarket orange juice in the US must have. Same goes for most bread and a whole range of other products. Nearly everything you buy in the US tastes a lot sweeter than in Europe (yeah unless you buy organic super foods at Whole foods, but as a post-doc that means your entire paycheck turns into food).

2. Food availability. On the campus where I work now, there is 1 little supermarket, 1 restaurant (that is too expensive to eat lunch at on a daily basis) and a bunch of cafeteria's that have mostly soup and sandwiches but nothing fancy. The building that I'm in now, does not even have a vending machine! I bring my own lunch every day, because it is just too far to walk to anywhere I can buy food. Also: no free cookies/pizza/lunch or anything with meetings (I would be lying if I said I don't miss that..). But my point is: it is much harder here to find food, and there's much less of a culture of buying food for lunch.

3. Exercise. In the US, I would drive to work, park my car and have a 5 minute walk to daycare and the lab. I could bike to work, but I deemed it too dangerous to bike with BlueEyes, so only one of us could bike at a time. Here, we COULD drive to work, but we would have to park much further away from the lab. Also, because of traffic in the afternoon it literally takes an hour to get home, while it's a 20 minute bike ride. So we bike to work everyday, with BlueEyes and Little Brother in the cargo bike. But also in general, you usually have to walk just a bit further to get to a parking space from a store or to go to the downtown area of most cities. It's a lot easier to get 'free' exercise.

I'm not saying one is better than the other: I love the infrastructure in most US cities that allows you to park right where you need to be, instead of some European cities where taking your car to go pick something up from a store means trying to find very expensive parking for hours (and I realize this is very different between US cities too!). But it does make me realize how a bunch of seemingly small changes make such a big difference (at least for me) in how easy it is to lose weight without having to resort to long daily runs and eating iceberg lettuce for dinner.

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It's been a while since I wrote about sleep

It's 1 am and I wake up because Little Brother is stirring and wants to nurse. Since he sleeps in the co-sleeper right next to me, I can just pull him towards me and breastfeed while I'm still half asleep. Normally I would fall back asleep but now BlueEyes wakes up too: "Mama miiiiillk!!". So I turn over, because he sleeps  in between me and Dr. BrownEyes and nurse him too. More for show than for real because he only takes two sips and then tries to sleep. But he stays awake and can't seem to manage to fall back asleep for the next hour and a half.

That whole hour and a half I lay awake wondering if this attachment parenting is screwing up my career or at least my ability to make smart remarks during lab meetings or while meeting new people. I wonder if I would have gotten more sleep had we trained our kids to sleep in their own room. Or if I would get more work done at night if it wouldn't be necessary to stay with BlueEyes until he sleeps in the evening which sometimes takes more than an hour. Or if I wouldn't need to pump milk at work twice a day.

These are the things that seem important at night. But then in the morning I realize that I'm really not that tired (perhaps because of this?) and that there's really no way of testing this hypothesis because there is only one me and only one time that I get to parent small children. And then I'm glad that I only read a two 'parenting' books, the most important one being "Our babies, ourselves" (If you're the parent of small kids: go read it!!).

And to conclude this post I will quote the second sentence my new (German) department head said when I first met hir:"Good, back to work then!".

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