Here in the United States, an overwhelming majority of women return to the workforce within 6 months of giving birth. Some return much sooner, many of them within weeks of giving birth. Planning for this return can be overwhelming. In addition to the emotions you may feel over leaving your infant, if you are breastfeeding, the added logistical considerations can be challenging. You may be asking yourself questions like: When do I start pumping? How much milk do I need to have stored? What are my pumping rights at work? This post will help you with the basics of back to work planning.
The Early Days
If you are fortunate enough to have a parental leave that is several months long, it is recommended to spend the first three to four weeks focusing on breastfeeding. This is when your body is its most reactive to breastfeeding. What you do during this time period can have an impact on your long-term milk supply. It is important to feed your baby frequently and “on demand” – throw those schedules and “wake windows” out the door. The more frequently you empty your breasts in those early weeks, the more milk you will produce (this assumes you do not have any risk factors for low milk production, including hormonal or anatomical challenges). Aim to empty your breasts at least eight to 12 times per day. A guiding principle to this is: empty breasts make milk more quickly; full breasts make milk more slowly. If breastfeeding is going well and your infant is gaining weight appropriately, there is no need to pump just yet. If you are exclusively pumping, pumping for at least 120 minutes per day (that equates to pumping eight times a day for 15 minutes) should be sufficient.
Starting to Plan
After the first three to four weeks, it is appropriate to begin pumping and introducing a bottle. It is recommended to have a partner or caregiver introduce a bottle to your infant. If you are exclusively breastfeeding, you will need to pump (maybe multiple times) to provide milk (two to four ounces) for the bottle. Once you introduce a bottle, it is best to keep a bottle in the rotation several times a week while on leave to avoid any issues with bottle refusal. A paced bottle feeding approach is preferred. You can find more information on paced bottle feeding HERE (great for caregivers!).
Many moms feel better if they have a small supply of breastmilk in the freezer prior to returning to work. Depending on the length of your parental leave, it is best to start building a freezer supply one – two months prior to returning to work. For moms with a shorter leave, even two to three weeks prior can be helpful. To build a supply, you can add in a daily or semi-weekly pumping session after a feeding. Milk supply is highest in the morning, so pumping immediately after (or within one hour of) the first morning feed may yield the highest volume. If you are waiting to pump after a feed, try to allow at least 60 to 90 minutes before the next feed so your breasts have time to refill. Some women pump once per day while others may choose to pump twice a day. How long will this milk last? Refer to the Centers for Disease Control (CDC) Proper Storage and Preparation of Breastmilk.
How much should you have stored? The most common guidelines are three to five days of breastmilk. You can calculate the amount by determining the number of bottles your infant will receive while you are at work (assume a three to four ounce bottle every two to three hours). As an example:
Five days of storage in the scenario above would be 45-90 ounces of milk stored prior to returning to work.
While it is helpful to have a freezer supply prior to returning to work, please remember it is most important to feed the baby, NOT the freezer! Parents can easily get fixated on having a certain amount of milk in the freezer – and social media posts of moms with entire chest freezers full of milk can create unrealistic expectations of a typical milk supply. It is most important that your infant receives an adequate supply of milk before stocking the freezer.
Important Conversations
It can be helpful to have proactive conversations with your employer and your caregiver. With your employer, you will want to discuss your rights as an employee and the logistics of pumping (location, time required, etc). Under the Fair Labor Standards Act (FLSA), most breastfeeding employees have the right to reasonable break time and a place, other than a bathroom, that is shielded from view to express breast milk while at work. Certain employees are ineligible and small employers (e.g., less than 50 employees) are exempt.2
It is recommended to discuss your caregiver’s experience with breastfed babies, knowledge of proper milk storage guidelines, and paced bottle feeding. Many parents become frustrated with the impossible task of keeping up with milk supply when caregivers are either giving bottles that are too large or are giving bottles too frequently. You can also ask your caregiver not to give bottles after a certain time (e.g., “I will be picking up my infant at 6:00 pm every day. Please do not give a bottle after 4:00 pm.”). These conversations can be helpful in preserving both your breastfeeding experience with your infant and your milk supply.
Pumping While at Work
Your first day back has come. Now what? Your routine will vary depending on many factors, two of the most impactful being your overall milk supply (e.g., low milk supply vs. over supply) and your milk storage capacity (how much milk your breasts can hold). Moms with low supply or low storage capacity may need to pump more frequently, moms with high milk supply or large storage capacity may be able to pump less frequently.
Assuming average milk supply and storage capacity, most moms will need to pump every three hours for 15 to 20 minutes while away from their infant. Try to maintain a schedule, but do not panic if you have a busy day and cannot keep up. Just try to pump more frequently the next day and/or breastfeed your infant more when you get home to boost supply. Refer to the milk storage guidelines discussed previously for what to do with the milk after pumping.
It can be helpful to track your output using a paper log or an app so that you can monitor and adjust your pumping routine as needed after the first week or two. You may find that you need to pump more often than every three hours to keep up with your milk supply. Many moms find it helpful to look at a picture or video of their infant or to bring a piece of their clothing to smell when pumping. In subsequent MilkMake posts, we will discuss trouble shooting low supply after returning to work.
Returning to work can be an overwhelming time. Having a plan and proactive discussions should help make for a smoother transition. Best of luck!
Sources:
- Laughlin, Lynda. “Maternity Leave and Employment Patterns of First-Time Mothers: 1961–2008.” United States Census Bureau, 1 Oct. 2011, efaidnbmnnnibpcajpcglclefindmkaj/https://www2.census.gov/library/publications/2011/demo/p70-128.pdf. Accessed 13 Jul. 2023.
- “FLSA Protections to Pump at Work.” United States Department of Labor, 29 Dec. 2022, www.dol.gov/agencies/whd/pump-at-work. Accessed 13 Jul. 2023.
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