Work. Pump. Repeat.

The New Mom's Survival Guide to Breastfeeding and Going Back to Work

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• Publisher: Abrams Image
• Year: 2015
• Print ISBN: 9781419718700
• eBook ISBN: 9781613128831

The practical, relatable, and humorous guide to surviving the difficult, awkward, and rewarding job of being a breastfeeding, working mom. Meet the frenemy of every working, breastfeeding mother: the breast pump. Many women are beyond "breast is best" and on to figuring out how to make milk while returning to demanding jobs. Work. Pump. Repeat. is the first book to give women what they need to know beyond the noise of the "Mommy Wars" and judgment on breastfeeding choices. Jessica Shortall shares the nitty-gritty basics of surviving the working world as a breastfeeding mom, offering a road map for negotiating the pumping schedule with colleagues, navigating business travel, and problem-solving when forced to pump in less-than-desirable locales. Drawing on the war stories, hacks, and humor of working moms, and on her own stories from her demanding job and travel in developing countries, she gives women moral support for dealing with the stress and guilt that come with juggling working and breastfeeding. As she tells the reader in her witty, inspiring manifesto, "Your worth as a mother is not measured in ounces." 2015 Axiom Business Book Award Winner (Silver) in the category of Women/Minorities

SECTION 1

GETTING
READY
FOR THE
INSANITY

CHAPTER 1

The Basics of Making Milk

Supply and Demand

In a nutshell: Producing milk is all about supply and demand. You have to demand milk from your body every day for it to keep on making milk. And give or take a bit, you have to demand the amount of milk your baby needs every day in order for your body to keep producing the volume of milk that baby needs.

Rely on at least one of the standard breastfeeding books and any number of breastfeeding websites (see chapter 18 for a list of resources) as a necessary part of your arsenal. These resources can teach you about latching, positioning, clogged ducts, mastitis, and more. This is important stuff. I will not attempt to do the job of those resources, but as we learn about the dance of working and breastfeeding, I do think it’s useful to provide a little bit of the basics on milk-making.

Your baby demands milk from your body by sucking and compressing your breasts, and your body (for most women) responds by producing milk. Not only that, but as your baby begins to demand more milk—by nursing harder, longer, and/or more frequently, sometimes to the point at which you think you just don’t have any more to give the little sucker—your body reads those messages, too, and produces more milk over time.

This increased-supply-and-demand thing doesn’t happen instantaneously; it’s a gradual process. Sometimes you’ll notice that your baby is doing it—like during a two-day growth-spurt where you feel like all you are doing is nursing a vampire—and sometimes you won’t, but it’s still happening behind the scenes. Before you go back to work, if you aren’t pumping much, you might not even know it’s happened at all because you can’t see how much your baby is eating at any given feeding.

Just like increased demand can lead to increased supply, a drop in demand can, over time, reduce your supply of milk. Sometimes the baby does this himself—he goes on a nursing strike, he gets sick, or he is simply taking fewer ounces of milk for each feeding as he begins to eat solid food. In these cases, as he gets interested in eating again, or recovers from his illness, he will start to demand more milk from your body, and your supply is likely to go up again. (Other factors can reduce supply, too, like being stressed, taking certain medications like decongestants or hormonal birth control, or getting sick yourself.)

For the working mother, the other culprit that can harm supply is working itself. There are many ways that work can reduce supply over time. For example, some women’s bodies do not respond as well to pumping as they do to nursing a baby, so you might produce less milk during the workday than your baby is eating at home. Over time, that might lessen your overall supply.

Some women do find success with exclusive pumping (EP), which means providing breastmilk only by pumping, and not by nursing the baby. Some women EP because of persistent latch, tongue-tie, or cleft palate problems, or because they like it better, or because the discipline of pumping actually helps them set goals and maintain supply.

Even if pumping does produce a good amount of milk for you in a given session, the demands of work can affect supply. If you consistently can’t get in as many pumping sessions per workday as your child is having feeding sessions with his caregiver, you might see a gradual decrease in supply.

Making Sense of Supply

All of this sounds like a total nightmare to a new mother planning a return to work. It’s a lot to take in and a lot to try to accomplish on top of keeping a new baby alive, worrying about your nanny or day care or mother-in-law keeping your baby alive, being presentable for work every morning, doing your job extra well to prove to your boss that you haven’t lost it as a result of having a baby, and balancing a new budget that includes hefty kid-related line items. It’s stressful to feel like you have to stay on top of your milk supply, that precious resource you are trying so hard to keep flowing for your baby.

The first thing I want to say about supply stress is that I’m sorry. I have been there, as have millions of other working mothers. And we agree that, like your trusty breast pump, supply stress, well, sucks.

The second thing I will say is that establishing breastfeeding early is the best thing you can do to set yourself up for success. If breastfeeding is important to you, put in the time early on to see dividends later.

Ann, a consultant, noted, “I was successful at breastfeeding and working—nineteen months with the first child and I’m still breastfeeding a seven-month-old—because I was able to strongly establish nursing patterns before going back to work.”

Finally, I want to note that this supply-and-demand thing is pretty resilient. With my first baby, I seemed to think that all that milk that was spraying across the room whenever I took off my bra would just dry up in an instant if I didn’t keep a constant vigil over it. If you are able to establish a decent supply of milk during the first couple of months of the baby’s life, your supply will hang in there with you through some ups and downs.

If you have a couple of days at work that are so back-to-back that you can’t pump more than once, you can bounce back from it. If you go on a business trip and find yourself producing less milk even when you are fitting lots of pumping sessions in, you can bounce back from it. Just like supply gets built up over time, it is lost over time—not overnight.

At some point, you are going to find yourself sitting in a lactation room or a supply closet or your car or an airport bathroom, staring at your two pump bottles with half an ounce of milk in them, when you’re used to producing two, or even five (some overproducers go even higher) ounces per session.

You are going to look at those stupid not-full-enough bottles and think, “This is it. I’ve ruined my supply and I’m not going to be able to do this and I’m a horrible mother . . .” and on and on. Believe me: One bad pumping session, one bad day, one bad business trip, will not ruin your milk supply.

CHAPTER 2

Meet Your Pump

Your Pump: Freedom and Burden

Working motherhood has long involved a trade-off that is painful for many: Breastfeed or go back to work. Today, many working mothers have a third choice: Go back to work and bring your breast pump along with you.

This technology is liberating. We can work (most of us have to for financial reasons; some of us also want to because we love it) and continue to provide breastmilk for our babies.

We also can feel trapped; because the technology exists, many of us feel we have no choice but to use it, no matter how difficult, stressful, and awkward the process might be, and no matter how much profanity we direct at our pumps.

Often both dynamics—liberation and burden—are at work at the same time.

For example, when my son was five months old, I had to go to Nepal on a business trip. Even planning for the minimum possible time on the ground (less than four days), with travel that had me literally circumnavigating the globe, I was going to be gone for a whole seven days.

Getting on a pumping schedule early on by pumping immediately after the morning feeding while I was still on leave meant that by the time this trip came around I had almost 300 ounces (or almost 9 L) of breastmilk in my freezer. (I recognize that this is a lot of milk, and I really stressed myself out stockpiling it. I realize in hindsight that a little formula while I was gone wouldn’t have killed the kid.) In a world without breast pumps, I would have had two choices:

1. Skip the trip.

2. Go on the trip and stop breastfeeding.

But because this device exists, I had only one choice, in my guilty-working-mother mind: Store up 300 ounces of milk in five months. Go on the trip, bring a pump and lots of batteries, and pump and dump six times a day for a week. Do this on airplanes, in the backs of moving Land Rovers, in the crowded domestic terminal of the Kathmandu airport while wrapped in a shawl (please do not attempt this), in bathrooms of all levels of hygienic upkeep, in a parked car in a field while two boys on bicycles watched me through the window, and in the presence of my company’s CEO. Then come home and keep breastfeeding. This duality of freedom and burden was never more obvious to me than during that wild week.

Whether you see your breast pump as your best friend or your worst enemy, if you’re going to pump at work, you need to get to know this machine. Just beware: You may become so close that you start to hear actual words in place of the pump’s sounds. My friend Emily absolutely swears that her pump says “red-hot panini” over and over.

Now, it’s time to choose your frenemy.

What Is a Breast Pump?

Remember: When a baby nurses, she uses both compression (squeezing) and suction to get the milk out. Hand-expressing uses compression. A breast pump uses suction, but you can simulate a little bit of compression by squeezing and massaging your boobs while you are pumping.

A lot of the breastfeeding books that were written years ago and are in their zillionth edition of print will be confusing to a new mother getting ready to go back to work. First of all, most of them speak in a voice that is decidedly directed at stay-at-home moms. Plus, when it comes to expressing milk, they have things like diagrams showing a woman hand-expressing milk into a little cup, which is not really practical at work. When they talk about pumps, they talk about single, manual pumps vs. double, electric pumps, as if these are all equally usable choices for a working mother. Please let me clear all of this up: If you are going back to work, you need a double electric pump.

By all means, get yourself a single hand pump to keep next to your bed for the early weeks when your baby starts to sleep longer at night and you wake up with porn-star boobs, or to bring out on date night to take the pressure off. Keep this single pump in the car or at your desk once you’re back at work in case you forget your pump or an essential part of it one day (this will happen).

Learn to hand-express as well, but do not confuse either tool with the milking machine you will need at work. For the average woman, trying to hand-express milk every day at work would be impractical, although I do know of a few women whose bodies don’t respond to the pump and who, amazingly, successfully use hand-expressing while at work. Some women use a hand pump at work, but it does take at least twice as long (because, two boobs, ladies) and it might eventually give you Incredible Hulk muscles in your hands. This isn’t a hard-and-fast rule, but most of us go double electric and never look back. Some women even splurge on two pumps—one for home and one for the office—to minimize the schlepping and the inevitability of forgetting the pump and/or some of its parts at home or at work.

Choosing Your Pump

I am pretty conservative when it comes to breast pump choice. I figure bestselling must mean something, so I used the Medela Pump In Style twice. (They’re not paying me to say this.)

There are other reputable brands out there—Lansinoh, Ameda, Avent, and Hygeia, for example—and I think the choice really comes down to asking your friends and your lactation professional and, since the Affordable Care Act requires nearly all health insurance plans to cover breast pumps, seeing what your insurance company provides (more on this health insurance thing in just a bit).

As you are shopping around, pay attention to:

• Cycling rates: A cycling rate between 40 and 60 times a minute is best, as this mimics a baby’s sucking. Anything under 30 is probably too slow. This information can be hard to find on some pump brands. Most of the major brands will fall within this range, but if you’re curious or concerned, give their customer service line a call.

• Suction (vacuum) strength: La Leche League suggests vacuum pressure of 220 to 2...

Table of contents

• Cover
• Title Page
• Copyright Page
• Dedication
• Acknowledgments
• Contents
• Introduction
• SECTION 1 GETTING READY FOR THE INSANITY
• SECTION 2 YOUR BOOBS AT WORK
• SECTION 3 ROAD TRIP!
• SECTION 4 OH SH*T: WHAT TO DO WHEN THINGS GO WRONG