Breastfeeding Mom's Guide to Returning from Maternity Leave

Tonight, I got an email from a friend that's preparing to return to work with her first baby in the next few weeks and she's going to continue breastfeeding. She asked me how to you supply milk and prepare for Day 1 of returning to work from maternity leave. It reminded me that there's lots of logistical details that are often left out of most breastfeeding information about returning to work. Here's a compilation of things I've learned along the way from being a breastfeeding and working mom to my almost 11-month babe. I've admired my mom friends who have managed to breastfeed despite work travel and long hours and have asked them for advice before I started. That's what I love about motherhood is having friends help each other.

While you're still home on maternity leave. Your maternity leave should be the time that you're relaxing and enjoying your baby, while taking care of yourself. Here are some ideas....

• Make sure your baby will accept a bottle. I would let Aaron give Ava a bottle of expressed milk while I was running an errand. She got used to it, but has always preferred nursing.
  
• Great time to practice pumping and squirrel away the extra milk that you might have, but don't go overboard. Store milk in small increments such as 2-3oz so it's easily used by your caregiver.
  
• Get familiar with the storage guidelines for fresh and frozen milk (see link in the bottom of this post)
• Set expectations with your caregiver that you'll be nursing your baby when you arrive. By doing that you can take advantage of reconnection with your baby right away and it's practical because it's less pumping/bottle exposure your baby will have. High bottle exposure can encourage early, unintended weaning.
  
• Create a short list of care guidelines for your daycare. I included to feed my baby on-demand (like we nurse) and to feed her until she's done. I've been very sensitive to overfeeding, because we prioritize our nursing time rather than bottle feeds to ensure our relationship.
• According to La Leche League, a breastfed baby in general takes 1oz of human milk for each hour of separation from the mother and generally takes it in 2-4oz increments. My baby drinks 3oz at a time and in general takes 9oz in 10 hours (even at 11-months). NOTE: Some caregivers may be concerned because formula babies take more in in their bottles at a time. You can remind them that formula is very different from human milk and that your baby is content and growing. Some babies hold out at daycare and wait to get the majority of their milk while at home (evenings/mornings) with mom.
  
• Check out my post on caregiver tips for a breastfed baby.

Your Work Day Pumping Schedule: It takes me between 15-20 minutes from set-up to tear-down. I have a 30 minutes time block in the mothers room and we book it in our Outlook Calendar like a conference room. It's advisable to pump every 2-3 hours to maintain your milk supply and avoid plugged ducts.

What to Pack in your Bag:

• Your Pump with all the parts (flanges/tubes/battery pack if needed)
  
• Cooler bag and cool pack
  
• 4 Bottles with caps (Pump in bottles 1 and 2, pour in bottle 1 and store, session 2: pump in bottles 2 and 3, pour off and repeat for session 3 with bottles 3 and 4). For high supply moms, you can use larger 8oz bottles or a mix of Pump and Save Bags.
  
• Medela Pump and Save Bags - in case you ever forget bottles (they're sterile and you can pump directly in them and store them)
• Extra flanges - good to have, a friend of mine forgot hers and had to hand express
• Medela steam bag - in case you had to sterilize. 2 oz of clean water in the bag and about 3 minutes in the microwave.
  
• Pumping bra to give you hands-free pumping (see my review post) so you can work while pumping! Brilliant!
• Permanent marker to write the date on your storage bags.
  
• Antibacterial wipes in case you need to sanitize the table you're using, etc.
  
• Clean plastic bag to store your used flanges for the next pumping sessions. The flanges arrive clean, but for the next 2 pumping sessions you don't have to wash them. You can store your used flanges up to 6-8 hours in room temperature because human milk is antibacterial or you can store them with your milk in the refrigerator or cooler bag. This saves you a ton of time.
• Picture of your baby: Aaron had an idea to take a picture of me nursing Ava the night before I went back to work so I could see it when I was apart from her. Many moms find looking at pictures of their baby helps with let down.
  

Supplying milk for Day 1 and beyond: Since you're going to work, you're going to nurse your baby overnight and before you leave for daycare. It's likely that you'll have extra milk since mornings are typically the time that moms have abundant milk. Breastmilk changes throughout the day so you have more milk in the morning and it's thinner and thirst quenching for the baby who's waking up for the day. As the day progresses, you have thicker milk with more cream and less volume. The evening milk is fatty which helps the baby sleep at night.

It's always a good idea to keep enough frozen milk for 1 day in case you forget your milk one day to work. It will save you time and then you'd never worry that your baby has enough breastmilk at daycare.

• Morning of Day 1: Nurse your baby before work to get a good feeding and stimulate production when you're apart. I find it works best to nurse her in bed when my alarm goes off at 5:30am and she's still sleeping. Then I nurse her again just before 7am before we're about to leave for daycare. It's an easier way for her to wake up gradually, too! I pump extra milk from both breasts (I have an oversupply), which supplies her first 3-oz bottle for daycare (and then I save the rest for freezing). Many moms find the morning before work nurse the baby off one side and pump the other.
  
• Daycare Dropoff: bring any milk you pumped fresh that morning and frozen milk (for Day 1 only).
  
• At work: Pump 3 sessions and store this milk for Day 2 and so on. I pump at 9am, 12pm, and 3pm. Remember that you'll likely pump more quantity in the morning session than the afternoon.
  
• Daycare Pickup: nurse your baby when you arrive.
  
• At home: Take the pumped milk from the day and make up your bottles for the following day and freeze any extra milk. Some moms freeze only on Friday's when they know there is milk that they won't need. When you get into a routine, you'll figure out the best way to do this.
  

TIP: Friday's milk is for Monday the following week. The fresh milk contains the best antibodies (some is lost during freezing/defrosting). Plus, when you baby comes into contact with a bug, you will make the antibody to fight that bug in real time! That's why I minimize leftover milk and give the baby fresh milk.

• Alternative or part-time: If you don't work Mon-Fri, you might have to figure out the best way to supply your milk. You might find that freezing will help.
  

Great resources:

• Kellymom's page on pumping and returning to work (storage guidelines, how much a baby needs, etc).
• Great article on Working Mothers on the La Leche League website from Lactation Consultant, Kirsten Berggren, the author of Working Without Weaning.