Tag Archives | pumping

Traveling as a Pumping Mother

7497500748_5f37df32aa_bBy Nicole Goodman

One of the biggest challenges working mothers face is traveling away from their babies while they’re still breastfeeding. Pumping while on the road – or in the air – can be inconvenient, uncomfortable, and downright unpleasant, but many mothers find that is it worth it so they can continue breastfeeding.

Here are some hints to help you prepare for trips away from your little one. Working mothers going on a business trip or those that stay at home getting away for a weekend can benefit from planning ahead.

Supplies Checklist

Pumping while traveling requires some additional supplies that you may not need when you’re at home:

  • Batttery pack & fresh batteries – Make sure your battery pack works BEFORE leaving and load your pack with fresh batteries.
  • Extra batteries – Depending on length of your trip, it’s always a good idea to carry an extra set of batteries. Remember to keep batteries with your carry-on luggage to avoid any problems with checked luggage.
  • Convertor/adapter – If you are traveling internationally, make sure to pack the appropriate power convertor/adapter plug so that the pump will work at your final destination.
  • Milk storage bags/containers – If you plan to bring milk home after the trip, make sure to pack plenty of storage bags. I like the Medical-Grade, Pre-Sterilized Plastic Storage Bags. Freeze them flat so you can stack them up on the return trip.
  • Ice or cold packs – Especially for long or multi-segment flights, ice or cold packs will help keep milk frozen on the return trip. Some thawing may occur, so put the milk into the freezer as soon as possible. Use the milk pumped on a trip as soon as possible after you return.
  • Cleaning supplies – I LOVE the microwave disinfecting bags. You might not always have access to a place to scrub pump parts while traveling, but most hotel rooms and offices have a microwave. Throw everything into these bags, pop into microwave for 3 minutes, and everything is sterile for their next use.
  • Power cord, tubing, membranes, breast shields & pump parts – A breast pump won’t do you any good if you don’t have all of the essential parts with you! Pack a few extra pump membranes, just in case.
  • Hand sanitizer – It’s always a good idea to pack a little (3 oz or less) bottle of hand sanitizer in your carry-on.

Pack Smart

If you can fit a pump into your small rollerboard suitcase, great! Otherwise, you’ll need to check your suitcase and keep your computer bag/purse and pump as carry-on items.

Do NOT check a breast pump in a suitcase or as a stand alone item. Travel delays happen all the time; luggage gets damaged or lost. The last thing you need is to end up at your destination without your pump!

Be Security Savvy

In the United States, pumping mothers are permitted to travel with breast pumps and breast milk, regardless of whether or not they are traveling with their children. If a security agent says otherwise, ask to speak to a supervisor.

To make the security process as smooth as possible, you should alert the security officers so they know you are traveling with a pump:

  • Pull the pump out of your carry-on bag and place it in a separate bin before it goes through the x-ray machine. Tell the agent that the item is a breast pump.
  • If returning from a trip and carrying breastmilk, place the milk in a separate bin and alert the agents that the liquid is breastmilk. Breastmilk is NOT subject to the three-ounce limitation.
  • If a security agent asks to test the milk, ask to speak to a supervisor. They may want to swab the outside of the milk bags or containers, but they cannot make you open your milk and test it.

A mother may be asked to go through additional screening. I’ve had my pump searched and swabbed and I’ve also been subjected to a pat down. Be prepared for either scenario.

Pumping en Route

Sometimes it’s necessary to pump before you reach your final destination. Because I fly in and out of a small airport, I always have to make at least one connection, which can make for a long travel day. Most major airports have family bathrooms with electrical outlets and they are a great place to pump. On longer or international flights, you may need to pump in your seat or in the airplane bathroom. Ask the flight attendants if they can suggest a pumping location.

Well Worth the Effort!

Pumping while traveling presents some unique challenges, but it’s ultimately worth the extra effort. With a little planning, preparation and patience, you can maintain your milk production while you’re away from your little one and they will be ready to welcome you home at your breast.

You can find the TSA official guidelines for traveling with breastmilk HERE.

Nicole_GoodmanNicole Goodman is a full-time working mother who successfully nursed both of her daughters through their first 12 months. She had to go on many business trips while she was still nursing and has lots of funny stories about her experiences pumping & (sometimes) dumping. You can learn more on Nicole’s blog, Work in Sweats Mama.

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Combining Work and Breastfeeding: Successful Strategies and Tools

By Wendy Wright, MBA, IBCLC

Photo by Jerry Bunkers via Flickr Creative Commons

Photo by Jerry Bunkers via Flickr Creative Commons

In May 2012, I had the opportunity to contribute “Pumping Strategies for the Working Mother” to Lactation Matters. We have had tremendous interest and discussion on this topic, so let’s explore the topic a bit further.

Over the past several years, I have helped hundreds of breastfeeding women in the work force and have found three tools that provide the most help to working mothers:

  1. Creating a breastfeeding calendar
  2. Hands on pumping
  3. Childcare provider education around breastmilk feeding

Creating a Breastfeeding Calendar

Most mothers intending to breastfeed have their due date and back to work date firmly in place on their calendars, so, what about adding other dates that can assist in scheduling and milk supply forecasting? At each Back-To-Work Breastfeeding class I teach we have an exercise where we pull out our calendars, and actually import important dates into them for enhancing breastfeeding success. Here are the dates I help women to import:

  • Due Date: We discuss the importance of being ready, finishing important work projects in plenty of time and handing off responsibilities so there are no last minute phone calls from the hospital.
  • 11-day Growth Spurt: Many new mothers are not aware of this growth spurt and often interpret it as “my baby is not getting enough milk.” By marking it on their calendar, they are more likely to remember being warned about this 11 day push to increase volume and take in stride with greater confidence in their breastfeeding abilities.
  • Three-week growth spurt: Initiating pumping after this growth spurt is a great way to minimize the breastfeeding burden on the mother during the first few weeks. I encourage mothers to allow their infants to “program” their milk supply for the first three weeks, until the growth spurt, and then take on pumping for storage and bottle introduction.
  • Initiate pumping (3 – 4 weeks): A great time to learn about the pump, work pumping into daily routine and begin milk storage for return to work.
  • Introducing a bottle (4 weeks): Breastfeeding should be well established by this point, and the return to work is on the horizon, bottles should be small and only once a day at most but again, once baby takes a bottle, mother’s confidence is enhanced as the return to work grows closer.
  • Return to work date: Other dates, if appropriate or helpful, can be incorporated here as well, such as: secure childcare, test childcare, practice days for returning to work or part time return to work days to get caught up on items missed during leave.
  • Three month growth spurt: Good to have this on the work calendar – mothers often become fearful about supply during this growth spurt, “How can I possibly pump that much?” Once they realize it is only temporary, breastfeeding confidence again return.
  • Introduction of solids (around 6 months): This is a great relief for fully breastfeeding, working mothers. Just knowing that if a meeting runs late or traffic is terrible, the baby can enjoy avocado or banana until the mother returns home tends to lessen stress around milk supply. Milk is of course still the primary source of nutrition yet the stress about exclusivity is reduced as solids are introduced.

Hands-On Pumping

Teaching hand expression and hands on pumping to mothers returning to work can ensure milk supply when the mother and baby are separated. Jane Morton, MD provides a helpful video and has found that adding breast massage and hands on pumping increased mothers’ average daily volumes by 48%.2 This additional pumped milk may make the difference in breastmilk exclusivity for the first six months of life especially once the stress and fatigue of returning to work set in for the very busy working mothers.

Child Provider Education Around Breastmilk Feeding

In California, by three months of age, 41% of mothers are breastfeeding, this means 59% are not. Due to this statistic, many of the care providers in our state have limited experience handling breastmilk. Here are some questions I arm my clients with as they select the care providers for their breastfed infants:

  • Are you familiar with the latest milk storage guidelines?
  • Will you refrigerate and reuse any leftover breastmilk? Let her know the re-use parameters you’re comfortable with, if any (for example, two hours).
  • Will you store a back up supply of my breastmilk in your freezer?
  • Do you require all parents to clearly label milk containers to avoid mix-ups?
  • Will you check with me before supplementing with formula?

I hope these three simple tools help the mothers you are working with ensure success as they return to work while breastfeeding. Anticipatory guidance with the calendar and careful childcare selection along with increasing parental confidence with enhanced breastmilk supply utilizing hands on pumping should help all mothers meet their breastfeeding goals.

References:

La Leche League’s, “The Breastfeeding Answer Book” (1997) by Nancy Mohrbacher,
IBCLC and Julie Stock, BA, IBCLC

Morton J, Hall JY, Wong RJ, Thairu L, Benitz WE, Rhone WD. Combining hand
techniques with electric pumping increases milk production in mothers of preterm
infants. J Perinatol. 2009, July 2.

WEndy WrightWendy Wright, MBA, IBCLC spent 15 years in the biotech industry in the Bay Area and worldwide prior to breaking out on her own and founding Lactation Navigation in 2007. Wendy has a B.S. in Health Services Administration from the University of Arizona and an MBA with a Marketing emphasis from the University of Cincinnati. Wendy’s daughter is 13 and her son is five; both, of course, were breastfed! Lactation Navigation allows Wendy to combine skills learned in the corporate setting over the past 15 years with her love of breastfeeding. It allows her to spend time with her children and also with new mothers. It also encourages health and happiness for other families, and brings bottom-line profits to progressive companies.

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The Top Lactation Matters Blog Posts of 2012!

As we wind up 2012, we thought we’d take a look back at our most read blog posts of the year. It has been an exciting year at Lactation Matters, as we have passed our 100,000 views mark. We are well on our way to our second 100K and we’re looking forward to adding new regular features and bringing in dozens of new writers in 2013. If you are doing something new and innovative in your practice, have a tip or technique to share, or want to tell us about how IBCLCs are impacting breastfeeding families around the world, please send us an email to lactationmatters@gmail.com. We look forward to hearing from you!

Here are our top 5 blog posts of 2012!

5464706246_6acccd82f6A Closer Look at Cultural Issues Surrounding Breastfeeding: This fantastic post, by Emma Pickett, an IBCLC in the UK, highlighted not only some of the unique cultural beliefs surrounding breastfeeding around the world but also turned some of our most common beliefs on their ears.

gennaAn Interview with Catherine Watson Genna: As IBCLCs, we are constantly on the look out for new insights into infant behavior that will help us to educate and encourage new mothers. Cathy’s observations of how infants use their hands in regards to feeding has changed practice and helped parents to work WITH their infants and not against them. In this interview, she explains why allowing infants to use their hands is important.

Pic for Jennie post 4

Synthetic Oxytocin and Depressed Newborn Feeding Behaviors – Could There Be a Link?Jennie Bever Babendure explores how birth practices can impact breastfeeding and how labor induction and augmentations can be sabotaging neonatal feeding reflexes, which can throw road blocks down in front of even the most committed breastfeeding efforts.

KimberlyPublicity-300x200Why Beyonce Nursing in Public is So Significant: Robin Kaplan interviewed Kimberly Seals Allers about the impact of an African American celebrity (let’s face it…Beyonce is THE African American celebrity!) on breastfeeding. “Celebrities can help create a lifestyle cache and trendiness, particularly among young women, that helps broaden our ideas about who breastfeeds in the black community.”

imagePumping Strategies for the Working MotherOur most popular post of the year (by over 6,000 page views!) was this practical one by Wendy Wright, of Lactation Navigation in San Diego. In it, she highlights why workplace lactation support is so vital as well as answers the critical questions from mothers going back to their place of employment like “How often should I pump once I return to work?” and “How much milk will I need each day?” .

We give a HUGE thank you to all of our contributors this year. 2012 was an absolutely stellar year for Lactation Matters and we look forward to watching this blog grow in 2013!

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From JHL: How US Mothers Store and Handle Their Expressed Breast Milk

Written by Robin Kaplan, M.Ed., IBCLC

Image via Mistel de Varona

Breast milk storage guidelines can be incredibly complicated for mothers to decipher. With each pump company and breastfeeding website having its own storage and handling recommendations, how’s a mother to know which one to follow? Plus, throw in whether the baby is full-term, pre-term, healthy, or in the NICU, and we have quite a confusing situation.

In the most recent online publication in the Journal of Human Lactation, How US Mothers Store and Handle Their Expressed Breast Milk, Judith Labiner-Wolfe and Sara B. Fein analyze the data they collected from over 2,000 pumping mothers in the United States. Their findings will probably not shock any lactation consultants, yet the authors bring up very valid conclusions for how we can educate the breastfeeding and pumping mothers that many of us work with.

Here are some of the significant results of the study:

  • 95% of mothers either never stored their milk at room temperature or did so for less than 4hrs. Recommendations range from 1-10 hours.
  • Roughly 50% of mothers never refrigerated their milk for less than 1 day and no more than 4% left it in the fridge for more than 5 days. Recommendations range from 1-8 days.
  • 10% of mothers heated their breast milk in a microwave, a practice that can cause uneven heating, as well as destroy some of the nutrient and anti-infective factors in breast milk. The professional consensus is to never microwave breast milk.
  • 17% of mothers with babies under 6.5 months old reported that they occasionally only used water to rinse the bottle nipples, which the authors stated could cause the baby to ingest harmful bacteria. Recommendations range from rinsing in warm, soapy to sterilizing daily.

What are our professional guidelines?

There are also some discrepancies as to how long pumped milk stays fresh and viable, even in our own professional guidelines. While these recommendations are similar to one another, there is still enough variability to cause confusion for even the most educated lactation consultant. Here are the recommendations, for a healthy infant, according to the newest edition of the Core Curriculum for Lactation Consultant Practice (2012):

Room Temperature 77 º: < 6 hrs.
Refrigerator: < 8 days
Insulated cooler with ice pack: < 24 hrs.
Completely thawed in the refrigerator: < 24 hrs.
Freezer compartment in 1-door refrigerator: 2 weeks
Freezer door in 2-door refrigerator: < 6 months
Deep freezer: < 12 months

The Academy of Breastfeeding Medicine Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants states:

Room temperature 16-29ºC (60-85ºF): 3-4 hrs. optimal; 6-8 hrs. acceptable under very clean conditions
Refrigerator ≤4ºC (39ºF): 72 hrs. optimal; 5-8 days under very clean conditions
Freezer < -17ºC (0ºF): 6 months optimal, 12 months acceptable
Reusing stored human milk – There is little information regarding the issue of refreezing thawed human milk or the duration of time that human milk can be used once a baby has begun drinking from the bottle or cup.

Both resources recommend washing human milk storage containers in hot soapy water and
rinsing or washing in the dish washer. Sterilization is not necessary.

How do these findings impact our practices when we work with breastfeeding and pumping mothers?

When we are discussing safe storage guidelines for breast milk, it is important to review our professional recommendations, as well as include warming, safe handling, and pump/bottle cleaning recommendations to protect the integrity of the breast milk, as well as the health of the child.

Recommendations should be accompanied by rationale, so that the mother understands WHY her breast milk is less compromised following these standards.

Where do we go from here?

This study’s findings highlight the need for a more systematic, researched-based recommendation for the viability of breast milk and what constitutes safe handling and storage. With so many variables (temperature of the storage space, type of storage equipment, handling, feeding, and cleaning procedures, etc.) there are just too many options, which I, myself, find incredibly confusing. While there are many factors that go into keeping breast milk viable for consumption, there has to be some way that we can create guidelines that are easier for new parents, and lactation consultants alike, to navigate and follow.

Robin Kaplan received training to be a Certified Lactation Educator and an International Board Certified Lactation Consultant from UCSD. She holds a Masters in Education from UCLA, a multiple-subjects teacher credential from UCLA, and a BA in Psychology from Washington University in St. Louis, MO. In 2009, Robin started her own business, the San Diego Breastfeeding Center, where she offers in-home breastfeeding consultations, free weekly support groups, breastfeeding classes, and online support through her business blog.  In addition to her private practice, Robin was the founding Co-editor of theInternational Lactation Consultant Association’s (ILCA)blog, Lactation Matters, and a regular contributor toILCA’s E-Globe newsletter.  She also is the host/producer of The Boob Group online radio show and the Director of Marketing for NaturalKidz.com.  Robin lives in her native San Diego, where she enjoys cooking, hiking, trying new trendy restaurants, and traveling with her family.

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Is Pumping Out of Hand? Why Hand Expression in the First 3 Postpartum Days is Important

Stanford trained, Jane Morton, became a partner at the Palo Alto Medical Foundation, where she practiced general pediatrics and was repeatedly recognized by her colleagues as
one of the top pediatricians in the Bay Area.  She was invited to join the Stanford neonatology faculty to develop their Breastfeeding Medicine Program. She designed a nationally recognized educational program, published her original research and traveled extensively and internationally as an invited speaker.  At the 2011 ILCA Conference in San Diego, CA, Jane presented this plenary session titled, “Is Pumping Out of Hand?”

Jane Morton, MD
Cl Professor of Pediatrics
Stanford Pediatrics
www.burgesspediatrics.com
drjane@burgesspediatrics.com

A low milk supply is the most common reason for mothers to stop breastfeeding. (1.)  We have learned that what we do (or do not do) in the first 3 days after delivery can have a major impact on future milk production potential.  In our research, we found that milk production in pump-dependent mothers of preterm babies depended on the frequency they used hand expression in the first 3 days after delivery. (2.)  Mothers who used hand expression more than 5 times a day in the first 3 days yet pumped with the same frequency as other study mothers, expressed an average of 955 mls, about a quart a day by 8 weeks. This is more than a term 4 month old would need. Mothers also found consistent increases in production when they did not rely solely on pump suction alone to remove milk, but used “hands-on pumping”. This technique combines breast massage, compression and hand expression with electric pumping and does not require more time.  Of the 67 study participants, several volunteered to demonstrate hand expression and hands-on pumping on the Stanford website.  (3.)

For mothers of term and late preterm babies, there is an important role for an alternative way to remove colostrum when the infant has not yet learned to latch on and nurse effectively.  About 50% of mothers will have some difficulty getting their babies to latch on well in the first day. (4.) While providing a mother with a pump may be the easiest solution from the nursing standpoint, a recent study suggests it is more effective to teach her to hand express milk after breastfeeding. (5.) At 2 months, mothers assigned to hand expression were more likely to be breastfeeding (96.1%) than mothers assigned to breast pumping (72.7%). (p=0.02)

A smaller study suggests more milk can be removed with manual expression than with a new, double rental-grade pump in the first 48 hrs post partum. (6.) Given the feasibility and safety of spoon feeding, (7.) perhaps the routine practice in the first several days for infants at risk for suboptimal intake and/or mothers at risk for suboptimal milk production should be to encourage hand expression and spoon feeding after breastfeeding. This provides more milk for the baby and more stimulation to the breasts than breastfeeding alone. There seems to be no cost or risk and only potential benefit in this approach.

  1. Ruowei Li, Fein SB, Chen J,
    Grummer-Strawn L. Pediatrics 2008; 122(2):S69-S76.
  2. Morton J, J
    Perinatol. 2009 Nov;29(11):757-64. Epub 2009 Jul 2
  3. http://newborns.stanford.edu/Breastfeeding/  See: Hand
    Expressing Milk — video
    and Maximizing via Katy TX
    Milk Production — video
    . Complete video, Making Enough Milk, the Key to Successful Breastfeeding, can be
    previewed and purchased at www.breastmilksolutions.com
    . Soon available in Spanish
  4. Dewey KG.
    Risk Factors for Suboptimal Breastfeeding Behavior, Delayed Onset of Lactation
    and Excess Neonatal Weight Loss. Pediatrics 2003;112:607-619
  5. Flaherman VJ, Archives of Disease in
    Childhood 2011
  6. Ohyama M. Pediatr Int. 2010
    Feb;52(1):39-43
  7. Kumar A. J Perinatology 2010;
    30:209-217
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