Tuesday, January 22, 2008

Breastfeeding and work; pumping for pleasure

It’s a boring title, I know, but I’m hoping that somewhere there I may be able to help someone who googles it like I did.

I’ve been back at work now for about 5 months, and I’m still managing to breastfeed Patrick almost exclusively. I say almost because there was that time I worked nights and I couldn’t get out to pump as often as I should and we ran out of milk and had to use formula. We still occasionally do, but maybe no more than once or twice a month.

I’ll start out by saying that I know I am extremely lucky to be a super-cow. This has its upsides- I can always get something out when I pump, and normally at least 150mL- but also its downsides- I leak like a runny tap: if it’s been a while since my last pump and I hear some poor wee baby crying in PACU I’m done for. At least in my job changing clothes is as easy as getting some new scrubs from the locker room, and we always have a handy arrangement of soaky-uppy things blueys, green guaze, peri pads, abdo packs, op-sites and always heaps of tissues if all else fails). So I don’t have any hints for how to increase your flow when you pump. Sorry. What I am going to tell youse all is how I manage to make it work for us.

First of all, check your workplace, union, state award (remember those?)’s policies on breastfeeding and work. It helps to be fore-armed with exactly what you are legally permitted vis-à-vis lactation breaks. Again, I’m lucky that NSW health is (supposed to be) a breastfeeding-friendly workplace. That means I’m (supposed to be) entitled to at least two 30-minute lactation breaks in addition to my normal breaks per 8-hour shift. I’m also entitled to have a private place to pump (that isn’t a toilet), a refrigerator to store the milk and a sink.

You’ll note I put in some ‘supposed to’s there. Well, that would be because I don’t get lactation breaks in addition to my normal breaks- I get a grudging (normally) 30 minute break before lunch (instead of a 15-minute tea break and a lactation break) and I take 40 minutes for lunch (instead of my regular 30-minute lunch break and a 30-minute lactation break). If I’m lucky I get an afternoon break (instead of my tea break and a lactation break) but most of the time I don’t. I also regularly work 10 hours a day, not 8, so I should be getting an afternoon break for sure. I also work 12-hour days (like weekends) and occasionally 14-hour days, and that should make 3 and possibly 4 lactation breaks in addition to my normal breaks, but it very, very rarely does.

I know that in most respects I’m very lucky, and that for many women even taking one lactation break is hard, but it is frustrating to know my rights but not be allowed them, especially when the very people determining my breaks are doctors and should know better. My one pet hate is being out on a usually-long-overdue lactation break and I’ll be pumping with one hand and shovelling food into my mouth with the other when my boss pages me and demands to know if I can finish up quickly and return to theatre. Grrrrrr!

So, back to the whole point of the post: things that help.

  1. Knowing your rights (and standing up for them- which I have singularly failed to do, it seems).
  2. A good pump.

If I had known then what I know now, I would have forked over the extra cash for a electric pump, like the Medela Swing. Having one free hand when pumping makes it so much easier to multi-task, and with my F-cups, this aint always possible.

I will, however, heartily endorse the Medela pumps- I have a Harmony at work and an Avent Isis at home, and I know which one I prefer. One of the very simple reasons for this is that the Medela pumps will screw directly onto a normal narrow- neck baby bottle, which is the kind my lactation consultant (aka the angel of mercy) recommended. This means that I can pump directly into the bottle, and don’t have to fork out extra for breastmilk bags, which are about $1 each. I know that’s not a lot, but it was actually working out more expensive than formula, and one of the benefits of breastfeeding is that it’s meant to be cheap, right? On a more personal level the hospital also uses Medela pumps so if the valve stuffs up totally I can beg a new one out of NICU .

3. A room to do the deed.

Most important: don’t let them make you do this in the loo! Would you feed your baby in the loo? No way. Ideally, again, there would be a comfy chair, a sink for washing up the pump, a fridge and a LOCK. I am lucky enough to have all of these things, but it also happens to be the pantry for the clerical and admin staff, so unfortunately I’m sometimes interrupted by people wanting to get their lunch or make a cup of tea. Thank God for the lock or my co-workers would have seen a lot more than they bargained for.

4. Supportive staff

As above, I don’t always have this. Most people- and that includes most doctors- don’t have a clue when it comes to breastfeeding. The only people who’ll sympathise are others mothers who have done it before. I’m lucky that the two admin staff whose office the pantry comes off are both experienced breastfeeding mums, so they understand.

5. Balls.

I mean, you need to be firm and assertive about this. In my experience you can't wait for your boss to invite you to have a lactation break. You need to take charge and say "I need to have my break soon/now". You have to be polite but firm about needing a private place to pump. And you have to be pretty dedicated: unfortunately pumping takes up all the time I would ordinarily be socialising with my co-workers, and there's nothing I enjoy more than a good goss. It's like anything to do with being a mum: there's give and take- if you want to pump you have to be a stranger to the tea-room (unless you are veeeeery comfortable with public lactation, I suppose!).

The next big problem comes with how to tell your boss or co-worker what you need to go do. I tried all the euphemisms: feed the baby, milk the cow, talk to Mr Medela, do the mummy thing, take a load off my chest, go down a cup size etc etc but they mostly meet with blank looks. I find the best way is to say ‘lactation break’ and if they still look puzzled I just tell them I need to go express some milk so I don’t get all leaky. Mostly they are fine with this, but some (mostly the older men) get a bit flustered, but that’s better than using hand signals. Sure, they won’t be able to look you in the eye after this, but at least they will generally give you as much time as you need, and then some.

The logistics of how I do it are as follows.

I keep the pump in a near-waterproof 1-litre lunchbox container that is big enough to submerse all the parts. At the start of the day I make up a solution of Miltons: 12 mL to the 1-litre lunchbox of water, and let it sit until I take my first break. I go into the room, get the pump bits out, shake them off and assemble them and then fill up the sink full of fresh, hot soapy water, then close and lock the door. This gives maximum time for someone to ‘just nip in and…’ before I get my kit off. Once I have locked the door, I find it easiest to just pull my top off rather than worry about leaking all over my shirt from the other boob. I’ll often stuff some tissues down the ‘second’ boob anyway. I pump, then put my top on, open the door and put the milk into a ‘cool bag’ type lunch box in the fridge. By then the soapy water in the sink is cool enough to wash everything without scalding my hands. I rinse off all the soapy water and put the disassembled pump back into the miltons lunchbox, making sure it’s all submerged.

At the end of the day, it’s ok to leave the pump in the Milton’s overnight, but you need to change the solution after the first pump of the morning, as you’re meant to change the solution every day. My Miltons I keep in a screw-top jar: the kind that we send small ‘pathology specimens’ (eg gallbladders, appendixes) in. I measure out the Miltons with a syringe (did I mention there are perks to my job?). Be careful with the undiluted solution as it is basically just bleach, and it’ll bleach little spots on your clothes (or, in my case, a fabulous messenger bag I bought off etsy). I've now made my own little carry bag- PVC fabric lined.

I wanted the outer fabric to have cows on it but I couldn't find any so I went with this cutesy print.

I’d recommend that until you feel a comfortable about pumping at work that you leave the door locked until everything is out of sight, so no-one has to feel all uncomfortable looking at your breastmilk or milky pump. I have to say, I’m pretty blasé about it now, and the only people who get embarrassed about it are other people, not me.

I’m glad I’m still breastfeeding Patrick: at first I aimed for colostrums, then I aimed for 6 weeks, then 12, then 6 months, and with less than a month to go, one year looks likely. I’m not sure when I want to stop: it is the one thing that only I can do for Patrick, and the days we have off together it’s so nice to snuggle up in bed for the first feed of the day. It probably will be a mutual decision, but then again, maybe I’ll have to give up:

I’ve started taking folate again.


Anonymous Anonymous said...

a very casual comment there at the end!!!

i have almost stopped breastfeeding now. when i went back to work i started sending a couple of bottles of formula to childcare with the twinkle and still do breastfeeds morning and night. (too lazy/busy to pump, and also i broke my electric pump by dropping it on the floor). i discovered that she wasn't getting much from the two remaining breastfeeds coz she was always starving for more at the end of each feed, so i realised my supply must be drying up from under-stimulation. so now it's four formula bottles a day, plus a token breastfeed every morning. it won't be long before i get kicked out of ABA.

22/1/08 22:28  
Blogger E, M, and the Little Man said...

Your post made me...tired! God, I really admire you for still sticking with it. I also am envious of your plethora of milk, although as you said, it has it's downsides.

I hated pumping - every.single.time. I was only able to pump at work on days that I worked full-time and always was supported (luckily). I am a teacher and the days I work 4 hours I wasn't able to pump because I was teaching the whole time. Therefore, my milk supply dwindled a lot in the mornings and I ended up supplementing with formula.

Mateo ended up not wanting it anymore during the day a few weeks ago. I've read since that this can happen when they eat more solid food. I'm still nursing him once at night, but that's it. Oh well. My goal was to nurse him for a year, but I can honestly say that I don't miss it and I don't think he does either.

I've been wearing a regular bra for the past few weeks and I am so happy. Shirts just look so much better in it.

I also endorse Medela. I bought the Swing (and like J-Le dropped and broke it, but taped it and it still works). I also bought the Pump In Style (double) second-hand, and that has worked well.

Good on ya, and hope you and the baby continue to enjoy it!!

24/1/08 20:12  

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