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Are you planning your return to work but picking your brain on how to pump and nurse at the same time? How does combined feeding work?
What you should know before you start:
If you want to be a pumping pro and still have enough left over milk from your baby, you need to be prepared to put in a little extra effort.
I’m not saying it’s not doable – there are plenty of moms who juggle this combination, but you’ve got to be prepared for it.
Especially for you, I’ve come up with some of my best tips for when I’ve been there.
First and foremost, if you haven’t already read my post on ….here.
- When to pump
- How much to pump
- Conserving a freezer stash
- How to get in a routine
- Tips to help you start
What you need:
Before you do anything, unless you’re planning to hand pump litres of milk – which can be pretty tiring in the end – you need a good breast pump.
I have the Medela Single Electric Breast Pump which I highly recommend as it’s easy to use, lightweight when you’re on the go and the ‘warm up’ stimulation it gives you is the perfect time before you have a let down.
You can also get the double pump if you’re planning to pump long term, I just didn’t really need more than this.
You’ll also need these Breast milk freezer bags for your milk stash.
I’ve personally used bags that are not available in the US (I live in France), as well as these Lansinoh storage bags, which take up a little less space in the freezer but are less sturdy.
I’ve heard a lot of great reviews about the first storage bags I mentioned, and I’ll definetly consider them for my second baby.
Before you start
Make sure that you have the right nipple shield/flange, to prevent any soreness or cracked nipples ocurring. If you have larger breasts, you will probably need a bigger shield.
You can get different size shields here. There is a sizing guide on the product photos to guide you.
It can be a little tricky to measure in the beginning, so you want to try the one that comes with the pump first, if it feels tight then you may need a size up and vice versa.
Okay, that said – let’s dive in!
When to pump?
I’m gonna say it loud and clear: there is no ideal time to pump. Just avoid evening time if you are aiming for quantity instead of high fat.
Why? Because in the morning you will notice that your breasts are much fuller of foremilk – this is more watery and quenches baby’s thirst.
Once you get to the evening time, your breasts will seem empty and if you don’t know about this beforehand, it can come as a bit of a shock.
Many moms, in fact, believe they have low supply as a cause of it.
The actual cause is the higher fat content so as to fill baby up for the night (we hope!)
So here’s the dilemma: If I can get my highest quantity of milk in the morning, does that mean I should only pump then?
Not really – you see if you’re storing your breast milk for a later date, you need to make sure it contains the two.
One way you can do this is by separating your milk as you pump. For example, you can store a good quantity of milk from your first letdown in a sachet and label it ‘foremilk’.
Once your breast is no longer engorged as it was, you can pump again – this time the milk will have a higher fat content and this is the milk you want baby to be getting.
A typical ratio is 1/3 fat.
We will clear this up with some sample schedules below.
But how do you pump with baby nursing?
The question you’ve been waiting for, right? Here’s the magic answer: you pump right after baby’s nursed.
It may seem like you don’t have a lot ‘left’ in you, but you’ll soon find you won’t have a problem.
I do feel kinda contradictive to this however, as I would sometimes do the opposite. This is because my breasts became engorged and I didn’t want my baby nursing only foremilk.
I would hence end up pumping a little to relieve the engorgement, let baby feed and then pump again to get a little fat content in the pumped milk.
How much to pump
This one’s kinda on you.
Every mom is different and will produce different quantities of milk – so there is no strict guideline.
Also, it depends on what your goal is when you’re pumping. If, for example, your goal is to get a couple of hours peace a week, you can go easier on yourself.
If your aim, however, is to have enough milk for a few hours every day (say you leave your baby in daycare), you need to make sure you’re storing enough.
It’s important to set out some realistic goals before you start. A good idea is to start pumping as soon as you can to gradually increase your supply and save freezer-stored milk.
So, if you’re planning to create a sufficient freezer stash to cover you for a few weeks of work/daycare, you need to be pumping in the morning.
In the morning, you will have the largest quantity of milk and you also send your body the signal that it needs to produce more.
How long to pump for each session
This largely depends on whether you’re pumping as part of your daily routine, or power pumping to up your milk supply.
In any case, you should be pumping at least 10 minutes each time. Every mother is different and will have a different let-down rate.
For example, if you know that you can get a lot of milk from just one let-down, then you may be able to stick to a shorter pumping time.
If you need 3-4 letdowns to produce the quality you need, you’ll need to pump somewhere around 30-40 minutes.
That’s why I recommend that you note down how long you’ve pumped for and how much you produced as a result.
You can find out how to track this below so keep reading.
How to store a freezer stash
You can only decide how much you’re going to store once you know how much milk you produce. What I mean to say is that first observe the quantity you’re getting out of each session, then work around that.
Let’s say, for example, I make 3oz per session. I do 4 sessions a day so sum that up to 12oz.
(Note this is just an example and you will most likely pump more than that!)
Now you need to measure how much your baby will drink from the bottle. According to Kellymom, babies between the age of 1-6 months drink an average of 25oz (750ml) daily.
Though obviously milk intake varies from baby to baby so they could drink up to 30oz.
Now all you need to do is divide the daily amount by the number of nursing sessions baby will have. Bear in mind, baby may not nurse as much as while she’s with you. So she may drink more per session yet further spaced out.
Unfortunately there’s no way of knowing how often baby will drink without you until the time comes. It’s best to pick an estimate in the beginning – say 5 times a day – then work around that.
Looking at our previous example when I calculated 12oz, if we wanted to produce 25oz to store daily we now know that requires 5oz per pumping session.
If you want to secure yourself a month’s worth of milk, therefore, you need to be pumping for about a month (from this example only). Of course, you pick your figures! I’m sure you’re capable of pumping more.
How to get in a pumping routine
This will largely depend on whether or not you’ve returned to work yet. If you haven’t, then you are free to pump at any time of the day.
Providing you have, pumping can be a little more restricted to office break times and squeezing a session in before you leave the house.
My best advice is to have a pumping schedule written out. You are more likely to stick to it and it will help you remember the last time you pumped.
There’s an app that Medela provides called ‘My medela Breastfeeding companion‘ which is handy because you can track everything from nursing, to diaper changes to sleep.
Of course, you can use it exclusively for your pumping schedule too.
If you’re more of a pen and paper kinda girl, write down the hours that you’re usually pumping.
At first, you’ll need to be strict with yourself and have a stopwatch of some sort by your side. As time goes on, you’ll begin to recognise yourself how much time you’ve been pumping and whether you’ve collected enough.
To round up:
- Write down your routine or download the app
- Be consistent
- Time yourself to begin with
Pumping at work
Though breastmilk is still a scandal in most industries, now there is a new ‘Break Time For Nusing Mothers’ law in place that means that your employer should provide you with both the time and space to pump at work.
You need to calculate the time you think you will need for your pumping break and do be aware that it will not be paid.
That’s not to say that you can’t use your paid break times to squeeze a pumping session in – if you choose a hands free pump you can even eat simultaneously!
It’s worth noting that, the law applies to hourly paid employees under the Fair Trade Standards Act. (see Kellymom for details)
Talk to your employer beforehand and let him know your preferences and needs, to avoid future confusion.
You can do this whilst on maternity leave, of course.
How often should I pump at work?
Basically, you need to be pumping every time baby would feed. This helps you keep up your supply, even whilst in the middle of your working day.
If you’re a forgetful person, set a reminder on your phone that you need to go and pump.
The average pumping mother will pump 8-10 times daily during the first few months of baby’s life. After which, you will gradually decrease milk intake once introducing solids.
Tips to help you start
Now I think we’ve covered the basics when learning how to nurse and pump at the same time.
Just to finish off I’ve put together a little summary of my favourite tips to help you out:
- Start pumping as early as possible if you want to store your breastmilk for return to work
- The largest quantity of milk will be in the morning
- Pump after nursing to ensure baby gets fed and you get important hindmilk in your storage
- Write down a schedule, grab these free ones or download the Medela Breastfeeding App
- Inform yourself of your rights at work and let your employer know your pumping needs
- Make sure you fully empty your breasts while pumping
I hope you’ve been able to take something away from here and have a better idea on what combined pumping/nursing is like.
Further reading: How to deal with oversupply
How does breastfeeding affect your sex life?