Pumping and storing breast milk can help provide a stay-at-home mom with the chance to have time for herself.

Once she returns to work, keeping up her supply of breast milk can be more of a challenge. She will need to keep her milk supply by continuing to pump and collect breast milk for her child to use while she is at work.

However, good planning, support, and the correct equipment can help a woman continue to breastfeed, even after returning to work outside the home.

Related topics:

• Deciding to breastfeed
• Formula feeding
• How to breastfeed
• Overcoming breastfeeding problems
• Self-care for mothers who breastfeed

Milk - human; Human milk; Milk - breast; Breast pump information

Milk is produced in small, sac-like glands in the breast. Certain hormones (such as estrogen, progesterone, pituitary prolactin, and lactogen) cause these sacs to grow and develop. This process starts during the second trimester of pregnancy.

The human breast does not store a large volume of milk. Your breasts will make new milk with every feeding.

• Suckling causes the release of a hormone called prolactin. This hormone starts the milk production and causes the release of another hormone called oxytocin.
• Oxytocin causes the "let-down reflex" of the milk glands. The milk is squeezed out of the milk gland, into the milk ducts, and into the nipple.

During every feeding, the makeup of your breast milk changes.

• At the beginning of the feeding, the milk is bluish and contains lactose and proteins, but little fat. Such milk is called foremilk.
• The end of the feeding produces hindmilk. The hindmilk contains more fat, the main source of energy for your baby.

Breastfeeding or pumping on a regular schedule, along with drinking plenty of fluids and eating healthy, will help you maintain your supply of breast milk.

The first step is to establish your milk supply and breastfeeding skills before returning to work. Your baby also needs time to develop his or her breastfeeding skills.

TIPS TO MAINTAIN YOUR MILK SUPPLY

Once you and your baby have a steady breastfeeding pattern, introduce your baby to bottle feeding (with pumped breast milk). This allows plenty of time to establish good feeding habits. Do not start before your baby is 3 - 4 weeks old.

Two weeks before you return to work, buy or rent a breast pump. Start building up a supply of frozen milk.

It is best if you only breastfeed when you are with your baby in the evening and on weekends. Other members of the family will need to help in the home to give you time to breastfeed.

After returning to work, you will need to express milk 2 to 3 times a day, every 2 to 3 hours.

• An ideal workplace will provide a private room for breastfeeding moms, with a comfortable chair and an electric breast pump for use by all nursing mothers.
• If possible, arrange to nurse your baby at lunch time.

If you can only get one break a day and you are unable to pump a full day's worth in one pumping, you may need to give your baby a supplemental bottle of formula. Be aware, however, that formula feeding decreases the need for breast milk, and your milk supply will also decrease.

Every day, nurse your baby right before leaving in the morning and right when you return home from work. You may find that your baby nurses more often in the evenings on the days you work. Feed on-demand when you are with your baby.

BREAST PUMPS

There are a number of breast pumps on the market. Pumps may be hand-operated (manual) or work by battery or electricity. Hospital-quality pumps are available for rent through medical supply stores.

Personal models that are easy to carry are available for purchase. You should find the type that is comfortable for you to use and allows you to collect your breast milk in a reasonable period of time.

The most dependable and comfortable pumps are electric. Electric pumps create and release suction on their own and do not require much training to use.

Either a lactation consultant or the nurses at the hospital or your doctor's office can help you purchase a pump, as well as teach you how to use it. A lactation consultant is a person who specializes in breastfeeding.

COLLECTING, HANDLING, AND STORING MILK

When storing milk for home use, wash your hands before expressing (pumping).

• Use 2- to 3-ounce bottles or hard plastic cups that have been washed in hot, soapy water and rinsed well. They should have a cap that fits tightly, such as a screw cap.
• Heavy duty bags that fit into a nursery bottle are also okay. DO NOT use everyday plastic bags or formula bottle bags. They may leak.
• Always date the milk before storing it.

Fresh breast milk can be kept at room temperature for up to 8 hours, and refrigerated for 5 to 7 days.

Frozen milk can be kept:

• In a freezer compartment inside the refrigerator for 2 weeks
• In a separate door refrigerator/freezer for up to 3 or 4 months
• In a deep freezer at constant 0 degrees for 6 months.

Frozen and thawed milk can be refrigerated for up to 9 hours, but it should not be refrozen.

Never microwave breast milk -- overheating destroys valuable nutrients and "hot spots" can scald your baby. Bottles may explode if left in the microwave too long.

THAWING AND USING BREAST MILK

The two best ways to thaw frozen breast milk are:

• By putting it in the refrigerator
• By swirling it in a bowl of warm water

When leaving breast milk with a child care provider, make sure you label the container with your child's name and the date.

Other advice:

• Do not refreeze breast milk once it has been thawed.
• Do not save breast milk from a bottle that has been used.
• Never add fresh breast milk to frozen milk.

Payne PA, Tully MR. Breastfeeding promotion. In: Ratcliffe SD, Baxley EG, Cline MK, Sakornbut EL, eds. Family Medicine Obstetrics. 3rd ed. Philadelphia, Pa: Mosby Elsevier;2008: section D.

CDC. Breast-feeding/Proper Handling and Storage of Human Milk. Page last reviewed: March 4, 2010.

Eglash A, Montgomery A, Wood J. Breastfeeding Disease-a-Month. 2008;54.