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Subject:
From:
Chris Mulford RN IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 16 Feb 1998 08:24:25 EST
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To Sharie Aikins:
Congratulations for your first post on Lactnet!  Now that wasn't so hard, was
it?

I'll answer your question from a purely theoretical and numerical point of
view. This mom's baby is 3 weeks old, and she wants to know how much milk
she'll need to leave for feeds when she goes away from the baby for a week at
4 months.  Figuring that she has 9 weeks, each 7 days long, before she goes,
that's 63 days.  Figuring 8 feeds a day for a 7 day week that she'll be away.
that's 56 feeds.  So if she expresses once a day every day from now until she
goes away, and saves the milk, she ought to have enough.

I once rented a pump to a mom who was going back to work, and she did just
that.  Every morning after the first morning feed (when her baby often did not
"empty" both breasts anyway), she pumped and froze that milk.  By the time she
went back to work she had a nice stash in the freezer.

Expressing at the same time every day should stimulate the breasts to make
enough for an extra feed at that time every day.

Another theoretical and numerical answer, and one which really doesn't help
much, is to remember that the average daily milk production for exclusively
breastfed babies 0-5 months is 750-800 cc (Nutrition during Lactation, p
81-2), with a range of 450 to 1200.  Hatloy & Oshaug in JHL Dec 1997, report
global figures ranging from 400 to 961.  The main reason for her to know this
is not to panic if she does not end up with a quart a day of milk for the
baby, because the baby probably will not drink that much, although people
might percieve that her baby needs that much, especially if it's a big baby.

Another theoretical musing...would it make sense to plot the baby's weight on
a breastfed babies growth chart (not the chart that Ross hands out, natch!)
and assume that a baby at the 50% percentile for weight would take about the
mean amount of milk, while a baby at the 25% or the 95% would take a
correspondingly lower or higher daily amount?  I wonder....

Now, speaking practically, I have three thoughts.  1) Be sure she has a
reliable means of milk expression, whether that's manual expression or a pump.
2) Be sure she understands that she'll have to express milk while she's away
about as often as the baby nurses.  This requirement will have a major impact
on whatever she's doing during that week.  If the baby is still nursing at
night at 4 months, she may need to wake up and express milk at night.  What
will she be doing and will keeping on "Baby Time" with her breasts fit in with
that schedule?  3) Explore with her thoroughly the possibility of taking the
baby along.  What is she doing for that week?  If it's something that
absolutely precludes having the baby with her---offhand I can't think what
that could be if she's not in the diplomatic corps, the military, or
inspecting a toxic waste dump somewhere---she should think carefully about
ways to have the baby with her, even if that means bringing an extra person
along to care for the baby during the day.  Plans we make or agree to before
we have a baby can look very different after the baby arrives and we have
fallen in love.

One mom I have never forgotten called me for help with planning a week-long
trip to Hawai'i that her husband had won for being the best widget salesman in
his company.  She planned ahead carefully, wrote a detailed manual for her
mother in Maine who was to mind the baby (who was around 4 months old) for
her, pumped gallons of milk, taught her baby to drink from a bottle.  She flew
with her baby and her frozen milk to Maine a couple of days before the trip to
Hawai'i and spent time seeing that her baby was well settled in with Grandma.
She called me on the night that she was back in Delaware getting ready for the
flight to Honolulu the next day.  She was grieving, mourning, devastated,
couldn't stop crying.  She missed her baby so much that she couldn't imagine
how she'd make it through a week without her.  She was angry at her husband
for wanting to take her away from the baby; she was angry at herself for
agreeing to go; she was angry with his company for giving him this nice
"reward" that felt like torture to her.  She knew that, however much fun her
husband would manage to have in Hawai'i under the circumstances, she would
have very little.  All in all, this event which is every American's idea of
the epitome of luxury and class---a trip to Hawai'i---was a bomb for her.  And
all because no one could stretch their minds enough to see that a 4-month-old
nursing baby is still physically a part of her mother, and needs to go where
she goes.  Imagine flying to Hawai'i with a baby that age---the perfect age
for air travel---and hanging out in a fancy hotel, having your meals served to
you and the bed made every day by someone else, walking on the beach or
strolling around to see the sights with the baby in a sling---it could be a
perfect vacation.  But, although the mom and I had explored this option, she
was told flat out that she could not bring the baby, and she had chosen not to
push it further.  I think her husband was not keen on bringing the baby with
them---but he certainly hadn't understood the torture his wife would be going
through without the baby.  Other options, like declining the prize with
thanks, or asking for a rain check, or taking someone else---his mother or
father???---had not been explored.

Another mom who went to Hawai'i for a week when her baby was about a year old
came back to a baby who refused to nurse---ever again.

So, after you answer her questions and help her see how she can arrange for a
week away from the baby, please also discuss other options with her.

Peace.  Chris

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