This is in regards to the mom who will return to work at 8 weeks postpartum
and is planning to breastfeed at lunch time and tandem pump for morning and
lunch for baby's expressed breastmilk to be used at other times.
The question is asked about when is the best time to start the desired
schedule prior to returning to work.  In my experience pumping for my three
while out of the house full-time and in helping moms who pump after
returning to work, the ones who are the most successful at maintaining a
full milk supply are the ones who empty the most milk from the breasts.  I
often run into moms who complain they can't produce enough by pumping, who
are pumping just once in the day, when baby is actually being fed 3-4 times.
The mom in question may be able to maintain her supply with her planned
schedule, or she may find that she needs to add an additional pumping
somtime when she is either at work, or home with baby to keep up.  I, and
many pumping moms I've met have found that we needed to pump a little more
often than baby was fed to have enough EBM to exclusively supply baby.
Tandem pumping, or pumping after baby is down at night, but before mom goes
to sleep are some options.  Of course, that's not true for everyone.  A
close friend whose baby I had the pleasure of watching for several months
was able to pump her baby's total daily EBM need in 1 lunch-time pumping
session (and she was gone 11 hours a day!)
As far as the need to try out the schedule ahead of time, I may be in the
minority here, but aside from making sure baby will accept a bottle, I'm not
a big fan of following the work-day schedule when at home.  I found I always
produced more milk after a few days at home just nursing the baby, and was
able to switch back to the work schedule easily.  Most (healthy, growing)
babies are more efficient at removing milk than any pump.  I usually advise
moms to exclusively breastfeed at home, and not worry about keeping to any
kind of schedule.
As for how much milk to stockpile ahead of time for her comfort -- whatever
you can get!  It's always comforting to a pumping mom to see a pile of
frozen milk available for the days you just don't get quite enough!
I definitely never had a problem with overproduction, and for much of my
pumping career struggled to keep up (although I never had a problem
supplying enough when I was home and able to directly breastfeed.)  My
record was 252 ounces of breastmilk in the freezer (which is pretty measly
compared to some of my friends' stockpiles.)  I managed to stockpile this
during a 3 week long school break when my daughter was about 7 mos.  I ended
up using it all to keep to my goal of supplying her with breastmilk for
daycare for the first year.
Jennifer Tieman
Family Physician
Mom to 3, and new baby #4 expected 5/31/03

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