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SupportSupport

• Family and FriendsFamily and Friends

• Lactation consultants in:Lactation consultants in:

• Community Health NursingCommunity Health Nursing

• Women Infants Children (WIC) Women Infants Children (WIC)

• State and Local Health DepartmentState and Local Health Department

• Medical Treatment FacilityMedical Treatment Facility

• La Leche LeagueLa Leche League

Your Partner and Family Your Partner and Family Members: Other Ways to BondMembers: Other Ways to Bond

• CuddlingCuddling

• Bath timeBath time

• WalksWalks

• Diaper changesDiaper changes

Mom on the MoveMom on the MoveBreastfeeding DiscreetlyBreastfeeding Discreetly

• It is possible to breastfeed It is possible to breastfeed discreetly in publicdiscreetly in public

– Wear clothing for easy accessWear clothing for easy access

– Use a blanket or diaper to cover Use a blanket or diaper to cover breast and babybreast and baby

– ““Sling” baby carriers are usefulSling” baby carriers are useful

Feeding Options for Feeding Options for Working MothersWorking Mothers

• Direct breastfeeding Direct breastfeeding

• Expressing milkExpressing milk

• Supplementing with Supplementing with formulaformula

Another Option:Another Option:Reverse Cycle FeedingReverse Cycle Feeding

• Baby feeds less often during the Baby feeds less often during the workdayworkday

• Baby feeds more often when you are Baby feeds more often when you are together together

Before Returning to WorkBefore Returning to Work

• Practice with the pumpPractice with the pump

• Get baby used to the bottleGet baby used to the bottle

• Talk to your supervisorTalk to your supervisor

• Consult Occupational Health about Consult Occupational Health about hazardshazards

• Simulate work scheduleSimulate work schedule

• Breastfeed exclusively on weekends Breastfeed exclusively on weekends to keep supply upto keep supply up

Reasons for Working Reasons for Working Mothers to Express MilkMothers to Express Milk

• Maintain an adequate supplyMaintain an adequate supply

• Engorged breasts are painful and Engorged breasts are painful and decrease your milk supplydecrease your milk supply

• Express milk manually or by pumpExpress milk manually or by pump

Milk Expression BasicsMilk Expression Basics

• Wash hands thoroughlyWash hands thoroughly

• Breast cleansing is not routinely Breast cleansing is not routinely necessarynecessary

• Wash pump and collecting kits in Wash pump and collecting kits in hot soapy water after each usehot soapy water after each use

Manual ExpressionManual Expression

• Use all senses to Use all senses to foster effective let-foster effective let-downdown

– Baby’s pictureBaby’s picture

– Blanket with her smellBlanket with her smell

• Use gentle breast Use gentle breast massagemassage

• Adapt manual Adapt manual technique for your technique for your comfortcomfort

Illustration by Joyce Kopatch, USACHPPMIllustration by Joyce Kopatch, USACHPPM

Breast PumpsBreast Pumps

• TypesTypes

– ManualManual

– BatteryBattery

– ElectricElectric

• Performance varies greatly Performance varies greatly

• Hand pumps, battery pumps, & small Hand pumps, battery pumps, & small electric pumps are intended for occasional electric pumps are intended for occasional useuse

• Price RangesPrice Ranges

– $20.00-$250.00$20.00-$250.00

Breast PumpsBreast Pumps“Hospital Grade”“Hospital Grade”

• Best choice to establish Best choice to establish and maintain milk and maintain milk supplysupply

• Dual pumps/collecting Dual pumps/collecting kits are helpful for kits are helpful for women employed full-women employed full-time outside the hometime outside the home

RecommendedRecommendedPumping ProtocolPumping Protocol

• During a normal workshift, a During a normal workshift, a mom should plan on 2-3 mom should plan on 2-3 pumping breakspumping breaks

• Dual pumping results greater Dual pumping results greater total milk volumetotal milk volume

• If a single collecting kit is If a single collecting kit is used, each breast should be used, each breast should be pumped for 15 minutes per pumped for 15 minutes per sessionsession

Illustration by Joyce Kopatch, USACHPPMIllustration by Joyce Kopatch, USACHPPM

Extra TipsExtra Tips

• It is better to express for 15 minutes 3 It is better to express for 15 minutes 3 times a day rather than 45 minutes times a day rather than 45 minutes straightstraight

• You will yield more milk and keep your You will yield more milk and keep your supply upsupply up

• Hand massage helps to drain the breast Hand massage helps to drain the breast fasterfaster

Storage of Human MilkStorage of Human Milk

• Store in the coldest part of the Store in the coldest part of the refrigerator or freezerrefrigerator or freezer

• Antibacterial properties of human milk Antibacterial properties of human milk help to prevent bacterial growthhelp to prevent bacterial growth

• Store milk in feeding-size portions to Store milk in feeding-size portions to minimize wasteminimize waste

• Milk that has been partially used should Milk that has been partially used should not be reused (1 hour window)not be reused (1 hour window)

Milk Storage RecommendationsMilk Storage Recommendations

• Room TempRoom Temp 4-6 hours4-6 hours

• RefrigeratorRefrigerator 3 days3 days

• FreezerFreezer 3 months3 months

• Deep FreezerDeep Freezer 6-12 months6-12 months

Storage ContainersStorage Containers

• Hard-sided, self supporting containers Hard-sided, self supporting containers with air-tight caps are the bestwith air-tight caps are the best

• Label containers with infant’s name, Label containers with infant’s name, date of expression, and number of date of expression, and number of ouncesounces

• Use oldest milk firstUse oldest milk first

Thawing Frozen MilkThawing Frozen Milk

• Never microwave human milk!!Never microwave human milk!!

• Run lukewarm Run lukewarm (not hot!)(not hot!) water over water over containercontainer

• Set container in pan of warm waterSet container in pan of warm water

• Leave in refrigerator overnightLeave in refrigerator overnight

• Avoid excessive heatAvoid excessive heat

Warming Human MilkWarming Human Milk

• Use warm waterUse warm water

• Shake warmed milk to resuspend fat Shake warmed milk to resuspend fat globulesglobules

• Too much warming may initiate Too much warming may initiate bacterial growthbacterial growth

QUESTIONSQUESTIONS

AcknowledgementsAcknowledgements

Ms. BethAnn CameronMs. BethAnn Cameron

Health EducatorHealth Educator

Directorate of Health Promotion and WellnessDirectorate of Health Promotion and Wellness

US Army Center for Health Promotion & Preventive MedicineUS Army Center for Health Promotion & Preventive Medicine

Ms. Cindy PlankMs. Cindy Plank

Health EducatorHealth Educator

General Leonard Wood Army Community HospitalGeneral Leonard Wood Army Community Hospital

Fort Leonard Wood, MissouriFort Leonard Wood, Missouri

Wellness CenterWellness Center

Martin Army Community HospitalMartin Army Community Hospital

Fort Benning, GeorgiaFort Benning, Georgia