On our Facebook page, a mama asked about resources for moms that are pumping past one year. Unfortunately, there is very little information about this topic, most likely because so few moms continue to pump for their children after that magic first birthday "deadline". The American Academy of Pediatrics states their recommendation as follows:
...exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby. (AAP 2012)
The final portion of the statement, "as long as mutually desired," is a little vague, and so most people cling to that "12 months of age" as the definitive word on how long mothers should supply breastmilk for their babies. In contrast, the World Health Organization statement is:
Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. (WHO 2015)
Recommendations aside, moms who exclusively pump, or who work full time and pump to supply breast milk to their children during separation, have many hurdles to overcome to continue providing their milk.
Typically, supply issues are a common concern. As the infant grows into a toddler, moms begin to increase the amount of solids they give to their children and decrease bottle feeds. The change in demand will effect the supply, since moms won't feel so pressured to provide as many ounces, and begin to phase out a pumping session or two. A pregnancy can also negatively impact supply. "I think that I would have continued to pump until my supply dwindled to the point where it didn't make sense anymore," Amanda Glenn, author of Exclusive Pumping and Milk Supply, told me. For her, that meant only 1-2 ounces per day, but after the pregnancy, her supply dipped so much that she weaned her son. Moms also get really tired of pumping. I asked Alina L, another mom who pumped while working full time, what she thought about it. "Pumping is not fun," she said. "I think everyone loves hitting that one year mark when they can 'hang up the horns'."
Most of the general rules about pumping for an infant also apply to pumping for a toddler. Moms need to fit pumping sessions in when they can, have enough pumping sessions to fill the demand of your child, and use relaxation and hands-on pumping techniques to get the most out of your breasts. Some things do get easier as your baby grows. "You don't need to pump as often, as [a] toddler rel[ies] less on breastmilk and more on solids," Amanda said. "Generally, you can schedule pumping sessions while they are sleeping, and toddler sleep tends to be more predictable than infant sleep." For moms that pump at work and breastfeed directly from the breast when together, weekends can be a "catch-up" time in order to boost supply without worrying about the breast pump.
What about other challenges?
Alina told me that cluster-feeding and reverse cycling were common in her experience. "A lot of working moms are not prepped for the cluster nursing and nighttime nursing," she said. "[They] also get trapped because baby wakes up at 5am and wanted[sic] to cluster feed then Mom cannot take a shower and get dressed. [...] I used to suggest setting an alarm for 4am and do a dream feed with baby." (A dream feed is when you put baby to the breast while they are sleeping, and they nurse without waking.) She does note that this will result in less sleep for mom, so it is a personal decision whether or not you choose to do this.
Many moms are concerned about their supply dwindling as they cut down on pumping sessions. I asked Alina if pumping was necessary to continue a breastfeeding relationship if the mom needs to work. "No," she said, "you can always give formula during the day and breastfeed when you are together. And you have to be willing to get up at night." Amanda began introducing cow's milk after the first year, by mixing it with breast milk in the bottles. "I started adding a splash (literally about a tablespoon) to my son's bottles, just to see what happened [and] if he'd take it. He took it just fine, and I gradually increased the amount until the bottles were completely cows milk," she said. Alina noted that many pumping moms she knew continued pumping past one year due to allergies to things like cow's milk. If allergies aren't an issue, moms may not need to pump during separation and continue breastfeeding when together.
What final advice do these moms have for moms who pump past one year?
Amanda said, "I would say to keep going as long as it makes sense for YOU. You have given your baby a great gift by pumping for as long as you have, and you should keep it up as long as you think that it's worth it and that pumping makes sense as part of your life. When it becomes a dreaded chore, or you want your pumping time back to do other things, or you cannot handle getting one more clogged duct, it's 100% okay to stop."
Alina brought up something I hadn't considered. "First advice is to check [the] laws of [your] state. Some states only protect pumping moms until baby is age 1." BABE is based in Texas, and there are no laws here that protect working moms at all. (As of this writing, a bill is being heard in the Texas Senate to fix this. Read more here.) Alina also advised that pumps need to be maintained, and tubes and membranes need to be replaced regularly. The manufacturer of your pump will be able to help you with that. Her final tidbit was that "[m]any women experience a supply dip starting at ovulation and continuing until cycle starts. Taking calcium/mag throughout the entire month steadily can help avoid this."
Pumping and/or working moms! What is your best advice for pumping past one year? Give us your experiences! There are so few articles out there, but I know you are out there!
The opinions expressed belong to the interviewee and do not necessarily represent the views of Bay Area Breastfeeding and Education.