shift work, sleeping through the night and engorgement

by Syreeta
(Philadelphia, PA)

I have a very healthy (and chubby!) four month old that is exclusively breastfed. I have returned to work and am doing ok for the most part with pumping and maintaining supply. The problem I'm running into is now that the baby is getting some cereal and sleeping for 5-7 hour stretches at night I'm getting pretty engorged by morning. Should I be pumping overnight or will the supply-demand reflex take over? The baby seems to make up for lost time in the morning and eats like crazy which isn't good when I'm working the morning shift and he is relying on pumped milk in a bottle. I'm worried that because I work shift work and am gone at all different hours that we won't be able to find a routine that works. Do you have any suggestions? I really want him to receive breastmilk exclusively and would only supplement as a last resort.

answer from the lactation consultant

Breastmilk production is a simple demand=supply system. You will make what you empty and you will lose what you do not empty. So, if you are concerned he will "run out" of pumped breastmilk, then yes you should get up and pump one time during the night. The only way your demand "reflex" will take over is if you feed/pump exactly on his demand schedule. So if you are able to pump every hour to two hours when at work, then that will mimic his natural schedule and you can skip the night pumping but if you are not able to pump that often, then I would pump at night. Your goal not to five him any formula is a good one.

I hope this helps,

Liz Pevytoe, RN, IBCLC