Nursing Strikes

Did you ever hear of a nursing strike? The La Leche League Womanly Art of Breastfeeding Guide reads. It’s when a baby abruptly refuses to nurse.

First drops of milk I
ever pumped, while still
in the hospital.

My start with breastfeeding was a bit unique – pumping around the clock for almost three months before my premature baby could even attempt to breastfeed – but we did manage to make it work, with the help of lactation consultants, hospital grade breast pumps, nipple shields, galactagogues, and various other techniques, and it worked relatively well…until…

I went back to work.

Then the nursing strikes began.

Given how hard I’d worked to protect baby boy’s milk supply, I was devastated.

I consulted several sources I had been referred to by various lactation consultants. A nursing strike could be teething related or due to a number of issues, these sources suggested. A common suggestion attributed nursing strikes to the baby receiving too many bottles.

I did not find these suggestions particularly helpful for the working mom, much less for the working mom nursing a premature infant. A popular suggestion from these sources is to discontinue all bottle feeding immediately…feed the baby with a spoon or an eye dropper… take your baby to bed with you for a “nurse-in” and breastfeed only for as many days as possible.

Feed him with an eye dropper? Are you kidding me? He sucks down four ounces at a time. Feeding him with an eye dropper would be like dangling a piece of meat in the mouth of a lion. Not to mention that unfortunately I can’t do extended nurse-ins. I went through eight years of sick time to be with my baby while he was in the NICU.

Last year we had $300,000 worth of medical bills. I have to work. I have to provide health insurance. So I cannot have nurse-ins. I cannot feed him with an eye dropper.

Despite my reservations, I tried what suggestions I thought were feasible for us. Like trying different nursing positions. Nurse him standing up. Nurse him while walking around. Nurse while lying down. Nurse when he’s drowsy. Pump first to get the milk to let down, then nurse him. Imagine me running around the house trying all these different things—a process I will refer to as the breastfeeding dance. If a person had any reservations about nursing in public, imagine doing the breastfeeding dance with a nursing striker. If I have to stand on my head, clap six times, and do a special dance to get him to nurse, it’s one thing for me to do it at home, but another thing to do it out in public! Obviously I had to start bringing bottles with me so I had a means of feeding him when he wouldn’t nurse (a big no-no in the sources I've been mentioning). But in my opinion, that baby needs to be fed, one way or another.

Baby boy! 9 months old

One day, after doing the breastfeeding dance, baby boy was lying beside me in our bed and he just sat there and looked at me. He looked so peaceful and trusting. Big eyes. I had been really worried about him, about the nursing strikes and was he getting enough and what should we do. In that moment he looked at me and I just felt like he was saying, mom, I’m ok. It’s fine. And then I realized that perhaps I needed to go with his cues. Perhaps I was having trouble letting go because I had worked so hard to provide his milk. I realized that he primarily preferred bottles during the day and nursing at night. Why wouldn’t he, after all, since that is his routine for most of the week. I decided to just go with it.

All the bottles and pump parts
that need to be washed multiple
times per day.

Baby boy had breast milk exclusively, whether by bottle or breast, until he was seven months old. After that we had to supplement with formula. The first time I mixed up the formula I was astounded. One scoop for every two ounces of water. He gulped it down. The whole process took only a few minutes.



I was astounded. For nine months, I’ve spent around 20 hours per week pumping and washing pump parts, between work and home.

It’s free. Plus it is what’s best for the baby. These were my thoughts (in that order) about providing breast milk when I first found out we were expecting.

Providing breast milk is what's best for the baby. I view it as the most important thing I've ever done, and I would do it all over again. But I wish someone had given me a realistic view of it and prepared me for the fact that pumping and providing milk would be equivalent to a part-time job.

Sign outside the pumping room
at work...let's just say there have
been walk-ins!

My point is this. If you know someone who is breastfeeding or expressing breast milk and bottle feeding, perhaps you will now have some insight into how hard she is working, how many challenges she may be facing just to provide milk for her baby. Give her a pat on the back. Assure her that any amount of time providing breast milk is amazing and she should be commended. Remind her that she is the only one who knows what is best for her and her baby.

Pumping, Pumping, Pumping

I have gotten a second job. It doesn’t pay well and requires lots of nights and weekends. In fact, it requires around the clock work.

Medela Symphony


“Whoosh, whoosh, whoosh.” I hear this sound even in my sleep. It’s the muffled, repetitive suctioning sound of the Medela Symphony, a state of the art hospital grade double electric breast pump. It’s a bright yellow thing, about three feet high, on wheels. Much better looking than the antiquated Medela Lactina I had to rent from Mayo for home use. The Lactina is a bright blue square thing with a yellow pumping widget inserted on the front that just looks like it shouldn’t be there, or like it’s cobbled together from spare parts.

The room is small and dark, complete with a dimmer switch for the lights, as well as a radio, rocking chair, sink and cleaning supplies. I now spend a lot of my time in rooms like these. Pumping rooms, we call them. Each pumping session takes about a half an hour per session, 10-12 pumping sessions every 24 hours. This amounts to pumping every 2-3 hours, except for one four hour stretch during the night so I can sleep a little. I calculate that this amounts to about 33 hours of work per week.

Why? Because my baby cannot nurse yet. Due to hormonal levels, you only have a two week window after birth to establish your milk supply, so you must begin pumping right away if your baby cannot nurse. Thereafter, you must pump to maintain your milk supply (it’s all supply and demand), pumping frequently much the way a newborn would nurse.

No wonder why I’m tired! Don’t get me wrong, I am not complaining, but rather marveling at this new, alternate universe I now live in. My concept of breast feeding was based on the experiences of friends and co-workers, all who had full-term babies. I saw that working moms generally pumped twice per day, once in the morning and once in the afternoon and I thought, I can do that. Plus it’s the best thing for the baby, and it’s free. Free? Now I have to admit, that dollar amount on formula doesn’t seem so expensive anymore compared to working another full time job!

I am attached to my breast pump. Pumping every 2-3 hours, this guideline is from start to finish, so by the time I’m done with one pumping session I only have 1.5 to 2.5 hours until the next session. It’s challenging to cram everything else into these small sockets of time, such as the two hour drive from the hospital to our home, kangaroo care with Wesley, dealing with the never ending amounts of paperwork and phone calls that need to be made, hosting visitors, etc….I barely do one thing and it’s already time to pump again.

I recently started working 1-2 days a week, to conserve some of my paid time off for when Wesley comes home. But with my pumping situation, working is quite the process! Before I went back to work, I asked one of the nurses in the neonatal ICU if I could use my Medela Pump In Style (the small, discreet kind of breast pump that comes in a black shoulder bag) while working.

“That pump is not for a mom with a baby in the hospital,” she replied sternly. “That pump is for a working mom who only has to pump twice a day.”

Medela Lactina



And so I cart a suitcase to work with me, complete with the Medela Lactina and a plethora of other equipment required.



I also calculate that for now, I am barely keeping up with Wesley’s needs. Right now, he eats 1 ounce every three hours, eight times per 24 hours, for a total of 8 ounces. I recently started tracking it and I was pumping about 12 ounces of milk per 24 hours. I gasped. All that work for 12 ounces! And will I even be able to keep up with him?



I flew into a frenzy, calling lactation consultants and researching ways to increase my milk production. I would be so disappointed if I lost my milk supply before he is even able to start nursing. After adding—yes, more pumping sessions—and making sure I’m hydrated and eating more, this week I am up to almost 16 ounces per 24 hours. Ideally, I should be at 19 or more ounces. I also produce more milk when I have direct contact with Wesley, such as after kangaroo care. (I also wonder if my lower milk production is partially due to the fact that I am separated from my baby.) Take fenugreek, the lactation consultant told me. This is an herb that is known to increase milk supply by increasing prolactin levels. This is my next step. She also encouraged me, saying that milk supply often increases on its own after the baby starts nursing. No electric pump can remove milk from the breast as efficiently as a baby can, isn’t that amazing?! Once again, it’s all supply and demand.



But regardless of the time required or the amount of milk you can produce, the benefits of breast milk in any amount are undeniable. Did you know that a woman’s body produces milk uniquely suited for the age of her baby? In other words, when Wesley was born at 28 weeks, I produced milk specifically formulated for a 28 week old baby, rather than for a full term baby. Isn’t that amazing? Pre-term milk is higher in calories, protein, and fats, as well as an enzyme that helps digest the fats. Pre-term babies have trouble digesting fats, particularly the fats found in formula.



Providing breast milk is the one thing I felt I could do for him. Even when he was in an isolette, and I couldn’t hold him without enlisting the help of at least two nurses, I could always produce his milk and know that I was doing something he really needed. In the beginning, he received only one milliliter of milk every three hours and now he is receiving 33 milliliters (about an ounce) of milk every three hours, still through a tube inserted in his nose and stomach. In six weeks, Wesley has grown from 1 pound 15.3 ounces to just under four pounds. He is making steady gains every day, in addition to now breathing independently and maintaining his body temperature, which means he is now in a bassinette and we can pick him up and hold him whenever we want. I love knowing that I played a role in helping him thrive.



But I am getting anxious. I really want to feed him. The pumping thing is getting old. It’s a machine. Right now the closest I have to feeling like I am feeding him is by holding him while he receives his 33 milliliter “bolus feed” via a pump attached to his feeding tube.

We have tried breastfeeding three times now. Still no luck. Recreational breast feeding, the nurses call it. One night the nurses were laughing hysterically because one of the new resident doctors wrote the order for recreational breast feeding as “the mother may recreate at her breast.” Anyhow, I guess “recreational breast feeding” means that we still haven’t gotten the hang of it. He’s still not quite ready…so far Wesley gets sleepy very quickly and not much happens. It’s more of a “getting to know you experience” the nurses say. We are told to practice “recreational breast feeding” once per day. Thus the pumping sessions continue, to maintain the milk supply until Wesley is ready to eat.

So for now, I keep pumping, pumping, pumping.