Happy CRNA Week- How to have a happy breastfeeding and pumping CRNA

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First of all, happy CRNA Week. Today I’d like to talk about how to have a happy pumping CRNA.

Before I became a first time mom, I really had no idea what breastfeeding and pumping entailed. It’s not really talked about anywhere online especially regarding those working in healthcare and how they managed to work and pump. Now that’s been more than 8 months, I’d like to share my experience to encourage new moms to continue their breastfeeding journey once they return to work.

It’s good to share than the American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant. Personally, I set my breastfeeding goals to the first month, then 3 months, and then every 3 months to one year.

What I’ve discovered that the breast pump represents freedom from the baby and the ability to still provide the best and complete nutrition for your baby. You don’t need to have your baby attached to your hip to be a good breastfeeding mom. The breast pump gives you freedom to express milk whenever you want and it is not dependent on when the baby is ready to eat or if the baby has trouble latching. Also in the beginning, nipples take a beating (boo… I highly recommend Motherlove Nipple Cream and Lansinoh Hot/cold pack and Ameda gel pads especially for the first week or two) from breastfeeding so pumping gives your nipples a break.

Ever since I got back to work, I’ve had the support of my colleagues and family and the opportunity to continue feeding my baby breast milk. I have to be thankful for the positive nursing culture and a built-in system in the surgical department. That really is key!

It is super helpful to have supportive CRNA leadership, especially from someone who’s done it before. It’s also helpful to have an understanding from all the other CRNAs who can give me a little extra time to pump (getting a 20 minutes break instead of the usual 15 minute breaks).

For me, I take 10 minutes to pump. 5 minutes to clean my pump parts and use the bathroom. 5 minutes for walking to and from the pump room and getting my cooler bag. However, some moms may take more time to pump, usually up to 20 minutes.

My cooler bag from RTIC includes:

In addition, I just wear my nursing/pumping bra to reduce the time that I have to put on and take off a specific pumping bra. I love the one from Kindred Bravely.

When I get to work every morning, I write down my pumping times on the assignment board so that someone can get my pump break at those times. Breastfeeding is a matter of supply and demand and requires you to pump at least every 4 hours to maintain your supply throughout the day. It is extremely helpful to try to maintain this. It is ok to seldomly miss it but not on a regular basis. Otherwise your supply will take a hit.

Anyways, I try to pump at 5am, 9am, 1pm, 5pm, 9pm. However I do adjust my schedule and move it one hour earlier to accommodate the OR schedule. For example, at 5am (at home), 8am, 12pm, 4pm, 8pm. Many moms will try to pump around the same time she would feed her baby.

Having a dedicated private pump room that is close by to the OR is extremely helpful. When the pump room is far away, it takes so much more time to walk there and back, which cuts into the pump time (and every minute counts!). Also, when there are more than 2 pumping moms in the same unit, it is extremely helpful to have additional pump rooms available nearby. The reason is that frequently, pumping moms will have a similar pump schedule. Our unit has multiple pumping moms. We started with one room when I returned to work 5 months ago. Now we have 4 private pumping rooms near the OR. This will ensure timely pump times.

Here are “must haves” to a private pump room:

  • A lock to lock the room or curtains to separate the space in a large pump area
  • Private room with no windows or a screen if the room has indoor windows so no one can peek in
  • A table large enough to put all the pump bag and supplies (for example, a bedside table typically found in hospitals)
  • Chair where your feet touches the ground
  • Trash (housekeeping should empty this daily)
  • A whiteboard and a dry erase marker for the outside of the door when there’s more than one pumping mom to indicate the estimated “out” of the door time so the next pumping mom knows when the room will be available. It’ll help her decide to either wait for the room or try to find another room.

Here are “nice to haves” (but you can have workarounds):

  • Sink to wash parts
  • Paper towel to dry parts, clean off sink and pump area
    • Workaround: Use the wipes from above
  • Mini-fridge to keep the milk/breast pump parts cold
    • Workaround: get a cooler bag and place an ice pack in there. Or put the whole pump bag or just the milk bottles into your work refrigerator (but it may take more space)
  • Nice ambiance conducive to a relaxing environment. Stress decreases milk production so thinking or looking at pictures of videos of the baby helps
  • Extra pumping supplies. If the hospital already has a mother/baby unit that has a hospital grade breast pump, having this extra set is extremely helpful when something breaks (your own breast pump, parts) or is missing (you forgot to pack it!).
    • I always keep a manual breast pump (the hospital gave it to me after giving birth before I left for home) in my locker for those “just in case” times. I’ve used it several times and I could actually empty one breast in 5 minutes but it definitely requires using one hand to pump and the other to manually pressing the breast towards the nipple to empty the milk ducts.
  • Snacks such as lactation cookies- breastfeeding requires an additional 500 calories a day. Moms are feeding for two!

Whenever possible when I’m home, I’ll directly nurse the baby. Once you get the hang of breastfeeding, I find it to be easier than exclusively pumping. However, there are definitely pros and cons to both.

In conclusion, having a happy pumping mom at work is so vital to prevent burnout and help moms do great work and feed her little one. Having a private pump room close to the OR and a respected pump break time helps immensely.

If you’re a potential or current pumping mom, what would or has made your pumping journey easier?

If you’re in management, what can do you to implement a better pumping culture to reduce burnout for new pumping moms?

Michigan vs MSU

All this week, there’s been so much hype about the Michigan vs MSU. With Coach Jim Harbargh at Michigan, Michigan football is doing better than ever. Usually, I don’t really follow but my fiancé is a huge fan (he listens to podcasts and even submits questions via Twitter, haha) and now I’m a student!!

Anyways, Michigan has been dominating the last 4 games although MSU has won all five games undefeated thus far.

Apparently people all over the country are driving or flying in, staying in the cheapest hotel almost 30 minutes area at $250, with the cheapest tickets going at $175 this year (unless you’re a student who got season tickets).

Guy Fiori is going to be at Meijers this morning. “Game Day” is happening at the Diag. Somehow my friend talked me into going so I woke up early to get some studying done before I take a morning break and start back up in the afternoon.

It’s gonna be a lot of fun.

Speaking of studying, there’s a lot of new material. There’s a final exam in physical assessment and a principles exam coming up on pediatrics, fluid and electrolytes, blood products, and part I of the anesthesia workstation (yes, I can draw the oxygen molecule from the hospital outside, through the entire machine, and to the patient circuit— wow!).

I definitely feel on edge at a much higher rate than ever before. I’m usually a pretty calm person but now more than ever, I can feel my heart racing and getting anxious. And that’s almost everyday. I try to calm my nerves by either studying more, or setting time aside to go for a walk or watch some funny TV. Taking care of myself is probably one of the most important things I can do to endure through the program.

I learned this week (amongst other things), that a “sugar high” isn’t really a sugar high. As a tasty candy bar, full of “simple sugars” or glucose or monosaccharides readily available for insulin to act on, glucose is too quickly shoved into cells, causing a hypoglycemic effect. The alpha cells in the pancreas senses the hypoglycemia and releases glucagon. Epinephrine is also released from nerve endings and adrenals. Both glucagon and epinephrine go to the liver, which then undergoes glycogenolysis, breaking down glucagon into glucose and releasing it back to the bloodstream.

However, image the little kid full of epinephrine, setting off the sympathetic nervous system, causing him to run around like crazy during recess or banging his head against the wall. So a “sugar high” is really caused by “hypoglycemia” that’s induced by our more primitive insulin that floods our bloodstream when sensing a huge amount of glucose. If instead the ingested glucose was complex such as a starch, then our insulin is a much better match, releasing the appropriate amount of insulin without going overboard.

I did a few spinals this week (how cool and amazing it is!!) but next week I will try to do more general cases. All right, enough updating. Until next time.

Jessica

PS. I know the first round of interviews is coming up so I just want to say good luck to anyone who’s interviewing at UM.

PSS. The double rainbow outside my window on Thursday is the featured photo. Nature is beautiful.