Breastfeeding: PCOS, lipase problems, and your dream pumping room

Hot topics in breastfeeding:

First, over at Jo's there's an interesting "share-your-story" going on about breastfeeding and polycystic ovarian syndrome (PCOS). While some women with PCOS have normal milk supply and others have oversupply, many suffer from low supply (which can sometimes be linked to breast hypoplasia--the thought is that hypoplasia and PCOS are both results of endocrine regulation problems). It's only been extremely recently that this has been noticed by lactation and medical professionals, so women with PCOS need to seek out info and educate themselves before or during pregnancy, since your doctors and lactation consultants cannot be relied upon to know this stuff yet.

The first writing about PCOS and supply is being done by IBCLC Lisa Marasco, who started putting together the pieces before most other people did. Check out the second half of Jo's post and be sure to read all the comments to find more stellar links and data points about Metformin, low supply, pumping, galactagogues, and online support for PCOS and breastfeeding with PCOS.

Second, I got an email from Tanya recently, asking if I knew anything about why her pumped milk spoils in a matter or hours in the refrigerator, when breastmilk is supposed to be fine for several days in the fridge. This isn't an issue of spoilage. Instead, it's an excess of the enzyme lipase (a normal enzyme that helps to break down the fat) in the milk. I don't know why some women have an excess of lipase (I'm one of them, although I don't have as much as Tanya does--my milk is fine in the fridge, but tastes a little bit sour if frozen and then thawed), and I haven't found anything yet indicating that anyone else knows why some women have it, either. The only remedy for the problem seems to be scalding the milk as soon as possible after pumping it, but before storing it.

Kellymom.com (where else?) has a nice succinct article about excess lipase and scalding milk. Does anyone else have this issue? How do you work around it?

And finally a request: Kate has the chance to recommend to the heads of her company what the company's new lactation room should contain. She says, "I would like to take full advantage of this and really push to make it great for everyone but especially those non-professionals, without private offices, for whom pumping might be especially challenging a la the recent NYT article {Ed--the article discussed the "two-class" problem for pumping moms at work--the obstacles can be too huge to overcome for women without private offices}." Could you tell her what your dream pumping room would have? Thanks.

Comments

[spinster]

(my apologies for glitches in English, I'm a native Dutch speaker...)
The pumping room of my dreams would have
- full privacy, of course;
- heating and/or air conditioning, whichever your local climate dictates;
- door with a toilet-style lock;
- a double kitchen sink with hot and cold tap water and a large enough dripping area;
- antiseptic hand soap dispenser;
- paper towel dispenser;
- hygienic wastebin;
- reliable fridge, to be used for breastmilk only;
- comfy couch and a low table (both not too low though);
- power supply as close to the couch as possible;
- a wall clock, mounted NOT opposite the couch;
- if you're splurging anyway: an ethernet connection and/or wifi for ladies who like to surf the web on their laptop while pumping, and perhaps a radio, a TV, some magazines;
- and all of the above should be cleaned, checked and re-filled regularly (weekly).

Good luck preparing this!

[Jo-Ann]

I pumped at work for my first for 14 months and for a few months with my second (I quit working so I quit pumping) I have pumped in a locker room, and 2 empty offices. One of the offices had a pc. That was a life saver for me. I could not produce for the pump well but if I read the internet or worked I got alot more milk.

The second thing that would help would be lockers so that you had a place to leave your pump. It would be nice not to have to carry your pump to and fro all day.

[Amy]

I second the requests for privacy. I was fortunate to never have to pump while at work, but sometimes I would have to pump at home while a Grandma was over. My husband and baby were the only ones I wanted to see me strapped to the pump, but a few times a Grandma walked in on me. I hated those moments.

If I had to pump in a public place, I'd like it to have two sets of doors you have to pass through before actually entering the room (like the entrances to many restaurants here in Southeast Michigan and the entrance to the "Mother's Room" at my local Babies R Us). If not that, perhaps an indirect entrance, like the maze-like entrances to many restrooms. (You go in, you turn left, you turn right, there's the bathroom.) Then the person pumping will hear the intruder and won't be totally startled when they come in.

That's pretty ideal, and not many workplaces would have that kind of cash to lay out, but hey - we are talking about our "dream" rooms. Maybe it could be accomplished on a smaller scale with room dividers or decorative screens.

[ElleryScott]

In addition to the comments above, I would have loved to have had a hospital-grade pump provided for me at the office, thus eliminating the need to haul my pump to and from the office every day. Many of my girlfriends' companies provide the pump so all they have to take to work are the cup attachments and bottles for storage.

[Rosemary]

Well, my ideal pumping room would have power points right next to the sofa or chairs. It would have a sink and draining board as well as dishwashing detergent dispenser and loads of paper towels for drying. Also, separate areas for each mum pumping (dividers or curtains). I've used a room that had little cubby holes for each mum's equipment.

Also, maybe the company could buy a hospital grade pump and each mum just has her own lactaset. That would be really useful for the lower paid mums who would then get the benefit of a really god, reliable pump without having to pay to much for it. You could also get the trolley that the pump can sit on so that it can be pushed around rather than carried around.

Also, in Australia, you can get corporate memberships to the Australian Breastfeeding Association (equivalent to LLL) and they provide heaps of support and information and resources. They also accredit workplaces and advise on things such as pumping rooms. They give magazines, posters, handouts on storage of breastmilk and would be a good conduit for questions if the employer had any.

Finally, I would suggest that the existence of the room be included in your company's employee handbook and recruitment material. Many mums would be too scared to ask, but it would send a great message to potential employees.

[jomama]

I addition to what has already been mentioned, a microwave to sterilize equipment would be nice.

[Katie]

The hospital grade pump is a beautiful idea that would really help address the two-class system. I had to pump in a borrowed office, and in shared offices. Carrying drippy pump parts around the office (even wrapped in towels) took the most getting used too. So, it would definitely be nice to have a plug and a couch and a table. One office, the only "table" available was an automatic signature machine/light table thing that I was pretty sure shouldn't be dripped on. So, there I was setting up on the floor. If there are work tasks that can be done on computer, then providing a computer is nice too. Once you get the hang of it, I liked being able to get some e-mails done or "be productive." Sure, I definitely sometimes just used the time for an all around break (don't provide me a table and I won't feel bad just reading my book), but I liked being able to continue my work so I could take a decent lunch break without worrying about how much of my work day was spent working.

[Emmie]

I didn't really need much but a good lock, a decent chair, and an outlet, but I only work part time.

I want to add something about the lipase. While I know some babies won't drink it, I had very stinky pumped milk, and my twins never minded a bit. I mention this because the lipase won't hurt them any (the milk isn't really "spoiled"), and some moms might not think to even offer it because of the smell, and the baby might be just fine with the milk.

[Mary]

I was lucky enough to have a private office while pumping for both of my kids. I was able to pump handsfree at my desk and make phone calls and return emails. I'd like to have that option in a pumping room, too. It sounds like a lot of people pump while sitting on a couch, but I would prefer a desk and office chair. So a few different options (with lots of plugs and maybe some extension cords) would be nice.

[Katie]

The hospital grade pump is a beautiful idea that would really help address the two-class system. I had to pump in a borrowed office, and in shared offices. Carrying drippy pump parts around the office (even wrapped in towels) took the most getting used too. So, it would definitely be nice to have a plug and a couch and a table. One office, the only "table" available was an automatic signature machine/light table thing that I was pretty sure shouldn't be dripped on. So, there I was setting up on the floor. If there are work tasks that can be done on computer, then providing a computer is nice too. Once you get the hang of it, I liked being able to get some e-mails done or "be productive." Sure, I definitely sometimes just used the time for an all around break (don't provide me a table and I won't feel bad just reading my book), but I liked being able to continue my work so I could take a decent lunch break without worrying about how much of my work day was spent working.

[Meramoo]

The bf room at my recent employer's offices had a "Occupied/Empty" indicator on the door, like some restrooms do when you lock the door.

[mayberry]

These are great suggestions for the pumping room. I agree that there should be a PC with internet access available. WHen I pumped and could do so in an office with a connection, I could keep up with reading my email or whatever, and didn't feel so guilty about being away from my desk (I know, I shouldn't have anyway, but I still did).

Julia at Uncommon Misconception has written about the lipase problem.

[SarcastiCarrie]

I couldn't pump unless I was leaning slightly forward, so a desk chair was great. A couch would not have worked as well.
I used a small, colored Ziploc-brand disposable tupperware-type container to transport my pump horns and valves from my office to the kitchenette. The color of the container sort of hid what was inside. I rinsed the parts in the sink in hot water then let them air dry in the container in my office (in a discreet location).
So, my dream room would have desk chairs and tables, a sink, lots of electrical outlets, hand soap and dish soap, a microwave for sterilizing (also helps the parts dry much faster), a computer for working/emailing, lockers or cubbies for the pump/magazines, and refrigerator for milk only.

[HollyRhea]

Hi, Moxie,

This is just a plug for a research study being done at Northwestern University in Chicago on PCOS. I was on the el the other day and saw the ad. Please, go here (http://www.pcos.northwestern.edu/research_studies.htm)and see if you qualify. It will help us all understand it more, perhaps gain some treatment and you get PAID for being a part of it (which includes weight management help and diet guidance).

[Beth]

Regarding the lipase, I know that many women only discover they have this problem if their babies start rejecting their expressed milk. I discovered it by "checking" some milk that had been in the fridge for 4 days. I stuck my finger in and took a little taste.

It tasted like soapy vomit! I was really upset and tossed it, but later discovered that it tasted bad as soon as 12 hours after pumping. But he slurped it up anyway, even 3 or 4 days later, even frozen and thawed. Some babies will reject it, some won't. If you've discovered you have the lipase problem, wait to see how your baby reacts before resorting to scalding. I only had to scald a few times, for example, when Friday's pumped milk from work had to last until Wednesday when I returned to work.

[Amy]

My firm has a dedicated pumping room for the use of all women who wish to use it. While I have a private office, I usually pumped in the pumping room since it was so well equipped.

The firm employs a certified lactation consultant who visits monthly and meets with anyone who wishes to make use of the room to give them info, guidance, support, etc. The room itself has a dedicated hospital grade pump, so each woman just needs to buy her own kit (which are available through the lactation consultant). There are baskets in the room on shelves, labeled w/ names, so that you can store your kit there. The room also has a comfy couch, pillows, magazines and books geared towards moms/babies/nursing, and a small fridge for storing milk. There is also a bulletin board where you can post a picture of your baby if you'd like. No computer, but it does have a phone.

The system in place works very well -- everyone who is currently using the room is asked to sign in/out and note the times that they expect to pump. An "in use" sign is placed on the door. When I was using it, I never had any scheduling conflicts, but the lactation consultant works with everyone to make sure schedules are coordinated and everyone gets the slots during the day that they need.

The room itself is located in a quiet spot at the firm, adjacent to a women's bathroom, so its very private. My only complaints about the room were that it didn't have a dedicated sink, but rather we had to go into the bathroom to wash our pump kit when done, but it was a pretty minor inconvenience.

Finally, only those with a key can get into the room. Keys are issued to women after they meet with the lactation consultant and are yours for as long as you wish to use the room. When you're done pumping, you return the key. And, in addition to the "in use" sign on the outside, the door locks from the inside, so you never had to worry about someone barging in.

[liz]

At my old job there was one lactation room for the whole campus (3 buildings) that was connected to a women's bathroom. There was no door separating the lactation room from the bathroom, and in fact, you could see into the lactation room from the hall if the bathroom door was open. And there was only one electrical outlet.

Doors, multiple outlets, desks, all would have been lovely.

I ended up mostly using an abandoned storage closet or borrowing offices.

At a different former job, most people had their own offices, but they put the one breast-feeding mother in an office that had glass walls on two sides and only gave her blinds for one of the walls. There were other, more private offices they could have given her, but the manager gave them to team leads (all men.)

[Kate]

Thanks Moxie and everyone else for the great lactation room ideas. I really appreciate it!

[wendy]

lipase - i have a good friend who had the same milk spoiling problem. she was actually able to fix the problem by using better bags. she found that the lansinoh storage bags were the only ones that worked for her.

[erika]

I want to work at Amy's firm.

[Melis]

I'm pretty sure Amy's firm and my company's parent are modeled after each other-ours sounds identical.

[selzach]

A lactation room would have been a dream. I was lucky enough to work in a lab with a separate incubator room at the back and pumped in there during breaks. Even with a sign on the door, my male boss still nearly walked in on me.

[Rudyinparis]

My workplace has a private area--door has an access code to punch in--and when you enter there is a main room with a sink, a fridge, lockers, bulletin board for photos and info, phone, and a couple chairs. Off this main room are five small rooms (not cubes or stalls--rooms) that each have a comfy chair, footstool, disinfectant wipes, and what I believe are hospital pumps which each woman only needs to bring her own shields and such (I use a Medela electric portable so am slightly mystified by other pumping implements!). I feel very, very lucky. (No--scratch that--we shouldn't feel LUCKY--we are saving the company so much money by nursing--this should be provided as the norm in EVERY business!)

[bernalgirl]

My dream pumping room would have cubicles -- seriously!! When I went back to work, my company had completed a gorgeous WW HQ, with top-of-the-line pumping room. Yep, HQ with one pumping room. Everyone pretty much wants to pump at the same time of day, and it was impossible to get an appointment. I actually pumped in my car using the cigarette lighter adapter more than once. A company of any size should offer multiple places to pump, most easily achieved with cubicles (with doors or curtains for privacy) in a common, enclosed space. And to heck with comfy arm chairs, most of us need to catch up on email or other work, because we need to leave "early" to relieve our childcare providers. A place to set a laptop or pad of paper would also be great. A shared set of easily accessible sinks and a large fridge with sufficient shelves to accommodate stored breastmilk are also key -- don't make us leave the privacy of our pumping room to tidy up, please!

[Marilyn]

hi to every one Dr.nancy dunne said that
The risk of women younger than 40 years developing breast cancer over a 10-year period ranged from 2.6% for those with the highest testosterone levels to 1.5% among those with the lowest levels.You can take a look at her book here:Dr. Dunne's all about pcos .

[Marilyn]

Hi everyone, I came across a book that might be relevant to the topic discussed here. It's called "The Natural Diet Solution for PCOS and Infertility" by Dr. Nancy Dunne. It's a comprehensive book that covers dozens of PCOS and dietary topics.

[Marilyn]

Hi everyone, I notice there was a medical study of18 women withabnormallylowprogesterone levels who were given vitexchasteberry) daily. After 3 months of treatment,13 showed ncreases in progesterone and 2 became pregnant.Igotthis information from:
www.ovarian-cysts-pcos.com/vitex.

[Maril]

Hi everyone, I found an article that I hope is relevant and helpful. It says that by preventing optimal absorption of vitamins B12 and folic acid, metformin could induce or contribute to megaloblastic anemia. Megaloblastic anemia occurs when your bone marrow doesn't have enough B vitamins to manufacture red blood cells.Your bone marrow then releases immature and dysfunctional red blood cells into circulation. Metformin impairs the optimal absorption of some B vitamins.This anemia is not real common,buta potential risk to be aware of, according to
Dr. Nancy Dunne's Glucopage and PCOS article.

[Lyn]

I was reading Dr. Nancy Dunne's natural diet book for PCOS when I discovered her 14 tips for increasing your fertility. Here they are: stop junk food, eat whole foods, go organic, avoid genetically modified foods, balance your essential fats, minimize gluten grains, have plenty of fiber, reduce saturated fat, change your carbs, reduce alcohol, reduce stress, exercise, lose weight, reduce insulin resistance, check partner's fertility, and consider nutritional supplements.

[Lyn]

Hi everyone, you're aware of the recent news regarding Avandia and heart attack risk. But did you know it also increases the risk of bone fracture? That's according to an article by Dr. Nancy Dunne. She says improving the composition of your diet, getting more exercise and controlling chronic stress can go a long ways toward solving your insulin resistance problems. She describes how to use diet, exercise and stress management in her PCOS diet book.

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I had 7 miscarriages. I don't have PCOS, but do have insulin resistance. I actually did the test on my own volition because my dr refused to prescribe a glucose test, saying I don't have PCOS, so I wouldn't be insulin resistant. My fasting glucose levels were 11. After this, (I also have sticky platelets, which I already knew about), I managed to have a successful pregnancy, and am now the mom of a beautiful boy, who rocks my world! Just thought that I'd metnion for what it's worth that PCOS & insulin resistance are not necessarily hand in hand.

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[Priya]

PCOS and IR are not hand in hand. But,in majority of the PCOS women IR exists.Also PCOS women with estrogen dominance might have issues as low levels of estrogen is neccessary for high levels of Prolactin which is needed to produce milk. On the other hand PCOS women with high levels of prolactin will have oversupply.

http://treating-pcos.blogspot.com

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