Thursday, 31 July 2014

Travelling with Expressed Breast Milk

As more working moms are breastfeeding now (I do not have an official statistic to quote, but just judging from my workplace and from breastfeeding forums, I think this is on an increase), I get asked this question a lot as travelling is a part and parcel of the job. So, when they have a business trip, they are often stressed out about how to manage pumping and the possibility of bringing back the precious "liquid gold" for their baby. Plus, as travel becomes more and more affordable, nursing moms who are going for a vacation without their baby also would be thinking about this. 

The below is based on my own experience when I went  for overseas travel. I am not sure if you are traveling locally or not, but I am sure these tips are useful for any travelling moms. :)

In November 2011, I was away for 1 week for an overseas trip and hence I did a lot of research to prepare for my trip. I am glad that now I can share my little experience with other mommies who are also breastfeeding their little ones. It's really quite straight forward and with some practice, you'll be pro soon! :)

Actually even before you travel, it's worth a mention that you may need to practice pumping round the clock for 24 hours to know how your breasts will "react" when you are actually away from your baby, without any direct latching. If you are an exclusively pumping mom, then this will not be a concern. However, I remember the first time I put my baby at my mom's for a night, I developed plugged ducts for the first time in my life. Well, that is because no pump is as efficient as your baby, and there is a tendency of over-sleeping and missing or delaying a pump session, which may lead to why you may develop plugged ducts. You will need to be disciplined or risk being in a lot of pain...

You may also want to let your baby get used to not latching in the middle of the night and giving you a chance to estimate how much milk you will need to store while you are away. Don't say I didn't warn you... It will be very emotional leaving your baby for the night for the first time. I think I cried more than my baby. I was so worried of him being away from me and not latching to sleep... Will he be crying the whole night? What if the EBM is not warm yet when he wakes at night and he cries the whole house down? What if he refuses the bottle at night? 

Yeah, I was a nervous wreck just thinking of all this. And once you settled this part, you then worry about the possibility of your baby going on a nursing strike after being on the bottle for a few days. "Will he latch on back again?" We, Mothers, worry about everything under the sun, don't we. :) Anyway, my baby was all FINE and he slept early and only woke up at about 6a.m., which is normally the time he does when he is co-sleeping with me. Hmmmph... I am beginning to believe they are born to "bully" their mommies and suddenly turns into an angel when he is with grandma. :P

Now, let's get back to the topic... 

Once your travel details are confirmed, i.e. the airline that you are on, which hotel you are staying in, etc., I suggest that you get in touch with the hotel to check if they have any minibar that you can use during your stay there. Some hotel's minibar is electronically tracked where, whenever you open the minibar, there is a recording mechanism that is triggered and you may get charged for items that maybe be "missing". This was my case for the hotel that I was staying in during my trip and we were advised not to open the minibar if there is no real need to do so. Hence, I used the Coleman cooler box as my "fridge" in the night. Some minibar is not cold enough, so be prepared.

Then, I asked the hotel if I can store my ice packs and EBM in their fridge/freezer and luckily I could do that. Every morning, I would send my EBM that was expressed at night to the concierge to be kept in the staff fridge and took out the ice pack that I put in their freezer the night before. In the evening when I return to the hotel, I would ask them to keep the EBM that I pumped during the day into the fridge and then the ice pack to the freezer.

It depends how long are you going to be away, if  it is only for 2-3 days, there is no need to freeze the EBM. If any longer, then you should freeze all the EBM. Just bring a container/large zip lock bags to put your EBM before going into the fridge and bring a permanent marker to label on the container: "Contains breast milk. Do not remove from the fridge." If you are going overseas, get the hotel staff or to write it in local language too.

Next, you can call the airline to find out about their policy on bringing EBM on board with you. You can check-in the frozen EBM that you have into your luggage or cooler box which will last for more than 24 hours if packed and sealed properly. But you will need to pump on the journey back home. Hence, I had the Fridge-to-go and Medela cooler bag with me all the time. On pumping in the plane, try to get a window seat and bring a shawl as a nursing cover and trust me, no one will even notice you are pumping. :) I try not to pump in the aircraft toilet. After pumping, I would pass the EBM to the stewardess to be chilled in their fridge.

Before arriving to your destination, do get ice cubes from them and put it into a zip lock bag and you can keep the EBM nicely chilled until you reach home. You should not have problems with the security officers at your home base airport, and just tell them it is breast milk. But, if you have to pump before you board the plane, there is a possibility that the Airport security officers might bar you from bringing liquids onto the plane. So, as an extra precaution, before my travel, I got a letter from my doctor to say that I am breastfeeding bla bla bla... I will attach the letter for your reference.

On washing and sterilising the pump parts, I brought along a tooth brush and a small bottle of cleanser and just wash my pump parts with tap water and rinse well. If you can get hot water, rinse with hot water after that. If not, it's OK as long as the pump is washed properly. 

I pump everywhere that I can find a quiet corner, like buses (that's a breeze), airport benches, restaurants and if I can't help it, I have pumped in toilets (try to find dry and clean ones). If you are going to be out for the whole day, your ice pack may not last for more than 6 hours (it also depends if you are in a winter country or not). But, fret not, you can just ask for ice cubes in restaurants and usually they are more than happy to give you some. Put the ice cubes in to zip lock bags and you can change to fresh ice to keep the EBM constantly chilled. 

At night in the hotel, you can soak the pump parts with boiling water. In the hotel where I stay, they don't even provide a jug kettle, so, what I did was just soak the parts with the hot water from the tap. Turn it to the maximum for hot water and wait until you see steam coming out and use that water to soak the pump parts.

Below is some tips on how I stored and brought my EBM back:


Techni Ice that is long lasting if your cooler box is well insulated

And for the Coleman,I have the 9Qt one, which is like the picture below:


Here's some info for the Coleman,
Capacity:
5Qt = 4.95 Liter
9 Qt = 8.5 Liter
16 Qt = 15.12 Liter
28Qt = 26.46 Liter
Approximate Dimension of 9 Qt = 9"x9"x11"

Dimension for 16 Qt :
H =14"
W = 14"
L = 9.5"

Dimension for 28 Qt:
H = 13.5"
W (Side to Side) = 18.5"
W (Handle to handle) = 21"
L = 10.5"

I would suggest that you at least get a 16Qt cooler box for the 1 week's worth of EBM. In the 9Qt, I can keep 10 packs of flat frozen EBM, 5 oz, in a plastic container with ice pack comfortably. I think without the container, i can keep probably 15 packs of EBM, if I lay them flat.


During my trip, I'd fill the Coleman with ice in the evening when I get back to the hotel room. I will pump and keep my pump parts in a zip lock bag and store them together with my EBM storage bags in the Coleman for the night. I will put a sheet of ice pack and towel on top of it before I cover the lid too. The next morning, there will still be ice. :)


I have also used a styrofoam box that my ex-company uses to transport beer yeast from Europe. It takes 1 week to reach Malaysia and my colleague said that there will still some dry ice upon opening the box. I used it to transport my 1 week supply to my mom's place before my trip. But it's quite big in size and if luggage space is a concern, it's not an option. I have attached a picture for you to see. 


Do take note that it's very important to pack the cooler box, means you can use towels, and even paper  to fill up the space and finally tape the opening with masking tape to keep the temperature cool for a longer time. The volume of frozen milk is also important, whereby 8 oz of frozen breast milk (FBM) will stay frozen longer than a pack of 5 oz.

For my trip, I decided to donate all my EBM that was pumped during my few days there to another baby whose mom had breast cancer. I got in touch with a Lactation Counselor before my trip and made this arrangement. So, I only brought back the EBM that I pumped on my way home for my baby. All in all, it really depends on what you would like to do with the pumped milk. But, I "NEVER" pour EBM away. I think it's really a waste of blood and sweat and so many other babies can benefit from the precious liquid gold. :) 

Aside from my own experience, here are some good links to refer to:


Template for Dr's Letter:

Print on Hospital’s letter head, if possible.

DDMMYYYY
To Whom It May Concern
Re: Breastfeeding Mother
This is to confirm that, ______________, passport number: XXXXXXXX, is fully breastfeeding her baby. Since she is not travelling with her baby, she will be expressing breast milk every 4 hourly to avoid any infection to the breast. Breast infection is a potentially a serious medical problem that requires medical attention.
Kindly allow her to take her breast milk back into the plane for storage.
Thank you very much for your understanding.


Sincerely,

………………………….
Dr XXXXXX
“Clinic chop”

Good luck! Keep Calm and Travel with EBM 

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