Once you successfully make it through the early weeks of breastfeeding, and manage to overcome any problems you may have had in the beginning (soreness, engorgement, hormonal rushes, etc.) you usually experience a ‘honeymoon period’. Just at the point when you are beginning to get the hang of this whole mothering thing and are settling into a routine, it is time to go back to work or school. Although many working mothers used to nurse for a few weeks and then wean before they returned to work, more and more moms are choosing to continue to nurse after they return to work. As the many advantages of breastfeeding become more obvious, mothers don’t want their babies to miss out on the benefits of nursing just because they have to return to work or school.
There are several important elements to consider in order to successfully continue nursing your baby when you return to work or school: first, you need to select an appropriate pump which will empty your breasts quickly and efficiently. Second, you need to select a care provider who supports your commitment to breastfeeding. Third, you need to arrange breaks at regular intervals (ideally, about every three hours) during your day in order to have time to pump. Fourth, you need to find a private place to pump, preferably with access to an electric outlet. Fifth, and very important, you need to establish a good milk supply after your baby is born and before you return to work or school. This will make maintaining your supply when you are separated much easier.
You will want to purchase or rent your pump no later than three weeks before returning to work. Even if you are at home with your baby for the first several weeks or months, it is helpful to have the pump to store up some milk to have on hand when you start working, to introduce baby to bottles so you can be sure he will take them when you leave him with a care provider, and to give you time to familiarize yourself with the operation and cleaning of your pump, as well as get an idea of how long each pumping session is likely to take.
You will feel better if you have some extra milk stockpiled in the freezer. You don’t need to have gallons on hand, just enough for a few feedings. Pump after feedings for five minutes, or on the other side when your baby takes one breast at a feedings (your supply will be more plentiful in the mornings) and store the milk in 2- ounce portions. Try to have at least 12 ounces on hand. If you have strong feelings about not wanting your baby to have any formula at all, or if he is allergic to formula, you may want to have a little more stored up.
Selecting a care provider is seldom easy. Leaving your baby will be much less stressful if you feel really comfortable with your child-care situation. Putting a baby (especially a tiny infant) into a day care center with multiple infants is probably the least optimal situation. Look for a center with the highest possible ratio of adults to infants. Drop in unexpectedly and see how things operate when they aren’t expecting a visit. Be sure to let the care providers know that you are nursing. If they aren’t familiar with handling human milk or nurturing nursing babies, look elsewhere or share the information in “Caregiver’s Guide to the Breastfed Baby” with them. Take comfort in the fact that breastfeeding protects your baby from many of the nasty germs that seem to get passed around day care centers.
Try to do a ‘trial run’ the week before you return to work/school. Leave the baby with his caregiver and go to wherever you will be pumping. This will give you a chance to scope out the situation – Do you have an electric outlet? Do you need an extension cord? Do you need to find out which office space will be available, and when? Do you have access to hot water to clean your pump parts? Is there is refrigerator, and if so, can you store your milk in it if needed? etc, etc. You should also let the caregiver feed the baby while you’re gone, so you can see how he will take the bottle, and get an idea of how much he will take at a feeding. Leaving him for the first time is stressful enough, but will be easier if he is left in a familiar environment.
How often you pump when separated from your baby depends on several factors. One is whether your goal is to pump enough during the day for the baby to have exclusive breastmilk feedings the next day, or whether you plan to combine formula and breastfeeding. If your goal is for your baby to have only breastmilk, then ideally you will empty your breasts about as often as he nurses when you are together. For example, if you return to work when your baby is six weeks old and still nursing every 2-3 hours, then you should try to pump every 2-3 hours when you are separated.
This is an optimal schedule for the mother of a young baby who wants to provide only breastmilk for her baby:
-Set your alarm 20 minutes early (OUCH!) Nurse your baby, even if he is half asleep.
-Get both of you dressed and ready to go. Pack up everything you can the night before – diaper bag, bottles in cooler, lay out clothes, etc.
-Eat a good breakfast. Don’t skimp on this, even if it is something you can eat quickly like a carton of yogurt or bagel with cream cheese. Be sure to include a nutritious drink, such as juice or milk.
-Nurse again for a few minutes before you leave if possible. Some babies get so much milk at the first feeding that you can’t get them to eat again, but try anyway.
-Pump mid-morning. Allow at least 20-30 minutes for each pumping session (ten minutes for pumping with a good double pump, and ten minutes for assembly and clean-up). Have a drink and a nutritious snack while you pump.
-Pump again at lunchtime. If possible, leave work and go to your day-care site to nurse. More and more companies are providing on-site day care, or you may live close enough to travel home and back if dad is watching the baby or your caregiver lives nearby. It may even be possible for your caregiver to bring your baby to you at lunchtime. Once again, eat a nutritious meal with something to drink.
-Pump again mid-afternoon. Have a drink and a snack.
-Nurse as soon as possible after you pick your baby up from day-care or return home.
-Eat a nutritious dinner.
-Nurse your baby frequently during the night. Tucking him in bed with you is a good way to make up for the closeness and skin-to-skin contact that you miss out on during the day. Some babies start to nurse more frequently during the night when they are separated from their mothers during the day. This is called ‘reverse cycle feeding’ and works well for many mothers, especially if they find it hard to pump during the day. If baby is in bed with you, you will get the rest you need while he gets the milk he needs.
Don’t get the idea that if you can’t pump three times during the day, you shouldn’t even try to continue nursing. Many mothers have work schedules that are very inflexible, and they don’t have either the time or the place to pump more than once a day, or even not at all. If this is the case, you can still breastfeed. Pumping even once a day will give you some stimulation, help maintain your supply, and help keep you from becoming engorged. If you are only able to pump once each day, you will probably have to supplement with formula, but at least your baby will have one feeding of breastmilk, and you can continue nursing while you are together.
While some employers provide a special place set aside for mothers to pump, as well as frequent breaks during the day, this is the exception rather than the rule, especially in the United States. I expect that this will change as more and more employers realize that encouraging their employees to breastfeed is cost effective for them, due to breastfed babies being healthier (fewer trips to the doctor, resulting in fewer health care claims and less time missed from work to care for a sick baby). Studies have also shown that when employers promote and encourage breastfeeding, it creates a better work environment and a more loyal, satisfied employee.
Given the fact that, in many cases, we are light years away from a uniform breastfeeding friendly work environment in the U.S., here are some suggestions on places to pump: lounge, locker room, unused conference room or office, your car (yes, that’s one reason that Medela makes vehicle lighter adapters), or a women’s restroom. As yucky as it sounds, for many mothers pumping in the restroom is the only option they have. Make sure you have hot water available for cleaning pump parts, and bring your own soap. You may even want to bring your own basin from home if you don’t feel comfortable with the cleanliness of the sinks.
Try to find a comfortable space with an electric outlet. If you absolutely don’t have a place to plug in your pump, you can use a small battery pump (which is less effective than the Pump In Style or the Lactina) or you can rent or buy a PowerPack. Medela offers this option that allows you run either the Pump In Style or the Lactina on battery power, and it also contains a vehicle lighter adapter for pumping in the car.
Before returning to work, you may want to discuss your options with your employer. If at all possible, try to return on a part-time basis, even if only for a week or so. You may also try to return to work on a Friday rather than a Monday so that you’ll have the weekend to recover from your first day back.
While all employers should be supportive of your efforts to continue nursing, you may occasionally encounter a boss or supervisor who not only is not supportive, but may actually be hostile when you try to pump at work. In situations like this, sending a copy of the following letter may be helpful:
To whom it may concern:
Jane Doe, the mother of a six-week old breastfed infant, will be returning to work on a full time basis on March 11, 2000.
While nursing an infant this age, it is important for the mother to empty her breasts at regular intervals (ideally every two to three hours) in order to maintain her milk supply and prevent medical complications such as plugged ducts and mastitis (breast infection).
My recommendation is that Jane be allowed several fifteen minute breaks each day, in addition to her regular lunch break, in order to express her milk with an electric breast pump.
I hope that you will be willing to work with her regarding this matter, since regular milk expression during prolonged periods of mother-baby separation is in the best interest of both mother and child.
Please feel free to contact me with any questions that you might have.
Anne Smith, IBCLC (International Board Certified Lactation Consultant)
Leaking at work is much more of a concern than leaking at home. Soaking through your shirt may be inconvenient while you are at the grocery store or visiting a friend, but when you are making an important presentation in front of your boss and a roomful of clients, it can be disastrous. That’s why I offer the BLIS (Breastmilk Leakage Inhibitor System) This product can be a life -saver for moms who leak a lot and have to be separated from their baby for extended periods of time.
Here are some other tips for dealing with leaking:
-If you feel your milk letting down, cross your arms across your chest and apply pressure for about ten seconds or so. No one but another nursing mother will know what you are really doing.
-Choose bright or dark colored prints. Avoid white and pastel colors. They show leaks more. Cotton and synthetic fabrics show leaks less than silks, linens, and clingy fabric
-Wear a loose jacket or blazer to throw over your blouse.
-Keep the clothes loose and comfortable. You may find that your pre-pregnant clothes don’t fit well anymore, so invest in a few multi-purpose outfits that fit loosely. Choose outfits that button in the front or two- piece outfits that you can pull up easily.
-Keep a spare blouse at work (one in a neutral color that can be worn with most outfits).
-This may seem obvious, but choose clothes that are washable and don’t require ironing. Your life is complicated enough right now without adding ironing to your list of things to do.
Continuing to breastfeed after returning to work is a real labor of love, but it is well worth the effort. No, it isn’t easy, and requires a great deal of commitment and work on your part. Only you can provide the best possible nourishment for your baby, and there is no doubt about the physiological benefits (immunities, fewer illnesses, less time missed from work/school), the financial benefits (cost savings associated with fewer doctor visits and not buying formula, which can cost anywhere between $100 - $200 per month, depending on the type), and the psychological benefits (the closeness, bonding, and skin-to-skin nurturing) that only you can provide.