Breastfeeding and the Working Mother

If you have any questions about combining working and breastfeeding, please feel free to email me at cecilia@birthyourwayjax.com.

When my son was born, I was a single mother. I was the sole support for my family so I had to return to work when my son was 10 weeks old. I had nursed my other child until she weaned herself (I was married and working in a family business at the time so I was able to have her with me all the time), and I knew I wanted to let my second baby nurse for at least a year. I decided to commit to pumping for a year so I could avoid giving him any artificial baby milk.

It was extremely important to me to provide the very best nutrition I could for my baby, but I found that the benefits of breastfeeding and working went way beyond just providing a delicious, nutritious drink for my baby. Combining working and breastfeeding became very important to me because:

• I never had to pay a penny for all that good, nourishing milk Trevor drank.
• I didn't have to use a single moment of my precious time with my son preparing artificial baby milk to take to the caregivers the next day. The time I invested every work day to pump my milk for the next day's bottles was well worth the immeasurable return my son and I received.
• Even though pumped milk does lose some of its immunological properties after it has been refrigerated or frozen, I found that pumping during the day allowed me to maintain my supply so that I could provide ample milk for my baby and ensure that he DID get an abundance of immunities from our nursing at home. This is obviously extremely important for children in group daycare situations.
• I always knew that, although I had to leave my baby with a caregiver all day while I worked, I was still providing him with something no one else could provide - his own, customized Mommy milk.
• Nursing my baby after work gave us the chance to reconnect in a way I can't imagine would be possible with other feeding choices.
• Somehow, on a level I can't even explain, it felt like nursing my son allowed him some primal technique of identifying me and differentiating between his Mama and the other women who lovingly cared for him while I was working.

Ultimately, I pumped for 14 months, then continued to go to the daycare center at lunchtime to nurse my son to sleep for his nap until he was 18 months old. My son never had a drop of artificial baby milk and was exclusively breastfed until he began trying solid foods at about 8 months old. If you have any doubt about whether he was getting enough to eat, click here to see Trevor at seven months old, when he had had nothing but Mommy milk! Trevor continued to nurse until he gradually weaned at his own pace when he was almost 4 years old. Combining working and breastfeeding was not always easy, but it has been worth every second of effort. Of all the things I've done as a parent, I have to admit this is one of my proudest accomplishments. Read on for details and recommendations for successfully nursing your baby after you return to work!

I tried a couple of small, battery-operated pumps and couldn't find one I liked so I decided to use hand expression, which I had learned by reading Gale & Karen Pryor's NURSING YOUR BABY and practice, practice, practice [also try Gale Pryor's NURSING MOTHER, WORKING MOTHER]. I used hand expression very successfully for a few weeks, but then decided it was taking such a long time that I really needed to find a more efficient method. I thought I couldn't afford to rent or buy a good electric pump so I ended up with a Comfort Plus cylinder-type manual pump, but I don't think these are available any longer. It only cost about $20, worked wonderfully for me and was easy to clean and transport. If a mom is comfortable with this type of pump, I can certainly recommend it.

Having said that, I must add that I now recommend that working, breastfeeding moms consider investing in a good, efficient, electric pump. The Medela Pump-in-Style or the Ameda Purely Yours are two popular and highly recommended options. Generally, they are more efficient for most women than hand expression or manual pumping; and they are definitely quicker. The initial cost may seem significant, but, if you just think about all the money one saves by not buying artificial baby milk (about $2000 for a year's supply), it's a worthwhile investment.

Another thing to be considered is that insurance companies will sometimes pay for the cost of pump rental if your healthcare provider "prescribes" pumping for some medical condition. I've heard of women using such reasons as plugged ducts, thrush, mastitis and other fairly common maladies encountered by the breastfeeding mother. It's worth a try! I would certainly think that any woman whose baby is in Neonatal Intensive Care could count on her healthcare providers to help her lobby for coverage of the cost of the pump, at least while her baby is in NICU, on the basis that breastmilk is essential for her baby's survival!

My normal schedule went something like this...

• Woke up with baby about 5:30 or 6 AM, nursed him back to sleep
• Showered, dressed, grabbed some breakfast and made my lunch
• Arrived at my company's onsite daycare center by 8:10 or so, sometimes nursing Trevor again before leaving him there
• Arrived at my office about 8:30-9:00
• About 10 AM, closed office door and began pumping session
• 10:30, put pumped milk in a canvas lunchbag and put it in the refrigerator in the break room; washed the pump with hot water, dried it and put it in another canvas bag. *See below for a "typical" pumping session.
• Around noon to 1 PM, the caregivers called to tell me Trevor was awake; and I went over to nurse him... at first, I would take my lunch with me and eat while I nursed, but as he got older, this was impossible so I ate at my desk either before or after I went over to nurse him. Sometimes, I'd be in the middle of my lunch when they called. I found it was very important to make things that would "keep" in the event I got interrupted. :) Spending my lunch hour with my son was the best part of the workday...
• 3:30 PM - another pumping session, identical to the earlier one except that the "yield" was sometimes more or less depending on how late I went over at lunchtime and how enthusiastically Trevor had nursed then. I could still usually get 8 oz, sometimes more.
• 5:30 or 6 PM, picked Trevor up from daycare, usually nursing him as soon as I got there if he was interested... sometimes waiting until we got home.

At home, I put the freshly pumped milk in the back of the top shelf of the refrigerator, being sure to "rotate the stock" forward. I then washed the pump really well with soap and hot water, dried it and packed it in my briefcase for the next day. I'd also wash out the bottles Trevor had emptied that day and get out the clean ones for the next day, also packing them in the briefcase. And put the canvas bags back in my briefcase, too. About once a week, I'd get out a fresh "lap towel".

I made a quick dinner for myself and my other child (she was 14 when the baby was born so... she would cook sometimes), then I usually spent the rest of the evening nursing my baby. We usually took a bath together, too, and always slept together. I noticed that my son gradually adjusted his "schedule" so that he was awake and nursing more during the night than he had been. He slept more during the day, but he still usually drank all the milk I could pump.

*A "typical" pumping session, more or less...

• Got out all my supplies... a towel for my lap, four 4-oz bottles, the pump
• Unbuttoned my shirt or pulled it up
• Massaged my breasts (see Assisting the Milk Ejection Reflex) and did some deep breathing for relaxation
• Started pumping... I usually leaned forward slightly to allow gravity and the heaviness of the milk to help with letdown
• Closed my eyes and thought about my baby. Some women find it helpful to have a picture of baby or something that smells like the baby there, but my imagination was usually enough to help bring on a letdown
• Emptied the pump about every ounce or two, alternating between two of the bottles (my minimum goal for a pumping session was 8 oz. If I got a good letdown or two, I could get up to 16 oz - sometimes even 20! - especially on Mondays or Tuesdays after nursing nonstop all weekend). I alternated the bottles in an attempt to balance the foremilk and hindmilk in each bottle somewhat.

NOTE: We started letting Trevor drink his milk out of a sippy cup at the daycare center as soon as he could manage it (about 4-5 months old), but he still had a bottle before his nap. He never drank breastmilk from a cup or a bottle at home, of course.

I mentioned the increase in supply in the early part of the week. Don't be surprised or discouraged if supply is off a little towards the end of the week. Just be sure to nurse, nurse, nurse over the weekend. Laze around in bed and just nurse as much as baby will. Hey, it's the perfect excuse for catching up on your rest, after a long week at work. Furthermore, in my experience, the three most important things in successfully combining working and breastfeeding are getting plenty of rest, getting plenty of nourishment and making a sincere commitment to provide your baby with the very best nutrition for at least the first two years of his or her life. Here are some more suggestions for increasing your breastmilk production.

An awful lot of babies develop some nipple confusion, especially in the early weeks after Mom has returned to work and Baby is getting bottles in her absence, and may begin to prefer the artificial nipples because it is so much easier to extract milk from the bottle than from the breast. If you and your baby are struggling with nipple confusion, read these suggestions for dealing with nipple confusion in the breastfed baby.

Another common concern for working, breastfeeding mothers is a baby who is reluctant to take the bottle after having been exclusively breastfed for the first weeks or months of her life. Here are some thoughts on beginning bottlefeeding of a previously exclusively breastfed baby.

For more information about working and breastfeeding, check out these sites:

• Vivian's story - Combining Breastfeeding and Shift Work
• IBCLC Janet Talmadge's Lactation Innovations, including a page on increasing milk supply
• Casey Scalzi's The Working Cow
• "Managing the Milk Supply from 43,000 Feet", Jane Bledsoe's experience combining breastfeeding and business travel
• The Traveling, Working, Nursing Mom, Kin Chao's story as a working, breastfeeding mom who successfully maintained her milk supply and provided milk to her baby while she was traveling for business.

And again... if you're planning to combine working and breastfeeding - or you're already doing it! - and you have questions or concerns, PLEASE feel free to email me at cecilia@birthyourwayjax.com. Good luck and stay committed!!! The rewards are many and last forever.

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