mamamilkandme

I never met Kerry in person. We had one of those La Leche League Leader/Mom phone relationships. She initially called me with a few basic questions about breastfeeding her newborn. She then reached out to me as she was going to be working full time. She was having trouble pumping enough milk for her baby while she is away. I asked if it was possible to visit her baby during the day. We live in New York City and Kerry’s office was two subway stops away from her office – about a mile away.

Every Monday through Friday Kerry hopped on the train during her lunch break.

She had communicated with her nanny that she was on the way and that she would be nursing her baby.

This worked for Kerry and her baby as she had planned this in advance. Kerry communicated with her employer that she would take her lunch break out of the office. She communicated with her caregiver not to feed the baby a bottle at lunch.

Kerry was able to make up the difference with pumping while at work and at home in between nursing.

Employment outside the home is one of the biggest barriers to breastfeeding in the United States.

Does that mean it is impossible? No.

There are strategies and lifestyle decisions to consider.

What are the obstacles employed moms face?

• Maternity leave duration
• Time to pump
• Quality pumps
• Support from family and caregivers
• Support from employer
• Inconsistent information
• Balancing home and work life

Tina, an attorney, negotiated her maternity leave as well as her pumping schedule while she was pregnant and still working. She noticed that many of her colleagues returned to the grueling hours and were not breastfeeding when they returned to work. Tina laid out a plan for her firm and told them what she needed. This communication helped both her and her employer. They had never had a mom who was breastfeeding once she returned towork. Tina changed the culture of her firm. Some of those moms saw her as a champion and when they had a second baby they too had more success in breastfeeding.

Women are often told they need to sleep train their babies. That she needs to have her baby sleep in a separate room. If a baby sleeps for twelve hours and the mom is gone for nine hours that leaves three hours a day for them to be together. What is a mom to do?

Stacy, a physician, nursed her baby through her residency by keeping her baby in bed with her, despite criticism from her community. She was gone for twelve hours at a time. “How else would I get to know my baby?” she stated in delight.

Unfortunately, in the US standard maternity leave is twelve weeks. Sometimes moms will negotiate for more. Others will spread it out. For example, Lisa, a bookkeeper, returned to work at nine weeks for two days a week. It was early but it gave her an easier transition. She felt this allowed for her to slowly build up to five days a week instead of being home full time and then suddenly being gone all week.

Similarly, some moms who do need to return full time will have their first day back to work on a Thursday (if she works Monday through Friday) making this first “week” away a short one.

I am frequently contacted by moms of older babies of about three or four months of age. Breastfeeding was going well until two or three weeks back to work. Her milk supply is faltering and she cannot keep up.

She is pumping but the baby is flying through her stash.

Sometimes moms nurse and pump while on maternity leave and put themselves into an oversupply. They stockpile great volumes of milk and then when they head back to the office they rely on that stash. Even if they are pumping at work they may not be pumping as much as the baby is consuming. Then suddenly there is no more stash and the mom now has a low milk supply.

Some moms are truly not able to pump at work for various reasons so pumping during maternity leave is essential. For these moms it is important to nurse as much as possible when she and her baby are together. And she can add some pumping sessions in at home between nursing.

Many moms who are able to pump at work can enjoy the maternity leave without having to focus so much on pumping milk. As they transition back to work they can nurse the baby as much as possible when they are together.

To keep up and to reduce the need for more bottles and more pumping a mom can nurse her baby as the last thing she does before they part ways – either at the day care center or with the caregiver. She can then pump first thing when she gets to work to have one pumping session done. Then pump one or two more times during her workday. Then as she reunites with her baby the first thing she does is sit and nurse. This gives her and her baby the opportunity to reconnect and it also gives the opportunity for the mom and the caregiver to communicate. On days off the mom can focus on nursing her baby as much as possible.

Another challenge is the marketing of the faster bottles for older babies. This can undermine breastfeeding as the baby consumes more than he may need because the flow is faster. Once the baby has a bottle that works there is not need to move to a faster flow. Also, the caregiver can use paced bottle feeding to avoid overfeeding and flying through the milk.

Here are some strategies to keep nursing while working:

• Establish a good supply from the beginning
• Communicate with your employer
• Communicate with your caregiver
• Pump when you are away from baby
• Use a slow flow bottle
• Nurse your baby when you are with your baby
• Nurse all weekend (or on your days off)
• Pump as soon as you get to work (this gives you a jump start)
• If it is possible: visit your baby during the day so you can nurse
• Have your baby sleep with or near you

It is important to remember that breastfeeding is not just a way to get a baby fed. Breastfeeding is a complex relationship. By nursing a mother and her baby’s bodies are communicating. Bacteria are passed back and forth to build baby’s immune system. Hormones are passed back and forth to tell a mom’s body to make milk, to give her baby melatonin. There is feedback we do not entirely understand. And breastfeeding does not have to be all or nothing. If a person needs to supplement they can keep nursing for however much works for her and the baby. Working does not have to mean weaning.