Working and Breastfeeding
October 13, 2018
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.
Tandem Nursing
August 10, 2016
Tandem Nursing means nursing two babies at once. This can be twins or it can be siblings born at different times i.e. an toddler and an newborn.
Many people believe that you cannot get pregnant while nursing or that if you are nursing when you are pregnant you need to wean.
You can get pregnant while nursing.
Breastfeeding can be birth control under specific conditions. There is the Lactational Amenorrhea Method (LAM).
LAM works like this:
- No return of menses since birth
- breastfeeding on demand, night, and day
- baby does not take any food or other liquids regularly
- baby’s sucking needs met primarily at the breast (no pacifier or bottles) baby is less than 6 months old.
- baby does not go longer than four hours during the day and longer than six hours during the night between nursing
With LAM there is about a 1-2% chance of getting pregnant – similar to taking birth control pills.
Many people get pregnant while nursing. Often moms are advised to wean their older baby if they become pregnant. There is no need to wean unless you are at risk for premature labor and you are advised by your health care provider to refrain from intercourse.
What can you expect while nursing while pregnant?
About halfway through pregnancy your milk changes from mature milk to colostrum. Colostrum is thicker and does not flow as easily as mature milk. Some toddlers get frustrated and wean. Others hold on for dear life!
One telltale sign of pregnancy can be sore nipples. Some moms find nursing painful or they become averse to nursing and they choose to wean their older baby.
Others will put limitations on nursing – one mom used counting as her strategy – “you can nurse for ten seconds – 10, 9, 8 . . .“ Another mom had a nursing chair where they could only nurse sitting in the chair in a quiet room.
Some advantages of tandem nursing can be:
- nursing toddler can help relieve engorgement
- older baby not feeling left out
- mom doesn’t feel she is abandoning the older child
- she still has her magic toddler wand
- sibling bonding
- stronger immune system of the toddler
Disadvantages:
- mom may feel touched out
- judgement from family, friends and health care team
When nursing twins it can be a good idea to alternate breasts for the twins. This can be every feeding or everyday – Twin A gets the left breast while Twin B gets the right breast for one feeding and then alternate the next feeding or on Monday Twin A gets left breast and Twin B gets right breast and on Tuesday Twin A gets right breast and Twin B gets left breast and so on. Many moms of twins will choose to nurse one at a time once they get older to have one on one time. In the early days it can be a time saver to nurse both at once.
How does one manage tandem nursing babies of different ages?
The Lactivist
February 4, 2015
Lactivist
The word was accusatory. I felt her anger over the internet.
What had I done to her? I did not say anything about formula feeding. I did make the case against the unethical marketing of formula. That is distinctly different from condemning moms who formula feed.
There is a formula campaign going around social media under the guise of making the “Mommy Wars” go away. In actuality most of the conflict of motherhood, parenthood really, is sparked by media and advertising.
The line between marketing and entertainment is becoming more and more murky. I have learned for the most part to discern what is being sold to me as opposed to what is there to entertain me.
This is the comment I made:
This is not about breastfeeding vs formula feeding, it is about the nefarious marketing of the pharmaceutical industry that undermines all families. Formula has its place. This is about using guilt to promote their product and to make us divisive – are we really? At the heart of it on the playground I can say that most moms get along. The images in the media create fear and defensiveness. I work professionally to support all mothers, I know when formula is needed and wanted. People are not always given the opportunity to make an informed choice.
Why was she angry with me? Why did she think I was attacking her?
I started thinking about it. She was directing her anger at me because I am safe. She does not know me – I am just that breastfeeding advocate. What had happened to her? Was she really experiencing grief and anger over her baby feeding experience?
I have many friends who did not breastfeed and they are not angry at me. They made informed decisions or at least dealt with what they were handed and they have made peace with it.
I thought about the times I get angry at people. I moved to New York for many reasons but one of the big ones was for an acting career. I am not a Broadway or TV or movie star. I could list all of the obstacles that prevented me from becoming famous but it doesn’t matter. I still get jealous and angry sometimes when I see actors my age who have made it. I also wrote and performed stand-up comedy. I loved watching the Golden Globes but I felt little jolts of envy watching Tina and Amy up there.
These feelings are far overshadowed by my happy life. I have a loving husband whom I love hanging out with – he really is my best friend and I am looking forward to growing old with him. We have three awesome children who are smart, healthy and beautiful.
I have moved on. (Casting directors – I can still provide a resume!)
I am also a bit envious of the moms who have had babies at home. Complications prevented that from happening with my babies and me. Still, I ache a bit about some of the birth experiences my babies and I went through. In the end they are all healthy and we made it through.
I have worked out the things in my life that got in the way of some of my goals. I have accomplished many of my goals and I am a happy woman.
So, going back to the name caller, I think she is angry and sad that she is not breastfeeding. I do not know if her birth interfered with her plans. I do not know if her family gave her a hard time about breastfeeding. I do not know if she is taking a medication that is incompatible with breastfeeding. I do not know if her body never made milk. I do not know what experiences she may have had in her past that makes it uncomfortable for her to have anyone touch her breasts.
I sure as hell bet she loves her baby immensely. I hope she can find some peace. I will be the brunt of many a new mom’s anger and frustration.
That is a role I can play.
Change and Magic
June 26, 2014
Yesterday was my birthday. Today was the last day of school for NYC Public School children. This weekend all three of my children will begin their summer at camp in the Berkshires and Rob and I will be alone for four weeks.
My oldest child has one year of college under her belt. My second child will be researching high schools in the fall. My youngest will begin fourth grade.
This summer many friends are leaving New York. They are going to Portugal, Massachusetts, Portland (both East and West) Israel, and Phoenix. The list goes on.
Change is hard. I have trouble with change. I have a hard time packing. I am challenged to move things around like furniture and art on my walls. I am a creature of habit.
But I also have change envy. I am envious of all those friends starting out on new adventures. I feel a little left behind.
Working with breastfeeding moms and babies I get to relive those early challenges of motherhood, the dramatic changes in the body and the heart. As someone who advises about weaning I get to relive the emotions of that milestone.
I was talking to Finn on the way to school this morning and he told me he wishes he could perform magic. The first thing I imagined I would do if I was magic would be to bring back my mother. This year in October it will be ten years since she died.
If I was magic . . .
Oh, the possibilities.
For now, I will remain in New York. I will continue to mother my children through all of the changes they experience. I will nurture my relationship with Rob. And I shall seek change that is positive. I will embrace each day, each challenge, each wrinkle and gray hair.
You see, this is about getting older. Yesterday was my 49th birthday and I am thinking deeply about 50. It is such a milestone. When I was a kid I used to imagine a grownup being 35 years old. I am past that quite a bit. I have to consider what this means.
I walk down the street and I look at other women. I try to figure out how old they are. I try to analyze their state of mind. I try to figure out if they are happy and healthy.
I will take in this final year of my forties. I am happy and I am healthy. And I know deep down I do possess some magic!
Head Games for Smart Women
June 4, 2014
I often play a game with myself to protect my children from potential angry outbursts from their mother – these outbursts are not unprovoked – no one can push your buttons like your offspring but it is my responsibility, my job, to model appropriate behavior. However, I am only human so I must enable strategies to guide my babies into functioning adults.
The game is that I pretend that I am the subject of a documentary or television show and I am supposed to demonstrate good parenting. Maybe this comes from being a Southerner who gives a damn what others think – though this aspect of my psyche is fading with my youth – but this idea had to spring from somewhere.
My children are growing (and so is my body) so I am finding less of a need to “act” like a decent mother. Or perhaps I acted like it so much that as a Method actor I became the Decent Mother!
I have had a new epiphany. You see, I noticed back at Thanksgiving that I was bursting out of my clothes as I gobbled up turkey and gravy and pecan pie and this wine and that cocktail and this cheese and that Pernil.
Something had to give besides my seams. So, I joined Weight Watchers in early December.
It is now June and I am within five pounds of my starting weight. I could celebrate a pound a month but at this rate I may be retired before I hit goal. In December my membership was truly a preemptive act to avoid more weight gain – let me hold steady through the holidays then come January I will slim down. Ha!
I know how to do this as I am a Lifetime Weight Watchers Member but the last time I lost any weight on the program I was nursing a baby into toddlerhood and let him suck the calories right out of me. I don’t know how large the wet nurse market is and I do not need another baby!
So, today I decided that I would use my parenting strategies in my weight loss journey. I will pretend that Weight Watchers has a film crew following me around and I am the epitome of the model Weight Watchers Member. I will make smart choices. I will choose smaller portions, more nutrient dense, high fiber foods. I will eschew my beloved gluten free brownies. When I make my children buttery eggs in a hole I will eat a boiled egg and a half a grapefruit. I will leave morsels behind on my plate. I will choose mangos over cookies.
I will be the envy of those humans bursting at their seams as I begin to swim in my clothes.
Weight Watchers will make me their new spokes person and I will be voted Mother of the Year!