Working and Breastfeeding

October 13, 2018

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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.

 

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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.

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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

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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.

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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.

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How does one manage tandem nursing babies of different ages?

Elizabeth Tandem nursing Read the rest of this entry »

Weaning

June 23, 2016

I remember when all three of my children weaned.

My plan for Phoebe was to nurse for one year.

I figured I could avoid formula and bottles if I nursed her for twelve months.

At my baby shower for her I received 36 bottles! I had not registered for anything and told people I would be breastfeeding. We did not have a dishwasher. The thought of washing bottles overwhelmed me and made me want to breastfeed even more.

Laziness was a motivating factor initially in some of my parenting choices. Breastfeeding and co-sleeping were the bomb!

Though we struggled together initially, nursing became an extension of my mothering Phoebe.

As her first birthday approached I got anxious about the weaning process. How would I do it? Who would it benefit? How would I calm a tantrum or get her to sleep?

photo Read the rest of this entry »

The Lactivist

February 4, 2015

Lactivist

Chloe nursing at the World Walk for Breastfeeding NYC 2002

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.

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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.

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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.

Uniforms and Fairy Dust

January 30, 2015

Why do new parents seem so guarded or opinionated or defensive? Well, much of it is that they are protecting their new family.

Another thing I have noticed is that parents feel they have to subscribe to a specific style. In the years since I first became a new mom – over nineteen years ago, I have noticed that so much around parenting is trademarked. I believe that is all about marketing. I have written about how poor parents are the biggest target of marketing these days.

I remember when it was time to start feeding Phoebe solid food a mom at a La Leche League meeting suggested baby led weaning. This made sense to me – let her take food off the table – I would bite off a tiny piece of apple and let her chew it, I would continue to nurse her. Eventually I became a La Leche League Leader. A couple of years back at a meeting I was leading for toddlers a mom mentioned baby led weaning and I was thrilled to hear this concept being embraced until I heard about all the “rules around it. Rules? There is a book! Wow. I thought it was about being instinctive with a few guidelines about what foods to give and which foods to avoid so that they would not choke.

Baby Chloe 1

I also noticed how people would comment on how attached Phoebe and I were. Of course, I am her mom, we are together (the company I worked for closed while I was on maternity leave and I was a full time mom then.) Then I learned there is an organization called Attachment Parenting – which I love! But I hear moms asking, “Is it is AP to . . . “ Or “does it go against AP if I . . .”

Then there are the breast feeders and the bottle feeders and the co-sleepers and the baby never comes into my bed, and there are “Never let the baby cry” and the Cry It Outs.

I belong to way too many groups on Facebook and I hear so many new moms asking permission to go outside of the rules of whichever category they have chosen to join. I hear arguments about how you cannot do this or you should do that.

Titles: Tiger Mom, Hippie Mom, Crunchy Mom, Stay At Home Mom, Working Mom

Does one need only belong to one “club?” Does anyone only do things exactly as planned out in a book? Do breastfeeding moms never give their babies a bottle? Do most parents have their kids in their bed at least some of the time? Do the families that make their own baby food sometimes use a jar or sometimes eat convenient food? Do the touchy feely moms yell? Does the Tiger mom cuddle? Does the home-schooling mom want to send her kid away to boarding school? Does the mom with the most awesome and fulfilling career want to quit her job and stay home?

If you asked these questions to these parents you would get a resounding YES from time to time.

It seems like a new mom has to wear armor to defend herself and her choices. She has to seek permission to care for her baby. Whatever happened to instincts? Have we cultured intuition away by writing books and coining phrases and categorizing everything and everyone?

Maybe the extended family has done things differently so a new mom feels she needs to defend her choices. Perhaps she is faced with criticism and needs to wear a uniform.

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Whatever it is I wish I could hug all new moms and blow some instinct like fairy dust at them and let them take it in, take in their babies. I want them to clear out the noise so they can hear. So they can hear that voice inside them that tells them: this is your baby, your child, do not strive to fit in, strive to find love, strive to find the wonder in your little person, strive to grow along with them.

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In the meantime I will interject my thoughts in those groups when I have it in me to do so. I imagine fairy dust with each click of the keyboard.IMG_7271

The Power of Tears

January 10, 2015

You never know what may come out of your mouth and how it may impact another person

In my early years as a La Leche Leauge Leader I used to hold meetings in my apartment. One steamy summer afternoon I sat on the floor of my living room folding laundry as Phoebe napped. The buzzer jolted me as I wasn’t expecting anyone. It was the day after the Series Meeting. A voice over the intercom said “I am here for the Meeting.” I buzzed her in.

At my door was a petite new mom with auburn curls and a five-month-old baby asleep in a dark red Baby Bjorn carrier. Beads of sweat speckled her stiff body. Tension permeated her.

“I am sorry but the Meeting was yesterday. Come on in and have a glass of water,” I said.

Her face fell but her body remained at attention.

“Come on in, I‘m just folding laundry. Have a seat.”

“No, I don’t want the baby to wake,” she replied.

She stood in my living room as I sat back down on the floor and went back to the task of folding a load of pinks, greens, oranges and yellows.

“It’s hard being a new mom isn’t it?” I asked.

“Yes.” There was a pause.

Then, “and my own mother wants me to stop breastfeeding. She doesn’t understand me. I just want to cry,” she blurted out.

“Well, then, cry,” I offered.

“I don’t want to cry in front of my baby. I don’t want her to think I am weak,” she was incredulous.

“You know, there is strength in tears,” I said as I folded one of Phoebe’s flowery sundresses.

The floodgates opened. I didn’t know if it was five months of pent of tears or a lifetime.

Her body softened with each sob. Even her curls fell easier around her face. Her baby girl woke up and she sat on my couch and nursed her. At first she was stiff. I touched her shoulder and gently pressed her back into the back cushion. More tears fell.

This woman had traveled from the Upper West Side of Manhattan to the East Village. If you live in New York City you know that is quite a journey on public transportation, particularly for a new mom.

I never saw the woman again or heard from her but I learned the power of simple words that day.

I often cry with the moms with whom I work and I cry in front of my children. I always feel powerful after.

Those Eyes

November 13, 2014

Looking through old photos of Phoebe I was taken back to the moments she was born. The thing I remember more than the pushing, the pain, the fear of what was going on with my body, more than thinking about our apartment move as I was in labor, more than thinking about moving out of Manhattan, more than thinking of whether she would be a boy or a girl, about what we would name her, I remember those eyes. Those eyes saw right into me. More than thinking if I would be a good enough mother, more than thinking about breastfeeding I remember those eyes.

She is a young adult now and I am still taken with her eyes. Looking at this photo when she was about two years old, the image is a bit blurry but look at those eyes.

Little Phoebe

I would wonder what was going on behind those eyes, what she was thinking.

There are certain moments in mothering that leave indelible images in my mind. There was when Chloe, at three weeks of age told me she did not like the light in her eyes while she was nursing – she pulled off my breast, turned her head toward the lamp beside the bed and fake cried then turned back toward me and stopped – she repeated this action until I figured out to turn off the light. She then happily latched on and nursed herself to sleep in the dimmed room.

There was the moment when two year old Finn looked up at me, a stressed moody mama trying to get out the door and get three children to school on time on a rainy day – you know that level of stress – I began to raise my voice, speak angrily. Instead of heading my demands to get into the stroller he stopped, crossed his little arms across his chest and proclaimed, “you have to be patient, Mama.” A tear rolled down his check. I listened.

There are many stories like this but there is nothing like a first. Phoebe’s first look into my soul made me the mom I am. Never forget to look into your child’s eyes. Never forget to watch your baby’s actions. Never forget to listen to the wisdom of a two year old.