I’m Breastfeeding and Returning to Work: Now What?

By Meg Stalnaker, IBCLC

Women have always worked and breast fed, but in our modern day world it can present some unique challenges, particularly in the United States.

As a lactation consultant and a childbirth educator, I often find that the hopeful fantasy of bringing a baby home and the postpartum time often conflicts with the reality. As a culture we find ourselves unprepared for the challenges of caring for a new baby, learning how to breastfeed and adjusting as a family to the new roles during those early weeks.

I ask pregnant couples what our culture tells us, through the media, of what is expected of us when we have a new baby. They often say; “The message is that we can manage it all; that we can have a new baby, breastfeed, take care of our house and family, go back to work quickly and look great doing it.”

The reality is that everyone needs time to adjust to this enormous change of having a baby, no matter what country we are from. I often find that it takes about 8 to 12 weeks for mothers and fathers to feel a sense of confidence and enjoyment of their baby and breastfeeding. Many cultures around the world also have traditions around this adjustment phase that often involve other family members or the community, feeding the new family, taking care of the other children and household chores, nurturing the new mother with special foods and massage and treating this postpartum time as a special healing and bonding time with the new baby.

Most countries allow for that adjustment to happen with paid parental leave from work. A large majority of countries provide more than 14 paid weeks maternity leave.

Only four provide none. Those countries are: Lesotho, Swaziland, Papua New Guinea and the United States.

According to the Center of Disease Control’s 2010 report on breastfeeding rates in the United States, we have 3 out of 4 new mothers starting out breastfeeding. By 6 months this has fallen to 43% and by 6 months this has fallen to 22 %.

As we prepare to bring a baby into a very challenging situation of little support from our society and culture, it is even more important to create new traditions of support and nurturing of our baby and ourselves, so that we able to go back to work without compromising our mental and physical health.

Make a Plan for those early weeks when you are still home with your baby.

Have your partner or a family member be the “Guardian” of the Postpartum Gate.  Have anyone that comes over those early weeks do some helpful chores or bring a meal. If your friend or family is just there to “visit” have them only stay 15 minutes.

Have an area of your house that is totally private from any family or visitors so that you have a place to escape and rest with your baby.

*Get all the help you need with household chores, food preparation and help with  other children and pets.

*Get off to a good start with breastfeeding and get all the support and help you need to make that happen.

*Focus on connecting with your baby and focus on that above all else with lots and snuggle time and skin to skin contact.

Planning your return to work.

*Take as much parental leave as you can afford.

* Explore options of bringing your baby to work or working from home.

*Work with your employer before you come back to work on where you will be pumping and how often you will pump.

In Oregon the workplace breastfeeding support provision in the Patient Protection and Affordable Care Act requires all employers to provide reasonable, unpaid break time and a private, non-bathroom space for an employee to express breast milk for her nursing child for one year after the child’s birth.

Once you are back to Work:

*Start back to work slowly if you can. Have both you and your partner start back to work on a Wednesday or Thursday so that you can have the weekend to adjust after a shorter work week.

* Allow for extra time in the morning to be with your baby and breastfeed right before you leave your baby for work.

*See if you can go visit your baby at lunch or see if your care provider can bring the baby to you to breastfeed.

* Get a good pump that pumps both breasts at once.

*Plan on pumping every 3 to 4 hours while at work for about 15 minutes on  average.

Understand how that body makes milk and the ways that you can “trick” your body into producing milk for the pump just like you can for your baby. Remember that milk production is a demand – supply process. Your breasts also gets a stronger message to make more milk the emptier the breast is. So when your breasts feel empty, women often make the mistake of thinking that the milk production is now “done,’ but the opposite is true. When the fullness of the breast is gone, the milk production message to your brain is even stronger and you will make more milk.

Try to pump for two oxytocin-induced let-downs of milk by starting with hand expression and following with the pump. Remember that oxytocin is the “love” hormone that facilitates the bond with your baby. As we try to induce let down, often doing breast massage and hand expression can induce a let down better then just putting the pump directly on. Start your pumping session with breast massage and hand expression, then once you see a bead of milk that indicates the let down of milk has begun, start pumping. After you have been pumping for a short while, you will see that the milk appears to stop flowing or slows way down. When that happens, turn the pump off, start with massage and hand expression of the breast again and then pump some more. Babies almost always induce at least two let-downs during a feeding so if we only pump for one let-down while at work, our bodies will get the message to make less milk.

Get a hands-free bra so that you can do some ductal stimulation with breast compressions while you are pumping. This has been shown to increase milk supply sometimes by 30 to 40%.

Relax while pumping, look at a picture of your baby, take deep breaths and see pumping time as “me” time when you get to take a mental break from work.

Find a supportive caregiver for your baby that supports you as a breastfeeding mom and will do “baby led” bottle feeding. Also make sure that the care provider is not over-feeding your baby so that your baby is too full to nurse as much when you are home with them.

Communicate with your care provider about when you will pick up your baby and try to time a feeding when you get there.

Plan on some extra snuggling, nursing time with your baby when you get home and ask for extra help while at home so that you can focus on your baby, especially in those early weeks back to work.

On the weekends, plan on breastfeeding more and resting more with your baby as you reconnect with each other and help create and maintain a good milk supply.

Enjoy your baby and your new family!

To get more information about this topic check out the new class at Zenana Spa and Wellness Center.

Working and Breastfeeding

Some of the topics we will discuss are:

~Pumping most effectively and efficiently at work.

~ Working with your employer to create a supportive atmosphere to pump or breastfeed your baby.

~Creating a realistic plan with your family and care providers to support your goals as a breastfeeding mom.

~Being familiar with pump options and other supportive equipment needed for the working/breastfeeding mom.

Partners are encouraged to come to learn about bottle feeding for the breast fed baby and tools on how to provide support for the working mom. This Working and Breastfeeding class will be taught by Meg Stalnaker, IBCLC. She is a lactation consultant for Zenana Lactation Services.

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