by Donna Walls, RN, ICCE, IBCLC, ANLC

Congratulations on choosing to breastfeed your baby! Now, if you are returning to work or school after your baby is born you may wonder how you can combine breastfeeding and working. With a desire to breastfeed, and some careful planning, you can do it. As a working mother there are some special advantages to continuing breastfeeding after return to work or school. While there may be many caregivers for your infant, breastfeeding is something only you can do for your baby and working mothers enjoy the special time with their baby that nursing provides.

How can I return to work and continue to breastfeed my baby?

Many new mothers successfully combine working and breastfeeding. Exclusively breastfeeding in the first weeks and months is the best way to optimize your milk supply- avoid supplementing with formula unless medically necessary. Once you return to work you will develop a breastfeeding pattern that works for you, your baby, and your time away. Breastmilk production is a “supply and demand” process— the more the baby nurses, or you stimulate your breasts with hand expression or pumping, the more milk you produce. Each woman’s working schedule and situation will be different, including time availability and accommodations for pumping and storage of milk. Federal laws are in place to assure that most women are legally protected to express the milk they need for their baby for the first year of life. Often new mothers feel like they need to have a large reserve of milk by the first day they return to work, but, in reality, all they need is milk for day one and maybe a few bottles for “emergency”. No need to pump madly for a huge stockpile.

How will my baby be fed while I’m at work?

Your baby’s feeding patterns change frequently during the first year of life. A six-week-old infant will breastfeed more frequently than a four-month-old. Generally, there are three ways your baby can be fed while you are working:

• Breastfed by you if you work at home or have access to your baby at work
• Fed by bottles of expressed breastmilk
• Fed by supplemental bottles of formula

A general guideline is that you will need to express you milk the same number of times you would be feeding if you were at home. Another option is to use “reverse cycle” nursing which is moving to a pattern of more frequent feedings while at home and less frequent feedings or milk expression while you are away at work or school.

How do I store breastmilk?

You can begin storing breastmilk 1-2 weeks before your return to work or school. Glass bottles are recommended over plastic bottles or storage bags because of the exposure to harmful plasticizing chemicals. It is easiest to remember 7s – 7hours at room temperature, 7 days in the refrigerator, 7mo in the freezer. When in doubt, smell or taste it! To warm milk place bottle in a glass of hot water or run hot water over the bottle until the milk is no longer chilled, although some babies might prefer cool milk. DO NOT warm milk in the microwave. If the milk is frozen store overnight in the refrigerator for use the next day or warm in a glass of hot water.

What do I need to express breastmilk?

You first need to educate yourself on the options available to express your breastmilk. There are a number breast pumps currently available, including manual or electric with a wide range of styles and prices; your childbirth educator, doctor, midwife or lactation care provider can answer questions about their favorite models.  Another way is by hand-expression. Women report varying degrees of success with both these methods, although after some practice and experience they become comfortable with one or a combination of both. It is helpful to become comfortable with expressing milk, trying both methods before returning to work. You will need a clean container and a place to store your expressed breastmilk. If a refrigerator is not available a small cooler chest works well.  Finally, find a comfortable place to express your milk, preferably somewhere private and quiet. Some women find that bringing reminders of their baby helps, too. Try looking at a picture of your baby, smelling an article of your baby’s clothing, or listening to a tape of your baby’s sounds. The amount of milk you can expect to express varies from woman to woman and also depends on the age of your baby but most infants between 1 and 6 months will need about 2-4 ounces at each feeding.

What can I do to maintain my milk supply?

There are a few things you can do to make sure you establish and maintain your milk supply. These include:

• Nurse or express milk often, at least 8-10 times each 24 hours, especially if your baby is less than three months old, the breast stimulation provided by frequent nursing or expression is important for mothers to build and maintain a milk supply.
• Spending time skin to skin with your infant also helps maintain a good supply.
• If you are noticing a decrease in your supply, “power pumping” is an effective technique to increase your milk production. Simply spend a block of time, several times a day, and pump frequently between feedings. An easy way to work power pumping into your schedule is to pump during every commercial while watching a TV program.

Will my baby begin to prefer the bottle?

This is difficult to know in advance since each baby is unique. Try having someone else give any bottles, so that your baby associates breastfeeding only with you. If you find that your baby seems to prefer the bottle, try the following:

• At each feeding nurse your baby first
• Offer the breast while the baby is still sleepy
• Spend time cuddling skin to skin
• Stimulate your breasts so that the milk is available at the beginning of the feeding
• If your baby does not nurse well (or at all) pump or express to maintain milk production.

What about weekends and holidays?

There is no need to express milk and bottle-feed your baby when you are at home. Breastfeed full-time during weekends and days when you do not work.

What about child care?

Choose a child care provider who is supportive of breastfeeding. Talk with your care providers about milk storage, paced bottle feedings and your baby’s individual feeding cues and needs. It is very helpful to have a child care provider who is willing to support you, your baby, and your schedules. Continuing to breastfeed after return to work or school Is certainly possible. Prepare yourself by talking with other mothers who have successfully combined working and nursing as well as co-workers and your boss. Plan ahead for childcare options as well as places to pump and store your milk. Separation from your baby can be stressful but with good planning and support It can make the transition as easy as possible.

Resources

https://www.dol.gov/whd/nursingmothers/ www.LLLI.org https://www.womenshealth.gov/breastfeeding/going-back-to-work.html https://kellymom.com/bf/pumpingmoms/milkstorage/milkstorage/ https://www.askdrsears.com/topics/feeding-eating/breastfeeding/while-working/working-and-breastfeeding https://www.bfmed.org https://www.babycenter.com/0_breastfeeding-as-a-working-mom_641.bc