Nursing Mom, Working Mom: Part 2

Going Back to Work

As a pediatrician who specializes in breastfeeding, I have worked a lot with working, breastfeeding moms. I was a working, breastfeeding mom myself. I went back to work when each of my kids was 6-7 weeks old and spent a LOT of quality time with my breast pump. Going back to work can be one of the hardest times for new moms. Some moms want to stay home but can’t because of finances or other obligations (in my case, I had a Navy contract that required that I go back to work). Some moms like their jobs and want to go back to work. Whatever the reason, there is often (but not always) guilt and stress with going back to work and maintaining breastfeeding. Will the baby take a bottle? How will you find time to pump?  What if you have a problem with breastfeeding?

Finding time (and space) to pump at work
Different states have different laws, but here in Oregon, companies with more than 25 employees are supposed to give workers a 30 minute break within every 4 hour work period to pump unless doing so unduly affects the operation of the business. They are also supposed to provide employees with a location to pump that is not a restroom. If there isn’t already a policy in place for pumping, talk to your supervisor before returning to work and see if something can be set up.  It can be hard to do, but other women at the company may be willing to back you. If you have a place to pump, breaking away to do so every 2-4 hours can be tough. I found that setting an alarm for 2 hours after I last pumped was helpful. It reminded me that I needed to get to a stopping point with whatever I was doing and start getting the need to go pump in my head.


Pumping and what to do with the milk you pump
Try not to stare at your bottles while you pump. Stress inhibits let-down and staring, and milk bottles not filling is just about the most stressful thing there is. Put a baby blanket (preferably one that smells like baby) over the bottles, so you can’t see them. Keep a picture of baby nearby to look at. Call a friend. Flip through a magazine. Do some work. When I was in pediatrics residency, I had friends who would write patient notes while they pumped. Being able to pump hands free can be really helpful. Some of the nursing bra manufacturers make hands free pumping bras, but you can also take a sports bra and cut holes in the cups. The bras are stretchy enough to fit the pump flange inside and hold it in place. Ideally, there would be a refrigerator where you are pumping to store the milk. If not, milk is safe in a cooler with ice packs for up to 24 hours.


Feeding the baby
It is important that your childcare provider understand breastfed babies and how they feed. Make sure they know that every fuss or cry does not mean baby is hungry. Explain how to do paced bottle feeds or give them a handout. Try to be the only person to feed baby when you are home and to only feed baby at the breast. This helps to maintain your supply, and it’s a LOT easier to breastfeed than to pump. It will be super tempting to let someone else feed baby at night, so you can get some sleep. You’ve gotta do what you’ve gotta do to get through the day, but try to limit the number of times you go long stretches at night without emptying your breasts, especially early on. Breastfeeding is a demand and supply activity. If you don’t take milk out of your breasts, your body will eventually think it’s not needed any more and will decrease how much it makes. An occasional night might not hurt, but regularly going all night will be a problem.


If you have problems
Breastmilk production tends to drop in response to stress, dehydration, and fatigue. All of these things can happen when you are back at work. If you feel like your milk production is dropping, don’t panic. Make sure you are pumping every 2-4 hours (or as close to that as you can do). Increase your intake of noncaffeinated drinks. Try to get some extra sleep. Put baby to breast a lot when you are home. If you can, take a weekend of just hanging out at home and nursing as much as baby will nurse. Have your partner or a friend deal with food and other kids. Milk supply drops sometimes, but it usually comes back. If you completely deplete your supply and baby has to get some formula, that’s OK. Keep pumping and see if your supply comes back. Keep nursing when you are home (babies are better at taking milk out of a breast than a breastpump is). During the day, offer baby whatever milk you are able to pump. Formula is not poison. Feeding some formula to get you through a rough patch can be incredibly helpful in terms of taking pressure off of you to help you get back to where you want to be.


If your nipples are getting traumatized by the breast pump flanges, your nipples are rubbing against the flanges when you pump, or you never really get much milk when you pump, your flanges may be the wrong size. If you suspect that your flanges might not fit but you aren’t sure, there are some websites with good information on how to test if your flanges fit. Most pumps come with one or two flange sizes, but the manufacturers have more sizes available for order. Check out the company website to find out.


If you are working and breastfeeding, you might feel kind of alone. A lot of new mom support groups meet at times that don’t work for working moms. Look for resources on line, look for telephone support, and look for weekend support groups.


Most importantly, give yourself a break. A lot of moms have a goal in mind for how long they want to keep breastfeeding. Goals are good. They help give you a road map. You aren’t a failure, though, if you don’t follow the map the way you thought you would or the way someone else did. You are a good mom no matter what.