Frances Biagioli, M.D.
The number of working mothers is ever increasing; in the year 2000 60% of women were working outside of the home. Mothers understand that breast milk is the best food for their babies, but returning to work greatly deters a mom's ability to continue to breast-feed.
Sixty-eight percent of mothers initiate breast-feeding at the birth of their child, but only 22% of mothers working full time still breast-feed at six months. The workplace can be less than inviting when it comes to breast-feeding your child, but the reward is great and the obstacles can be overcome.
Before going on maternity leave, or before returning to work, you should discuss your plans for breast-feeding with employers and coworkers. This may seem embarrassing, but the discussion will help iron out any foreseeable problems.
Things to discuss might include: break schedules, work schedules, and facilities ‚ a location that you could pump (or feed if your child can be brought to your work site), a sink to wash, and a refrigerator to store the milk.
Pumping Breaks
In order to maintain an adequate breast milk supply when you are at work, you have to mimic the infant's feeding pattern by pumping as frequently as they would feed. This frequency varies with age and with growth spurts, but usually you will need to pump every three ‚ four hours.
Pumping can be done quickly (10-15 minutes) if you are able to use a good double electric pump (one that pumps both breasts simultaneously). Less efficient pumps, manual pumps, battery powered pumps, or single pumps may take longer and pumping times will vary based on how much milk your body is making, and how familiar you are with using your pump. Including time to get undressed/dressed, to set up the equipment, and to store the milk, a pumping break should be at least 20 ‚ 30 minutes long.
Work Schedules
A maternity leave should be a minimum of four weeks. Longer is better, but at four weeks, your breast milk supply is usually well established. In addition, working part time helps with the ability to maintain breast-feeding. If this is an option, you should consider working part-time for at least the first few months after you return to work.
The first week you return to work is usually the most difficult. Working less than four- six hours a day in this first week may help ease the transition. Many find the first week much more tolerable if they can set a return date of Wednesday or a Thursday, so the first week is shorter. Other schedule options are to lengthen the entire day, but take longer breaks to visit your infant or more frequent breaks to pump. Finding a schedule that accommodates both you and your work place is beneficial to both parties.
Where to Pump
Although pumping can be done in a setting as bare as a toilet stall, having a comfortable, private area to pump will increase your chances of being successful. Your breasts have a "let-down reflex" which allows them to release their milk. This let-down occurs best if you are relaxed.
Some things that may help you relax include: a comfortable chair, a pillow to rest your arms while pumping, a portable radio or CD player for relaxing music, a "Do not Disturb" sign to hang, and a shawl or a blanket for privacy in case of that inevitable interruption. Since thinking of your baby will also stimulate the let down, a picture of your baby, or a piece of their clothing may also help.
Some other things to remember include:
• You should wash your hands and equipment before each use.
• If there is no refrigerator, you will want to bring a small cooler to store the milk.
• You will want to bring enough milk storage containers for the day.
• It is easier to pump if you have clothing that opens from the front. Button down tops are easier than full-length dresses or T-shirts.
• Leaks happen. Wear patterned fabric as it shows wet spots less than solid colored fabrics. Consider bringing an extra shirt, vest, or a sweater for occasional leaking breasts.
Milk Storage
While breast milk can be stored at room temperature (less than 77ƒ F) for four to eight hours (remember this for any day that you inadvertently forget your cooler), it is best to put it in a cooler or refrigerator soon after pumping.
It can be stored in the back of a refrigerator for three to eight days, and at the back of a freezer for several months. Fresh milk is better for your baby than stored breast milk, but milk that has been refrigerated or frozen retains its most important protective qualities proteins and nutrients. Properly stored breast milk is always better for your baby than formula.
Breast milk should be stored in portions that your baby will eat in one day. This amount will increase as your child grows. To thaw the milk, let it sit in the refrigerator the day before, at room temperature until it thaws, or if needed, it can be swirled in warm water until thawed. Do not microwave breast milk, this will destroy most of its protective qualities.
Once frozen breast milk has been thawed, it will separate into a thin liquid with a fatty layer floating on top. Do not skim off this fat (fats are important for children's brain development), just shake it to re-mix the breast milk before the child drinks it.
How Can I Learn More?
Many states have legislation to help mothers who are breast-feeding. At minimum, the Family Medical Leave Act provides 12 weeks of unpaid time for workers to care for their newborns.
Support groups can be found through your local La Leche League groups or by calling 1-800-525-3243. Frequently asked questions are listed online at www.lalecheleague.org.
Other useful web sites include: Pumping Moms Information Exchange at www.pumpingmoms.org, Promotion of Mothers Milk, Inc. at www.promom.org, National Woman's Health Information Center at www.4women.gov/breastfeeding, and WIC (Women Infant Children) Works Resource System, Breast-feeding, Topics A-Z at www.nal.usda.gov/wicworks.
Dr. Biagioli went to medical school in Toledo, Ohio, and is now is a family doctor practicing and teaching in Portland, Oregon. She completed additional breast-feeding training by taking a lactation course, and has been involved with teaching other doctors about breastfeeding since. She has two young children and a supportive husband.
May not be reproduced in any format without written permission.
