Breastfeeding & Returning to Work
Returning to the workforce may bring concerns about how you will be able to manage a busy day juggling both family and work. Balancing the two can be successfully done with a little preparation and planning.
Breastfeeding moms usually fall into a pattern for feeding their baby about 4-6 weeks after delivery. Babies are variable in their patterns, some nursing very frequently, others much less frequently. You might be exclusively breastfeeding, or may have offered expressed milk (pumped breast milk in a bottle) in addition to breastfeeding. It is a good idea for you to begin expressing some of your milk and storing it several weeks before you plan to return to work. This should be done after a breastfeeding session several times each day (ideally 3-4 times). This pumping will not only allow you to start building a supply for use when you are away, but will also increase your daily milk volumes to help your breasts adjust to being away from your infant while you work.
Equally important is providing your baby the opportunity to practice feeding with an artificial nipple and bottle. Offering a bottle after breastfeeding is well established (2-4 weeks) should not interfere with their breastfeeding ability. However, if a bottle is offered too soon or too frequently, some babies may prefer the faster flow of the bottle and struggle to maintain breastfeeding. Consult with a lactation consultant if you notice breastfeeding challenges during this period.
There are no hard and fast rules, however babies need time to adjust to a new and different way of feeding (with the bottle) and will definitely let you know that they prefer their mother’s breast! There are a myriad of types of bottles and nipples on the market, many being marketed specifically for breastfeeding babies. Unfortunately, there is not a bottle nipple on the market that tastes, feels, functions and changes shape like the human nipple, and your baby will figure this out immediately.
Expect your baby to take several sessions before adapting to bottle-feeding. Generally, the longer a baby has exclusively breastfed, the more challenging this transition can be. Be sure you are providing expressed breast milk in the bottle. Fresh breast milk (not frozen) may be more acceptable to your baby during these initial attempts. If possible, have someone other than yourself provide the bottle feedings. Your baby knows your unique smell, taste, body rhythms and will resist your attempts to provide something other than your breast. Initially try offering the bottle once or twice a day. Some babies seem to respond better when they are very hungry and others when they are sleepy. Experiment and see what seems to work best for your baby. Remember that feeding should be a pleasant and comforting experience, and feedings should never be forced. All bottle-feeding sessions should be stopped if the baby begins showing you signs of distress.
Expressing milk to store for later feedings can be done manually or with a manual or electric breast pump. Some moms have to express some of their milk to relieve engorgement during the first week postpartum and have already purchased or rented a pump. Recent research on mothers of preterm infants suggests moms who use manual hand expression with electric pumping, actually make more milk for their babies than those exclusively using an electric pump (http://newborns.stanford.edu/Breastfeeding/HandExpression.html).
Many lactating moms prefer an electric pump which supports expressing both breasts at the same time. Be sure that when you purchase a pump (whether manual or electric) that the manufacturer stands by their product and will provide good customer service for your equipment. Spending a few hours at your local breastfeeding boutique looking at the different brands and types of pumps will definitely be worth your while.
Returning to work can be challenging, however, living in Colorado is a definite plus for breastfeeding mothers. Colorado has one of the highest breastfeeding initiation rates in the United States. Our state passed a workplace accommodation law in 2008 that mandates employers to provide reasonable paid or unpaid break time to allow an employee time to express breast milk (in a private location) for her child for up to two years. You will need to pump at least once for every four hours you are away from your baby and carry a small cooler to store your expressed milk while you are away.
At the federal level, the recent passage of the new healthcare reform bill has created even stronger support for lactating mothers. The bill mandates that an employer must provide their employees time to get to a lactation room, set up their breast pump, express their milk, clean the equipment, store their milk and return to their workstation. The room must be someplace other than a bathroom stall that is shielded from view and free from intrusion from coworkers and the public (U.S. Department of Labor Wage and Hour Division, July 2010(http://www.dol.gov/whd/regs/compliance/whdfs73.htm).
If you have concerns about workplace accommodations, do not hesitate to contact a Lactation Consultant, the Colorado Breastfeeding Coalition or the U.S. Breastfeeding Committee.