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Returning to work as a breastfeeding mum?

4/16/2013

18 Comments

 
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This post was originally written for http://www.nurturingmumsuk.com/ 

The first few weeks are often a blur for new mums. The learning curve is steep and you survive day to day – remembering to shower and put food in the fridge for yourself if you are lucky. For those mums still in the middle of that blur, the thought of the eventual return to work can be one that provokes anxiety.

You can’t imagine how it will feel to leave this new special person in your life.

How do you people cope with drop-offs to childcare and getting back to work after potentially several night-wakings?

What do you do if you don’t want to give up breastfeeding?

As a breastfeeding counsellor and lactation consultant, I’ve been supporting breastfeeding mums on their return to work for the last 6 years and there are a few things that are worth bearing in mind.

Here are my SIX top tips for returning to work as a breastfeeding mum.

1.       Don’t think about it.

OK, now I don’t mean that too literally. My message is just that if you are going to take 6 months, 8 months or a year off work and you spend several months of that stressing about the return to work, you will be seriously missing out.

STOP yourself thinking about it too much. If you stare at your gorgeous three month old and think fleetingly, “How can I ever leave you?” (which is how nature very much wants you to feel), that is fair enough. But if you spend chunks of your maternity leave feeling anxious and worrying about practicalities, you will be wasting the special times you do have together.

This time is precious. Your baby now is not going to be the same person when you return back to work. They will sleep differently, feed differently, and interact differently. You will not be leaving THIS baby but an older one.  So get your childcare sorted (which you may well have thought about in pregnancy anyway) and other than that, there’s not too much more to do! If you intend to express milk at work, it’s a good idea to write to your employer about 2 months before you go back to work to talk about arrangements. And then just carry on as normal. If your 4 month old baby won’t take a bottle and that starts you panicking because you have to go back to work at 8 months, don’t think about it. An 8 month old baby can breastfeed when you are with them in the morning and evening, take a sippy cup, drink from an open cup – you will have options. And a four month old baby that refuses a bottle may not if you try again after leaving it for a few weeks. It’s very easy to set yourself into a panic when the truth is that things usually work out with the right information and the right support.

2.       As mentioned, speak to your employer.

http://www.hse.gov.uk/mothers/faqs.htm#q14

http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/breastfeeding-back-to-work.aspx

The recommendation is that you inform them that you will be returning to work as breastfeeding mum so they have a chance to assess your health and safety and what provisions you may need. Your employers are required to keep you safe. They also have a legal requirement to allow you to ‘rest’ as a breastfeeding mother. Sadly, in the UK, there is not a clearly established legal right to express breastmilk at work and it’s important you talk to your employer so they have advanced warning and you can come to an arrangement. Some women need to have break times re-organised or a room found. Although there is no ‘legal right’ the VAST majority of employers understand that it is in their interests to try and meet your needs and provide you with facilities. Your morale matters and a baby receiving breastmilk is less likely to suffer from illness meaning less time off work for you. There are health and safety executive recommendations and many employers understand the benefits of supporting you as much as possible. However, employers will be more likely to be accommodating if you give them warning and explain your needs clearly.

3.       Talk through your schedule with a breastfeeding counsellor or lactation consultant.

Drop-ins are not just for people with problems with positioning and attachment. It’s really common for a mum to come along a few weeks before their return to work to talk about how they hope to organise their feeding and pumping schedule and how to organise things practically. I’ve included some typical scenarios later on.

4.       Practise pumping.

Is the breast pump you are using a home something you are familiar with? Do you have a backup if you need to pump at work? Is it worth sourcing a double pump if time is an issue or even hiring a hospital grade electric breast pump for a few months which can just stay at work? You’d be looking at paying around £45 a month (http://www.ardobreastpumps.co.uk/breastpumps_for_hire)

There are tricks such as preparing the breast using massage and warm compresses. And we know that women who finish a pumping session using hand expression techniques can increase their output considerably.

http://lllrochester.weebly.com/uploads/7/9/5/4/795404/marmet_technique_tearoff.pdf

It’s also not a bad idea to build up a bit of a freezer stash before you go back. If you start pumping for one extra session each day and storing that in a freezer bag (store them flat and build up layers of thin flat bags which defrost more easily and take up less space), you will have some wiggle room if you need it. It’s not entirely predictable how pumping will go at work and some women find that their pumping output decreases towards the end of the week and then a weekend of normal breastfeeding boosts it back up again. If you have that freezer stash, it will take away some of their anxiety.

5.       Get your kit.

So you need a pump and some bottles and some breastmilk storage bags. What else? Surprisingly not much. You don’t need to store freshly expressed breastmilk in the fridge at work if you don’t want to. You can have a freezer block and an insulated bag and put any expressed milk in there. It is fine in that for 24 hours. So if you store it like that at work, put it in the fridge when you get home, then that milk can be given to your baby’s carer for the next day.

http://www.breastfeedingnetwork.org.uk/pdfs/BFNExpressing&Storing.pdf

It’s also really important to note, you don’t need to wash and sterilise the pump between pumping sessions. Breastmilk is fine at room temperature for up to 6 hours. So you certainly don’t need to wash a pump between your 11am pumping session and your 2pm one. Lots of working mums use a technique called ‘wet-bagging’, putting a pump in a plastic bag between sessions and then putting it back in the fridge. Then simply take it out next time and wipe any wet parts with paper kitchen towel if you don’t fancy cold drips against you! This also saves precious time.

6.       Breastfeed when you can.

Your supply is more likely to be maintained if you breastfeed when you get the chance. Is your childcare near work or home? Could you visit your baby at lunchtime?  Could you work from home for one day a week for the first few weeks? You could breastfeed early in the morning, then once more at drop-off, once more at pick-up and again at home later in the evening. Those 4 feeds would be enough breastmilk overall for a baby of 8 months or more. You may not need to be carrying bottles back and forth. And breastfeeding at the weekends and during holidays will help to boost your supply.

Here are the stories of three mothers I have supported (names and some details have been changed):

Carla is going back to work full-time at 6 months. Her son is an enthusiastic exclusive breastfeeder and she’d like to avoid using formula if she can. When her son is 4 months old, she writes to her boss (she is a PA in a law firm) and explains she would like to express her milk at work. Her boss explains the company procedure of having a small office set aside for pumping and there is also a fridge available. Carla explains she intends to express around 3 times in the working day and one of those times will be during her lunch break. Her boss is fine with that. She has a double electric pump which she starts using from 4 months and she gives her son a bottle every other day to get him used to it. She finds he prefers to sit a bit more upright and usually takes 3-4oz from the bottle.

She starts solids around 10 days before she goes back to work and he takes small amounts initially and Carla knows his breastfeeding schedule will remain unaffected for a while. The week before she starts work, they visit the nursery together and he has a few hours there. He then has two trial days where Carla practises her expressing schedule and the nursery workers give him a bottle and some solids.

On her working day, she breastfeeds him as normal at 6am. She drops him off at nursery at 7.45am and offers again and he takes a small feed. At work she expresses at 11am, 1.30pm and 3.30pm. She collects her son from nursery at 6pm. He is keen to breastfeed when she arrives and they breastfeed at nursery. She breastfeeds him again at home at around 10pm as a dreamfeed.  He wakes once at around 2am and she breastfeeds him again.

While he is at nursery, the carers give him bottles and offer solids and he usually takes around 12oz in total while they are separated. As he has 3 good breastfeeds in addition to that in 24 hours, Carla isn’t worried. Carla expresses more milk at work than her son takes in a bottle at the moment. Over the next few weeks, she moves to expressing only twice. Carla ends up offering exclusive breastmilk until 12 months and then she gradually introduces cow’s milk.

Phoebe is returning to work at 10 months. She is a graphic designer and works from home with some client visits necessary around London. Her daughter breastfeeds around 4 times in 24 hours and enjoys solids which she started at 6 months. Phoebe doesn’t enjoy pumping and finds it difficult so would rather avoid it if possible. She finds a child-minder who lives near her home. Phoebe breastfeeds at 8.30am and drops her daughter at the child-minder. If she is working from home she visits at lunchtime for another breastfeed. She then collects her daughter at around 4pm and takes her home to breastfeed at 6pm and around 11pm. While her daughter is at the child-minder, she eats solid food and drinks water. The child-minder doesn’t give her milk. When Phoebe has a client visit, she sometimes hand expresses for a few minutes into a plastic bag when she can grab a private moment. This is just to stay comfortable when she feels particularly engorged. This will help to reduce her risk of blocked ducts and mastitis and help to maintain her supply. She doesn’t keep the milk. Phoebe continues breastfeeding her daughter until she is 18 months old. At the end she is only breastfeeding in the morning and evening and Phoebe doesn’t feel the need to use any hand expression when they are separated.

Catherine is returning to work at 8 months. Her son breastfeeds around 6 times in 24 hours. He started solids at 6 months. He doesn’t particularly like bottles and usually only takes around 2oz max. Catherine finds that he will take more milk from an open cup called a doidy cup. He will also more likely to take it if she mixes the breastmilk with ripe banana and makes a smoothie! Catherine gets through a lot of bananas! She works 4 days a week (and at 12 months will go back to being full time). Catherine is a teacher. Her headteacher has struggled to find her a private room for pumping but has given her the key to the medical room and if that is in use, she uses a stock cupboard and she has told staff that when her scarf is on the door, please knock! Usually the medical room is empty. Her colleagues have agreed to relieve her of playground duty while she is breastfeeding. She breastfeeds her son at 5.45am and again at 7.45am at the child-minder. She arrives at school at 8.15am. She expresses at 10.45am during morning break. She expresses for 10 minutes. She expresses again at lunchtime for 15 minutes and at around 4pm for another 10 minutes. She has to use a double pump as her pumping time is restricted. She remains at school for meetings and lesson preparation and collects her son at around 6pm. She breastfeeds him at 7pm and 10pm. He wakes to feed between 1-2am and Catherine is happy for that to continue for the time being as he feeds and goes back to sleep quickly.

With the child-minder, her son takes around 3oz of breastmilk in his smoothie, 2oz mixed into a porridge and another 1-2oz from his doidy cup. She also makes sure his solids contain good sources of fats and calcium. Sometimes she struggles to pump in her breaks as she really needs to continue working. She finds herself dipping into her freezer stash and as time goes on, the child-minder sometimes uses formula to make up the porridge. On the weekends and on her day off, he breastfeeds more frequently.  

There are many women who effortlessly combine breastfeeding and working. If it sounds hard, remember that in the USA there is no statutory maternity leave and women often return to work after just a few weeks. However they have 16% of babies exclusively receiving breastmilk at 6 months and the UK manages 1% (http://www.cdc.gov/breastfeeding/pdf/2012BreastfeedingReportCard.pdf).

Working and breastmilk are not incompatible. With modern electric breast pumps and using breastfeeding support available locally and through the National Breastfeeding Helpline, it’s never been easier. However if we could get the statutory right to pump at work it would certainly help. Contact your MP if you feel the right to express at work (as exists in 92 countries throughout the world) is something UK mums should be entitled to. 


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My book is available now from Amazon.co.uk and from other retailers.

"You may be worried about breastfeeding and worried that it might ‘not work’. This is a common feeling when you live in a society where breastfeeding is often sabotaged by incorrect information, patchy support from a stretched health service and powerful messages from formula companies. But it’s not a feeling that is entirely logical. We are mammals. We get our name from the dangly milk-producing bits. It defines us. 

This book aims to make you as well-prepared as possible. I would like you to breastfeed for as long as you want to and as happily as possible. I want you to feel supported. 

Some of this new life with baby will be about flexibility, responsiveness and acceptance. If you are used to a world of schedules and decisions and goals, it may be a bit of a shock. Learn about human biology before you think it sounds a bit too scary! Babies are the products of millions of years of evolution, and we are too; if we can just tap into our instincts and trust them a little bit. 

Success comes when we tap into those instincts and when we know when to get help when our instincts aren’t answering all of our questions. 

Can everyone who wants to breastfeed make it work? No. Not everyone may be able to exclusively breastfeed due to medical issues. Most of these people can give their baby breastmilk, though, which the book also covers. (And let’s not start this journey by imagining you’ll be someone who won’t make it...!)"

http://www.amazon.co.uk/dp/B019JE5E44

18 Comments
Ellie
4/11/2014 02:28:52 pm

Thanks for this. I'm just starting to contemplate returning to work in about 10 weeks time when my daughter will be nearly 9 months. So true to not stress about it! She's just 6 months and ebf, we're just starting solids. Is there a better time of day to pump to start building up a stash?

Reply
Emma Pickett
4/11/2014 02:45:17 pm

Hi Ellie,
Most people get a better pumping volume earlier in the day e.g. 30-45 minutes after the first feed of the day (or immediately after if you only fed from one side and you pump the unused side).
However the key thing is to find a time when you can relax and perhaps prepare the breasts with massage and warm compresses. Some people pump after a bath at night and we find pumping output will improve over several days if you pump regularly at the same time. The body receives the signals for extra demand at that time and adjusts. It's hard to make rules as everyone needs to find a time that works best for them. For some it might be at lunchtime if their baby takes a longer midday nap. Hope it all goes well.

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Kiwi
8/1/2015 01:46:39 am

This article is really helpful, thanks.

I'm returning to work in six weeks when my baby will be nearly six months. However, I'm worried about building up a stash of milk for her because we'll be away on holiday for the last few weeks. Even if I manage to pump (sometimes in a campsite!) and store, we will have to take two flights back (journey time 5-6 hours). I'm not sure if my milk will stay cool enough to be useable after that...

I'd be grateful for any advice!

Reply
Emma Pickett
8/4/2015 11:56:03 am

That's certainly a challenge :)

I might be tempted to suggest that you don't focus too much on the stash while you are away and breastfeed and enjoy that stress-free time.

However if that feels wrong, most commercial campsites have an office where you could have access to a fridge. You could contact them in advance to ask about possibilities. If there was a freezer too, you could freeze some ice blocks and milk can be stored for up to 24hrs in an insulated bags with ice blocks. The flight time wouldn't be a problem (though pack it in checked in luggage to avoid hand luggage security issues).

There are camping fridges which are powered from car batteries or even gas if that's of interest.

But you know what - this holiday will be special - plenty of people go back to work without a significant stash and pump during the working week. I think you could reflect on how it might feel to put pumping aside for the holiday, breastfeed when you can. Perhaps sometimes pump to practise bottles with her but don't worry about storing or transporting the milk.

Reply
Mira
8/17/2015 03:03:07 am

Thank you for this article; I enjoy reading about how other mothers combine breastfeeding and working outside the home - it gives me hope!

However, whenever I've read the accounts of mothers who've returned at around 11 months (which I'll be doing soon; baby's currently 10mo), their babies have only been breastfeeding a handful of times a day. My son still feeds like he always has - every 2hrs day & night!! He loves food but he loves boob more! I'm worried about engorgement/mastitis when I return to work 3 days a week and I'd rather not have to express with a pump at work.

I've tried reducing the number of feeds during the day at home in preparation but he's not a happy bunny.

Is it likely that my body will adjust or will I be soaking through my shirt at the end of every day?

I'd be so grateful for any advice. Thank you again for this great resource!

Reply
Emma Pickett
8/17/2015 05:06:05 am

Hi Mira,

Bodies can be soooo different. Some women manage without emptying the breasts and don't run into problems. Others get full blown mastitis only missing one feed. It's hard to make rules.

Brutal honesty time: I've not yet met a mum who was feeding every 2 hours who could get through a working day without pumping. To do so would risk discomfort, leaking, blocked ducts, mastitis, even abscesses.

I think you've got 2 choices: reduce daytime feeds significantly (and accept it may not be easy and could be upsetting got both of you). Or accept that you may have to take some milk out at work. I would suggest you take some time to consider the latter. It doesn't have to be a big faff. Just 5 minutes of hand expression/ hand pumping could make all the difference. Your health is protected and your child is happy. It doesn't have to mean 30 minutes in a locked room with some giant machine. You don't even need to keep the milk or wash anything. This option seems particularly a good one if you'll only be working 3 days. For the other 4 days, your son gets what he needs and his needs met. You wouldn't have to pump/ hand express every 2 hours. Even every 3-4 hours could be enough. You may find you are more uncomfortable on the first day back at work, but less so after 3 days. As your child naturally drops sessions, you can adjust what you do. Most working lives accommodate employees having coffee/ going to the toilet/ having a cigarette. Pumping a bit of milk need take no more time than that.

Reply
Mira
8/30/2015 02:55:59 pm

Thank you so much, Emma. This is most likely what I'll have to do. I was recently away from my son for the day and, despite hand expressing, returned home with enormous, rock-hard breasts. I'm hoping my body will adapt one way or the other and that I won't still be expressing milk in 6 months' time! Again, thank you for this excellent resource and your advice!

Reply
Alice
5/2/2018 11:03:12 pm

Can i say that I am that mother? My daughter was feeding 2 hourly when I went back to work (and was apart from her 8-6 5 days a week). The first few days I would hand express a little bit at lunchtime - just a few ml - but after less than a week I didn't need to. She was 11 months then, she is 19 months now, and still feeds before and after work. I thought it was going to be really hard but it wasn't.

And my frozen milk was useless - she refuses milk except from the breast even now! Eats well though.

Reply
Francesca
9/18/2015 08:47:36 pm

Hi Emma

Great article thank you.

I'm back at work now my son is 8 months. I am doing 3 days a week but mostly working from home, I am however really struggling to get anything much when I pump. The first few days I worked I easily got 6-9 oz total for the day but now my supply has definitely adjusted and I'm struggling to get more than 30ml at a time (even after 4-5 hours since last feed when I used to start feeling quite full again). My son feeds fine and frequently when he is with me the other 4 days a week, and feeds morning/evening on my working days fine. Any advice? Should I just ditch pumping altogether? It has been really stressing me out, worrying that it could be the beginning of the end (hormones make me melodramatic....!) but you say here that 4 feeds in a day for an 8 month old is about right so could he be getting all he needs from me before/after he is at nursery?

Thank you!

Reply
Emma Pickett
9/21/2015 02:23:46 pm

Hi Francesca,
If you don't mind a night feed, it's possible you won't need to pump for bottles in the day at work. It's difficult to say for sure but if we assume 24hr intake is 20-25oz, then 4 feeds could be enough. You'd want to make sure he can drink water when you are separated and eat a good range of solids. Having said that though, it might be that your supply would be better protected (and your risk of mastitis and blocked ducts reduced) if you pump at least once. I think you might have to reduce pumping gradually and see how your breasts feel in response.

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Heidi
10/14/2015 09:29:51 pm

Hi. I am due to go back to work in december, my daughter will be 1 year old. She has never really taken to having expressed milk from a bottle but will drink a bit from her cup e.g around 1 ounce in 6 hours. She drinks water no problem but prefers milk from the source! She does not eat very much solid food at all - she is getting there but refuses to be spoon fed so i keep offering finger foods but they mostly go on the floor. I will be working from home 2 days but am really worried about the 3 days I will be in the office. She usually breast feeds 3 /4 times during the day i.e between 8am and 5.30pm she then has another feed at bedtime 7pm and another at around 10. We co sleep so she nurses a couple of times during the night as well. Do you think I should gentle discourage her from nursing at night to try to increase her appetite for solids ? I'm happy to feed through the night now while I am not working but am worried I will get very tired when I am back at work. Also how much do you think I should express for her when I'm in the office bearing in mind she does not really drink milk from a cup. Any advice would be greatly appreciated. Thank you.

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Sandra
6/19/2017 02:10:44 am

Hi Emma, I am in the same situation as Heidi so hoping very much for your advice. Thanks!

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Stacey
11/17/2017 06:33:36 am

Hi just wondering how you went on I'm due to return to work very soon my babies 11 month old and refuses a bottle he still fed in the night but I am up early hours cos start work 6am I'm so scared he's going to cry for me just wondering how you got on.

Reply
Laura link
1/11/2016 08:20:26 pm

New reader here, I really love your blog and your message! Before I became a mom, I used to do the same thing. It's just as wonderful as you imagine it being, and even more so, to be a mom. It's just as peaceful and natural as you think it'll be.

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Stacy Feldmann
5/9/2018 03:07:25 pm

Hi.
I just found this advice as I start to doubt myself, and my belief that breastfeeding my 10 month old around my working day, is doable. The example of the mother with a 10 month old who doesn't want to express and sometimes feeds over lunch but not always..gives me hope. My son is already quite well settled in nursery for 5 hours a day so far. Later this week, he will be introduced to being without me for the whole day. Currently, the mid afternoon feed is proving difficult to drop, in preparation for going back to work next week. But "reverse cycling" seems to be working. The example gives me hope that we will find our way without expressing or formula. Thank you.

Reply
juliet
8/22/2018 09:30:48 am

This has been so helpful and the best advice I have read, I have been trying to get my daughter to take a bottle for 3 months as returning to work week after next (3 days) when she is nearly 9 months. I managed to spread out her feeds to be similar to when she is with her CM and she would take a small amount from a bottle, loves solids and would eat loads. However she has a bad cold so has been feeding non stop so back to square one just before I am due back.
I am a teacher with very short 'breaks' so expressing isn't an option. I breastfed my second and it worked although I found feeding her at 2 years very draining physically and emotionally and it took her just over 2 years to self wean but it all seems stressful again and has left me feeling anxious, I feel better after reading this. Thanks

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Gemma
5/11/2019 01:32:58 pm

Hi, I'm returning to work in a few weeks and planning to bf at 7am, drop at nursery at 8.20am, collect at 5.40pm and bf as soon as we get home. My employer has told me I can go home at 11 and 3 to pump as she won't allow me to do it in the office. Will twice during the day be enough? My daughter is 7 months and feeding around 5 times still during the day! Also on 3 small meals, blw and eating a good amount.

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Emma Pickett
5/12/2019 08:13:08 am

It’s interesting your employer is making that demand as it will surely take your more time to make that journey and pump at home. I’m assuming you are in the U.K., as it most countries in the world, you would have a legal right to pump more. I think moving from 5 day time feeds to 2 pumps may be tricky. Ideally you would have the chance to pump at least once more, even for just a few weeks to give your body a chance to adjust. I can’t imagine she wants you to be in discomfort or suffer from other problems. Do you have a lunch hour? That is free time where a short expressing session (even hand expression) wouldn’t impact on your work. You may want to talk to the Maternity Action advice line about how to manage an unsupportive employer.

Every woman is different in terms of storage capacity, risk of engorgement and mastitis and risk to supply, so it’s hard to say how you might be affected. It would be sad for you to reduce day time feeds when you are with your daughter, or to restrict feeds at the weekend, because you have an employer who doesn’t appreciate the responsibility they have for your well-being and safety. There are very few work settings where space and time can’t be found. Even traffic wardens can find the office of a friendly cafe manager rather than have to head home.

You may be OK. Your baby is getting enough milk. But I don’t think you should have to worry about whether you might be OK. I would try and arrange the option for one more session if you need it. If worse comes to worse, she may not need to know if you are taking 5-10 minutes for one more hand expressing session. Good luck!

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    Author:
    Emma Pickett IBCLC

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    A Lactation Consultant supporting families in North London.

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