A study in Pediatrics highlighting the importance of breastfeeding and the challenges for working moms was published earlier in 2009. Today, it circulated through a business journal and got some more attention.
I read the study today for the first time. Then I re-read it a number of times. I talk about breastfeeding with moms and parents in clinic on a daily basis. I certainly know the challenges of trying to breastfeed through a transition back to work. I also know how hard it is not to be able to do what you set out to do.
I had my go. With my first son, I saw about 9 lactation consultants in the first week. I am not exaggerating. Me with those women hovering over me trying to help while my little man screamed his head off. The beginnings of motherhood. I breast fed, finger fed, pumped breast milk, finger fed, breast fed, then pumped my way into a sleepless oblivion.One month into this circus, I was hospitalized for 4 days with a severe breast infection. This didn’t stop me. I had set out to breast feed after learning the health benefits, waiting for my baby and supporting numerous moms do the same. I ended up exclusively pumping breast milk until my son was almost 5 months old. By then, my supply was nearly gone, my time with the pump had me spinning and I had no place at work I felt comfortable pumping. I threw in the towel. Teary-eyed and filled with failure, I gave in to being with my son over the pump and started to feed him formula.
I didn’t make it to 12 months like I had wanted. I would have been pleased with even 6. But I didn’t make it. I did learn a lot along the way though.
Here’s my take when it comes to breast feeding and working. There is math involved. You were warned.
I think working moms who are able to breastfeed and maintain their milk supply have a fairly onerous task. I think it’s exhausting to go back to work with a newborn. It’s more exhausting to breastfeed a newborn. The combination is intimidating.
In the first few months of life, the time it takes to nurse a baby is equivalent to a 8-9 hour work day for most women. Most babies will drain a breast in about 12-15 minutes if they are eager and actively feeding but babies often stay on the breast for up to 20 minutes or even 30 minutes at a time. Therefore, if you sit down, feed your baby on the right, feed you baby on the left, burp the baby and then change the inevitable diaper: poof, one hour. And, most newborns feed up to 8-10 times daily. 1+1+1+1+1+1+1+1+1. Math is easy when you do it this way. Breastfeeding alone is a full time job for the first few months.
Therefore, mothers who go back to work early in their newborns life are really tackling the challenges of a few jobs: the mom job, the milk supplier, and the worker bee. Challenge, yes. Surmountable, of course, but this study points out some flaws in our expectation of the singular worker bee-milk-supplier-momma-person.
- Woman were less likely to continue breastfeeding if they went back to work before 12 weeks (the average for all women in the study was return to work at 10 weeks).
- Stress level and position at work (if inflexible or not a supervisor level) affect women’s ability to continue breastfeeding.
- Women with maternity leave for less than or equal to 6 weeks had a threefold increased risk of quitting breastfeeding compared to moms who didn’t return to work.
Cessation of breastfeeding can be traumatic for all involved. With only 24 states in the US with laws relating to breastfeeding, it can be difficult for women to protect this goal. The benefits from breastfeeding are astounding. Pediatricians work hard to support families in their goals to breastfeed their babies knowing well the benefits are worth the initial struggles. Benefits including maternal-baby bonding, reduced stomach infections, reduced ear infections, reduced rates of obesity, and reduced hospitalizations are just a few of the benefits to breastfed infants. Moms who choose to breastfeed and work and find success at doing both, simultaneously, amaze. They expect miracles of themselves. And although they should expect miracles, the stresses of attending a job, caring for a newborn and supporting their own bodies with good nutrition, hydration, and rest to make milk may at times be herculean.
Tips for Successful Transitions Back to Work While Breastfeeding
- Make a plan for breastfeeding before you have the baby. Ah, yes, yet another to-do for your list. Do this. Discuss with co-workers, supervisors, your boss or any one else at work who is experienced, where and how they suggest you find time and a safe, clean place to breastfeed or pump breast milk when you return to work.
- Rally your troops. Tell you spouse, partner or good friends (in and out of work) your goals for breastfeeding and ask for their help during your transition back to work. (meals, phone calls, texting while attached to the pump, magazines to read)
- Have patience with yourself if some days your milk production is down. Stress, dehydration, illness, separation from the baby, and pumping versus feeding can all affect your milk supply. If you only pump 2 oz on Tuesday at work, don’t give up! You never know what Wednesday can bring…
- Partial breastfeeding is better than no breastfeeding. Most policy statements and studies compare exclusive breastfeeding to no breastfeeding. The reality is that many babies receive a safe mix of breast milk and formula during the first year. If you find you have to supplement your infant once you or your partner is back to work, FINE! Formula is good for babies. After your baby drinks the pumped breast milk, have your partner or childcare provider offer formula if you think the supply of milk from pumping is down in the mother’s absence. This is not only okay, it’s good for your baby.
- The availability of work site lactation facilities is well known to affect breastfeeding success. If you’re not comfortable with the spot you have been offered for pumping breast milk, ask for another. There is nothing less conducive to pumping milk than a scary, unclean, unlocked, cold, exposed or intimidating place. It is never too late to ask. It is okay to re-visit this issue even if you’ve found yourself pumping milk in the walk-in refrigerator at work for 1 month.
- Do the ridiculous. Fill your pumping bag with photos of your baby. Carry a water bottle everywhere you go. Take the break you need to go and pump milk even when inconvenient to the needs of your work. Leave work on time. Continue to take your prenatals.
- Then, be easy on yourself or your partner who is trying to do it all. If you can’t do it, you can’t do it. Find support in others’ experiences. Talk to your friends and you’ll find you have many allies in these waters.
I just wanted to thank you for this conversation. My children, all non latchers, have been breast fed through a bottle during the first year of their lives. I have a 12 yr old, a 10 yr old, and now a 4 month old, who is exclusively bottle fed breast milk. It’s stressful, all the way around and I just wanted to say that I appreciate the truth of this blog. It is a full time job, plus a regular full time 9 to 5 job, plus the mommy job. Thanks.
Lani Wolfe says
Thanks for sharing much-needed wisdom and humor on this intense topic, so near and dear to so many of our hearts. I was fortunate to have had a much more successful experience juggling work / breastfeeding with my second child than my first — different baby, better perspective, who knows? Life was certainly exponentially busier! So to you and others — on we go, doing our best juggling act, benefitting immensely from the comraderie of our fellow worker-bee-momma-persons whether milk-supplying or not.
Hi Seattle Mama Doc! I really enjoyed this post. I had the extreme fortune of being blessed with an amazingly trouble-free breastfeeding experience with both my kids. But I have many friends and patients (I’m a dietitian/nutritionist) who struggled. It’s frustrating to hear many docs simply tell their new moms to just stop nursing and go to formula with few offers of support or referrals to lactation consultants. I love your blog and it is one I will read regularly. Thanks for starting it.
Wendy Sue Swanson, MD says
Thanks for the comments. I appreciate your perspective and stories. I too, had an easier time breastfeeding my second son. Maybe because I was more calm (I had LOW expectations) or because I simply was an experienced momma-milk-maker?? No idea, but it was easier. I also had an easier time pumping at work because I had the confidence to demand a better place to pump. The first time around I was offered a patient exam room (window, no lock on the door, patients in/out all day and the pump had to sit on the floor) and felt entirely uneasy about it. Finding ways to ask for an appropriate place changed the experience for me and for other pumpers at work. One of our staff members told me that she previously pumped her milk in her car for months (under a towel!) during her lunch break when she couldn’t find a spot inside. Imagine!
This is great advice for new moms and moms-to-be! The pressure to breastfeed can be intense and the sense of failure if it doesn’t go as planned can be equally intense. I had twins and had good intentions when it came to breastfeeding. In reality, it didn’t go great, but I take comfort in the fact that it wasn’t for lack of trying! Thank you for giving women permission to plan, try, express frustration, seek support, try again, make adjustments and go with the flow!
I just received so much validation and praise from this post, I’m in tears (reading it while at work, no less!). I returned to work FT 13 weeks after my son was born. Fortunately for me, I had 100% support from my husband (SAHD). Also, thanks to my supervisor at work, our company created a new space for a lactation area. I had amazing support from the B.A.B.I.E.S. Clinic through Silverton (OR) Hospital. Those things (combined with my determination and stubbornness, I’m sure!) helped me breastfeed my son exclusively. He’s 20 months old and my husband still brings him to me to nurse every day on my lunch break. My goal is to nurse for 2 years and I am confident we’ll make it!
Wow! Thank you so much for your encouragement. Breastfeeding has been one of the most frustrating things in my whole life. My daughter finally learned how to breastfeed at 3 1/2 months….hours and hours spent trying to teach her. Then at 6 months when I began giving her solids, my supply tanked. I have spent the last 4 months pumping at work to give her anywhere from 1-12 ounces of breastmilk a day, supplemented with formula of course. All of my friends have told me to give up, that it isn’t worth the stress/time. I just want to say thank you for releasing me, but also encouraging me that if I can do it, it is worth the effort.
Thank you for the information. I had a horribly difficult time breastfeeding my daughter-born 3.5 weeks early. I tried and tried for about 2 months until our pediatrician finally recommended formula due to her inability to gain weight. I had lots of trepidation around having a newborn but the one thing I was never really “warned” about was breastfeeding. I just assumed it would come naturally and that it would be problem free. I even took a breastfeeding class in advance of her birth-the teacher spent the majority of class explaining the benefits of breast milk and never mentioned the potential difficulties. Because I wasn’t expecting it, it made the difficulty that much harder. I did not invision hours of trying to get her to stay awake long enough to feed and a variety of infections. It’s amazing how much guilt is associated with not breastfeeding. I wanted to be able to provide this nutrition for her but we had physical limitations. I can’t imagine being back to work full time and balancing pumping on top of it all. I admire anyone that is able to sustain that balance. Thankfully, my daughter is healthy and now in the 50% for weight! Thanks for talking about such an emotional topic.
Annie @ PhD in Parenting says
This is a great post. I need to take the time to write about my experiences working and pumping at some point.
As a Canadian, I had access to one year of maternity leave. As the primary breadwinner in my family, I ended up sharing that leave with my partner because we couldn’t afford for me to take a full year off and because he wanted to take some of it as well. I ended up going back to work at 3 months with my son (part-time initially, but up to full time by the time my son was 5 months old) and 6 months with my daughter. This gave me enough time to have a well established milk supply and a good breastfeeding relationship (good latch, good routine, etc.). I think that extra bit of time makes a world of difference.
I ended up pumping at work until my son was 12 months old and until my daughter was 18 months old.
Wendy Sue, I’ve never worked harder at anything than nursing my kids.
I’m wondering if you have met Maryanne O’Hara. She is amazing and made the difference for us where 4 lactation consultants and 4 pediatricians failed. My second baby had problems latching and exchanging milk. I went through the gring (with daily weight checks) and was convinced them that: 1) his frenulum was too tight. 2) his suck wasn’t coordinated or strong enough. I didn’t give a rip what the AAP said about frenulums. Sure, his tongue reached the right place when he yawned, but it didn’t when he latched, and that’s what mattered. And I also didn’t give a rip what anyone thought from sticking their pinky finger in my baby’s mouth. I nursed my first child till age 2 (and 6 months pregnant). My nipples had an estimated 4,500 hours of practice. My son had an unrelated medical problem that resulted in his admission to Seattle Children’s where I finally got that OT consult. With Dr O’Hara’s help and about 6 hrs of OT over the course of 5 weeks, I was able to get that baby nursing.
I’m not suggesting this course for all moms out there who struggle with nursing. In our case, both my kid had milk, soy, and corn allergies and couldn’t tolerate hydrolyzed formula. My son had suspected EE and insurance wouldn’t pay for Neocate. (Washington is not a state where elemental formula coverage in mandated.) Sometimes you have no choice but to bust your behind.
Final point: donation. I had 300+ ounces of excess milk that I pumped when my son was in the hospital. I was able to donate most of it to a friend and another mom in a mom’s group. You can purchase human milk from human milk banks in both liquid and powder forms. (It’s not for anyone, just saying…)
I realize this is way after the fact but this is a wonderful post. I just wanted to share the thing that saved me when I went back to work. I’m an RN and so can’t always count on having breaks. I got myself a hands free pumping bra so I didn’t even have to hold the pump in place. This meant that I could microwave my lunch, then run into the lactation room (I was lucky enough to have one!) and eat and pump at the same time. So even if I could only get a 15 minute lunch break I could still pump AND eat enough to maintain my supply. On slower days I had more time to pump but I’m convinced that bra helped me maintain the bare minimum of pumping that I needed to meet my goal of one year.
With a desk job and a private office, the pumping bra would be ideal. You could sit and pump while still working on the computer, making calls, etc. But I have the furthest thing from that kind of a job and it still helped me.
Good luck to any mom out there who wants to work and pump!
Over a year since this was written, but curious if you have suggestions for my situation. I’m going back to school (4th year medical student) and rotations in July when my babe will be 10 months. I would really love to continue breast feeding after that point, and am worried sick over how I am going to manage pumping in unknown situations and constantly rotating in new places. There will be the need to explain my need for TIME to pump along with a place to pump, and I will have to ask for this repeatedly every 4 weeks when I rotate. I have so much anxiety over this already!
I love this post! Your blog is so balanced and just refreshingly rational! There are always two sides to a situation. I was blessed to have a supportive team of my spouse, daycare provider, and work environment, and made it to 12 months breastfeeding and working. Even with all of that, it was HARD. I applaud moms, either at work or at home, who try to breastfeed at all. And, whether they are able to reach their goals or not, they are giving their baby a great start.
Rachel Fleishman says
FYI — https://www.bostonmagazine.com/health/blog/2014/09/10/mit-hosting-breast-pump-hackathon/