Updated: Aug 20, 2020
As we kick off this week’s line-up of virtual events for World Breastfeeding Week, we’d like to turn our attention to all the nursing moms going back to work. It can be a highly stressful, emotionally-draining experience when a mom leaves her precious baby in another’s care to resume working life. Besides figuring out schedules (both mom’s and baby’s) and striking a balance between work and home life, breastfeeding moms have a whole host of other concerns.
We asked Amy Siegrist, an International Board-Certified Lactation Consultant and one of our telehealth providers at EmmaWell, to share her recommendations for some common questions related to breastfeeding and working. Note that her advice here is general and may not apply to every mom’s individual preferences or struggles. When doing a back-to-work consult, Amy would consider important details about a mother’s situation (e.g. the age of her baby, the nature of her job, her long-term feeding goals, her history of plugs or mastitis) and tailor a custom plan to ensure a smooth return to work.
What are some steps I can take while breastfeeding during maternity leave to make my transition back to work easier for me and my baby?
Try to establish a good milk supply in the first few weeks of lactation. Your body usually gives you extra milk in the beginning, so take advantage of this with frequent breastfeeding and/or emptying your breasts at least 8 times in 24 hours. A good supply in the beginning will make your whole breastfeeding journey easier.
Introduce a bottle around 3-4 weeks if you haven't already. When possible, it's best to exclusively breastfeed for the first few weeks, and then add in the practice bottle. This helps prevent bottle refusal, which can happen as early as 6-8 weeks.
To get started with pumping and bottles, I usually recommend pumping twice a day. Pump once in the morning after breastfeeding to fully drain any leftover milk. Then, around the same time your baby is drinking a bottle, pump again. One pumping session will go towards extra milk for the freezer, and one pumping session will supply tomorrow's practice bottle. Set up a daily routine in which your baby gets one bottle per day or at least a few bottles per week. I suggest using a slow-flow nipple.
What questions should I ask my employer’s HR department about policies for breastfeeding mothers?
It's helpful to know that there is a law that requires employers to provide break time and a private place for hourly paid employees to pump breast milk during the work day [Read more on the Patient Protection and Affordable Care Act here]. Ask where you will be able to pump, such as a lactation room, private office, or conference room. Discuss break times and scheduling. It will take you about 15-30 minutes to pump and 5 minutes to clean up. After discussing with HR, you might find it helpful to talk to colleagues who have previously pumped at work.
What equipment will I need to pump and store breast milk?
Extra pump parts kit
Hands-free pumping bra [All registrants of our virtual events this week will be entered to win a Lilu Massage Bra in our World Breastfeeding Week giveaway!]
Cooler bag with ice packs to store and transport the milk
[Read this article for more detailed suggestions on what to stock up on in preparation for pumping while working.]
If I’m planning to prepare bottles of breast milk for my baby to drink while I am working, when should I start pumping and storing milk?
The milk you pump one day can be consumed by your baby the next day. So, as long as you plan to pump about every 3 hours at work, you don't need a huge freezer stash of milk. Most moms pump once or twice a day after breastfeeding and store this milk. You can start this routine when you start offering practice bottles, which is usually recommended around week 3.
Where and how should I store my breast milk in the workplace?
Find out if there is a refrigerator you can use. If not, use an insulated cooler bag with ice packs. You can safely store your milk in a cooler for up to 24 hours. [Read our Breast Milk Storage 101 post for more guidelines.]
How many ounces of breast milk should I give my baby’s caregiver to cover each work day?
Babies eat roughly 1-1.5 ounces of milk per hour you are away. For a 9-hour work day, I recommend providing about 10-12 ounces of breast milk. Some caregivers will allow you to leave some extra frozen milk to use as back-up.
After I return to work, should I adjust my breastfeeding schedule during non-working day and night hours?
It is generally recommended that you breastfeed as much as possible when you are with your baby. This should help you maintain an adequate milk supply and will provide lots of time for bonding and snuggling. On non-working days, many moms choose to pump a couple of times per day right after breastfeeding to store some extra milk for the following work week.
How frequently should I plan to pump while working?
Plan to pump about every three hours. Some moms like to arrive at work 15 minutes early and pump immediately. Others breastfeed right before leaving their baby and then wait until lunchtime to pump. In a typical 8-10 hour workday, pumping three times is ideal, but two pumps may be enough if you are able to feed your baby right before and after work.
What can I do to prevent engorgement and mastitis if I need to go for long stretches without draining my breasts?
Learn hand expression or get a Haakaa type manual pump. If you are very full and can't use an electric pump, you can express a small amount just until you are comfortable. When you do use an electric pump, drain your breasts well and massage them to make sure there are no full ducts/clogs.
What emotions should I anticipate as I adjust to working life?
There will definitely be an adjustment period. Give yourself several weeks to adjust to the new routine. It's okay to feel sad or to doubt your decision to go back to work. Talk to other friends or coworkers, join a virtual support group, or make a telehealth appointment with a therapist.
What are some ways I can emotionally connect with my baby in the absence of breastfeeding during the workday?
Continue to breastfeed when you are with your baby. Spend lots of time together - singing, rocking, lying skin-to-skin, and playing on the floor in tummy time.
What precautions should I take in the workplace when it comes to COVID-19 and pumping?
The CDC has prepared two handouts on proper milk storage and pumping hygiene. One provides easy-to-follow guidelines on how to keep your pump kit clean, including sanitizing the pump area before and after pumping and using a separate basin and brush for cleaning the parts. The CDC’s guidelines for storage and preparation of breast milk also covers how to clean and thoroughly sanitize baby feeding items.
If I’m going to work from home every day, should I try to squeeze in time for breastfeeding meals or stick to bottles?
It's great to fit in breastfeeding whenever possible. Breastfeeding can often be quicker than setting up your pump, pumping for 15-30 minutes, and cleaning all the parts. This is especially true as your baby gets older and becomes more efficient with breastfeeding.
If I’m going to work from home occasionally, should I plan to keep my baby’s feeding method consistent (e.g. bottle-feed pumped milk vs. sporadic breastfeeds)?
It's not necessary to stay consistent. Most babies do very well alternating between the breast and bottle. Keep your baby on a slow-flow nipple for as long as you are breastfeeding. Continue to offer bottles at least a few times per week. If your baby starts to prefer a bottle, spend your non-work days relaxing and doing extra breastfeeding sessions.
If I’m planning to wean my baby off the breast when I return to work, what is the best strategy for transitioning to formula?
Start by picking one feed per day and give your baby a bottle of formula instead of nursing. Express just a little milk (1-2 ounces per side) and use ice or cabbage on your breasts if they feel uncomfortable. Every few days, add in another formula bottle feeding. If you need more personalized help with the process of weaning, I’d recommend scheduling an appointment with one of EmmaWell’s lactation consultants.
Tune in on Instagram at 3:00 PM for a live interview with our very own “Boob Donna!” We will cover some common concerns related to breastfeeding and working, particularly in the current climate of the pandemic. Get helpful tips (e.g. remember to turn off your Zoom tele-conference video while pumping) and ask Donna any questions of your own!
With Warmth and Wellness,
Your EmmaWell Team