15 Nov Working Mothers Can Also Breast Feed
By Jane Pitt – Breastfeeding Advisor
Breast milk has antibodies that pass from mother to baby, protecting baby from infection and this could mean having fewer medical bills and less days off work caring for sick children. Babies in crèches can pick up more infections than babies at home.
Even if you breastfeed or give baby expressed milk only once a day, your baby still benefits from these antibodies. Recent studies show that breast milk has stem cells and we have yet to discover all the benefits of these stem cells.
Most mothers are employed outside the home. While you are on maternity leave enjoy these precious first few months breastfeeding your baby even if you have no intention of feeding longer.
How do working mothers continue to breastfeed?
The first option is to take your baby with you to work and this needs to be negotiated before you return to work. Some mothers even arrange for crèches to be opened in the workplace and then they feed baby at lunchtime and tea breaks, a wonderful solution.
- Expressing breast milk for the feeds you miss is the key factor. This helps maintain breast milk supply.
- Not expressing when you miss a feed especially in the beginning could cause inflammation leading to mastitis. To reduce overfilling at least express to comfort level.
- Expressing must be painless, quick, hygienic and cost effective.
Some mothers manage well with hand expressing. Most find breast pumps quicker and more hygienic, especially in the workplace. The really good pumps are gentle and effective, easy and comfortable to use. Good pumps should not give you aching hands or a sore neck or be painful in any way.
Multi-user electric pumps (Medela Lactina) can be hired and it is suggested you investigate and experiment. For hygiene reasons every mother should have her own kit. Ask to use a pump with a disposable sterile kit while in hospital before you decide to buy. When costing for pumps, remember to calculate the saving on regular monthly formula bills about R500 to R700.
Most hand pumps require two hands to operate. Some pumps only require one hand, leaving the other hand available to support the breast. To operate them with only one hand can be tiring. One manual model also enables someone else to pump for you, if you so wish. Only one make is convertible to a mini-electric model.
Many manuals are the piston type. The cheapest ones do not have any vacuum regulation. Those with precise vacuum settings, cost more and are recommended for comfort reasons especially for mothers with sensitive nipples.
Expressing a little prior to latching, if breasts are very full or hard, can improve latching and aid comfort. Nipple problems are best prevented by good management including variable feeding positions and correct latching techniques.
Some breast pumps have various funnel (breast shield) sizes available for best nipple comfort. You might need a bigger or smaller size nipple fitting than the standard size supplied with the pump. Before you pump, wet the nipple and whole areola with milk or clean water so the skin moves freely inside the pump. Ensure your nipple is pulling centrally to the vacuum action.
Some piston type hand pumps function better when the rubber seal is wet with sterile water. Those with vacuum adjustments are far easier to operate and are much more comfortable. Make sure all replacement parts are available locally.
Pumping after a hot shower is recommended or even in the shower with a hand pump – although this milk cannot be saved and used. Try a quick, gentle, suck and release action to stimulate a let-down, then a slower, stronger action to express your breast milk. Be patient and practise a little each day. Some electric pumps do this 2-phase pumping action automatically.
To most working mothers, time is of the essence and these mothers often prefer an electric model. True one-handed electric models are the most versatile, allowing you to pump and feed or read or write and now there are even double pumps.
It has been noticed that mothers get a much better letdown reflex with an automated action breast pump. This means the pump automatically releases at the end of each pumping phase.
When to Express?
Early, before or while you feed baby in the morning, once or twice when you are at work and perhaps again before you go to bed, especially if baby misses a feed. Some mothers need to express less often than other mothers, to maintain their milk supply.
To increase milk supply, pump after feeds until milk stops flowing. Then pump for an extra 3-5 minutes on each side, 3-5 times a day and in a few days time, your supply should increase. For best results, use a gentle effective automated breastpump.
On the whole, use the milk you express today to give the baby’s caregiver tomorrow.
Milk supply fluctuates – working mothers have most milk on Mondays – least on Fridays and it builds up again over the weekend, when she breastfeeds more often.
It is essential, after use, to wash all working parts of the pump with liquid soap and to clean off fat with a bottlebrush. Dry with a paper towel. Re-sterilise before pumping. Re-usable steam sterilising bags used in a microwave are very useful for mothers who are not at home.
Breast milk can be stored at room temperature for 6 hours in a clean, closed container and then should be used. Expressed milk can be refrigerated for 48 hours before being used or frozen in a freezer for 3 months. Normally, the milk you express today, you give to your baby tomorrow. Date your milk, so that you can use the oldest first. There are disposable freezer bags and breast milk storage bottles available especially for storing breast milk. Make sure they are all BPA free. Some freezer bags are double lined to prevent freezer burn and to maintain the optimum nutritive value of your breast milk.
How much and how often?
Working mothers always ask how much milk should they leave for the baby for a feed when they are at work? You take the baby’s weight in kilograms and multiply by 120ml breast milk or 150ml breast milk substitute and divide by the number of feeds baby has in 24 hours.
For example for a breastfed baby –
a 4kg baby x 120 = 480ml in 24 hours,
feeding four hourly = 6 feeds in 24 hours
480ml divided by 6 = 80ml per feed
Recent studies show that from 3 months to 5 months of age breastfed babies gradually require less breast milk per kg of body weight. This is good news for the mum who is expressing. Also, of course, once solids are introduced at 6 months all babies require less milk. Experiment and see what your baby needs.
How long does it take to pump?
This is the question on everyone’s lips. This varies from mother to mother and pump to pump. Some mothers can pump even faster than they can breastfeed, others pump twice to get enough milk for one feed. Some mothers express easily. Other mothers need the very best and most effective breast pumps available, which mimic the sucking action of the baby, exactly and comfortably. The really sad thing is that if a mother uses a breast pump and it doesn’t work for her or it is painful she sometimes does not try another pump, thinking that all pumps are the same.
Most breast pump surveys state that pumping with a good electric pump is quicker than manual pumps. Double pumping is definitely fastest, (this means both breasts at the same time). A recent study shows that double pumping also increases the fat content as well as the quantity of mother’s milk especially for mothers of premature babies.
Expressing at the office
Before you return to work, ask if you can have a private place to express. You will have more bargaining power than if you wait until you are back on the job. If you have your own office, you can close the door and pump whilst still working, holding the pump in one hand. These small electric pumps suck and let go automatically like a baby sucks and you do not need to do anything, the pump does all the work. You don’t get tired, hot or sweaty, as you can with manual pumps. Mothers who work in an open plan office pump discreetly in a corner, others choose to go to the ladies room. Some look forward to this break at lunchtime, put their feet up, read a book, eat their lunch and pump, all at the same time.
Some mothers do not pump at work at all. They feed their baby just before leaving them with the caregiver, or pump and feed, just before going to work and then on returning home, feeding the baby first and pumping afterwards, keeping the extra milk for the next day.
Mixing the fore milk and the hind milk
When breastfeeding a baby, the first milk the baby receives is very watery to quench baby’s thirst. The middle milk looks like ordinary milk and the hind milk or the last milk to be drawn off the breast is rich and creamy. When leaving a baby a feed, it is good to have the hind milk and the fore milk mixed together. In other words, expressing an entire feed is easiest. If you express before a feed, ensure you also express towards the end of a feed to give baby a mixture of fore and hind milk.
Breastfeeding and working – what to look out for
Feeding expressed breast milk to your baby
How can my caregiver feed my expressed breast milk to my baby without running the risk that my baby might prefer the bottle and become reluctant to breastfeed.
There is an innovative and unique feeding device designed for breast milk called Calma. Calma is not intended to replace breastfeeding but to enhance and assist continued breastfeeding for mothers going back to work or having to be apart from their babies for whatever reason.
In a study conducted at the University of Western Australia (Geddes, DT, Kent JC, Mitoulis LR, and Hartman, PE (2008). Tongue movement and intra-oral vacuum in breastfeeding infants. Early Human development 84:471-477) it was shown that babies at the breast produce a vacuum to stimulate milk flow. Babies learn that a combination of specific tongue and jaw movements is necessary for breastfeeding. Most mothers have been taught that a good “latch” is also essential for good milk flow and to avoid sore or cracked nipples. Unlike conventional teats, with Calma babies have to create a vacuum to get the breast milk to flow, just as they do with breastfeeding. Babies can thus maintain their natural sucking rhythm and can drink, pause and breathe regularly, without having to remove Calma from their mouth. This enables an easy transition between the breast and Calma and back to the breast. Note how your baby feeds on the breast after having introduced a bottle. Suckling action on the breast should not change. If the suckling action does change it could cause your milk supply to drop. Watch out for this. It is best to introduce Calma as the first feeding device, as baby has to work to get the milk out, like breastfeeding. Dip the Calma teat into some expressed breast milk for the first few times that you use Calma, to encourage your baby to start sucking because no milk flows from Calma (even if you turn the bottle upside down),until your baby starts sucking. You need to “latch” your baby onto Calma just as you would when breastfeeding.
It is suggested that you breastfeed exclusively for the first 6 – 8 weeks, without any bottles, allowing breastfeeding to become well established.
Do remember that these are only suggestions and mothers cope in many different ways. It is amazing what solutions mothers will find if they really want to work and still enjoy the pleasure and benefits of breastfeeding their baby.
Breast Pump Hire
(011) 788-9172/02 083 300 4302
Hospital grade breast pumps available for hire nationwide in many centres. Phone for your nearest agent or expressing advice.