In my work as a pediatrician and a breastfeeding educator and counselor, I have encountered many families who reported that they stopped breastfeeding their babies because the mothers returned to work already. Being a working mom myself, I sympathize with them and I truly understand the difficulties of pursuing breastfeeding when a mother has a job that requires her to be physically away from her baby for many hours a day.
And so in the breastfeeding classes I teach, I take time to emphasize that there are ways for working moms to still continue breastfeeding their babies. It will take a lot of effort and determination, yes, but it is possible and doable. As with most challenges, it can be accomplished with preparation and education for the part of the family expecting a newborn. ????
On a personal note, we just gave birth to our second child 2 weeks ago! What a blessing she is and what a comforting thought that I am able to breastfeed her given that she has special needs (more on our Baby Kaya in another post). ???? As I write this article, I am recalling how we exclusively breastfed our first-born even when the time came that I had to return to work already. I am reviewing too and giving myself a pep talk at the same time! Haha. ???? Some of the strategies I will mention here came from the personal experiences of other working moms who shared with me what worked for them (thank you for your insights, dear mommy friends!).
Let me share here my 13-point game plan for us working mothers. ???? I divided it into 4 parts to put things in perspective.
Let us then with confidence draw near to the throne of grace, that we may receive mercy and find grace to help in time of need.
BEFORE GIVING BIRTH
1. Attend a prenatal mother’s class.
The best time to start preparing for breastfeeding is while we are still pregnant.
Think of it as something similar to learning how to drive. Before we go to the highway with speeding cars (i.e. before baby is born), we would first learn how to drive in a big open road with no cars (i.e. baby is still happily inside the womb) so that we can internalize how to shift gears, make a left or right turn, drive backwards, maneuver to make a U-turn, stop and go up on an incline, and park. With regards to breastfeeding, this means learning the benefits and advantages, different positions and proper latching, and even troubleshooting.
This way, an expectant couple–free from the pressures and demands of caring for a newborn–can maximize learning in a relaxed manner.
Fortunately, we have a handful of these classes in the Philippines now. Hospitals, private groups and NGOs that advocate breastfeeding conduct such prenatal classes for parents.
And couples, take note, this class is not just for the pregnant woman. Personally, in the families I have encountered and counseled, it really helps a lot when the father-to-be (or aunt-to-be or grandmother-to-be or whoever will be helping the mom & baby during the newborn stage) accompanies the expectant mom to these classes.
Here in Cagayan de Oro, the dynamic mother support group, Modern Nanays of Mindanao, regularly holds “Nanay meet-ups” and organizes BUMP to BREAST talks.
Similarly, our Bundle of Joy team conducts Hello Little One Babycare Workshops quarterly. Send us a message on Facebook for our quarterly schedule.
Both the above classes discuss the basics of breastfeeding as we all aim to help parents-to-be in their journey of providing the best nutrition for their babies.
2. Let the workplace know that you plan to breastfeed.
For those employed in an office setting, you have to check out your breastfeeding room already, if your building has one. If your office does not have one, educate yourself with the Philippine laws as quoted below, then kindly and respectfully ask your employer or HR department if one can be arranged.
Republic Act 10028 has our backs with regards to this. Section 11 mandates that “all health and non-health facilities, establishments or institutions shall establish lactation stations” and Section 12 states that “nursing employees shall be granted break intervals in addition to the regular time-off for meals to breastfeed or express milk… counted as compensable hours worked… such intervals shall not be less than a total of forty (40) minutes for every eight (8)-hour working period.” There are some exceptions, of course, so for the complete law, please click here.
3. Learn how to do breast massage and hand expression.
Breast massage and hand expression are two skills that I believe every breastfeeding mother must learn, whether or not a mom is a SAHM or works outside the home. Some of my working moms would ask if they still have to learn these skills even if they have an electric breast-pump. And I would always answer, yes. Why? Well just in case of a power black out, or if you forget your electric pump or any of its parts. (Believe me, it happens! ???? )
More importantly, these skills are a sort of first-aid and a trouble-shooting strategy for the common breastfeeding-related problems like engorgement and clogged ducts.
Special reminder for expecting women, learn this in theory and practice on breast models first while you are still pregnant. Do not manipulate your breasts as a preterm labor precaution. Once your baby is born, then you can apply what you have learned.
BEFORE GOING BACK TO WORK
4. Direct latch on the first few weeks.
Once our baby is born, we must prioritize learning how to position our baby comfortably in our arms and how to let him latch on our breast properly first BEFORE anything else. Of course if there are medical complications, then that becomes a different story. But if all is well, and we get to bring home our baby with us right away, then direct latching should be our main focus in the early weeks.
This will help us build a good milk supply that corresponds well with our baby’s demand for nutrition. Remember that the best stimulus for our brain to tell our mammary glands to make more milk is our baby suckling on our breast. ????
5. Train your caregiver or guardian.
Perhaps our biggest concern as working moms is who will take care of our baby when we go back to work. Lucky you (and lucky me!) if your husband’s work schedule allows him to take care of your baby while you’re at work. But for most families I have encountered, somebody else would have to take care of the baby when Mommy goes back to work because Daddy is at work too.
These heaven-sent earthly angels—which in this article I would refer to as our “caregivers”–are the grandparents, aunts or uncles, “yayas” (nannies), or midwives who we leave in charge of feeding our babies, changing their diapers, putting them down for naps, and stimulating them with language and movement. Of course, of all these responsibilities we are delegating to our caregivers, the one most parents would be concerned about is the feeding.
Thus we really have to train our caregivers BEFORE we go back to work so we can have peace of mind that our babies will be fed the way we want them to be fed. An important note: cup-feeding is our recommended way of feeding babies our expressed breastmilk to avoid having our babies refuse the breast and prefer bottle-feeding instead. –aka nipple confusion.(Nipple what?! More on that in another post. ???? )
Apart from the actual feeding, we also need to train them how to thaw expressed breastmilk and how to make sure breastmilk is not spoilt. Of equal importance, we have to teach them our baby’s hunger cues and feeding pattern so that they can respond to our baby timely and accordingly. For more information about hunger cues, please read through these notes from kellymom.
6. Be familiar with your baby’s feeding pattern.
It is really important for us mothers to be familiar with our own baby’s feeding pattern. Keep in mind though that each baby has his or her own unique feeding pattern, so let’s resist the urge to compare our baby with our sister’s or our friend’s baby. Some babies get hungry at a predictable time with rests in between. Some seem to feed ALL THE TIME (unli-latch, mommies, who can relate? ????♀️).
In any case, to learn our baby’s feeding pattern, we have to focus on direct latching in the first few weeks so you can observe (and record if you are OC like me, haha), at what time does he or she wakes up, show hunger cues, and what are the signs that your baby has had enough (e.g. falling asleep after feeding, body relaxing, fists loosening so that the fingers are naturally curled but not tightly so, etc.).
This will allow us to simulate our baby’s feeding sessions when we are back at work. Let’s discuss how this applies when we get to point #8.
7. Begin to build your stash.
The operative word here is “begin”.
I usually advise my working moms to focus on direct latching in the first 4-6 weeks of baby’s life (recall point #4) and not pressure themselves on pumping right away. So how do we build our stash without pumping, you ask. By making the most of the let-down reflex (milk ejection reflex) of the other breast. ????
While breastfeeding our baby on one breast, most moms will notice that the other breast will be leaking milk which is part of the let-down reflex. This can happen a few times during an entire feeding session. We can collect this precious milk (instead of just catching the drippings into a “lampin” which for sure will just go to waste) by using a high-quality silicone manual pump that we can attach to the right breast for example, while our baby is breastfeeding on the left. (Parents, please research on the brands before you get your silicone pump since a lot of imitations are now available too.)
This silicone pump, partnered with breast massage and hand expression, worked very well for me personally. I started collecting about 10-15 ml which eventually increased to about 45-60 ml per expression. For 11 months (before a friend gave me an electric pump), I collected milk this way and was even able to donate my extra milk stash to our NICU and a handful of moms who came to me for help.
For most working moms, our target is to have 3-7 days worth of expressed breastmilk in stock. So if we begin collecting this way as early as possible (even if we don’t pump until 2-4 weeks before we resume work), then we can have a few days’ stash secured already. ????
WHILE AT WORK
8. Follow a schedule for expressing milk.
How to make a schedule for expressing milk? We begin by reviewing our baby’s feeding pattern (as we mentioned in point #6). For example, we know that our baby feeds every 2-3 hours. Then that means, we can breastfeed before we leave for work. Then while at work, we can express milk during our mid-morning break, at noon-break, at mid-afternoon break, and before we go home if we need to travel for a long time before reaching the house. (Please remember to direct latch again once you are home! ???? )
This way, our milk supply can match our baby’s feeding demands; because when she feeds at home, we are expressing milk as well. It is helpful to keep in mind that we have to “empty” our breasts so that our brain will tell our mammary glands to make more milk. Note that if the breasts are always full of milk (i.e. we don’t express milk—which can happen when we have successive meetings at work, or things are just too busy, or we forgot our breast-pump, etc), a feedback mechanism will tell our brain that we don’t need to make milk because they are still full, and so our milk supply will eventually decrease.
9. Wear comfortable breastfeeding-friendly clothes.
Whether we are directly breastfeeding or are pumping at work, wearing clothes with easy nursing access saves a lot of time! Instead of removing clothes or changing clothes or run the risk of getting our tops wet, these nursing clothes allow us to just open a slit or lift a flap, then breastfeed we go. Pretty straightforward.
On a personal note, I consider these clothes an investment for my work as a doctor and as a teacher in our medical university. They are convenient and comfortable. There are expensive brands (which I am not a fan of) but fortunately, there are also a lot of affordable local brands that are easily found online. Plus, if you have the time to DIY, that is also a good option. ????
10. Have a storage & transport strategy.
We can store our expressed breastmilk (EBM) in reusable containers or disposable milk bags (please look for brands that are biodegradable). Remember to always LABEL each container/bag properly including name, date, time and amount to make it easier to track which ones to consume first when we bring our liquid gold back home to our baby. While finishing our shift, we can place our EBM in a cooling facility which is ideally provided by the office’s lactation station (included in the Philippine law from point #2).
A insulated cooler with ice is also another option for storage if the workplace does not have a refrigerator. We can use this same cooler to transport our EBM from work to home at the end of our shift because if there is enough ice inside to keep the milk cool, our EBM can be stored inside it for around 24 hours.
My own OB’s experience with being a working mom is inspirational. She and a couple of other breastfeeding colleagues would have a “pumping session” together in one of the hospitals here in our city. When duty calls and they can not go home right away to their babies, the supportive husbands of these doctors would go to the hospital to bring their EBM home. Breastfeeding is really a family thing! ????
Here are some useful storage guidelines in storing your EBM from kellymom and CDC.
WHEN BACK AT HOME
11. Direct latch and feed at night.
This is something I actually look forward to when I come home from work. I take a quick shower right away and hold my baby close for our breastfeeding session. Instant bonding, instant reconnection. ❤️
Breastfeeding can also help us relax and feel good when we are tired from work. We produce oxytocin which facilitates the milk-letdown reflex when we breastfeed. This hormone is also responsible for the sense of well-being, for feeling loved, for relationship-building. Plus, it has anti-stress effects! ????
Most babies wake up to feed at night. So moms, please don’t feel pressured if your baby does not sleep through the night yet! Night-feeding is actually physiologically advantageous because moms produce more prolactin at night until dawn. This is the hormone responsible for making milk. So direct latching at night helps us keep a good milk supply.
12. Express milk in between direct feedings as needed.
For me, this is one of the most challenging aspects of breastfeeding as a working mom. There were times that I had to get up from bed after my baby has fallen asleep post-feeding so I can do a bit of breast massage and hand express the remaining breastmilk inside my breasts. To help me through, I kept in mind that this has 2 benefits. One, I get to store more milk for my baby. Two, my breasts will make more milk when they are properly “emptied”.
13. Rest and relax.
“HOW CAN I DO THAT?!” was the reaction I often get from my working moms when I tell them that sleep, rest and relaxation is important for us to keep a good milk supply. Remember, stress can affect our milk production negatively.
So I encourage breastfeeding moms to do something rejuvenating after our baby sleeps. We can reconnect with our husband and find things to laugh about, or sleep early if possible, or watch a feel-good movie, read an inspirational book, have a post-natal home service massage, or chat with or call our bestfriend. Whatever works for you is the best for you. Needless to say but I will say it anyway, we need to take care of ourselves well so we can take care of other human beings, specially our babies. ????
Hope this helps you as much as it helped me and my working mommy-friends. And always remember, for every breastfeeding problem, there is a solution—ASK FOR HELP. ????
And if you are a working mom who is breastfeeding, I would love to hear about your stories and tips too!