Working and Breastfeeding Made Simple? Nancy and Barbara discuss this important topic and how their new book group, Working and Breastfeeding Made Simple, can help make you an expert on this topic. Here are just five topics that will be covered in depth during the book group! Yes, it is possible to support working parents in achieving their infant feeding goals. Several critical factors for supporting breastfeeding/chestfeeding among employed parents have been identified in the literature and clinical practice. Despite the dire statistics, families in Barbara’s private practice actually do well. None of them discontinued breastfeeding during the first month of returning to work. Providing accurate information about how breast milk supply works and how to express breast milk, along with social and emotional support, appeared to help clients maintain breastfeeding despite occasional difficulties. Here are five critical factors that help families meet their breastfeeding goals. 1. Breastfeeding Is Going Well Before Returning to Work One critical factor for success is having the parent be good at breastfeeding before they return to work. It is well established that breastfeeding becomes less labor-intensive (and generally easier) for most mothers at approximately 6–7 weeks (Mohrbacher & Kendall-Tackett, 2010). If breastfeeding isn’t going well or a mother goes back to work before 6–7 weeks, she is more likely to be unsuccessful with this transition. If a mother is struggling with pain, has a baby who doesn’t feed well at the breast, or her milk supply is low when she returns to work, she is doubly challenged from the get-go! Providing a plan to address these issues along with hope, accurate information, and support can help mothers continue breastfeeding even as they return to work. 2. Support From an International Board Certified Lactation Consultant The support and information that an International Board Certified Lactation Consultant (IBCLC) can provide are critical for success. Many parents don’t have anyone in their lives who understands or cares about why they are even trying to continue to breastfeed and work. IBCLCs do care. They want them to achieve their breastfeeding/chestfeeding goals. Together, IBCLCs can help improve the low statistics on working and breastfeeding success. 3. Success at Milk Removals Another critical factor for success is how effectively the parent expresses their milk when separated from their baby. Most clients use a standard, personal-use, double-electric breast pump. However, not all pumps are created equal. Some work well, and some don’t work as well. Using a pump with adequate vacuum, different-sized breast shields (as necessary), and variable speeds will increase her chances of success. At the same time, if a pump has all these things and they is still not getting out their milk, IBCLCs have to get creative. Perhaps they need to try a different pump brand, rent a hospital-grade pump, use a hand pump, or hand express. Watching a parent pump is essential. Test the vacuum. Make sure their shields fit well. Many families are unaware that different-sized breast shields even exist. Positive associations to help them “Feel the Love” for their pump. Without an oxytocin release, parents are trying to pull the breast milk out of their bodies. With an oxytocin release, they are working in sync with their body. Their body is pushing the milk out of their breasts. This is much more effective. If the parent is having trouble “feeling the love,” suggest warm compresses, warm breast shields (Kent, Geddes, Hepworth, & Hartmann, 2011), and/or massage before pumping (Bolman & Witt, 2013; Bowles, 2011). They can also use “hands-on” pumping techniques to help get the breast if the milk is flowing (Morton, n.d.). Additionally, hand expression for a minute or two on each breast after pumping can support milk production (Morton et al., 2012). Some mothers find that visualizing their baby or their milk flowing helps. Others find that playing Candy Crush helps! There are some hypno-pumping visualization MP4 products out there. Have them practice pumping while getting a massage, eating chocolate, or watching their favorite comedy. It’s straight classical conditioning. Pair a condition with a response (think Pavlov’s dog). Clients can help train their bodies to have an oxytocin surge in response to their pumps. If a mother is having difficulties with her milk production, encourage her to blame her pump for lack of breast milk, not her body! If breast milk is not being removed effectively while she is separated from her baby, her supply will go down. 4. Supportive Child Care Working and breastfeeding success can also be at risk if the family’s child care provider does not value breast milk or the breastfeeding relationship with the baby. Overfeeding the baby while the parent is away is a common problem. The child care provider needs to understand that not all crying or fussiness is about food. They also need to know how to care for expressed breast/chest milk and how to bottle-feed a baby in a breastfeeding-friendly manner by pacing the bottle feed. It is now recommended that all infants be fed in this manner, not just breastfed infants, even when there is breast milk in the bottle. Pacing the feed helps the baby control his or her intake and prevents overeating, which may help prevent obesity in later life. 5. Avoid Overfeeding at Child Care The final stumbling block concerns overfeeding and subsequent reduced breastfeeding when families are reunited. When a baby has been overfed at child care, not only is it almost impossible to keep providing enough pumped breast milk for the baby, but the baby also doesn’t need to breastfeed as often from mom when they get back together. It is as if the baby is saying, “No thanks; I’m good! I had all my needed calories for day from my caregiver.” This does not hold true for all babies, but it does for many. Additionally, being away from one’s mother can be stressful and tiring. Babies can sometimes sleep longer at night because of this. Between not needing to nurse because of the calorie overload during child care and sleeping longer at night, mothers can end up breastfeeding far less than they were before returning to work. Suggesting that mothers pump before going to bed if their baby is scheduled to sleep at 8:00 p.m. and will not feed much during the night can help. This strategy appears to help improve their breast milk supply. Summary In Barbara’s clinical practice, she has found that these five factors can undermine a parent’s ability to continue breastfeeding/chestfeeding after they return to work. Again, breastfeeding not working well, the lack of information and support, milk removals not working well, lack of paced bottle feeding, and a parent’s daily milk removals reducing over time are the most common culprits that have been found to sabotage a mother’s success in meeting her breastfeeding goals when returning to work. Providing information about these issues may help families anticipate problems before they arise, or at least help them quickly identify when they are moving down a slippery slope, and can significantly increase their odds of having the breastfeeding/chestfeeding relationship they dreamed of before returning to work. The post All Things Breastfeeding Episode 105: Working and Breastfeeding Made Simple appeared first on The Breastfeeding Center of Ann Arbor.
