N U T R I T I O N   A C T I O N

Supporting Breastfeeding Mothers

Many women attempt to combine employment and breastfeeding, and some enjoy remarkable success. Others report frustration and disappointment due to a lack of support, pumping facilities, time, and energy.

Pediatricians, health professionals, and childcare providers can support mothers by encouraging them to give breastfeeding a try and by offering ongoing support as they transition back into the workplace. Mothers should be encouraged to think positively and not assume that breastfeeding will not be possible under their particular circumstances.

In order to combine breastfeeding and working, mothers need to have practical information, the support of their employers and coworkers, and the cooperation of their childcare provider.

To focus on the optimal initiation of breastfeeding, mothers can:

  • Acquire as much information as possible before delivery. This might include attending a prenatal class that covers the breastfeeding basics and gathering resources about pumping, storing, and feeding expressed breast milk.
  • Inquire whether their company offers any lactation support services for breastfeeding women. If no formal corporate lactation program or facility is in place, mothers can request informal support for their breastfeeding plan.
  • Use their hospital stays to optimize early breastfeeding experiences and prepare for breastfeeding at home.
  • Ask their pediatricians for more information about breast milk storage and guidelines for handling.

If employment and personal circumstances permit, mothers can explore the possibility of a gradual return to work by:

  • Requesting as much time off as possible or asking for a longer range of time off. In general, the longer the amount of time off, the better.
  • Not being afraid to ask for more time than they think will be granted or exploring part-time or job-sharing possibilities.
  • Mothers should begin collecting and freezing excess milk before returning to work by:
  • Becoming familiar with pumping options as early as possible and beginning to express milk while at home on maternity leave.
  • Remembering that babies need to nurse until they are content and, if all is going well, will typically gain four–seven ounces per week. Mothers should check with their baby's pediatrician or primary care clinician to determine what weight gain is appropriate for their baby, given the baby's age, development, and size.
  • Pumping and freezing extra milk to take advantage of and maintain a milk surplus; this also will help condition the milk ejection reflex to be triggered by pumping or hand expression. Guidelines for refrigeration and freezing of breast milk can be found in the AAP brochure, A Woman's Guide to Breastfeeding.
  • Allowing at least two weeks to prepare for the time when they will be away from their baby. They should express milk at least once each day, and save breast milk for the childcare provider to give to use. The mother should stockpile as much milk as she can-at least enough milk to feed her baby the first day she returns to work and to allow for the unexpected during the first few weeks (e.g., spills, missed pumping time at work, or a sudden increase in baby's consumption).
  • The support and cooperation of the childcare provider are important to the success of the mother who wants to breastfeed.

As a childcare provider, you may expect concerned mothers to:

  • Inquire about how supportive the provider is of breastfeeding for children.
  • Ask whether the caregivers have breastfed their own children or cared for breastfed babies, and determine if the childcare provider is willing to cooperate in the mother's attempts to continue breastfeeding.
  • Discuss with the childcare provider how she feels about handling breast milk, coping with a baby who may not readily take a bottle, and waiting to give a bottle if the mother is due back shortly and can nurse upon arrival.
  • Spend some time reviewing their baby's eating, sleeping, elimination, and behavior patterns.

Childcare Providers Role

Childcare providers have a role in helping breastfeeding mothers and can:

  • Support mothers in their decision to continue breastfeeding, and talk about why breastfeeding is so good for babies.
  • Tell parents that they are happy to care for breastfed babies and are willing to feed them expressed breast milk.
  • Listen empathetically and help mothers articulate their breastfeeding goals.
  • Provide a quiet place for mothers to nurse their babies.
  • Educate themselves about proper breast milk storage and serving methods.
  • Develop a plan with the baby's parents so that the baby can be fed on demand but, whenever possible, can be breastfed by the mother.
  • Include fathers and other supportive relatives or partners in decisions related to the baby's care, and encourage them to feel good about the role they play in supporting continued breastfeeding of the baby.

Mothers should never underestimate the importance of support from family, physicians, and childcare providers when choosing to breastfeed their baby while employed. Support is one of the key factors that enable many women to make the choices necessary for the outcome that they desire.

This article is adapted from the joint American Academy of Pediatrics (AAP)/Healthy Child Care America (HCCA) publication, Supporting Breastfeeding Mothers as They Return to Work.


RESOURCES

Healthy Mothers, Healthy Babies, offers resources and information about local/state breastfeeding chapters; 703-836-6110; www.hmhb.org

For a list of certified lactation consultants by area, contact the International Lactation Consultant Association; 919-787-5181

For referral to a local community breastfeeding support group, contact the La Leche League International; 800-LA LECHE; www.lalecheleague.org

AAP Resources

To request a copy of Supporting Breastfeeding Mothers as They Return To Work, contact the Healthy Child Care America (HCCA) Program, 888-227-5409.

The AAP has several additional resources for women who want to continue breastfeeding after they return to work, including A Woman's Guide to Breastfeeding; Child Care: The Best Choice for Your Family; Guide to Your Child's Nutrition; and Caring for Your Baby and Young Child: Birth to Age Five. The AAP also has resources on breastfeeding promotion for health professionals, including the AAP publications, Breastfeeding Health Supervision and Checklists for Breastfeeding Health Supervision, and the 1997 policy statement, Breastfeeding and the Use of Human Milk. Contact the American Academy of Pediatrics (AAP) Direct Order Line, 888-227-1770.

In addition, portions of Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-home Child Care Programs, the AAP Pediatric Nutrition Handbook, and the joint AAP/American College of Obstetricians and Gynecologists manual, Guidelines for Perinatal Care, also contain relevant information. For more information, contact the AAP Department of Marketing and Publications at 888-227-1770.

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