ShadowA study in Pediatrics highlighting the importance of breastfeeding and the challenges for working moms was published earlier in 2009. Today, it circulated through a business journal and got some more attention.

I read the study today for the first time. Then I re-read it a number of times. I talk about breastfeeding with moms and parents in clinic on a daily basis. I certainly know the challenges of trying to breastfeed through a transition back to work. I also know how hard it is not to be able to do what you set out to do.

I had my go. With my first son, I saw about 9 lactation consultants in the first week. I am not exaggerating. Me with those women hovering over me trying to help while my little man screamed his head off. The beginnings of motherhood. I breast fed, finger fed, pumped breast milk, finger fed, breast fed, then pumped my way into a sleepless oblivion.One month into this circus, I was hospitalized for 4 days with a severe breast infection. This didn’t stop me. I had set out to breast feed after learning the health benefits, waiting for my baby and supporting numerous moms do the same. I ended up exclusively pumping breast milk until my son was almost 5 months old.  By then, my supply was nearly gone, my time with the pump had me spinning and I had no place at work I felt comfortable pumping. I threw in the towel. Teary-eyed and filled with failure,  I gave in to being with my son over the pump and started to feed him formula.

I didn’t make it to 12 months like I had wanted. I would have been pleased with even 6. But I didn’t make it. I did learn a lot along the way though.

Here’s my take when it comes to breast feeding and working. There is math involved. You were warned.

I think working moms who are able to breastfeed and maintain their milk supply have a fairly onerous task.  I think it’s exhausting to go back to work with a newborn. It’s more exhausting to breastfeed a newborn. The combination is intimidating.

In the first few months of life, the time it takes to nurse a baby is equivalent to a 8-9 hour work day for most women. Most babies will drain a breast in about 12-15 minutes if they are eager and actively feeding but babies often stay on the breast for up to 20 minutes or even 30 minutes at a time. Therefore, if you sit down, feed your baby on the right, feed you baby on the left, burp the baby and then change the inevitable diaper:  poof, one hour.  And, most newborns feed up to 8-10 times daily. 1+1+1+1+1+1+1+1+1. Math is easy when you do it this way.  Breastfeeding alone is a full time job for the first few months.

Therefore, mothers who go back to work early in their newborns life are really tackling the challenges of a few jobs: the mom job, the milk supplier, and the worker bee. Challenge, yes. Surmountable, of course, but this study points out some flaws in our expectation of the singular worker bee-milk-supplier-momma-person.

  • Woman were less likely to continue breastfeeding if they went back to work before 12 weeks (the average for all women in the study was return to work at 10 weeks).
  • Stress level and position at work (if inflexible or not a supervisor level) affect women’s ability to continue breastfeeding.
  • Women with maternity leave for less than or equal to 6 weeks had a threefold increased risk of quitting breastfeeding compared to moms who didn’t return to work.

Cessation of breastfeeding can be traumatic for all involved. With only 24 states in the US with laws relating to breastfeeding, it can be difficult for women to protect this goal. The benefits from breastfeeding are astounding. Pediatricians work hard to support families in their goals to breastfeed their babies knowing well the benefits are worth the initial struggles.  Benefits including maternal-baby bonding, reduced stomach infections, reduced ear infections, reduced rates of obesity, and reduced hospitalizations are just a few of the benefits to breastfed infants. Moms who choose to breastfeed and work and find success at doing both, simultaneously, amaze. They expect miracles of themselves.  And although they should expect miracles, the stresses of attending a job, caring for a newborn and supporting their own bodies with good nutrition, hydration, and rest to make milk may at times be herculean.

Tips for Successful Transitions Back to Work While Breastfeeding

  • Make a plan for breastfeeding before you have the baby. Ah, yes, yet another to-do for your list.  Do this.  Discuss with co-workers, supervisors, your boss or any one else at work who is experienced, where and how they suggest you find time and a safe, clean place to breastfeed or pump breast milk when you return to work.
  • Rally your troops.  Tell you spouse, partner or good friends (in and out of work) your goals for breastfeeding and ask for their help during your transition back to work.  (meals, phone calls, texting while attached to the pump, magazines to read)
  • Have patience with yourself if some days your milk production is down.  Stress, dehydration, illness, separation from the baby, and pumping versus feeding can all affect your milk supply.  If you only pump 2 oz on Tuesday at work, don’t give up!  You never know what Wednesday can bring…
  • Partial breastfeeding is better than no breastfeeding.  Most policy statements and studies compare exclusive breastfeeding to no breastfeeding.  The reality is that many babies receive a safe mix of breast milk and formula during the first year. If you find you have to supplement your infant once you or your partner is back to work, FINE! Formula is good for babies.  After your baby drinks the pumped breast milk, have your partner or childcare provider offer formula if you think the supply of milk from pumping is down in the mother’s absence.  This is not only okay, it’s good for your baby.
  • The availability of work site lactation facilities is well known to affect breastfeeding success.  If you’re not comfortable with the spot you have been offered for pumping breast milk, ask for another.  There is nothing less conducive to pumping milk than a scary, unclean, unlocked, cold, exposed or intimidating place.  It is never too late to ask. It is okay to re-visit this issue even if you’ve found yourself pumping milk in the walk-in refrigerator at work for 1 month.
  • Do the ridiculous.  Fill your pumping bag with photos of your baby. Carry a water bottle everywhere you go. Take the break you need to go and pump milk even when inconvenient to the needs of your work.  Leave work on time. Continue to take your prenatals.
  • Then, be easy on yourself or your partner who is trying to do it all.  If you can’t do it, you can’t do it.  Find support in others’ experiences.  Talk to your friends and you’ll find you have many allies in these waters.