Breastfeeding and returning to work

Frequently women elect to return to work, study or other pursuits outside the home before they are ready to wean their babies. Several studies have shown that returning to work is a common reason for women ceasing breastfeeding.¹

However many women are able to continue breastfeeding after returning to work and make other arrangements for their baby whilst in care, such as:

• The woman may choose to express breast milk, for the baby to drink from a cup or bottle
• The woman may elect to give the baby infant formula, but continue to breastfeed whilst they are together
• The woman may arrange for a caregiver to bring the baby to her at work to breastfeed

If the woman chooses to give her baby expressed breast milk or infant formula, she will need to express breast milk whilst away from her baby to maintain supply and to prevent complications such as blocked ducts or mastitis.

Under Australian antidiscrimination laws a workplace cannot refuse a reasonable request for breaks to pump breast milk.² Many women find with practice they can pump efficiently to protect their supply, produce meals for their baby and maintain their breastfeeding relationship.

So here are my top tips to maintain supply whilst at work:

• Schedule pumping into your day – don’t wait until you have time. The most important factor to maintaining supply is frequent, regular removal of milk. You would not ignore your hungry baby whilst at home, it’s ok to not ignore your full breasts whilst at work. Advocate for yourself and your baby by advising people up front that you will be unavailable at certain times.
• Keep all your pumping gear together. Most women find it useful to have a dedicated bag with their pump, parts, storage bottles or bags and an ice brick together so they don’t leave anything at home, and have everything together when they need it. It’s also not a bad idea to include some snacks in the bag for when you are late, hungry and need to pump – at least you can address 2 out of 3.
• Don’t get caught up in too much washing.  For a healthy term baby, it is perfectly safe to rinse pump parts after each use and wash them only once a day.³ Most women prefer to keep a snap-lock bag or plastic container for storage – after use rinse the pump, put it straight into the container and into the fridge.  Repeat as necessary and wash parts in warm soapy water once a day.
• Double the pump, halve the time. By investing in a double pump you can express from both breasts at the same time, thereby reducing the time needed at each session.
• Consider a hands-free pump. Many commercially available breast pumps have the option to either sit inside your bra or be ‘strapped on’ allowing you to do other work whilst pumping.  Wearable pumps can be worn under your clothing without any breast exposure, and women may feel comfortable to pump in communal areas using these.  It is important to note that many women find they get a smaller volume of milk with a wearable pump, so you may need to schedule an extra pumping session.
• Bring something to remind you of your baby. Women may struggle to have a let-down whilst pumping, but looking at a photo, watching a video or smelling something that reminds you of your baby can help to trigger this, and reduce the amount of time you need to spend pumping.
• Try to keep milk on a one in – one out cycle. Women are tempted to fill their freezer with expressed milk before returning to work, but are then more likely to neglect pumping on a busy work day, potentially reducing their supply or risking blocked ducts or mastitis. Aim to pump enough each day for your baby to drink on your next work day.  For example, if your baby drinks 2x 100mL bottles during the day on Monday, aim to pump 200mL that day. That milk is then left for your baby to drink on Tuesday, and so on. Ideally you would do this at equally spaced intervals (eg. Every 3 hours), but the volume pumped is more important if this is not manageable.
• Make sure your pump fits!  Pumps come with a variety of sized flanges, make sure you have the right size for your nipples, otherwise this can cause nipple damage and pain. You should aim to ensure that your nipples can move freely within the flange without rubbing, but making sure that not too much areola is being drawn up into the flange.
• If using a bottle, ensure the care giver is giving paced bottle feeds. This helps to replicate the flow of milk with a breast feed and ensures the baby does not develop a bottle preference, as well as ensuring we respond to their signs of being full. Renee Keogh (RN, IBCLC) has made an excellent video demonstrating how to do this.
• Babies may fuss with a bottle to start with if they are used to feeding at the breast. Try not to panic, your baby will understand that you are not available and will take what they need.  The carer should not force the bottle, but to continue to try the bottle every now and then.  You can trust that when the baby is hungry or thirsty enough they will drink.⁴
• Unlike with formula, breast milk requirements do not increase with age or size. Breast fed babies under 6 months of age take about 30-37ml/hour, which then decreases as their intake of solids increases, so they don’t need to drink enormous bottles throughout the day.
• It’s a good idea to know how to hand express – if you get really stuck without your pump and full breasts you will be able to hand express into a clean container for comfort.

Whilst it is not uncommon for expressing to be time-consuming and challenging to begin with, with a little time and practice it usually becomes quick and efficient. Good luck, and enjoy the feeding whilst you and baby are together!

References

1.         National Health and Medical Research Council (2012) Infant Feeding Guidelines. Canberra: National Health and Medical Research Council.

2.         Australian Breastfeeding Association (2017) Breastfeeding and Work: Your rights at work.  Melbourne: Australian Breastfeeding Association.

3.         Australian Breastfeeding Association (2020) Expressing and storing breastmilk.  Melbourne: Australian Breastfeeding Association