The Breastfeeding Center of Ann Arbor

When a breastfeeding mother returns to work she actually doesn’t need very much from her employer to be successful.  Really, working and breastfeeding requires at a minimum; time to remove milk from her breasts, a place to do this, and a way to do it.  An employer does need to provide the first two necessities, time and space.  However, most mothers expect to provide the means, ie, hands or a breast pump to remove the milk.

Let’s talk about the time it takes to remove milk.  The younger the baby is, the more frequently the mother will need to remove her milk.  This is for two reasons.  One, her baby is growing very quickly.  During the first three months, breastfed babies grow an incredible amount.  If you look the World Health Organization growth charts of breastfed babies, you will see that they grow a lot in these months and then slow down into a steady upward slope.  Once a baby reaches about three months of age, their need for breastmilk remains fairly steady.  Most babies need about 30 oz of breastmilk a day until about one year of age.  Complimentary solids are added at about six months of age.   In many other countries, mothers return to work much later so they need to remove their milk less often.   Under 3 months of age, mothers often need to remove their milk about three times in a full work day.  Remember, it is not just a 9-5 job.  You have to drop the baby at child care, get to work yourself, and at the end of the day, reverse the process.  Your nine hours with lunch has now become about 10-11 hours.  It is recommended when babies are under four months or so that mothers remove their milk about every three hours.  If a baby is over four months, mothers are often able to remove their milk every four hours or so, and if the baby is over eight months or so most mothers are able to remove their milk just once while away from the baby.  If a baby is over one year of age, most mothers don’t remove their milk at all while separated.  They nurse the baby before they leave and then when they return from work.

Notice there are many “or so” and “abouts” in these above statements.  This is because each mother and baby are different and each pair will need to create  a unique set of guidelines for themselves.  These are general recommendations which mothers need to tailor to themselves.  In general, it takes about 20-25 minutes total to remove the milk.  Mothers should wash their hands before removing their milk but they do not need to wash out their pump kits if they are pumping.  Many mothers bring an extra insulated lunch bag with an ice pack and just put their pump kit in there, chill it between pumps, and wash it when they get home.  If any of you are doing lots of pumping at home, you can do this as well.  I do recommend you wash it in hot soapy water every twelve hours.  By chilling the kit between pumps, it stays safe and clean for multiple pumps.  It takes a few minutes of prep to get ready to remove milk, about 15 minutes to actually remove the milk, and a few minutes to put things away.

The next step involves how the milk is going to get out of the breast.  I have used the term “remove” her milk instead of pump her milk on purpose.  Some mothers find that hand expression is easier and more effective than even a good breast pump.  I was fortunate enough to attend the Human Milk Banking Association of North American’s International conference in the Fall of 2005.  I heard about Brazil’s Human Milk Banks and was blown away.  I do have a point here, just a moment!  In Brazil, the fire men, yes, fire MEN, pick up and drop off the donated human milk from mothers.  They are also trained in some lactation support if mothers should need it.  However, because in Brazil they have very high breastfeeding rates mothers are much more successful with breastfeeding then they are here at home.  Isn’t that cool!?  All right, back to our real subject, removing the milk.  My point is that almost all of these women who are participating with the milk banks use hand expression to remove their milk for donation.  No pumps involved.  So, it is possible to hand express very effectively.  Stanford University in California has a great website which includes an excellent video clip of explaining and demonstrating how to hand express.   We love our technology in the US, so most women I work with do own a breast pump, but remember, if this is not working well, consider hand expression or a combination of both to maximize milk removal.  I will talk about pumps in another blog, in the meantime, make sure you are spending your money wisely on a quality pump.  They are not all created equal and more money does not necessarily mean a better product.

We have talked about the time it takes, the way to get milk out, now let’s talk about a private space to remove the milk.  First of all, a bathroom really doesn’t cut it.  Would you want to make your lunch in one?  Many women end up moving their milk in a bathroom because there is simply no other place to do it.  This is a shame.  Most places of work, with some creativity, could create a little corner for moms to do this for their babies.  Some lucky mothers have their own private offices with a lock on the door.  One client of mine works at Google.  They have a special lactation room set up for her to use if needed.  Another client works at the U of M hospital.  They actually have some rooms with hospital grade pumps for their breastfeeding mothers to use.  These ladies are set!  Most mothers have a bit more of a challenge.  I have a mother who has converted a corner of an office into a mini-lactation area by hanging a curtain.  Some mothers put curtains across their cubicle doors.  Other mothers go out and pump in their cars on breaks.  In Michigan, this doesn’t always work, the past few days are a case in point and also February can be rough!  I work with many mothers who simply have NO place to pump or even a car to pump in.  These moms are often the ones going back to work even earlier, at three weeks sometimes.  We then make the best plan we can and she breastfeeds at home and uses some formula while she’s working if needed.  Remember, any breastmilk healthy mothers can provide for their babies is better then none!  I took The Business Case for Breastfeeding Training about a year ago and they had picture of all kinds of places to pump, rooms, corners of rooms, and tents!  Yes, tents!  A manufacturing company couldn’t provide a room, so they set up a pumping tent in their warehouse!

I have found that the biggest factor that leads to success is having a strong plan for returning to work.  Remember The Business Case for Breastfeeding created by the Health and Human Services?  These materials are available to all of you as well.

Finally, if anyone knows of a business that is breastfeeding friendly as an employee or a customer, the Washtenaw County Breastfeeding Coalition is looking for nominations to help recognize these fabulous businesses!  We need to let these businesses know that what they are doing is important to us as a culture.  To nominate a business or to get more information, visit http://www.motherfriendlyworkplace.org/

From 6-9 this Friday, June 11th, Ann Arbor will be hosting our Green Fair on Main Street.   This exciting event celebrates and shares what businesses and organizations are doing to help our environment.  I heard about this fair last year.  One of my neighbors, John Harding has an electric scooter business and he was going to have a booth at the Green Fair.  I thought the idea of a “green fair” was cool for Ann Arbor because, as a long time resident, I feel we really try to do our part for protecting the environment.  When I travel, I am always proud to say I am from Ann Arbor because we are known for two things, our football/U of M (of course!) and being green.

My next thought was about breastfeeding, as it almost always is, and I thought, wow, what is more “green” then breastfeeding!  It is one of the few things I can think of that goes directly from manufacturer (mom) to customer (baby)!   And can grow a whole baby!

I wasn’t surprised that others agree.

According to EcoMall, “Breastfeeding is probably the most overlooked means of contributing to the health of our planet.”

I began to think about what does it take to formula feed a baby?  I thought about all of the energy and resources it would take to produce formula.  Then I thought of all of the trash the use of formula creates.  I thought about the equipment needed to actually feed the baby the formula.  I started looking around for some data on how many resources would be used in the formula feeding process.  I found some interesting links to some estimates on this subject.  Then I wondered about how healthy these cans were for our landfills, would they cause leaching of toxins?

After that, I started to worry about our babies! I was not aware of the leaching that takes place with these cans of formula.

After all of this, it was clear.  Breastfeeding is green!  La Leche League of Ann Arbor will be having a booth this year to promote breastfeeding and help support breastfeeding famalies.   Breastfeeding information will be provided as well as a comfy chair to come and take a break and nurse your baby.

You may need help and support to be “green” and breastfeed, and La Leche League is there to help you do it!

Lately, there has been quite a bit of reporting in the news about artificial baby milk (formula) feeding.  The costs of our mothers choosing to feed their babies formula is tremendous.  According to one recent study, if mothers breastfed their babies for six months we would save staggering amounts of money each year.  “The United States incurs $13 billion in excess costs annually and suffers 911 preventable deaths per year because our breastfeeding rates fall far below medical recommendations.”  (Bartick,Reinhold Pediatrics, 2009)

That’s a lot of cash and more importantly, a lot of babies dying unnecessarily.

The author of the study, Dr. Melissa Bartick, makes it clear the mothers themselves are not to blame.  Parents receive many mixed messages about infant feeding and then lack support for breastfeeding from the moment their babies are born.  I feel this undermining of breastfeeding begins even before that.  Our culture is not a breastfeeding culture.  Many mothers do not come from breastfeeding families.  They have to become pioneers in their communities in order to participate in biologically appropriate infant feeding practices.  They get flack from their families and friends, stares in public, and pressure to wean from the first day of their baby’s life.  Often, their health care practitioners make it seem like an even choice.  Breastfeed, formula feed, eh, about the same.

It is not an even choice.  Mothers I have meet all around my area, wealthy and low income; all want the same thing for their babies, what is best.  It is not a life style choice, it is a health choice and your “choice” can save your baby’s life.

In a recent blog by “thefeministbreeder” breastfeeding as a health issue was presented in this way, “You know what else saves lives?  Car seats.  So, why aren’t people spitting mad at the NHTSA for saying that?  Why aren’t they leaving thousands of comments on car seat articles saying “But I just couldn’t afford a car seat, why are you trying to make me feel guilty?!?!” Well, maybe it’s because our society will admit that car seats save lives, and we’re willing to give them out free at fire stations and hospitals if we have to because it is that important.”   She maintains that breastfeeding is that important to our baby’s health.  The medical evidence seems to be backing her up.  The lack of car seats caused 400+ deaths in three years.  We have over 900 babies dying in one year from lack of breast milk.

I was just at our “Community Baby Shower” which is held every year at St.  Joseph’s Hospital’s Women’s Health Center.  Pregnant or early post-partum mothers can come and talk with vendors about anything that might impact their baby.  A mother came up to me and said her milk supply was dropping.  Her baby was in an isolette at the NICU (a special hospital nursery for sick babies) so she couldn’t put her baby to breast.  She was just able to pump her valuable milk for her little baby.    She had never intended to breastfeed her baby, but her Neonatologist, her baby’s doctor, had told her it was critical for her baby’s health to have her breastmilk, and by god, she started pumping!  Now her baby is getting the most appropriate nutrition possible.  Breastmilk was a health concern, not a lifestyle choice.  And breastmilk is healthiest for all babies.

Is breastfeeding the car seat of health for babies?  If so, let’s help mothers buckle up their babies.  Let’s send a consistent message of support for the fabulous protection she is giving her baby, her milk.

What has gone so wrong with breastfeeding in our country?  The United States lags behind most nations around the world in our breastfeeding initiation rates.  However, more importantly perhaps, is how short our breastfeeding duration rates are.  The majority of US mothers are all for giving breastfeeding a shot.  The percentage of mothers who “ever breastfeed” after birth is between 48.3% in Mississippi and 92.8% in Utah.  These numbers are based upon the CDC’s breastfeeding report card from 2008 which shows all of our states and what rates were reported.   If you check out the report card yourself, you can see our Southern states are having the hardest time.  If you go East, North, West, out to Hawaii, up to Alaska, they are doing better.  But by the time the baby has reached three months of age, all of these rates have plummeted dramatically!   Mississippi is down to 16.8% of moms who are still breastfeeding exclusively at 3 months and even Utah, our leader in breastfeeding, is down to 50.8%!  We are losing about one half of our breastfeeding families in the first three months.  By one year, only 8.13% of babies in Mississippi are breastfeeding and in Utah, 33.9%.  How are we doing in Michigan?  Not so well.  Our initiation rate is 64.8%, 23.5% are exclusively breastfeeding at three months, and only 14.4% at one year.  It seems as though breastfeeding is failing in the US.  The American Academy of Pediatrics recommends that mothers breastfeed exclusively for the first six months of their baby’s lives.  “Exclusively” means nothing but mom’s milk.  They then recommend that babies are breastfed for at least one year (my italics).   This means one year is the minimum that our United States Pediatricians feel babies need to be fed their mother’s milk.  WHO (World Health Organization) recommends human babies are fed their mother’s milk for at least two years!  Again, we are lucky here if we get a few months of breastfeeding in.  All this being said, I really don’t think this is the mother’s, the baby’s, the partner’s fault.  Also, any amount of breast milk a baby receives is a tremendous health benefit, even if it is only for one day.