Working and Breastfeeding: What do Mothers Need?

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/