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Not breastfeeding when you go back to work?

The United States is last in the world in how much maternity leave mothers receive. 

This means that women are returning to work soon after birth which means before breastfeeding is established. 

Just the idea of going back to work in the first few weeks or months causes some women to rule out breastfeeding.

Research shows that ANY amount of breastfeeding is beneficial and women should breastfeed at least until they return to work. However, even after breastfeeding is going well, going back to work increases the risks of early weaning. And all mothers acknowledge that working and breastfeeding is challenging.

Women often lack the support of their employer to pump at work

Studies show that mothers who breastfeed take fewer sick days than mothers who formula feed. Employers who accommodate nursing mothers have less employee turnover because women are happier.

Not sure if you want to breastfeed because you have to work?

1.  Do a cost analysis and see if it even makes sense to return to work. Add up the costs of daycare, transportation, work clothes, convenience foods and the likelihood needing to supplement or switch to formula feeding.

2.  Talk to your employer while you are pregnant about pumping schedules and a clean, private place to pump. Share “The Business Case for Breastfeeding” with them.

3. Try breastfeeding and see how it goes. You might be pleasantly surprised. Women who never intended to breastfeed are shocked when their baby finds their breast and begins nursing. Often, their reluctance to breastfeed fades and they enjoy it. is You really can’t predict how breastfeeding will go or how you will like it, until you start.

4. Don’t be afraid to combine breastfeeding and formula feeding after you go back to work. Some breastmilk is always better than none. Breastfeeding is a wonderful way for you and your baby to reconnect after being separated. Accepting that you may need to use formula takes the pressure off you pumping enough milk every day for your baby. You may find that you actually are able to pump more milk because you aren’t tense and anxious about starving your baby.

Being the mother of an infant, breastfeeding and working is overwhelming. Something has to give.

The first thing to go should be zealous perfectionism. Don’t compare your “insides” to someone else’s “outsides”. 

When you look at Facebook, Pinterest and Instagram, you may think everyone lives in super clean houses with perfectly cooked and presented dinners and wonder why your family is having pizza on paper plates for the third time this week. It takes a lot of time and energy to run a family in a showcase style. When you work full time and have a baby, you don’t have a lot of extra time to create a showcase lifestyle. It’s possible, but if you feel stressed, something has to go.

Why do women fail at breastfeeding?

Breastfeeding Infant

Breastfeeding is often intuitive and straightforward and many women begin breastfeeding easily and effortlessly. Yet a high percentage of women end breastfeeding without ever really knowing why it didn’t work out.

It’s not fair to say women fail at breastfeeding. It’s more accurate to say they are sabotaged and never have a chance to succeed. I’ve been helping mothers breastfeed for nearly 20 years and it can be heart wrenching work. If breastfeeding is so wonderful, so instinctive, so natural, then why are so many women not meeting their breastfeeding goals?

Even though about 80% of women in the United States leave the hospital breastfeeding, there is a huge drop off between 2 weeks and 2 months resulting in about 84% of babies receiving some or all formula feed by 6 months of age.

The United States Healthy People 2020 sets targets for breastfeeding. The targets for the year 2020 are: 82% of babies “ever breastfed”, 75% at 6 months, and 34% at 1 year. 

What's keeping moms from doing what's best for their babies? 

All kinds of people in the US are working to increase breastfeeding rates and we are making progress. Change is happening through three channels: 

  1. Protection - legal and medical protection for women and babies who breastfeed. This includes laws that protect breastfeeding in public, pumping breaks at work, maternity leave along with education and policy statements for health care practitioners to follow.
  2. Promotion - cultural and medical promotion of breastfeeding as the normal way to raise a baby. This includes women nursing in public, publishing research, creating public service ads, doctors encouraging women to breastfeed, World Breastfeeding Month, and using images of breastfeeding babies in healthcare settings.
  3. Support - cultural and medical support. This includes breastfeeding support groups, doctors referring women to helpful lactation resources, training more lactation consultants, and making breastfeeding information and supplies available through government programs like Center for Disease Control,  National Institute for Health, Food and Drug Administration, WIC and Medicaid.

The 2011 Surgeon General’s Call to Action to Support Breastfeeding identified seven barriers to breastfeeding and I’ve identified three more. What has happened it there has been a huge shift in promoting breastfeeding without a corresponding increase in protection and support. As a result, women get overwhelmed and stop breastfeeding. 

We know that supporting women through support groups, accurate information and family education works and good breastfeeding support puts all these pieces together.

 

Painful Breasts = Mastitis

When Cassie's baby was 8 days old, she started feeling like she had been run over by a bus. Despite a long labor and an unplanned c-section birth, she had felt pretty good up until that point. The previous day she had been to the store and to the pediatrician and, because nursing was not going well, to the Lactation Consultant. Her baby's diapers were pretty dry and she had painfully sore nipples. That morning, she woke up to painful breasts as well and over the course of a day developed angry red streaks on her left breast and red near the nipple on her right side. She had developed mastitis.


Mastitis is a common problem among breastfeeding mothers. The exhaustion, aching muscles and fever mimic the flu but the red streaked breasts and tender spots make mastitis unmistakeable.  Although there are several contributing factors, the most common one is exhaustion. Most mothers with mastitis try to do too much. Even mothers who feel great, may bring on mastitis simply by skipping naps.


Mastitis is more common around the holidays when added pressures pile onto an already stressed situation. Other contributing factors include over-abundant milk supply, skipping a feeding, fussy babies and babies who who don’t latch on correctly. Mastitis can come on rather unexpectedly the first time. The mother may notice breast soreness, flu-like symptoms, and the hard lump of a plugged milk duct before full blown mastitis sets in, or she may not.


Healing mastitis includes plenty of rest, canceling all activities and going to bed. The mother should continue to nurse frequently to unblock the plugged duct and drink plenty of water. Hot compresses can relieve soreness. Cold compresses and less frequent feedings after the crisis can help slow overactive milk production, if it is a contributing factor. If the mother doesn’t feel better with a day or so, of sleep and nursing, she should go to her healthcare provider who will probably prescribe antibiotics and rest. The mother should continue frequent nursing or pumpiong of the affected breast.


In Cassie's case,  she was already on post-surgical antibiotics and listened to her body, which was tired. The mastitis cleared up pretty quickly and she continued working to get her son to latch-on better over the next week or so. She went on to nurse pain-free for the next year. She had a few plugged ducts after that but none ever developed into mastitis. In hindsight, she should have stayed home and requested a visit at home from a lactation consultant or visiting nurse as soon as she came home from the hospital. She would have had better latching, less pain and more energy.
 
In cases of recurring mastitis, mothers should investigate poor latch or sucking problems. She may also want to see  how her bra fits, alternate nursing positions and work on increasing rest and reducing stessful activities and situations.