Fall 2009

Breastfeeding After You Return to Work

How to continue giving your baby the best in nutrition

An interview with Jennifer Daru, M.D., chief, pediatric hospital medicine, and Elizabeth Alber, LVN, IBCLC, certified lactation consultant

Human breast milk provides the best nutrition for your infant. The American Academy of Pediatrics recommends that women breastfeed their babies exclusively for at least the first six months. After that, complementary foods may be introduced gradually, with breastfeeding continuing for at least the first year of life, or longer.

That’s all well and good, you think, but how are you supposed to continue providing breast milk for your baby if you return to work?

“There are definitely challenges when you go back to work,” says pediatric hospitalist Jennifer Daru, M.D., who successfully breastfed her own child after returning to her job at California Pacific Medical Center. “We all know ‘breast is best,’ but you need to have a reasonable plan that works for you. You can pump and store your breast milk at work to maintain your milk supply and provide expressed milk for your baby while you are working. Then you can continue to breastfeed at home in the mornings and evenings and during the weekends.”

Plan Ahead with Your Employer

As of January 2002, all California employers are required to make a reasonable effort to provide time to accommodate employees who want to express breast milk for their infant. Employers must also provide a private room or location for pumping—other than a toilet stall—for sanitation reasons.

You also need to prepare yourself and your baby for the transition. “Introduce your baby to bottled breast milk before you go back to work,” says lactation consultant Elizabeth Alber. “You don’t want to start bottle feedings too soon, but once breastfeeding is well-established—around four to six weeks—you can gradually substitute more bottles of expressed milk for breastfeeding sessions. Babies naturally prefer the breast, so don’t delay too long, and be consistent in using a bottle. If you make the bottle a battleground, the baby will win.”

Jennifer Daru, M.D., Chief, Pediatric Hospital Medicine

Helpful Tips to Prepare Your Milk

Daru and Alber offer a number of other suggestions:

Stockpile breast milk in the freezer before you return to work, and regularly replenish the supply. Store the breast milk in specialized freezer bags. Allow 1 inch of space at the top of the freezer bag for expansion when frozen.
Label each bag of milk according to the date it was produced and use the oldest milk first.
Because most mothers have an ample milk supply in the morning, consider pumping after nursing your child before you go to work.
When pumping at work, avoid distractions. It may help to look at a picture of your baby so you can relax and your milk will flow easier.

The most important factor, Daru and Alber agree, is to have realistic expectations. “Remind yourself that some breast milk is always better than no breast milk,” Alber says. “Think about how much good you are doing for your baby.”

Regardless of how well you prepare for your return to work, you should expect a period of adjustment. It is normal to experience feelings of excitement, nervousness, guilt and sadness. However, your confidence will grow as you establish a routine. Support and encouragement from those around you is vital. If you have any questions or concerns, contact a lactation consultant at Newborn Connections by calling 415-600-BABY (2229).

Guidelines for How Long
to Safely Store Breast Milk

At room temperature 66-72ºF
(19-22ºC) 6 hours

In a refrigerator 32-39ºF
(0-4ºC) 6 days

In a freezer compartment inside a refrigerator Temperature varies 2 weeks

In a freezer compartment with a separate door Temperature varies 3–4 months

In a separate deep freeze 0ºF
(-19ºC) 6 months or longer