In my work as a pediatrician and a breastfeeding educator and counselor, I have encountered many families who stopped breastfeeding because the mothers returned to work already. Being a working mom myself, I sympathize with them and I truly understand the difficulties of pursuing breastfeeding when the mother has a job that requires her to be physically away from her baby for many hours a day.
That’s why we emphasize that there are ways for working moms to still continue breastfeeding! It will take a lot of effort and determination, yes, but it is possible and doable.
Let me share here my 13-point game plan for us working mothers. 😊 I divided it into 4 parts to put things in perspective. If you are a working mom or a working-mom-to-be, this is for you! 😊
BEFORE GIVING BIRTH
1. Attend a prenatal parents’ class
The best time to start preparing for breastfeeding is while you are still pregnant.
Think of it as something similar to learning how to drive. Before you go to the highway with speeding cars (i.e. before baby is born), you would first learn how to drive in a big open road with no cars (i.e. baby is still happily inside the womb) so that you can internalize how to shift gears, make a turn, drive backwards and up on an incline, and park. With regards to breastfeeding, this means learning the benefits and advantages, different positions and proper latching, and even troubleshooting.
This way, an expectant couple–free from the pressures and demands of caring for a newborn–can maximize learning in a relaxed manner.
We have a handful of these classes in the Philippines. Hospitals and private groups that advocate breastfeeding conduct such prenatal classes for parents. And couples, take note, this class is not just for the pregnant woman. Personally, in the families I have encountered and counseled, it really helps a lot when the father-to-be (or aunt-to-be or grandmother-to-be or whoever will be helping the mom & baby during the newborn stage) accompanies the expectant mom to these classes.
Our Bundle of Joy PH team previously offered quarterly workshops for expectant parents face-to-face . Since the pandemic, this became almost impossible, but we could not let it stop us from helping parents-to-be start their journey of providing the best nutrition for their babies. So we brought our workshops online! Now our breastfeeding and babycare courses are available per demand and can be viewed in the convenience and safety of your own home. You can even watch it again to review and share it with all the loving people who will be helping you take care of your baby! 😊 Thank God for technology!
2. Let the workplace know that you plan to breastfeed
For those employed in an office setting, and if a work-from-home option is not possible, you have to check already if your building has a breastfeeding room. If your office does not have one, educate yourself with the Philippine laws as quoted below, then kindly and respectfully ask your employer or HR department if one can be arranged.
Republic Act 10028 has our backs with regards to this. Section 11 mandates that “all health and non-health facilities, establishments or institutions shall establish lactation stations” and Section 12 states that “nursing employees shall be granted break intervals in addition to the regular time-off for meals to breastfeed or express milk… counted as compensable hours worked… such intervals shall not be less than a total of forty (40) minutes for every eight (8)-hour working period.” There are some exceptions, of course, so for the complete law, please check the article on The Official Gazette
3. Learn how to do breast massage and hand expression
Breast massage and hand expression are two skills that I believe every breastfeeding mother must learn, whether or not a mom is a SAHM or works outside the home. Some of my working moms would ask if they still have to learn these skills even if they have an electric breast-pump. And I would always answer, yes. Why? Well just in case of a power black out, or if you forget your electric pump or any of its parts. (Believe me, it happens! 😂 )
More importantly, these skills are a sort of first-aid and a trouble-shooting strategy for the common breastfeeding-related problems like engorgement and clogged ducts.
Special reminder for expecting women, learn this in theory and practice on breast models first while you are still pregnant. Do not manipulate your breasts as a preterm labor precaution. Once your baby is born, then you can apply what you have learned.
BEFORE GOING BACK TO WORK
4. Direct latch on the first few weeks
Once your baby is born, prioritize learning how to position your baby comfortably in your arms and how to let him latch on your breast properly first BEFORE anything else. Of course if there are medical complications, then that becomes a different story. But if all is well, and you get to bring your baby home right away, then mainly focus on direct latching in the early weeks.
This will help build a good milk supply that corresponds well with our baby’s demand for nutrition. Remember that the best stimulus for our brain to tell our mammary glands to make more milk is our baby suckling on our breast. 😊
5. Train your caregiver
Perhaps our biggest concern as working moms is who will take care of our baby when we go back to work. Lucky you (and lucky me!) if your husband’s work schedule allows him to take care of your baby while you’re at work. But for most families I have encountered, somebody else would have to take care of the baby when Mommy goes back to work because Daddy is at work too.
These heaven-sent earthly angels—which in this article I would refer to as our “caregivers”–are the grandparents, aunts or uncles, “yayas” (nannies), or midwives who we leave in charge of feeding our babies, changing their diapers, putting them down for naps, and stimulating them with language and movement. Of course, of all these responsibilities we are delegating to our caregivers, the one most parents would be concerned about is the feeding.
Thus you really have to train your caregiver BEFORE you go back to work so you can have peace of mind that your baby will be fed the way you want him to be fed. An important note: cup-feeding is our recommended way of feeding babies our expressed breastmilk to avoid having our babies refuse the breast and prefer bottle-feeding instead—aka nipple confusion. (Nipple what?! More on that in another post. 😊 )
Apart from the actual feeding, we also need to train them how to thaw expressed breastmilk and how to make sure breastmilk is not spoilt. Of equal importance, teach them your baby’s hunger cues and feeding pattern so that they can respond to your baby timely and accordingly. Here Kellymom talks about hunger cues in more detail.
6. Be familiar with your baby’s feeding pattern
It is really important for us mothers to be familiar with our own baby’s feeding pattern. Keep in mind that each baby has his or her own unique feeding pattern, so let’s resist the urge to compare our baby with our sister’s or our friend’s baby. Some babies get hungry at a predictable time with rests in between. Some seem to feed ALL THE TIME (unli-latch, mommies, who can relate? 🙋🏻♀️ ).
In any case, to learn your baby’s feeding pattern, you have to focus on direct latching in the first few weeks so you can observe at what time does he or she wakes up, show hunger cues, and what are the signs that your baby has had enough (e.g. falling asleep after feeding, body relaxing, fists loosening so that the fingers are naturally curled but not tightly so, etc.).
This will allow you to simulate your baby’s feeding sessions when go back at work. Let’s discuss how this applies when we get to point #8.
7. Begin to build your stash
The operative word here is “begin”.
I advise my working moms to focus on direct latching in the first 4-6 weeks of baby’s life (recall point #4) and not pressure themselves on pumping right away. So how do we build our stash without really pumping, you ask. By making the most of the let-down reflex (milk ejection reflex).😊
While breastfeeding our baby on one breast, some moms will notice that the other breast will be leaking milk which is part of the let-down reflex. This can happen a few times during an entire feeding session. We can collect this precious milk (instead of just catching the drippings into a “lampin” which for sure will just go to waste) by using a high-quality silicone milk collector that we can attach to the right breast for example, while our baby is breastfeeding on the left. (Parents, please research on the brands before you get your silicone pump since a lot of imitations are now available too.)
This silicone pump/milk collector, partnered with breast massage and hand expression, worked very well for me personally. I started collecting about 10-15 ml which eventually increased to about 45-60 ml per expression. For 11 months (before a friend gave me an electric pump), I collected milk this way and was even able to donate my extra milk stash to our NICU and a handful of moms who came to me for help.
For most working moms, our target is to have 3-7 days worth of expressed breastmilk in stock. So if we begin collecting this way as early as possible (even if we don’t pump until 2-4 weeks before we resume work), then we can have a few days’ stash secured already. 😊
But take note moms, since the introduction of the silicone milk collector, there are now concerns about it interfering with proper positioning and causing oversupply. I’ve learned from my pedia-friends who are lactation professionals that it is best to use the silicone milk collector at around 6 weeks after birth when the mom&baby has already “mastered” positioning and latch and the milk supply is already established. Should you wish to use it earlier because you have a lot of milk leaking from the other breast already, please ask for guidance from your doctor.
WHILE AT WORK
8. Follow a schedule for expressing milk
How to make a schedule for expressing milk? Begin by reviewing your baby’s feeding pattern (as we mentioned in point #6). For example, you know that your baby feeds every 2-3 hours. Then that means, you can breastfeed before leaving for work. Then while at work, express milk during your mid-morning break, at noon-break, at mid-afternoon break, and before going home if you need to travel for a long time before reaching the house. (Please remember to direct latch again once you are home! 😊 ) This way, your milk supply can match your baby’s feeding demands; because when she feeds at home, you are expressing milk as well.
It is helpful to keep in mind that we have to “empty” our breasts so that our brain will tell our mammary glands to make more milk. Note that if the breasts are always full of milk (i.e. we don’t express milk—which can happen when we have successive meetings at work, or things are just too busy, or we forgot our breast-pump, etc), a feedback mechanism will tell our brain that we don’t need to make milk because they are still full, and so our milk supply will eventually decrease.
9. Wear comfortable breastfeeding-friendly clothes
Whether you are directly breastfeeding or pumping at work, wearing clothes with easy nursing access saves a lot of time! Instead of removing clothes or changing clothes or run the risk of getting your top wet, these nursing clothes allow you to just open a slit or lift a flap, then breastfeed you go. Pretty straightforward.
On a personal note, I consider these clothes an investment for my work as a doctor and as a teacher in our medical university. They are convenient and comfortable. There are expensive brands (which I am not a fan of) but fortunately, there are also a lot of affordable local brands that are easily found online. Plus, if you have the time to DIY, that is also a good option. 😊
10. Have a storage & transport strategy
We can store our expressed breastmilk (EBM) in reusable containers or disposable milk bags (please look for brands that are biodegradable). Remember to always LABEL each container/bag properly including name, date, time and amount to make it easier to track which ones to consume first when you bring our liquid gold back home to our baby. While finishing your shift, you can place your EBM in a cooling facility which is ideally provided by the office’s lactation station (included in the Philippine law from point #2).
A insulated cooler with ice is also another option for storage if your workplace does not have a refrigerator. You can use this same cooler to transport your EBM from work to home because if there is enough ice inside to keep the milk cool, our EBM can be stored inside it for around 24 hours.
My own OB’s experience with being a working mom is inspirational. She and a couple of other breastfeeding colleagues would have a “pumping session” together in one of the hospitals here in our city. When duty calls and they can not go home right away to their babies, the supportive husbands of these doctors would go to the hospital to bring their EBM home. Breastfeeding is really a family thing!😊
These are useful storage guidelines : https://kellymom.com/bf/pumpingmoms/milkstorage/milkstorage/
WHEN BACK AT HOME
11. Direct latch and feed at night
This is something I actually look forward to when I come home from work. I take a quick shower right away and hold my baby close for our breastfeeding session. Instant bonding, instant reconnection. ❤️
Breastfeeding can also help us relax and feel good when we are tired from work. We produce oxytocin which facilitates the milk-letdown reflex when we breastfeed. This hormone is also responsible for the sense of well-being, for feeling loved, for relationship-building. Plus, it has anti-stress effects! 😊
Most babies wake up to feed at night. So moms, please don’t feel pressured if your baby does not sleep through the night yet! Night-feeding is actually physiologically advantageous because moms produce more prolactin at night until dawn. This is the hormone responsible for making milk. So direct latching at night helps us keep a good milk supply.
12. Express milk in between direct feedings as needed
For me, this is one of the most challenging aspects of breastfeeding as a working mom. There were times that I had to get up from bed after my baby has fallen asleep post-feeding so I can do a bit of breast massage and hand express the remaining breastmilk inside my breasts. To help me through, I kept in mind that this has 2 benefits. One, I get to store more milk for my baby. Two, my breasts will make more milk when they are properly “emptied”.
13. Rest and relax
“HOW CAN I DO THAT?!” was the reaction I often get from my working moms when I tell them that sleep, rest and relaxation is important for us to keep a good milk supply. Remember, stress can affect our milk production negatively.
So I encourage breastfeeding moms to do something rejuvenating after our baby sleeps. We can reconnect with our husband and find things to laugh about, or sleep early if possible, or watch a feel-good movie, read an inspirational book, have a post-natal home service massage, or call your bestfriend. Whatever works for you is the best for you. Needless to say but I will say it anyway, we need to take care of ourselves well so we can take care of other human beings, specially our babies. 😊
Hope this helps you as much as it helped me and my working mommy-friends. And always remember, for every breastfeeding problem, there is a solution—ASK FOR HELP. 😊
And if you are a working mom who is breastfeeding, I would love to hear about your stories and tips too!
DISCLAIMER: Moms and Dads, this post was originally written before the pandemic. Note that despite the challenges working moms are facing because of COVID-19, these strategies are still essentially useful and applicable. Here are some updates:
- Because we won’t allow this pandemic to stop us from reaching out to families, we brought our classes Bundle of Joy PH classes ONLINE and per demand. Parents can learn with us in the comforts of their own home during their own convenient time. 😊
- For moms who will be pumping at work, please discuss your level of exposure to COVID-19 and the use of personal protective equipment with your own doctors. Make sure you clean your hands and surrounding surfaces properly before you take out your pump and containers. For more information, please read through CDC’s article on Breastfeeding and expressing milk in workplaces.
- When coming home from work, wash hands, take a bath and check the best practices for disinfecting clothes and personal items before you go inside the house to breastfeed. Check out this article on how to stay safe when you come home from work.
- Get vaccinated, protect yourself and your loved-ones at all times by following what experts recommend. Check this guide on how to protect yourself & others.
Stay safe and keep praying! God is in control.😊
Getting ready for your baby’s arrival? Worried about establishing your milk supply? Want to learn the different breastfeeding positions or just know the life-saving benefits of breastfeeding your baby? Our Breastfeeding and Babycare online course will help you to prepare for the arrival of your little one and how to exclusively breastfeed your baby without the burden of not knowing where to begin.