Returning to work as a breastfeeding mother
By Shel and Fiona
YOUR RIGHTS
Many breastfeeding Mums cannot stay with their children until they are weaned off the breast and have to return to work at some point, either full or part time. The law gives some protection to breastfed babies and their mothers until the baby is 12 months of age, so that for instance you cannot necessarily be expected to work night shifts or odd shift patterns if it would interfere with baby's eating, also your employer has a duty to provide you with the time, facilities and some privacy to feed your baby, which means either to feed your baby if they are brought to you, or to allow you to express milk if you wish to do so, and make available a fridge for the safe storage of that expressed milk.
http://www.nctpregnancyandbabycare.com/page.asp?page=539
http://www.babyfriendly.org.uk/resourcefile/data8.asp
http://www.hse.gov.uk/pubns/indg373.pdf
EXPRESSING FOR BABY
By expressing your milk when at work, to be fed to your baby when they are away from you, you can continue to 100% breastfeed your baby with your own milk. However, as Fiona, who works long hours and sometimes shifts, says, it's not for everyone: “I can quite understand not wanting to express though: I've never been much good at it, though I did express at work til my second child was 18 months old: in all honesty though I would almost certainly have stopped doing it rather earlier than that had he not been allergic to dairy produce.” “With a combination of expressing, dashing over to feed him at lunchtime and having my husband bring him to me when I was working outside normal "office hours" we managed. There are lots of different options, but returning to work doesn't have to mean a complete end to breastfeeding.”
“My second child is cows' milk protein allergic, so that gave me a huge incentive to keep expressing. That, and a new job, meant that he had expressed breast milk in the day til he was 18 months and I decided he could do without milk during work hours. He's still breastfed morning and evening now. What will I do with my next baby? Well, I don't know for sure...having managed to express last time, I'll give it my best shot again, but unless he's also allergic will probably stop expressing at 12 months.”
Here are some tips: Express as often as you can, as after your own baby feeding directly, this is the next best way to keep supply up. If there's any way that baby can be brought to you during the day for a direct feed, take advantage: it's nice for both of you, and probably better for your employer as you're likely to feed her quicker than you express! Fiona says: “We did this with evening feeds with both of ours and it made life easier all round. With my son, his nursery is literally round the corner from nursery, so I used to take my sandwiches and feed him there at lunchtime too.”
“Sterilising... must confess I never bothered, just washed in very hot water. If you want to sterilise though, how about buying a microwave steriliser? They are simple to use, not too bulky and if you have a microwave at work that would solve the problem. Get a little cool bag for your bottles on the way home, especially if you have a long journey.”
GIVING FORMULA
Some mothers want to wean baby from the breast before going back to work – often Mums think this is the only way, but as discussed above, employers have a duty to support your return to work as a BF mother. For more information on this click here
However some mums simply want to stop BFing when they go back to work, and this of course is fine too: baby has had a fabulous start by being breastfed and if the parents now choose to give formula instead that is no body else's business!
MIX FEEDING BREAST AND FORMULA
Some mothers may have been mix feeding formula and breastfeeding from an early stage in baby's life, but some mums think that this is what they would like to do on their return to work: for instance giving formula during the day and continuing to breastfeed when mother and child are together. This doesn't work for everyone, but it's definitely a possibility. Fiona says: “When I had my first baby I didn't know a great deal about breastfeeding. When I went back to work I couldn't express enough so went over to sending bottles of formula to nursery, but I continued to breastfeed on demand whenever we were together. I did this very successfully, and found it really nice to still be able to bf her after work etc. Apart from feeling a bit uncomfortable on Mondays (I had Fridays and weekends off usually) we never had any problems. Much later I was told that it was "impossible" to do that.. .by which time I'd been doing it for a good 6 months! I'm glad I didn't know that it couldn't be done before I did it!”
GUILT & INFORMED CHOICE
Guilt is a big factor in being a parent: and informed choice is the best way to get over it. By making sure that you are doing the best that you can, in your circumstances, for your family, you can let go of the guilt.
Here are some of the things women have said about guilt and leaving their babies to return to work::
“I mix-fed from around 8 months when I went back to work. I tried to express during the day but for reasons too long and complicated to go into it didn't work out, so I reluctantly went over to giving formula whilst I was at work. I felt bad about it, and I would have liked not to have had to, but it was the best I could manage at the time.”
“I would have preferred to continue to give 100% breastmilk, but life's full of compromise”
“I did feel hideously guilty at first, but I got over it with time, as I felt that I'd made the best overall choices. Motherhood does unfortunately involve compromises."
“Some of the things I thought about were:
Pros : I didn't have to express, and I was working in a very unsupportive environment and getting increasingly stressed and depressed about it. Probably the biggest pro.
Meant that if I was late home or something DH was never panicking that he had nothing to give her.
Cons : risk of allergy (we have a family history)
Risk of constipation.
Risk of nipple confusion.
Risk of supply problems.
Cost.
GUILT!!
In the end, the complete tizz I was getting into about the expressing won the day, and fortunately none of the potential risks came to fruition, except the guilt of course, but that's part and parcel of motherhood isn't it??
I'm not going to attempt to tell you what to do, but I thought it might be helpful for you to know what factors someone else considered."
"Guilt, yep, that's a feeling every mother knows isn't it? Whatever we do, I think we are all plagued by the notion that we're not doing our best. But it's such a negative, unhelpful emotion! I've personally always found it helpful to sit down and have a long hard look at the real facts of a matter, often when I've done that, I don't feel guilty anywhere near as much, and if I still do, then maybe I need to rethink things.
But I seriously doubt you have anything to feel guilty about.
Look at it this way...
So far, your baby has been exclusively breastfed for X number of weeks. Fantastic! That is a really great start to their life, a lot more breastmilk than most babies in the UK get, and maybe a lot more than you ever thought you'd manage. So WELL DONE....stop beating yourself up and give yourself a great big pat on the back.
Next...I think breastfeeding is a very important part of mothering, but it's a part, not the whole. Your child is going to need lots of other things as they grow up: you are going to provide many of those things. Going out to work doesn't stop you being a mum.
And finally...returning to work doesn't mean that you have to stop breastfeeding altogether. There are a variety of options - you could express at work, so baby can have ebm when you're apart. Or if that doesn't work out, you may well be able to combine formula, and in due course solids, during the day, with bf when you're together. It's not always easy I grant you, but it can be done! If you are still enjoying it, you don't have to stop."
PROBLEMS WITH GIVING FORMULA
Giving formula once the baby is a bit older, perhaps after the middle of the first year when solids are starting to be introduced too, is a lot less problematic than mixed feeding a very young baby. Your supply will be well established and less likely to be adversely affected, and it's less likely baby will get nipple confusion. In a slightly older baby still, perhaps 9 or 10 months, they will presumably by now be eating a fairly varied diet, and may already have had cows milk in other forms. Some people do run into problems with nipple confusion or intolerance of course, but the older the baby the less likely this is. In a younger baby, particularly if you have a family history, then adding cows milk products into baby's diet increases the risk of allergy and atopic disease in the baby, and there is some evidence that introducing even small amounts of formula affects the bacteria in baby's gut, and undermines some of the benefits of breastmilk.
SUPPLY ISSUES
Fiona says: “Personally, I never had supply problems. I continued to breastfeed whenever we were together and never actually gave a bottle myself. I did get a bit uncomfortable towards the end of the working day, especially after a weekend, but she never seemed to go short! I've since had people tell me that this can't be right, it shouldn't have worked etc and that I should have kept to the same pattern every day. Maybe that's right for some people, and maybe what I did doesn't work for everyone. But I just did what came naturally to me - when she asked for milk I gave it to her!”
With a younger baby, supplementing baby's milk feeds with formula rather than the baby being breastfed could quite possibly affect supply. As you probably know, milk is made on a "supply and demand" basis, stimulated by the baby suckling. If the baby isn't hungry, because they have had a formula "top up"feed, then they won't ask to be fed. So the mother's body is getting the message that it needs to make less milk rather than more. So when he is hungry, the supply is down. So you give him a bit more formula. And so on.... Lots of new mums get into this cycle, and it can be difficult to break, so they end up stopping breastfeeding much sooner than thay wanted to. Of course for some mums and babies who are having major problems, formula can be really helpful, but in general terms "top ups" probably cause more problems than they solve. Now you will no doubt meet people who say they mix fed from very early on and had no problems. True. For some people it seems to work just fine, but not for everyone. In fact probably not for most where it is started in the very early days.
OTHER RISKS OF GIVING FORMULA
Fiona says: "I wouldn't criticise anyone for mixed feeding - I've done it myself when I went back to work after my first baby. But there are some potential downsides, namely the risk of nipple confusion and possible supply reduction. It certainly can work, but there are potential disadvantages, and the younger your baby is when you do it, the greater the risks. I'm afraid lots of people who go for mixed feeding early, do end up fully formula feeding sooner than they might have wished. I'd encourage you to get some expert help".
WHICH FORMULA?
As to choosing formula there's no one "best" and it's probably a matter of trial and error. Speak to your Health Visitor, friends and family for suggestions.
STRESSFUL
Going back to work is often stressful, but it gets easier with time, and it can actually be of benefit when moving your child into a new routine or different environment, to have a 'constant' like breastfeeding. As Fiona says: "Plenty of people have told me that I make life hard for myself by continuing to bf once I'm back at work, but I disagree. For me it has certainly eased the transition".
PLANNING
There are undeniably anxieties that go with returning to work, and leaving your baby in someone else's care. But, once you get into the swing of things, you may well find that it's nowhere near as difficult as you imagined. What you fear is often worse than reality. Good luck, whatever you decide. Enjoy this time at home, don't waste your energy on guilt, and try to make positive plans for returning to work.
Do bear in mind that your baby may not like bottles, or formula, or being fed by someone other than you though, and don't get too set on one course of action. Also, if you're planning to introduce solids to minimise the amount of supplemental feeds you need to provide for your baby, don't expect an instant drop in breastfeeds once you start solids. It's very variable: some babies will be eating loads of their solids happily almost as soon as they start, but not all, so don't rely on it.
There's another piece about returning to work, here: http://www.breastfeedingnetwork.org.uk/breastfeeding/beyond_barbara.php
And this is a link to an American Website 'The Working Cow' about breastfeeding working mums
More on your rights as a BF mum:
"Breastfeeding and Work
If, when you return to work after maternity leave, you are still breastfeeding, your employer has a legal obligation under Health and Safety legislation to ensure that your work does not harm you or your baby.
You need to inform your employer in writing that you are breastfeeding and they should then carry out a risk assessment to look at any risks (for example, working with dangerous substances, excessive stress and long hours ) your job poses to you or your baby. If your job involves such risks it might help to back up your own letter with a letter from your doctor or Health Visitor confirming that your working arrangements are jeopardising your ability to breastfeed and therefore the health of your baby.
Once your employer is aware of the difficulties s/he should take action to remove the hazards or provide you with suitable alternative work (at the same rate of pay) and exempt you from night work. If this is not possible your employer should suspend you on full pay.
Under the Sex Discrimination Act any breach of the Health and Safety legislation in relation to new mothers is automatic sex discrimination. This means you could bring a claim in the Employment Tribunal against your employer although you should take advice before doing so. You may also be entitled to some further protection under Human Rights legislation.
If you want to express milk at work, you will need somewhere private, clean, warm enough and with a chair. European Commission guidelines (2000) recommend that breastfeeding workers should have:
access to a private room in which to express milk.
use of secure, clean refrigerators for storing expressed milk and facilities for washing, sterilising and storing receptacles and
time off (without loss of pay or benefits, and without fear of penalty) to express milk or breastfeed.
The toilets are not suitable. It will probably help if you can identify the facilities that you want to use before you approach your employer."
from http://www.workingfamilies.org.uk/asp/family_zone/fs_pr1_matrights.asp