WORKING AND NURSING
Breastfeeding Basics Part 7
Can I breastfeed and work?
The primary problem in working and nursing is that the woman is
the working mother of a young infant. Feeding method does not
change some of the difficulties in working with an infant at home.
Many mothers have found that it "doesn't pay" for them to work.
By the time mother figures earnings and baby sitting costs, some
mothers find that they are working to pay the baby sitter and
have a little pocket change left over. The mother should talk
to an accountant or tax specialist. She may find that with just
one income, the family is in a lower tax bracket and can adjust
payroll deductions. She should be careful that she won't owe taxes
at the end of the year. If she doesn't work, she might break even
financially.
Another complaint I frequently hear from working women is that
the baby sitter gets to see everything first. For example, baby's
first steps, first words etc. It is not uncommon for the baby
to call the sitter "mama" on occasion. Mothers may often feel
that they have missed out on part of their child's babyhood. Mothers
may feel that someone else is raising their baby rather than themselves.
Often mothers try to make up for working by quality time projects.
Babies need large quantities of quality time. Part-time work may
be the solution.
In reality, thousands of mothers work and continue to breastfeed.
There are several ways to manage working and breastfeeding. Here
are a few suggestions. Each mother has to decide what is best
for her and her baby.
1. Work at home or part-time.
2. Pump milk or have the baby brought to her for feedings.
3. Reverse the baby's nursing pattern so he nurses when she is
home and sleeps while she is gone. (Babies sometimes to do this
on their own.) Reverse cycle nursing
4. Partially wean the baby, giving formula during the hours that
she would be away at work and nursing only during the hours that
she will be home. This eliminates the need for pumping in most
mothers. It will take several days for mother's milk supply to
adjust. In many ways this schedule is like nursing a toddler two
or three times per day. For the child who must be in day care
with other children, even partial breastfeeding has been shown
to provide protection against illness.
How often will I need to pump?
It will depend on the age of the baby when the mother returns
to work, and how long she will be away from the baby. If she returns
to work when the baby is six weeks old, she will need to pump
at least every four hours or more often, depending on how frequently
her baby has been nursing. If a mother can wait to return to work
until the baby is six months old, she may only need to pump once
in the middle of her workday or may not need to pump.
What is the best breast pump for me, the working mother?
I think the best pump for the mother who has to return to work
early and works full time (away from baby eight hours or more)
is a high quality electric breast pump with a double pumping kit. When
mother pumps both breasts simultaneously, pumping will take 10-15
minutes. Hand or single electric pumps require 30 minutes or longer
to use. Double pumping will also help maintain her milk supply.
What's available?
Medela still has some larger pumps available for rental. However both Medela and Ameda have smaller automatic pumps. Medela's Pump in Style and Ameda's Purely Yours have received great reviews by moms who are using them. These pumps are good for the mother who has to pump 2 or 3 times a day while away from her baby. They are not recommend for establishing a milk supply for the baby who is not nursing.
Where can I find more information about pumps and pumping tips?
There is a group of women who have dedicated themselves to pumping mothers: pumpingmoms.org. The web site is full of frequently asked questions (FAQ) about pumps and pumping. In addition they maintain an e-mail list for pumping moms through Yahoo groups called pump moms. Women who sign up for the e-mail list join a group of other women who are pumping for mother to mother support. Sometimes it really helps to "talk" to moms going through the same thing and facing the same difficulties for support and suggestions.
On Monday I can pump several ounces, then less and less by Friday.
Is this normal?
The mother's body is adjusting to infrequent nursings at the breast.
To increase the amount of breastmilk, mother should: increase
her fluid intake, pump more frequently throughout the workday,
rest and nurse the baby as much as she can when she is home.
How can I store milk safely at work?
Many women use a small cooler when a refrigerator is unavailable
for storage. Cooler bags are available through pump rental stations
and baby shops that look like a tote bag. The cooler will usually
hold several bottles of milk and may have a place for your pumping
equipment. Reusable cooling units are less messy than blocks or
cubes of ice.
How can I tell if breastmilk has gone bad (turned sour) ?
Human milk that has soured has a very distinct sour taste and odor - much like soured cow's milk. Occasionally breastmilk may not have a sour smell if it has spoiled but it may look curdled or be severely separated. severely separated, has a bad or nasty smell, throw it out.
My breastmilk smells off and looks (and tastes) like soap or metal after it's been stored. I have carefully followed every guideline for storing milk and it still happens
We have seen this frequently now that breast pumps are easier and cheaper to obtain. It isn't something that will harm baby but it will require an extra step before you store your milk. There is an enzyme in mother's milk called "lipase." It seems to be the cause of the problem.
A few mothers find that their refrigerated or frozen milk begins to smell or taste soapy, sour, or even rancid, soon after it's stored, even though all storage guidelines have been followed closely. Per Lawrence & Lawrence (p. 781), the speculation is that these mothers have an excess of the enzyme lipase in their milk, which begins to break down the milk fat soon after the milk is expressed. Most babies do not mind a mild change in taste, and the milk is not harmful, but the stronger the taste, the more likely that baby will reject it. Lipase is an enzyme that is normally present in human milk and has several known beneficial functions: * Lipases help keep milk fat well-mixed (emulsified) with the "whey" portion of the milk, and also keep the fat globules small so that they are easily digestible (Lawrence & Lawrence, p. 156). * Lipases also help to break down fats in the milk, so that fat soluble nutrients (vitamins A & D, for example) and free fatty acids (which help to protect baby from illness) are easily available to baby (Lawrence & Lawrence, p. 156). * The primary lipase in human milk, bile salt-stimulated lipase (BSSL), "has been found to be the major factor inactivating protozoans" (Lawrence & Lawrence, p. 203). Per Lawrence & Lawrence (p. 158), the amount of BSSL in a particular mother's milk does not vary during a feed, and is not different at different times of day or different stages of lactation. There is evidence that there may be a decrease in lipase activity over time in mothers who are malnourished.
What can I do if my storage problem is due to excess lipase?
Once the milk becomes sour or rancid smelling/tasting, there is no known way to salvage it. However, newly expressed milk can be heated to a scald which inactivates the lipase and stops the process of fat digestion. Scald the milk as soon after expression as possible.
To scald milk: * Heat milk to about 180 F (82 C), or until you see little bubbles around the edge of the pan (not to a full, rolling boil). * Quickly cool and store the milk.
Scalding the milk will destroy some of the anti infective properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated. Per Lawrence & Lawrence, bile salt-stimulated lipase can also be destroyed by heating the milk at 144.5 F (62.5 C) for one minute (p. 205), or at 163 F (72 C) for up to 15 seconds (p. 771).
What if the baby won't eat while I'm gone?
Tell the sitter to keep trying but don't insist. If the baby won't
take a bottle, tell her to try an eye dropper or a spoon. Some
mothers find that they have to experiment with several types of
bottle nipples before they find one that the baby "likes." If
the baby is older (four to six months), ask your pediatrician
if he is ready for solids. The sitter may be able to give the
baby solid foods instead of giving a bottle while the mother is
away. Some babies prefer to "stack-up" on feedings while the mother
is at home and not eat when she is gone. Other babies may nurse
frequently when she arrives home. Just to say "hello."
Copyright Marie Davis, RN, IBCLC 1999
Last reviewed:
Last Reviewed: Thursday, 21-Apr-2011 0:34 AM
© Marie Davis, RN, IBCLC 
Questions After The First 4 Weeks
Storage of EMM (Expressed Mother's Milk)