Making it Work: Supporting Working Women with Breastfeeding

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Making it WorkSupporting Working Women with
Breastfeeding

• Cathy Carothers, BLA, IBCLC, RLC
• EVERY MOTHER, INC.

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Learning Objectives

• Name at least 3 reasons continued breastfeeding
  is important after a mother returns to work.
• Identify 2 challenges to breastfeeding after
  returning to work, and at least one strategy to
  address each.
• List the 4 components of a successful worksite
  lactation program.

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• Employed women view returning to
• the workforce as more challenging
• than they expected, and felt overall it
• was a very negative experience.
• (Nichols 2004)

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Common Challenges of Employed Breastfeeding Women

• Emotional demands
• Physical concerns with making enough milk
• Schedule disruptions
• Hesitation to bring anything sexual to work
• Fear of not being taken seriously
• Child care issues
• Fear of critical comments from coworkers
• Lack of support from supervisor

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Turning Obstacles to OpportunitiesMaternity
Leave Challenges
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The Issues

• Ideal maternity leave time for establishing a
  healthy milk supply is 16 weeks (Galtry 97)
• Every week of maternity leave increases duration
  of breastfeeding by ½ week (Roe 99)
• Economically vulnerable women cannot often afford
  to take unpaid leave (Hofferth 2000)
• African American women are more likely to return
  to work early and have the lowest rates of
  breastfeeding (Caulfield 98 Klerman 98 Ryan 97)

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Making the Most of Leave

• Breastfeed exclusively to build milk supply
• Get help for early problems
• Practice pumping while feeding baby
• Express milk in the mornings (more prolactin made
  at night)

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Preparing Baby for Separation

• Most babies accept a bottle before 6 weeks
• Establish breastfeeding first wait 3-4 weeks
• Introduce a bottle 2 weeks before going back to
  work and no more than 1 bottle a day
• Have someone other than mom give a bottle
• If baby resists, dont make it a battle
• Try when baby is not hungry or is sleepy
• Berggren, K. Working Without Weaning A Working
  Mothers Guide to
• Breastfeeding. Amarillo, TX Hale Publishing

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Preparing MOM for Separation

• It is normal to feel sad or guilty leaving baby
• Its probably harder on mom than it is on baby
• It is also normal to feel guilty for WANTING to
  go back to work

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Returning to Work Options

• Gradual phase back
• Part-time or flex time
• Start on a Thursday or Friday
• Take Wednesdays off
• Split shifts
• Telecommuting
• Job sharing (Vanek 2001)

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Turning Obstacles to OpportunitiesEmotional
Demands
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Stresses of Employed Mothers

• Role conflict and role overload
• Family stress and competing demands
• Family/child issues
• Unresolved financial issues
• Psychosocial issues (fatigue, mood changes,
  depression)
• (Nichols 2004)

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Help Mothers to Prepare!

• Get organized!
• Make the most of the night before!
• Make a checklist www.workandpump.com
• Consider a practice trial run

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Childcare Options

• Direct access to baby
• On-site day care
• Bring baby to work
• Bring baby to mom for feedings
• Childcare choices
• Daycare center close to workplace
• Family member

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Support

• Encourage her to
• Talk with her family, friends, childcare provider
• Find a support group of other working mothers
• Take care of herself
• Eat well balanced meals
• Rest
• Make the most of time HOME with family

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Turning Obstacles to OpportunitiesPhysical
Challenges
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Physical Challenges

• Fatigue
• Breast issues
• Engorgement
• Leaking
• Maintaining milk supply
• Many women doubt their ability to make a good
  milk supply
• Real or perceived low milk supply cited as a
  primary reason for weaning at every critical
  weaning period (Lewallen 2005)

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On the Job Challenges

• No place to express milk
• Schedule disruptions
• Hesitation to bring anything sexual into the
  workplace
• Fear of not being taken seriously
• Lack of support from coworkers/supervisor

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Turning Obstacles to OpportunitiesWorksite
Challenges
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Lactation Support Program

• ? Private area to express milk safely and
  comfortably
• ? Flexible time to express milk
• ? Education (prenatal and postpartum) and access
  to resources/equipment
• ? Support (from employer and colleagues)

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Lactation Support Program

• ? Private area to express milk safely and
  comfortably

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Where to express milk?

• Private locked office or conference room
• Create a lactation room
• Empty office or closet
• Walled off corner
• Funny little space
• Cubicle options
• Using her car as a pumping room

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Basic Needs of a Lactation Room

• Near running water
• Basic amenities
• Comfortable chair
• Table or shelf for pump
• Door that locks
• Electrical outlet

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Challenges of Low-Wage Earners

• Job settings not always conducive to milk
  expression
• Nonstandard hours
• Maternity leave benefits

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Supporting Mothers in Non-Traditional Work
Settings
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Milk Expression Tips

• Drink something warm before pumping
• Warm washcloth or disposable diaper
• Massage breasts
• Thinking of baby
• Visualization
• How to handle to Octapus Syndrome
• STOP LOOKING AT THE BOTTLE!

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Storing Breast Milk

• Breast milk can be safely stored in a
  refrigerator or personal cooler
• Options
• Small refrigerator for pumped milk
• Personal cooler
• Public refrigerator

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Lactation Support Program

• ? Private area to express milk safely and
  comfortably
• ? Flexible time to express milk

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Breaks for Expressing Milk

• Flexible time to express milk
• Three 15-20 minute breaks
• 2 regular breaks plus lunch period
• Options for handling excess time needed
• Coming in early or staying late
• Using portion of lunch period to cover extra
  break time needed
• Taking unpaid leave time

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Other Tips

• Try to feed baby directly at childcare center and
  at home the more you can breastfeed, the less
  pumping needed
• Eat lunch while you pump
• Pump 15 minutes before a meeting is scheduled to
  avoid becoming overfull

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The Fallacy of the Stash
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Lactation Support Program

• ? Private area to express milk safely and
  comfortably
• ? Flexible time to express milk
• ? Education (prenatal and postpartum) and access
  to resources/equipment

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Education

• Prenatal education helps prepare women with
  realistic expectations
• Packets for pregnant employees
• Prenatal lunch and learn classes for pregnant
  employee and partners
• Back to work consult with an IBCLC

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Professional Lactation Support

• Prenatal education
• PP hospital and home visits
• Ongoing resource for questions and concerns

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Education Rebuilding a Wavering Milk Supply

• Breastfeed more often while at home
• Encourage more nighttime feedings
• Add a pumping session in the morning
• Be aware of birth control pills, decongestants,
  return of menses
• Make sure pump is working!
• Rest! Relax!
• Galactagogues

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Lactation Support Program

• ? Private area to express milk safely and
  comfortably
• ? Flexible time to express milk
• ? Education (prenatal and postpartum) and access
  to resources/equipment
• ? Support (from employer and colleagues)

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Help Her Talk with Supervisor

• Talk your employers language the bottom line

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Help Her Talk with Colleagues
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California Public Health Foundation
EnterprisesEmployee Perinatal Program

• 1st trimester class
• Prenatal support
• BF support group
• Trained lactation coach support (TLCs)
• Breast pumps
• BF-friendly work centers
• Whaley 2002

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Results

• High risk delivery rate reduced
• Breastfeeding rates among staff
• Breastfeeding rates among clients

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Resources for Mothers

• http//www.workandpump.com
• http//www.breastfeeding.com/workingmoms.html
• http//www.lalecheleague.org/NB/NBworking.html
• http//www.bluesuitmom.com/
• http//www.pumpingmoms.org
• http//www.wicworks.ca.gov