The Working Mom’s Guide To Breastfeeding

Editor’s note: There’s a selective guide to our favorite breast pumps of the year at the bottom of this page!

The benefits of breastfeeding—for both moms and babies—are well documented, but a significant number of women do not breastfeed for the recommended amount of time. According to the 2014 Centers for Disease Control and Prevention Breastfeeding Report Card, 79 percent of babies are initially breastfed, but that number steadily decreases by the time the baby is 3 months old, and drops even 450747095further by the age of 6 months. This is in contrast to the American Academy of Pediatrics (AAP) recommendation of exclusive breastfeeding for the first six months, and after the introduction of other foods and fluids at that point, continuing breastfeeding for as long as mom and baby are comfortable. Taking public health guidelines into consideration, breastfeeding becomes not a lifestyle or political choice, but an important decision of health and medicine.

When breastfeeding moms go back to work after maternity leave, they face a decision: To pump or not to pump? Nearly two-thirds of women are employed during their pregnancy, and approximately 70 percent take time off from work for maternity leave. While the average maternity leave is about ten weeks, 16 percent of women take only one to four weeks. According to the 2014 Lansinoh Global Breastfeeding Survey, 83 percent of women working full-time outside the home pump or plan to; and 80 percent of women working part-time outside the home do the same. Among women that stay at home, 74 percent pump or plan to.

“The bottom line remains essentially the same: Going back to work has an adverse effect on breastfeeding—this is universal,” says Julia Beck, the founder of Forty Weeks, a consulting firm focused on the needs of pregnant women and moms. “At present in the US, returning to work as a breastfeeding mother requires conviction, creativity, support, and planning. It absolutely requires the support of an employer.”

In March of 2010, the “Break Time for Nursing Mothers” law went into effect. Under this law, workplaces are required to provide women with adequate time to breastfeed and a clean, private space that is not a bathroom for them to pump in until the baby turns 1. Though the law has been around for several years, the Affordable Care Act (ACA) has made it more concrete and visible. In addition, companies that compensate employees for break times are required to do so for the time spent breastfeeding as well (typically, women pump about three times during an eight hour workday, for about 15 minutes at a time).

How Do I Talk With My Employer?

Returning to work after having a baby and deciding to pump can be nerve-wracking, but there are ways to help make the transition easier.

“The first thing that a woman will need is an understanding by her employer of her plans to return to the workplace and continue to breastfeed,” says Shari Criso, a registered nurse, certified nurse midwife, and International Board Certified lactation consultant. “By communicating this clearly and early, prior to the first day back at work, and also explaining what it is that she will need from her employer, returning to work and pumping can be a seamless transition.”

Gina Ciagne, a certified lactation counselor from Lansinoh, adds that talking to your company’s human resources team and finding out before going on maternity leave if there’s a designated pumping space—and discussing what it is you will need upon returning to work—can be helpful. Discuss the company policies on breastfeeding at work before taking leave, and go over any concerns or expectations you may have with your employer. If both of you are transparent and open, this makes misunderstandings less likely.

From a business perspective, making it easier for women to pump at work benefits both female employees and the company. “Companies that provide lactation support programs have a great return on investment, saving almost $3 for every $1 spent,” Criso says. “There is lower turn-over in these companies. Retention rates for employees of companies with lactation support programs is 94 percent, while the national average is 59 percent. Absenteeism is three times lower in breastfeeding moms as compared to formula-feeding moms, due to the lower illness rates in those breastfed babies. Which translates into lower health care costs, between $331-475 per infant, as well as improved morale, job satisfaction, and productivity.”

Deciding to Pump: Things to Know

A woman’s milk supply isn’t fully established until about four weeks after her birth, so pumping before then isn’t recommended. The priorities during this period are to establish a connection with the baby, to recover from childbirth and get your energy back. “Breastfeeding is a learned skill—it’s natural, but it doesn’t always come naturally,” Ciagne explains. It can take time to learn how to breastfeed and get used to it, so be gentle with yourself. Feeding on demand during this time is important, because this enables the baby to let your body know how much milk it needs to supply.

To make the transition to pumping easier, it’s recommended that you start pumping once a day after those first four weeks. Because the pump is different from the baby’s latching and stimulates your body in a different way, your body will need to adjust. Having an emergency supply of frozen breast milk is always helpful, so it’s a good idea to start pumping and storing milk about two weeks before returning to work. Milk should be stored in 2-oz bags because, once thawed, it can’t be reused, since bacteria can grow. It’s better to store and use small amounts until you know how much the baby will take; this way, you can stockpile some milk. Don’t be afraid that you will run out of milk if you start pumping—your body responds to the baby, so even if you recently pumped, you will have enough milk. You can even pump on one side while the baby nurses on the other, Ciagne says.

Most women adjust to breastfeeding through trial and error, and some women may have difficulty. It doesn’t always come naturally, and it’s important not to beat yourself up if you have trouble. Ciagne urges women to try and pump even if they don’t breastfeed, because this way, your baby can still get breast milk and all its health benefits. Even one feeding with formula can change the way a baby sucks.

The ACA mandates certain preventative health care measures for women to be covered by health insurance plans. This includes lactation support and counseling from a certified provider, as well as the cost of renting breastfeeding equipment. Find out what your insurance covers and what you can do to maximize your benefits. When choosing a pump, take into consideration its quality, ease of use, and efficiency.

“Look for portable electric breast pumps. Portability is really important, and how big the base is can affect that. Look for a pump that you can buy an extra pumping set for, which is everything but the base. This way, you can leave a pumping set at work and one at home, so you only need to transport the base and you won’t have to worry about leaving any parts at home,” Ciagne explains. “A double pump cuts down on time, and milk comes down on both sides anyway, even if your baby only nurses on one side during a session. By pumping both sides, it encourages your body to keep making milk. Maybe most importantly, choose a closed system pump. This is really important because your body temperature is 98.6, so your milk is warm when it goes into the pump. If it’s not a closed system, moisture and humidity are created in the tubing, and there’s no barrier between the nipple and tubing, so the moisture and old milk can stay in the tubes. This can create mold, and you don’t want mold spores going back and forth. If the pump doesn’t specify closed system, it’s not a closed system.”

The baby also needs to adjust to being bottle-fed, and there are several things you can do to ease the transition and help make bottle feeding resemble breastfeeding as much as possible. When introducing the bottle, Ciagne suggests that someone else other than the mother feed the baby, because the baby will be used to nursing and try to latch on, and then become confused when they’re not getting the breast.

There are also specific bottles and nipples specifically tested and formulated for breastfed babies, to minimize nipple confusion. The way a baby moves its jaw while at the breast is different than the way it moves its jaw and mouth with a bottle, so something as similar to the breast as possible helps the baby get used to bottle feeding. A natural wave nipple lets the baby elongate it and use the tongue to get milk, making the sucking motion nearly the same as it is at the breast. A soft and compressible nipple is important so the baby can control how much milk is drawn out, like with the breast. With a standard bottle nipple, the milk tends to gush out.

Pumping at Work

At work, your pumping schedule should mimic your baby’s natural feeding cycle. The amount of milk produced with pumping can be different than with your baby, and that’s okay. You can add an extra pumping session before or after work to get more milk if necessary. If you’re having trouble with getting started, it helps to hand-express for a minute, and then massage the breast while pumping, according to Bring your pump collection kit, storage containers, an insulated bag, ice packs, and extra breast pads to work.

Knowing your rights as a breastfeeding woman at work can help ensure that you get the time and space you need to pump and keep up your milk supply. When you’re not at work, get plenty of rest, since this helps your body stay healthy and aids in producing more milk. It is very possible to work outside the home without sacrificing breastfeeding and its health benefits—with communication, planning, and support, it can be an easier than expected transition for everyone involved.


Best Breast Pumps:  A Selective Guide