Tuesday, July 27, 2010

Caregiver Tips from a Working and Breastfeeding Mom

I've been back to work for 10 weeks and I've learned some things along the way. If you are a breastfeeding mom going back to work, you've probably heard all the tips about how to continue breastfeeding by pumping at work. Unfortunately, lots of moms feel they have to wean their babies when they go back to work because they may feel like it's overwhelming to pump while at work. Most of the advice for working and pumping moms is around literally working and pumping while at work and not about how to educate your caregivers who watch your baby while you're at work. Ava is been exclusively breastfeed since she was born and at 4 1/2 months, many of her peers nationally are not (only 33% of babies in the US are exclusively breastfed by age 3-months according to the CDC). This means that most daycares have limited knowledge of caring for a breastfed baby. I have some tips that I hope will help you as you're navigating through this with your baby. Feel free to share yours!

Tips for Educating Your Baby's Caregivers:
  • Handling breast milk: Warm breastmilk in warm water and gently swirl the milk to mix the layers of cream. It's important to gently swirl, NOT SHAKE the milk. Daycare caregivers are used to formula bottle preparation, which they shake to mix. I found some air bubbles in Ava's bottles and realized they didn't know not to shake the milk. There are living cells in breastmilk so the milk should be handled gently. My caregivers do a really good job about taking note of Ava's care needs and they have it printed on the board so anyone in the room that's filling in will see my care notes.
  • Breastfeed your baby when you arrive at daycare or during lunch: I read this tip in the book Working Without Weaning (which I highly recommend for the practical tips), and she typically wants to nurse when I arrive. Breastfeeding when you arrive helps you reconnect with your baby after the separation and allows you to talk to your caregivers and ask them how the baby was that day. And the bonus is that you can add another breastfeeding to help you stay in sync with your baby's demand and pump less for daycare. My daycare is 30 minutes away from work so I couldn't swing the lunch feeding, but many working moms can do this and it works really well for mom and baby.
  • Preferring to breastfeed and eating just enough at daycare: There are days when Ava is at daycare for 10 hours and only drink 2 bottles and a total of 6-7 oz. She holds out until I arrive and we breastfeed many days. Other days, she'll have about 11oz of milk from 4-5 bottles. When she's holding out at daycare, I've asked the caregivers to hold her while feeding (sometimes, they feed babies in the swing!) and I've brought in my shirt so she can have my smell nearby. That seems to work.
  • Baby's "on-demand" feeding schedule: Ava's caregivers ask me a lot about how often she likes to eat. And truthfully, you can't compare bottle feeding to nursing because babies nurse for comfort in addition to thirst and hunger. I have no way of knowing how much she eats (in ounces) because without a scale, there's no way of measuring. And breastfeeding mothers find that feeding on-demand is the best for baby. I know her hunger cues and that how I know she's ready. It's like a 6th sense for breastfeeding moms. They just know and our bodies help us out because we feel full. I just ask the caregivers to feed her when she's sucking on her hands. They write down her feeding schedule and they're doing a great job of feeding on-demand. Ava eats some bottles at 3oz and another times only 1 oz. Even from a bottle, Ava does a good job at regulating her intake. Every day is different so it's unrealistic to day, feed her at 2pm, 4pm, etc.
  • Keep extra frozen milk at daycare: The first week that I brought Ava to daycare a mom walked in and said "oh no, I forgot the baby's milk today. You'll have to use formula." I decided it would be a good idea to bring frozen bags of milk for the daycare freezer in case they run short on fresh milk for any reason. They've only used 2 bags in their stash, but it's a peace of mind to know that they always have it on-hand. Defrosted frozen milk has to be used within 24-hrs so it's good to keep smaller increments that you know your baby will eat.
My working and pumping schedule: I'm a very organized and efficient person so I integrate my pumping schedule with my work calendar and it's been working very well. I've been able to keep my milk supply healthy and strong in the past 10 weeks. I pump at work at 9am, 12pm, and 3pm, and often times bring my laptop and read work articles, do conference calls, or respond to emails on my iPhone. My coworkers are really supportive when we go to offsite meetings and help me by providing private places for me to pump.

Resources for Breastfeeding and Working Moms:


  1. Amanda, I'm so impressed at how you assert yourself. Asking the day care providers to hold Ava while feeding seems like a normal thing to do but some people might feel shy or feel like they are asking the day care provider for special treatment if they ask. Your article shows its a normal thing to ask for and the Day Care providers are okay with the request.

    Thanks for sharing!

  2. I would definitely agree with the "on demand" feeding issue at daycare also! I was shocked at how many times they asked me (with Rylan) well, does he eat every 3 hours or 4 hours? I said, "Well sometimes 2, sometimes 4, somtimes 3, just depends. Feed him when he's hungry!" They said most moms are super strict with formula feedings (I fed Rylan formula when I went back to work because I coudln't pump anything extra, only nurse when I was with him). So this is such a big problem! I don't want them pushing food on my kiddo, he knows how much he needs! We've always followed this with nursing, forumula-feeding, solid foods, etc! He knows how much he needs! :) Thanks for sharing tips, I'll have to remember these for this baby too! HOping to be able to pump extra this time!!

  3. I was so lucky that my caregiver was already very up to date in breastfed babies and adjusted weekly/daily to the boys' daily adjustments in feeding schedules.

    I think the frozen milk piece is a huge to success. For all the reasons you mention, but also because knowing that you have ample supply for the baby and the sitter has what they need allows you to relax more (which in turn does nothing but help milk production...nice cycle!) I particularly recommend getting a frozen milk bag holder for the home freezer to facilitate using the oldest milk first without constantly restacking.

    A nice side benefit of always having a little frozen milk available is weaning. When both boys pretty much weaned themselves at 12 months it made an easier transition to milk. Although they were starting to use cups rather than nurse (we weaned off bottled expressed milk and nursing at the same time), we gave them expressed milk in the cups for a couple of weeks to ease the transition. It worked beautifully. :)

  4. I love reading your posts about breastfeeding because it is so clear you really "get" it! I know lots of mothers who want to breastfeed but hold formula feeding up as the norm so they feel that something is wrong with their baby. They either think she is eating too frequently, not getting enough, or "using Mom as a pacifier." Mothers never see firsthand what a normal, physiological, breastfeeding relationship looks like so they rely on advice (often given by a DOCTOR) based on ounces or schedules or some other formula-based concept!

    Kudos to you for writing a wonderful guide for nursing, working moms! Great tips!

  5. Hi ladies! Thanks for all the support! I'm hoping that other moms find this post valuable and helpful.

    Jennifer, the freezer storage you suggested (First Years) is awesome! I have 2 of them in my kitchen fridge. I also stole a page from Amanda Leet's book and use gallon size zip lock bags, sorted by month in the garage freezer. Those I keep for future weaning (love your suggestions because I was wondering about that) and also for Milk Bank Donation. I'm donating 2 of 4 gallon size bags this Fri.

    Shon, I'm glad to hear that Rylan has taken that eat when hungry concept all the way to solids at age 2! That's what it's all about, right? So cool!

    Jill, it's wonderful having you to reach out to for advice and support! I was a formula fed baby so my mom can't help me, but fortunately, my mother-in-law is amazing for that! I found that most of the working and pumping advice out there is focused on the mom, when our babies at daycare are a bit different than formula babies. Ava eats no more than 3 oz in each bottle and sometimes 1 oz. And she never has preferred a bottle over the breast like I've been warned. She loves breastfeeding and I'm happy to indulge her even in the middle of the night!

    Fatima, I love that you're reading my blog even though you don't have kids right now. Thanks so much!

  6. Your perspective is awesome! My first ds had nothing but breast milk for the first 18 months while I worked full time. We are blessed that my husband is a SAHD so no daycare issues. I have a tip for pumping. I cut holes in my bra (i bought an inexpensive one)around my nipple area and use it to put the flang through. This way you can pump hands free and not pay a fortune for the systems that are out there. I used breast pads when not pumping to cover the holes.