The Breastfeeding Guide

Considering the many lifelong health benefits of breastfeeding for both baby and mom, it’s no wonder that new mothers commit to it. But to keep it going for a year or longer as is recommended by the American Academy of Pediatrics (AAP) requires a lot of support and preparation, especially for those times when you’re separated from your baby, like on a date with your husband, or for longer periods, such as going back to work.

Can you do it? Yes you can, say breastfeeding experts.

Take these steps to make sure your baby will be well nourished whenever you’re apart.

Build a Support Network

To make separation times go well for you and your baby, you’ll need help from your spouse, friends, family, caregivers, and perhaps a lactation consultant and other nursing moms, in other words, a village. When Los Angeles mom Cindy Johnson (a pseudonym) had her first daughter six years ago, she knew she would breastfeed. “I always thought, it’s the most natural thing in the world, what could be hard about it?”, she says. But when she returned to work three months after giving birth and thought her milk supply was too low, with great disappointment, Johnson stopped breastfeeding her daughter. To this day she regrets this decision, which she now sees was made with too little information.

Four years later, when Johnson was getting ready to give birth to her second daughter, she and her husband took a breastfeeding workshop to learn all they could. “With my second daughter, I absolutely wanted to keep breastfeeding for her as long as I could, a year was my goal,” says Johnson. Since she was prepared with support and information, Johnson returned to her job several months after giving birth, but was able to pump and breastfeed her for a full year.

(Smart tip: Your local hospital, doctor or midwife’s office may have listings of breastfeeding support groups.  Contact La Leche League, for local groups or to find a lactation consultant near you.)

Get a Good Breast Pump

“One that pumps both breasts at the same time and is hands-free is the best,” advises lactation consultant Corky Harvey, MS, RN, IBCLC, cofounder of The Pump Station, three breastfeeding support centers and stores in Southern California. New pumps are electric or battery-run, quiet and BPA-free. (BPA is a compound used to make plastics that the U.S. Food and Drug Administration considers hazardous to infants and children.) They usually come with an adapter and carrying case.

(Smart tip: If you don’t have a hands-free pump, a stretchy halter bra might help.)

Introduce your baby to a bottle of breast milk at 2 to 4 weeks

“We suggest a mother make sure the baby accepts the bottle at about 2 to 4 weeks old,” says Harvey, “providing breastfeeding has been settled and the baby has a good latch.” If you can, have only the caregiver give your baby a bottle, suggests Nancy Mohrbacher, IBCLC, FILCA, author of several popular breastfeeding books including Breastfeeding Solutions. “If a baby gets used to having the bottle only with her mother, when another person tries to give her one, she might refuse it,” says Mohrbacher. “So have your husband, grandma or the caregiver be the one to introduce the bottle. Have the baby spend time with the caregiver and have the bottle be part of that relationship,” she says.

(Smart tip: Most babies have no trouble taking a bottle, but if yours does, try feeding by cup, spoon or eyedropper.)

Manipulate Your Milk Supply

Worried that you don’t have enough milk to pump? “Most women don’t realize that they have choices about their milk production, and that they can make it go up or down,” says Mohrbacher. In a nutshell, “If the breast is too full of milk, it tells the body to slow down milk production,” she says. “If the breast is drained, then that signals the body to increase production.” Some women may need to breastfeed more often to keep milk production stable. “And this has nothing to do with breast size,” Mohrbacher adds. When it comes to milk production, “there is a whole spectrum of normal,” she says, so each each women must figure out how often she needs to pump and breastfeed to keep her milk production up.

Begin to pump milk long before your first separation from your baby so that you have a supply on hand for those times when you go out, and for your eventual return to your job. “Aim to have two to three weeks of milk before returning to work,” says Harvey. Add an extra pumping session at night or on the weekends, she suggests.

(Smart tip: Some women swear that “milk teas” can increase milk production, says Harvey. These herbal teas often found in health food stores contain fenugreek, fennel and other herbs.)

Store Breast Milk Safely

Once you start pumping, build a supply in the fridge or freezer, using BPA-free bags or bottles make just for breast milk. Breast milk can be refrigerated for up to eight days and frozen for up to 12 months, says La Leche League International. Label milk with the date it was frozen, and thaw it by dipping it in cool or warm water. To transport milk, place containers in an insulated carrying bag with an ice/cold pack.

(Smart tip: Thawed milk should be used within 24 hours, according to AAP. Spoilage is one reason, but another is that the vitamin content decreases over time.)

Communicate With Your Caregiver

Whether you are leaving your baby with your mother for a night or with a nanny while your work, take time to talk about how your child will be fed while you’re gone. “It should be a non-adversarial conversation,” says Harvey. Explain that experts recommend feeding on cue rather than on a schedule, but that giving a bottle isn’t the only way to calm the baby when fussy. “Babies will take more by the bottle than by the breast because it comes so quickly,” says Harvey. Discuss other calming techniques. “Ask, “What have you found helpful?”. “Get the caregiver involved in the decision making.” Ask her to record how much she feeds your baby, or keep a log on your refrigerator for the caregiver to fill out.

(Smart tip: Tell your caregiver that if your baby wants to feed toward the end of the day, give just 1 or 2 ounces, so when you come home, you can sit down to breastfeed as soon as you walk in the door.)

Take Pumping Breaks on the Job

Need to go back to work? Talk to your supervisor about taking pumping breaks. The U.S. Department of Labor says that employees must allow for such breaks and provide a private place for pumping that is not a bathroom. Consult the laws of your state to see what your rights are for breastfeeding (see the National Conference of State Legislatures at NCSL.org.)

(Smart tip: Before you officially return to your job, bring your baby into the workplace for a visit, suggests Harvey.)

Eat Well, Drink Well

While breastfeeding and pumping, you need to add only about 400 to 500 calories to your pregnancy daily diet, according to Boston Children’s Hospital. Aim for well-balanced meals of meats, beans, vegetables, fruit, grains and dairy. Drink water, juice, milk or soup throughout the day. Keep in mind that your drinking caffeine or small amounts of alcohol, (a glass of wine or a beer), is not harmful to your breastfeeding baby, though it may cause some fussiness. If you are concerned about alcohol’s effect, breastfeed your baby, or pump, before you have a drink, and it will probably but out of your system by the next feeding time. If a women is very intoxicated (and drinking this much is not recommended for nursing moms), she should give her baby pumped milk until she’s completely sober, advises La Leche League.

(Smart tip: Drink 8 ounces of water each time your nurse or pump.)

Learn About Letdown

It’s not always easy to pump when you’re stuck in a sterile office far away from your baby. Some tricks that help: “Try using sensory cues such as photo of your baby, a recording of your baby’s coos, or massaging the breast or using a warm compress,” says Mohrbacher.

(Smart tip: Bring one of your baby’s blankets with you. Inhaling the scent of it could help with letdown when it’s time to pump at a strange place or an office.)

Avoid Stress

Separating from your baby, even for a short time, can be stressful. Although stress doesn’t affect milk supply, it can slow letdown, say lactation experts. Working first-time mothers often experience so much stress that they give up breastfeeding. That’s why the AAP and other groups want to make the workplace more conducive to pumping.

(Smart tip: If you feel stressed, give yourself a pep talk!)

By Nicole Gregory

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The Breastfeeding Guide 1