Tips for Breastfeeding Moms When Returning to Work by Intermountain Health

The postpartum period is a time of transition, and many moms find themselves having to navigate through the additional transition of returning to work following maternity leave.

There are various options on what may best serve a mom who returns to work whether in person or from home when it comes to feeding their baby.

Moms who choose to breastfeed often find they want to pump and have their baby bottle fed.

Prepare

Dacia Stone, an international board-certified lactation consultant for Intermountain Health, recommends some preparation before returning to work.

“Plan to begin pumping 2 to 3 weeks prior to returning to work or school. Let your employer know you’ll need to pump,” said Stone. “Allot time to pump and feed your baby. Schedule 30 minutes every 2 to 3 hours to pump. Find out where the designated Mother’s Room is and where to store milk.”

Expecting mothers can receive a prescription from their OB or nurse midwife for a breast pump as soon as 37 weeks into their pregnancy and order it before baby is born.

Third party sites to order breast pumps from are Edgepark.com, Lactationstation.com, Lactationplus.com, Aeroflowbreastpumps.com, Lucinacare.com, byranhealthcare.com, or the specific site of the brand wanted.

Moms may call their insurance to find out what pumps are covered, as well as additional instructions on how to order or where to pick up pumps from if applicable. Moms that receive assistance from the federal Women, Infants and Children (WIC) program can call and schedule a time with WIC to figure out how to get a breast pump.

Moms may also pack their pumps in their hospital bags for questions they may have after delivery during their stay in the hospital.

Transition

“Begin to introduce a bottle to baby as early as 3 to 4 weeks old. Do some pump and bottle-feeding sessions 2 to 3 times a week in place of one of the breastfeedings,” said Stone. “Try to have the bottle be horizontal and not vertical. Feed baby like you’d feed at the breast with the same position and hold baby similarly. The only change is that you’re incorporating a bottle. Start with a lower amount of milk in case baby struggles to take and finish a larger amount. Be sure to do lots of good burping.”

Stone recommends it’s best to have someone other than mom try bottle-feeding when possible, so baby doesn’t become confused between nursing and bottle-feeding. Bottles are only safe at room temperature for one hour from when baby starts eating.

Pumping

Moms who choose to pump have options to keep up their milk supply. It’s important to have the proper flange size for breast pumps. Moms can visit a lactation specialist to get measured for their nipple size to ensure they receive the proper flanges when ordering their pumps.

Stone says there is no “one size fits all.” A flange that is too small can cause infections, decrease milk supply, cause nipple damage, and contribute to mastitis. This is why it’s important to have one that fits properly.

For moms deciding between breast pumps, handsfree pumps are now considered secondary, whereas double electric pumps are preferred. If there’s an option to choose a double electric pump, it would be preferred to help protect the milk supply. However, it’s better to pump than not.

“Building a good milk supply and storing frozen breastmilk before going back to work is beneficial once milk comes in and your body is still regulating. If an infant only eats from one side, then you can pump the other side and start storing that milk for when you go back to work,” said Stone.

Pump every three to four hours. Thinking of baby while pumping can help with milk let down. Looking at pictures or videos of baby can help. It’s also important for moms to relax while they pump.

When pumping, massage towards the nipple. Turn up the suction pressure and decrease speed after the milk starts spraying out, or after two minutes. This will help empty the breasts. Moms can adjust the pressure depending on their individual comfort level. Pump until the milk is no longer dripping.

Power pumping is an option if moms have a full hour a day. This can help boost milk production by making hormones. To power pump, pump for 10 minutes, rest 10 minutes, pump for 10 more minutes, rest 10 minutes, and repeat for one hour.

There are occasions where moms don’t have the opportunity to pump for a full 30 minutes. Moms don’t need to pump for longer than 15 minutes. If you can at least get five minutes, it’s better than nothing. Supply and demand are what boost hormones for milk supply.

It’s important to stay on a good schedule as much as possible. Moms should try to have baby feed before leaving for work and upon returning home from work.

Some frozen breastmilk can smell like soap or smell sour, resulting in baby not drinking it. Some moms have higher lipase levels (enzyme in breast milk). Moms can scald the milk to almost boiling right before storing it. Oftentimes, moms don’t notice this until they thaw their milk.

Factors leading to a decrease in milk supply

High levels of constant stress create cortisone, which results in a decrease in a mom’s milk supply. Moms can ask for help with daily tasks— at least until their milk supply is adequate. Do things to relax for at least 20 minutes a day. Whatever helps mom relax will help the body prevent a decrease in milk supply.

Additionally, moms should stay hydrated and eat. Set time aside to eat and drink. Sit down and eat at least three balanced meals and two healthy protein snacks every day. Drink six to eight full glasses of water or juice every day. Limit the intake of caffeine. Take a daily multivitamin with iron, and rest whenever there is a chance to—little things can make huge difference.

“Know that you don’t have to be a robot,” said Stone. “Some moms get very self-deprecating when they are not able to make time for every pump session. It’s okay. There are options to help and find the best fit for you and your baby. We don’t need this affecting your mental health.”

Intermountain Health’s Connect Care Telehealth lactation consultations are an option and convenience for new moms at home who are still healing from childbirth and have a baby who is just a few days old. These appointments are available to support moms in their breastfeeding goals.

Telehealth lactation consultation visits can help with these breastfeeding challenges:

• Milk supply
• Breast and nipple soreness
• Feeding positioning of baby
• Pumping breastmilk
• Plugged milk ducts
• Engorgement
• Mastitis
• Supplementation and bottle feeding
• Transition back to work
• Re-lactation
• Induced lactation, chest feeding
• Weaning

In-person lactation consultation visits work better for:

• Challenges with baby latching on properly
• Baby being tongue-tied, etc.
• Choosing the size of a breast pump flange
• Concerns about baby being underweight (pre and post weight from pediatrician’s office required).

For more information about virtual or in-person lactation consultations, visit the Connect Care lactation support webpage at intermountain health.org.

Intermountain also has a virtual breastfeeding class available for expectant parents. It’s a one session, two-hour class and offered often. The cost is $15.

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.