Returning to Work After Childbirth: Advice for the Breastfeeding Mother

Congratulations! You have already given your baby the most wonderful gift by choosing to breastfeed. Now you may be wondering what to do when you return to work. Below are some answers to common concerns.

• Can I maintain my breast milk supply at work?
• How can I pump effectively?
• Which breast pump is best?
• Should I store milk to use when I return to work?
• Can I wean the feeds when I will be away from my baby and still breastfeed when at home?
• When do I prepare for returning to work?
• How much milk should I leave for my baby?
• Which formula is better?
• When should I introduce a bottle?
• Which bottle should I use?
• What should I do if my baby refuses a bottle?

Can I maintain my breast milk supply at work?

This depends on the hours you work, the number of times a day you can pump and the type of pump you use. Some mothers have a flexible schedule and a private space to pump, and they can pump on the baby's breastfeeding schedule, which is ideal. If you can pump on the baby's schedule, your supply should remain sufficient. However, it is not unusual for your supply to be good at the start of the week (after breastfeeding throughout the weekend) and lower toward the end of the week.

If you cannot pump frequently enough to avoid a drop in supply, remind yourself that you are doing a good job maintaining any milk while working. You may wish to try some of the herbal supplements or teas that are reputed to boost production and breastfeed as often as you are able in the evening and on weekends.
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How can I pump effectively?

The quantity of milk you pump each session may be affected by how stressed you feel. Ideally, you want to pump in a private place and with adequate time. It may be difficult for you to release your milk (let down) if you are rushing. Make a pleasant routine out of pumping by having a snack and a drink, placing a picture of your baby by the pump and taking the time to relax. Several slow, deep breaths can make a difference.

Avoid the temptation to turn the pump to its highest setting and rush through the process as this can cause nipple discomfort or occasionally a little bleeding from within the nipple. Many mothers use a trace of nipple ointment or olive oil on their nipples prior to pumping to avoid chafing against the breast shield of the pump. Make sure you are using the right size shield, as most pump manufacturers now provide a range of sizes. Check the manufacturer's Web site for information for your pump.
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Which breast pump is best?

It is a good idea to look at the different pumps available before you buy one. Take a trip to a lactation center or browse the Internet to look for comments from other moms. Most mothers choose a pump that is fully automatic and empties both breasts at once. Speed and efficiency are important at work. Avoid borrowing a used pump; they can be unsafe to share and may no longer work well.
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Should I store milk to use when I return to work?

Some mothers overproduce and have no problem storing the extra milk. If you feel your baby is taking everything you make, you may still be able to store one ounce each day. If you do this for 30 days, you'll have covered your baby's intake for the first two days. Some mothers, however, find the baby is taking all the milk they make and that it is stressful to attempt to pump extra milk to freeze. These mothers will need to have some formula backup.
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Can I wean the feeds when I will be away from my baby and still breastfeed when at home?

Some mothers decide that pumping at work is not possible, but they would like to continue to breastfeed before and after work. These mothers can choose to wean the feeds that take place during their work hours. You are more likely to maintain a partial supply if you are able to wait until 12 weeks before weaning.
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When do I prepare for returning to work?

When deciding how soon to prepare for the return to work, consider that you want your milk supply adjusted (if necessary) and the baby comfortable with any bottles required ahead of time. If you are planning to wean some feeds, then allow three days for your breasts to adjust the supply downward for each feed you plan to skip. Replace one breastfeed at a time with a bottle of formula. Wait until your breasts are comfortable before replacing the next feed.

If you are planning to maintain some or all of your supply by pumping, then practice your technique. About a week before your first day at work, start pumping your milk as if you were at work, and then bottle feed the baby during what will be your work hours. This will allow you to become familiar with how much your baby takes, whether the bottle flows just right and how long it takes you to pump.
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How much milk should I leave for my baby?

By six weeks, babies are taking 25 to 35 ounces each 24 hours, and an individual feed could be 3 to 5 ounces. You can find out exactly what your baby is taking by practicing some pumping and bottling in the week or two before you start work. You may wish to combine this with some practice days with your nanny or daycare center so you can feel confident in the routine.
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Which formula is better?

Seek advice from your baby's doctor. Most parents start with a dairy-based formula.
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When should I introduce a bottle?

Your breast-fed baby can take an occasional bottle as soon as he or she is breastfeeding well. Some parents feel it helps to offer at least four bottles each week, or even one each day, to keep the baby familiar with bottle feeding.
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Which bottle should I use?

Once your baby has learned to breastfeed well, you should be able to use any bottle that your baby enjoys. It can be helpful to pick a nipple that delivers the milk at about the same pace your breasts do. New bottles are being introduced all the time, and there are many choices. Experiment with different varieties of bottles.
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What should I do if my baby refuses a bottle?

When some babies become self-aware (between four and eight weeks), they may choose not to take bottles. This can be a big problem if you are about to return to work. If you notice your baby becoming reluctant to take a bottle, you may want to increase the number of bottles you offer until the baby is enthusiastic again. For other ideas, visit the When Your Baby Refuses to Bottle Feed page.

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