Breastfeeding sabotages for working mothers can easily be avoided if you know what to look out for. As a breastfeeding medicine physician, I often see women who inadvertently harm the breastfeeding relationship with their baby by not understanding the physiology of breastfeeding.
In the spring of 2013, I gave birth to my one and only child. As a pediatrician who was a newborn hospitalist at the time, I had all of the confidence in the world that I would successfully breastfeed without any extra learning.
Very quickly, I discovered that I was woefully under prepared to conquer this challenge head on. From being offered a nipple shield early in the newborn hospital stay to getting mastitis within the first few days postpartum, I felt overwhelmed by the challenges of breastfeeding.
My difficulties inspired me to pursue board certification in lactation consulting and continue on to learn breastfeeding medicine. While my IBCLC training was focused on the practical, hands on learning, breastfeeding medicine delves into the anatomy and physiology. This emerging field of medicine offers more evidence based advice and direction.
Often in the breastfeeding “world,” tips, tricks and hacks are passed on from mother to mother and lactation consultant to lactation consultant over time. Frequently, this information is not based on evidence and sends mothers away from solutions to the problems that they face.
In my experience this includes several things that can sabotage your relationship with your breastfed baby. There are several things that stack up against a professional mother upon returning to work and maintaining a breastfeeding relationship with their baby.
As physicians, we know the benefits of breastfeeding but we don’t often know best breastfeeding practices because they aren’t a part of our training.
Breastfeeding Sabotage #1: Freezer Stash Treadmill
With the advent of social media in combination with our internal drive as physicians, I have often seen a measure of success among professional women to become their freezer stash of breast milk. As overachievers, we have normalized that a frozen stash of breast milk is a measure of successful breastfeeding.
There are several reasons why most working mothers should ditch the idea of building a large frozen stash of breast milk:
- Babies need to eat fresh milk.
- You are more likely to skip pumping sessions at work.
- Pumping extra milk can create an oversupply of breast milk.
- Keeping up with this chore takes up your precious time.
Breast milk is amazingly alive with immune cells and growth factors meant for your baby’s particular stage of life. Additionally, there is an interplay between the mother’s immune system and the baby’s system. As babies become exposed to germs, their saliva enters into the mother’s circulation and her breast milk delivers specific antibodies to her baby.
You don’t get this health benefit as fully if you are feeding mostly thawed milk from weeks ago.
Skipping Pumping Sessions
Imagine that you are getting slammed at work on a busy day and you really don’t want to take the time out to pump. It is much easier to do that if you know that you have a large freezer stash at home that can sustain your baby. However, if you continue to do that on a regular basis, you will sabotage breastfeeding by decreasing your milk supply.
There is a complex balance between prolactin and control of milk production at the level of the breast. Without regular emptying, your prolactin level starts dropping. Additionally, without regularly emptying your breasts lactocytes start to die off and you produce less milk volume over time.
Skipping pumping sessions will sabotage breastfeeding by decreasing your milk supply.
Extra pumping in order to create a freezer stash can lead to an oversupply of breast milk. This is especially true if you are doing the extra pumping in the early days postpartum while your milk supply is still regulating. Removing extra milk in those days signals your body that you might actually have more than one baby which leads to increased milk production.
While an oversupply of breast milk might sound like an ideal scenario, that is far from true. All of this extra milk in your breasts can lead to many problems such as plugged ducts and mastitis. Additionally, it is much more difficult to be a working mother with an oversupply because you are constantly feeling full and often leaking milk.
Pumping, washing bottles, carefully filling and labeling freezer bags all takes A LOT of time. Or maybe just a few minutes every day, but that adds up quickly when your time is so precious. As a working professional who is breastfeeding, every minute that you are not at work you likely want to spend time with your family.
Maintaining a large freezer supply of breast milk takes away from that time that you have at home. It is also unnecessary to maintain your exclusive breastfeeding relationship with your baby.
Additionally, your mental health can suffer if you stay on the freezer stash treadmill while you are trying to maintain the rest of life.
As a working professional who is breastfeeding, every minute that you are not at work you likely want to spend time with your family. Click To Tweet
Breastfeeding Sabotage #2: Perceived Low Milk Supply
The differential diagnosis for low milk supply is a long one, but at the very top is perceived low milk supply. You have this sense that your milk supply is low when it actually is adequate to keep you going on your breastfeeding journey.
In the early hours after birth, your baby gets a teaspoon or two of breast milk every few hours. After your milk comes in around day 3-4 postpartum, your baby will start taking larger volumes of milk but generally in the 2-3 ounce range every 1-3 hours.
Subsequently, when your breast milk supply matures between 2-4 weeks of life, your baby will need a static volume of breast milk each day on average. Generally, breastfeeding mothers make about 24- 30 ounces of breast milk per day between 1 and 6 months of life. Your supply will gradually decrease after that time as your baby starts taking more solid foods.
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Expectations of Milk Volumes
If your baby is growing well and you are feeding or pumping these volumes each day, your supply is adequate. You should bring home about 1 – 1.5 ounces for each hour that you are away from your baby. So, in an 8 hour day, you would bring home 8-10 ounces.
Ensuring that all care givers are pacing the baby at the bottle and understand appropriate feeding volumes will also go a long way to increase your duration of breastfeeding. Rarely do breastfeeding babies take more than 4-5 ounces per feeding. They are unlike their formula feeding counterparts who take increasing volumes as they get bigger.
Breastfeeding Sabotage #3: Discouraged by Your Baby’s Growth at 4 Months
Around 4 months of age, breastfeeding babies often have a change in their growth curve percentile. This is also the age where their velocity of weight gain slows. Both of these things are normal as babies start to find their genetic growth potential. Often, health care providers can become concerned over these changes if they are not well versed in these changes.
Additional pitfalls around 4 months of age are baby’s sleeping habits, how many feeds they receive during the day, their efficiency at the breast and their growing curiosity of the world around them.
Babies often start sleeping longer stretches after 4 months of life and will often decrease the number of feedings that they take. If their weight is on par, this is fine. If it has decreased you may need to add another feeding into their day.
At this age, they are usually incredibly efficient at the breast and often distracted. These things can play into the perception that they are not getting enough milk.
Breastfeeding is really difficult. Breastfeeding as a working mother can be even harder.
Hopefully, after reading this article, you can rest assured that you are doing a great job.
And if you are working and formula feeding your baby, you too are also doing a great job. Our weight as mothers is not measured in ounces of breast milk. We are all doing the best that we can to care for our babies.