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Child Care and the Breastfed Baby

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Melissa Portunato MPH, IBCLC, RLC

It’s likely that at some point, your breastfed baby will be cared for by someone else other than yourself. Sometimes it’s temporary while other times it can be long term like when returning to work. Child care options can vary from private stay at home nannies/family members, private home licensed child care, or commercial child care facilities. 

The process to find the perfect match for you and your baby doesn’t have to be stressful. Your breastfeeding relationship can absolutely continue and thrive with this new milestone. No matter who you choose to care for your baby, your breastfeeding goals should be supported and respected. Read on for tips on finding a caregiver for your breastfed baby including how to connect with local resources and how to share valuable education with your child care provider. 

Support and Communication 
Let’s start here. It’s OK if your child care provider isn’t a “breastfeeding expert” but they should be open and teachable when it comes to feeding mother’s milk to babies in their care. They should be willing and ready to accommodate your requests or accept breastfeeding-friendly education. An “open door” policy is one of the ways caregivers can be supportive of the breastfeeding dyad. Allowing mothers to drop in at any time without notice to pump or nurse their baby on demand protects breastfeeding. If your child care facility pushes back on your breastfeeding requests, then it’s probably not a good fit.

Knowledgeable Staff 
A child care provider whether in a private or commercial setting should have basic training on breastfed infant behavior, proper bottle-feeding techniques, and breastmilk storage handling.  All babies, breastfed or not, should be fed using The Paced Bottle Feeding Technique. This feeding method allows the baby to control the flow of milk, preventing overfeeding. Normal milk consumption for babies 1-6-month-old is 1- 1 ½ ounces per hour. Milk leftover from feedings should be discarded within 2 hours of initial use and proper breastmilk milk handling should be carefully followed. Download the handout here to share with your child care team. Breastfed babies should not be fed on strict schedules but rather monitored for hunger cues. For younger babies less than 3 months old this includes moving head from side to side (rooting), bringing fingers to mouth, and for older babies, actively moving arms and legs while gazing at the caregiver. 

Facility Accommodations 
Breastfeeding friendly accommodations on-site should include a designated area to pump or nurse your baby, other than a restroom. A fridge to store breastmilk and a sink to wash pump parts. You will need to label bottles and/or milk storage containers with the name of your baby and date with permanent, reusable, or personalized silicone labels. 

Additional tips for success:

🗹 Check with your local / state breastfeeding coalition to find breastfeeding-friendly centers here.

🗹 Take a tour with your prospective child care provider first before making a decision. 

🗹 Choose a child care provider nearby. You can hop into pump/nurse or simply check on baby anytime. 

🗹 A low child-adult ratio allows the caregiver to pay more attention to feeding cues and can prevent overfeeding. 

🗹 Long-standing caregivers provide added security your baby is in the care of an experienced professional. 

🗹 Send breastmilk in 1-2 ounce increments to prevent milk from being wasted. 

Always remember you are your baby’s advocate. No matter your breastfeeding goals, you should feel comfortable to easily keep an open conversation with your child care provider. 

Do you still have other questions about child care and breastfeeding? Email us at IBCLC@spectrababyusa.com anytime or schedule a complimentary consultation. Our International Board Certified Lactation Consultants are happy to assist you along your breastfeeding journey. 

We’re in this together and we support you! 

Sources

  1. How to choose a breastfeeding-friendly childcare provider. (2020, February 19). La Leche League USA. https://lllusa.org/choosing-a-childcare-provider/
  2. Proper Storage and Preparation of Breast Milk. (2020, January 22). Center For Disease Control. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  3. Anne Smith, IBCLC. (n.d.). Caregiver’s Guide to the Breastfed Baby. Breastfeeding Basics. Retrieved January 11, 2021, https://www.breastfeedingbasics.com/articles/caregivers-guide-to-the-breastfed-baby

5 Quick Tips for Pumping at Work

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by Amanda G.

Pumping at work gets much more manageable once you figure out the logistics and get yourself into a routine.

Here are five quick tips to make pumping at work easier.

  1. Leave an extra set of pump parts at your office.

Trying to leave the house on time and get to work is hard. It’s even harder when you’re trying to get your baby ready too and you need to get your pump bag packed.

A checklist can help you make sure that you have everything you need when you leave the house. But even with a system, there’s a good chance that one day you’re going to be in a hurry and forget something crucial, like breast shields or collection bottles to pump into.

(The first time I forgot my breast shields, in desperation, I actually tried putting my nipple directly into the connector and starting the pump. That was a very bad idea. OUCH!)

In order to avoid having to either go home or try to buy a replacement for whatever it is you forgot, have an extra backup set of pump parts and bottles at work. This way you’ll have peace of mind and be ready for when the inevitable happens.

 

  1. Get a hands-free pumping bra so that you can do other things while you pump.

If you’re pumping two or three times per day at work, that’s a total of 30-45 minutes a day, or about three hours a week, getting a hands-free bra so that you can do other things besides holding your breast shields during the time you spend pumping can be a game changer. This way, while you pump, you can work on a laptop, take notes while you’re on a conference call, or take a break and read a book or magazine.

 

  1. Have as many sets of pump parts as you have pumping sessions in a day.

I used to recommend leaving pump parts in the refrigerator between uses, but the CDC recently issued guidelines stating that pump parts should be washed as soon as possible after each use. (More about the new guidelines here.)

To avoid spending a lot of time washing pump parts – and deal with getting access to a sink, if your lactation room doesn’t have one – bring enough sets of pump parts to get you through a day. Then you can wash them all in one batch, either at home or at the end of the day at work.

 

  1. Carry as little as possible back and forth to work every day.

The more things that you can leave at work (in addition to the extra pump parts mentioned above), the less complicated your mornings will be. So, if you can leave your pump, a hands-free bra, and whatever else you need – breast pads, freezer bags, lanolin – at work, too, then you can travel back and forth with just empty bottles and an ice pack in the morning, and full bottles in the afternoon.

(Obviously, if you need your pump at home, this might not be feasible, but one option is to get an extra manual pump you can use at home when needed.)

 

  1. Make friends with the other pumping moms in your office.

If there are other women using the lactation room at your office, try to get to know them! Having a relationship in place can be really helpful when your boss schedules a meeting and you need to switch your pumping time with someone else.

Did you miss out Live Q&A?  We got you covered!

 

Working and Pumping: The Struggle is Real

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What To Know When Returning To Work

Well, it’s sadly that time, when you are headed back to work after maternity leave.  Hopefully, your employer offers that necessary benefit. The baby honeymoon is over and now you have some big decisions to make regarding child care and feeding.  If you’ve been breastfeeding up to this point, there is a good chance you’ll want to continue providing baby with your milk. After all, it is recommended to breastfeed exclusively for 6 months if possible to get the continued benefits such as less frequent illness.  Before your actual return, try to be as prepared as possible. Make sure you know your workplace rights, have all the gear you need and have at least a general plan for how you will feasibly pump enough to keep up your supply for baby. Here are the basics to get you started:

Protection under federal and state laws

In 2010, the Affordable Care Act was signed into law with provisions related to nursing mothers and pumping at work. The guidelines include employees that are not exempt under section 7 of the law.  This includes most hourly paid employees. The law specifically calls for providing a nursing mother unpaid (unless all employees are paid for their breaks) reasonable breaks with a private room for nursing that isn’t a bathroom.  If your employer is smaller than 50 employees, they may be exempt from this law if it causes them “undue hardship.”  For full details check out these great resources here and here.  If you aren’t covered under the ACA, make sure to check your state laws.  Twenty-eight of fifty states have some kind of provision related to breastfeeding.

Planning and educating yourself

First, figure out what laws you are specifically covered by depending on your employment from the resources above.  If you aren’t sure, talk to your boss, human resources, or a workplace lawyer so you can start making a game plan.

Next, equipping yourself with all the essentials for successful workplace pumping is key.  To maintain a good milk supply it is important to have access to the best possible pump. For time management and optimal pumping, look into getting a double, electric breast pump that is hospital strength.  Under the ACA, it is also required that your health insurance provide you with a pump (either a rental or single user depending on the model). There are several pump options available and companies that will do all the footwork for you to get you the pump you need with little hassle.  Spectra Baby USA is one of these companies with the added bonus of great customer service and lactations consultants on hand as needed.  Check out their page for a comparison chart of different pumps to find the best option for you and you can also check their insurance lookup tool that locates a DME (Durable Medical Equipment) company that will work with your insurance policy to get you a breast pump covered by your plan.

Lastly, consider any accessories to purchase to make your life easier as a pumping mom.  This includes items like a pumping bra, sterilizing tools, nipple cream, adequate collection bottles, freezer bags, and insulated tote to be able to get your milk safely to and from work.  Having the right gear will keep you organized and efficient!

When and how to pump: finding a schedule.

In general, you want to pump in a way that would mimic your baby’s current feeding schedule.  This generally means that a mom will have to pump every 3-4 hours. For a full-time employee that should be 2-3 times depending on lunch breaks and commute time.  How you want to schedule these into your day is completely dependent on what works in your day. Regardless, make sure that you try to actually schedule these times into your calendar to remind yourself and your co-workers.  It’s easy to forget or skip a pumping session if you don’t make it a priority and this can negatively impact your supply. If you are short on time one day, don’t stress and just try to get in as many short sessions as you can to keep the supply signal going to your breasts.

The last big consideration is your milk supply as your switch from breastfeeding to the use of a pump.  Your baby is much better at extracting milk from your breast than a machine, so if you have trouble initially with the amount you are pumping don’t be discouraged.  Keep these basic tips in mind: keep hydrated, eat healthily and frequently, stimulate an adequate let down with massage, heat or thinking of your baby (even look at a picture!), stay relaxed and comfortable and make sure you have the right size breast shield.

With the right preparation, you will manage the transition into a work-family balance well.  You rock mama! Keep up the good work providing liquid gold for your child while crushing those career goals.  

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