Returning to Work

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Human milk has the same important benefits for older babies as it does for infants. Just because you are returning to work does not mean you have to stop breast-feeding. Knowing that you will be able to provide milk for your baby while you are away will help ease your transition back to work.

Working women can manage breast-feeding in the following ways:

❖ Extend maternity leave so there will be more time for breastfeeding to become well established.

❖ Nurse your baby once or more during the workday if the baby is in a childcare facility at your workplace or nearby.

❖ Consider working at home.

❖ Work part-time, and nurse before going to work and upon returning home.

❖ Express milk every 3 to 4 hours while you are at work for your baby to drink later from a bottle or cup.

❖ Breast-feed when you are with your baby. When you are away, the baby will receive formula or solids (if approximately 6 months of age).

❖ Be sure to select a childcare provider or center that supports breast-feeding, and can safely handle the milk and feedings per your instructions. Also, engage the support of your boss, human resources staff, occupational nurse, and coworkers. Assure them that pumping milk will not interfere with your work duties.

If possible, go back to work on a part-time or flexible schedule at first. This can help you and your baby adjust to the new routine. If this is not possible, go back to work in the middle of the week to make it easier for you and your baby to adjust.

You will need to find a quiet, private place at work to express milk, such as an unoccupied office, the bathroom, or wherever privacy can be assured. Expressing milk takes 15 to 30 minutes. You will need access to soap and water to wash your hands before expressing. You will also need a refrigerator or a small cooler and ice packs to keep the milk cold until you take it home.

Follow these safe storage and preparation tips to keep your expressed milk healthy for your baby.

1. Always wash your hands before expressing or handling your milk.

2. Be sure to use only clean containers to store expressed milk. Use screw cap bottles, hard plastic cups with tight caps, or special heavy nursery bags to store milk. Do not use ordinary plastic storage bags or formula bottle bags for storing expressed milk.

3. Use sealed and chilled milk within 24 hours if possible. Discard all milk that has been refrigerated more than 72 hours.

4. Freeze milk if you will not be using it within 24 hours. Frozen milk is good for at least 1 month (3 to 6 months if kept in a 0° freezer). Store it at the back of the freezer and never in the door section. Make sure to label the milk with the date it was frozen. Use the oldest milk first.

5. Freeze 2 to 4 ounces of milk per container (this is the average amount of a single feeding). You may also want to freeze some smaller amounts.

6. Do not add fresh milk to already frozen milk.

7. You can thaw the milk in the refrigerator, or you can thaw it more quickly by swirling the milk container in a bowl of warm water.

8. Do not use microwave ovens to heat bottles because they do not heat evenly. Uneven heating can easily scald the baby or damage the milk. Bottles can also explode if left in the microwave too long. Excess heat destroys important proteins and vitamins in the milk.

9. Milk thawed in the refrigerator must be used within 24 hours.

10. Do not refreeze your milk.

11. Do not save milk from a used bottle for use at another feeding. Weaning

There is no specific time to wean your baby. It depends entirely on the individual desires and needs of you and the baby. Either one of you can initiate the weaning process.

Some babies lose interest in breast-feeding between 9 and 12 months of age, or after they learn to drink from a cup. If you notice this starting to happen, do not try to force your baby to keep breast-feeding. Understand that this is not a rejection of you, but rather the first sign of your child's growing independence.

You may feel sad, guilty, lonely, or depressed about giving up the closeness and intimacy that comes from breast-feeding. These feelings are natural. Continue to cuddle and interact with your baby, and remember that weaning is a natural step in helping your child to grow up.

If you initiate weaning, you can wean your child first to a bottle and then to a cup, or directly to a cup. During weaning, you can express milk with which to feed your baby from the cup or bottle, or you can use infant formula. Formula does not provide all of the special nutrients and protective qualities that breast milk does, so it is generally best to breast-fed as long as possible.

If you choose to supplement breast-feeding with formula, you will still need to express milk in order to keep up your milk production and to keep your breasts from becoming engorged.

If you decide to use a bottle, introduce it gradually over several days. Start with one feeding per day. If the baby is extremely hungry when you first introduce the bottle, the baby may be more impatient. It may also help if another person introduces the bottle when you are not around. Many babies get upset if they are given a bottle when their mother is in the house; they may even refuse the bottle because they want to breastfeed instead. Do not force your baby to take a bottle. It may take time. Pressure to take a bottle may cause the baby to refuse the bottle completely.

After bottle-feedings have started, some babies may get frustrated when they breast-feed because the milk does not flow as fast from the breast as it does from a bottle.

The following suggestions may help:

❖ Select a bottle nipple with a slow flow.

❖ Pump for 1 to 2 minutes before you breast-feed.

❖ Massage the breast as you nurse to help the milk flow.

❖ Use relaxation techniques to enhance milk flow.

❖ Offer the breast before your baby gets overly hungry and becomes impatient.

Weaning to a cup has the following advantages over a bottle:

❖ It eliminates the step of weaning first to a bottle and then to a cup.

❖ Bottle-feeding for long periods of time or while sleeping can lead to tooth decay.

❖ Drinking from a bottle while lying flat can lead to middle ear infections.

❖ Prolonged bottle-feeding can lead to the bottle's becoming a security object, especially after the child is 1 year old.

Start with a trainer cup that has two handles and a snap-on lid with a spout, or use a small plastic glass. This will keep spills small while the baby is experimenting with holding the cup (and throwing it). Do not be surprised if the baby treats the cup as a plaything at first.

Offer breast milk in the cup, when available, starting once per day. It may be easiest to substitute a cup for breast-feeding at the midday feeding first, and the nighttime feeding last. Nighttime nursing is often a source of comfort and calming before going to sleep, and may be the hardest feeding to give up.

Be patient. Weaning is a gradual process, and it may take months before your baby is willing or able to take all liquids from a cup. Proceed gradually and let the baby's willingness and interest guide you. Once you have stopped breast-feeding entirely, your breasts will stop producing milk very quickly.

Until you and your baby develop a feeding routine, stay positive and try not to become discouraged. Remember, breast milk gives the baby more than just food. It also provides important antibodies to fight off infection, and it has medical and psychological benefits for both of you. Breastfeeding is the most natural gift that you can give your baby.

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New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.

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