1. Supporting Working Women

2. Sneak Preview – Section 5  Learning objective: Identify at least 3 common challenges to sustaining breastfeeding after women return to work, and a strategy for addressing each.  Topics: Solutions for emotional, physical, and worksite considerations  Handout E: “Solutions for Working Mothers”  Resources in The Business Case for Breastfeeding  Folder #4, “Employees’ Guide to Breastfeeding and Working”  Folder #5, “Outreach Marketing Guide”

3. Supporting Working Women Ways to Use this Section  Provide classes at businesses  Train health care professionals  Guide support group discussion  One-on-one counseling  Integrate into community education for new families

4. Your Role in Supporting New Families  Support the family’s goals  Advocate for the family  Encourage worksite support  Offer education and support  Share resources  Work for community changes  Serve as liaison with employers See Folder #5, “Outreach Marketing Guide” for lesson plans and other ideas

5. Welcome to My World

6. Cultural Perspectives  Considering cultural issues are critical in assisting both new mothers and their employers  Avoid making generalizations or assumptions about cultural groups  Exercise sensitivity for cultural differences that are relevant to specific population groups you serve

7. Balancing Breastfeeding and Employment  Delicate balance  Infant formula advertising/prominence in society  Breastfeeding can seem dispensable in the face of challenges  Provide solutions framed as “options”

8. Ideas that Work: Return to Work Options  Explore options with supervisor  Return part-time at first  Work a 4-day work week (take off a day mid-week)  Telecommute  Job share  Split shifts  Return toward end of the week

9. Emotional Considerations  Role and family conflicts  Competing demands  Fatigue/sleep deprivation  Sadness  Depression  Guilt

10. Ideas that Work: Preparing the Mother for Separation  Plan ahead  Breastfeed exclusively during maternity leave  Get help with early concerns  Practice milk expression (especially at early a.m. feeds)  Attend classes

11. Ideas that Work: Preparing the Baby for Separation  Breastfeed exclusively the first 3-4 weeks  If mothers choose to offer milk in other ways, they can choose from several options, including bottle, cup, dropper, spoon, or syringe  “Reverse cycle feeding”  Start baby in child care early to ease transition Tips for Helping Baby Accept Other Methods  Have somebody besides mom offer it  Try when baby is not overly hungry  Try when baby is sleepy  Try varied methods  Don’t make it a battle…try again later (Berggren 2006)

12. Ideas that Work Dealing with Mommy Sadness  Breastfeeding helps mothers connect  Babies usually cope well  Connect with other working mothers  It’s normal to feel guilty about wanting to work

13. Ideas that Work: Minimizing Stress after Returning to Work  Plan ahead  Think through options beforehand  Develop routines  Take a practice “trial run”  Download checklist www.workandpump.comwww.workandpump.com and www.milkmemos.com  Enlist partner support  Take care of herself

14. Child Care Considerations  Financial Impact  Can cost more than tuition  10-30% of family income  Many mothers turn to family  Child care centers not always supportive

15. Ideas that Work Child Care Options  On-site child care  Bring baby to work  Bring baby to work during meal period  Choose a provider near workplace

16. Physical Considerations  Breast concerns  Uncomfortable fullness/engorgement  Leaking  Real or perceived low milk production

17. Ideas that Work: Maintaining Milk Production  Milk production a continuous process  Frequent breast drainage necessary  Breastfeed early and often  Access professional lactation support  “Find a Lactation Consultant Directory” www.ilca.orgwww.ilca.org See “Resource Guide” in Folder #3 for lactation resources

18. Ideas that Work: The “Magic” Number  When home with baby count number of times baby feeds on cue  This is her “magic” number  Keep the “magic” number steady after returning to work to maintain production  # of direct feedings + # of milk expression sessions = magic number  Using stockpile of expressed milk without continuing to express will decline production Concept used with permission from Nancy Mohrbacher, IBCLC

19. Ideas that Work How Much Milk Baby Needs  Milk production constant at 25-35 ounces daily (3-4 ounces per feed) from 1-6 months (Kent 2006)  To calculate baby’s needs:  Divide 24-hour period into fractions  8-hour work day is 1/3 of 24 hours  12-hour work day is 1/2 of 24 hours  Divide average of 30 ounces into fractions  1/3 of 30 ozs. is 10 ozs.  1/2 of 30 ozs. is 15 ounces  Baby’s needs highly variable  Store milk in 2-3 oz. amounts to minimize waste (Morhbacher/Ameda.com)

20. Ideas that Work: Rebuilding Declining Production  Breastfeed more often at home with baby  Breastfeed at night  Add a milk expression session when milk volume is higher  Know impact of medications  Be sure pump is working  Contact an IBCLC

21. Ideas that Work: Milk Expression Tips  Bring baby items that appeal to 5 senses  Drink something warm  Warm washcloth  Massage  Visualize milk flow  Avoid looking at collection bottle

22. Workplace Considerations  Lack of privacy  Job settings and work schedules  Jobs that require constant physical presence  Travel  Schedule disruptions  Inappropriate comments at work  Shyness in discussing needs with supervisor

23. Considerations of Low Wage Earners  Physical environment at work  Erratic work schedules  Multiple jobs  Lack of familial support  Lack of job security  Perception of being easily replaced ( Ehrenreich 2000 )

24. Ideas that Work: Dealing with Supervisors and Colleagues  Discuss how lactation support benefits the company  Approach a company nurse or wellness staff  Document your need. You can use the template letter in Folder #4 to communicate your needs. See Folder #4, “Employees’ Guide to Breastfeeding and Working” for “Dear Supervisor” letter and Folder #5, “Outreach Marketing Resources” CD-ROM for template letter to a supervisor from mother’s physician

25. Ideas that Work: Dealing with Other Workplace Challenges  Express milk before meetings  Communicate needs to supervisors  Seek creative ways to gain privacy  Access other working mothers for support

26. Resources for Supporting Breastfeeding Mothers  International Lactation Consultant Association (ILCA) “Find a Lactation Consultant Directory” at www.ilca.org and local US Lactation Consultant Association “chapters”www.ilca.org  La Leche League, International at www.lalecheleague.org www.lalecheleague.org  Human Milk Banking Association of North America for milk storage guidelines at www.hmbana.orgwww.hmbana.org