Returning to work and continuing to BF questions - Mothering Forums
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#1 of 6 Old 03-09-2003, 10:21 AM - Thread Starter
 
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Hi,
I've got a few questions concerning continuing to BF after returning to work (and am having trouble with searching the boards effectively)...

Here goes:

I'll be returning to work in mid-April. DD will be 3.5 months old at the time. I have to work 4 full days per week which means she'll be in daycare (a nanny at first but we're hoping for a slot in a "crèche" (regular day care centre) starting early October) from about 8:30am to 6:30pm.

I'm not looking for advice on what to feed her (EBM, etc.), nor really on pumping/storing--I've found lots on that. I am worried about possible nipple confusion and how to avoid it (or about how easy/hard it is to solve if it happens) and about maintaining adequate supply so she can be only BF (until we start solids, that is)--no bottles--on the three days a week I can be with her.

So, here goes my questions:

1. How common is nipple confusion in babies her age? Are there any advance warning signs that a baby is likely to develop it? (Because bottles would be easier on all involved but I'm worried about DD refusing the breast after.)

2. Just in case, if nipple confusion does set in, how hard is it to overcome? (I really want to BREASTfeed (not EBM bottles) until at least one year--I do NOT want a great BFing relationship to end early.)

3. I can pretty much work any 4 days I want but I have to "ask" work and can't change the days around once they're set. I'm hesitating between working Mon. through Thurs (=three day weekends, my schedule before DD) or working Mon. and Tues., Weds. off, working Thurs. and Fri., Sat & Sun off. I'm leaning towards the second option but would like input. Any thoughts on which is best, especially in regards to how easy it'll be to keep up my supply and storing EBM (we do not have a real freezer and can't afford one so I can't stock up much in advance, and no fridge at work so cooler packs--if I go with the 4 days on 3 days off option, can EBM last in the fridge from Thurs to Mon? Do I have to pump on Sunday for Monday? )?

4. How well do babies "get" the concept of bottles when mom's not there and NO bottles when mom's there?

5. Do I really need to get her used to bottles first? Or can the caregiver do that (if she's willing)? Will the "new feeding method" really be an additional trauma to add to the separation, like some people have said to me IRL?

6. Is it a good or bad idea to ask the caregiver to give her as little food as possible starting in the hour or so before I'm due to pick her up (that is, on demand all day until 5:30 or so and then as little as will satisfy her) so she'll be hungry when I pick her up? (But when she's really hungry, she nurses poorly and gets frustrated fast...)

7. Am I probably worring for nothing? Should I just go with the flow and deal with anything that comes up only when and if it comes up?

8. Is there anything I seem to be overlooking?

Thanks a million in advance!!
Ione
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#2 of 6 Old 03-09-2003, 04:22 PM
 
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We never had nipple confusion, so I can't help with that. DD switched back and forth from birth.

I would work the split shift. Having 2 days on the weekend and one during the week will really help maintain your supply. The pump does work, but the baby is much more efficient at getting the milk. If you do work m-th, bm will stay refrigerated for up to 7 days, so pumping on thurs for mon will be fine.

My dd had no problem knowing that I bf and others gave her the bottle. With my ds, I'm SAHM, so he's not had many bottles. He really didn't like them, though.

I would recommend getting her used to them before you go back. Different babies like different bottles. I have a friend who ended up quitting after she went back b/c her ds refused a bottle and cried from the time she left until the time she got home. Most babies will accept it, though. If bottle doesn't work, you can always try a cup or sippy cup.

I always told my MIL (who watched dd) to not feed dd the hour or so before I got home unless it was an absolute emergency. By the time I got home, *I* needed her to nurse. If she was full - I needed to pump and I would much rather have her nurse than pump. DD always looked so happy nursing right after I got home. It was the best to see her so happy expression- like there was absolutely nothing better on the face of the planet. I remember thinking I wish there were something so easy to make me that happy.

If you find you're having a tough time keeping up with pumping, try pumping one side while baby is nursing the other. You can do that with the first morning nursing or right after you get home. You may only get an ounce or two, but that made the difference for us.

Michelle -mom to Katlyn 4/00 , Jake 3/02, and Seth 5/04
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#3 of 6 Old 03-09-2003, 04:31 PM
 
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hello! You have a lot of questions! About the same I had when I was going back to work. I will try and answer as many as I can with my experience with my ds. I went back to work when he was 3 mo old and I worked 2-3 days a week. At this age nipple confusion is very uncommon. Most babies transition between the two very well. The difficulty usually lies in getting them used to a bottle. If possible I would start having dad or someone else give your daughter a bottle a least once a week. It may take you some time to find a bottle that your dd likes. (My son could NOT use the playtex bottles. he would fuss with it for 45 min and only get .5 oz. He had to use avent bottles.) Plus, then your dd willnot have to get used to the bottle and you not being there at the same time. Give those babies lots of credit. they know about the whole bottle thing once they get used to it. Most babies couldn't be less interested if mom is there but they do fine when she's not there. If you can work the 2 days on, 1 off, 2 days on again that would probably be best for maintaining your milk supply. Usually your milk supply starts to really adjust after 2 days of a different schedule. Plus most babies seem to do better with shorter, more frequent absences rather than longer ones. EBM will be good in the fridge for up to 8 days, and in the freezer for upto 3 months. As long as you are nursing and pumping frequently your supply should be good. Personally, I would recommend her care giver feed her on demand. A very hungry baby is never a good thing. Besides, even if she's not hungry she might nurse for comfort. otherwise you can pump if you are too full. I hope all this helps! Feel free to PM me if you want to talk more. And by the way, you are NOT worry too much! It is wonderful that you are so motivated and want to avoid any possible problems. That said, do go with the flow and let your dd teach you what is best for her. Best of luck to you!!

Peace and health, Jenny - Mama to my love 12/01, my lovely 7/04, and my beloved 10/06, and one angel. ****5****10****15***20****25****30****35***bellycast.gif40**
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#4 of 6 Old 03-09-2003, 04:36 PM
 
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DS1 got a bottle at 3 days and never had nipple confusion. DS2 got a bottle at 3 weeks and never had nipple confusion. I could even breastfeed and then immediately give them a bottle, then go back to breast without nipple confusion being an issue.

That said, I believe the recommendation re: nipple confusion is to wait until 3-5 weeks to introduce a bottle, but not to wait beyond that or the baby will have a tough time taking the bottle.

I've found both of my sons to be very resilient with breast vs. bottle. I could/can feed them with either method and never had trouble with breastfeeding one day, bottles from a caregiver or dad the next.

Best of luck to you.
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#5 of 6 Old 03-09-2003, 04:50 PM
 
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Quote:
1. How common is nipple confusion in babies her age? Are there any advance warning signs that a baby is likely to develop it? (Because bottles would be easier on all involved but I'm worried about DD refusing the breast after.)
I don't know how common it is but I do think you should start working on introducing a bottle now. As long as you are her primary source of nursing, and your nursing relationship is well established, I doubt she'll develop a bottle preference but the older they get the more they may develop a bottle aversion (and who can blame them, but it does make life more difficult). I haven't heard of any advance warning signs that will predict which babies are more or less likely to have nipple confusion.

I personally like the Avent bottles and newborn nipples.

Quote:
2. Just in case, if nipple confusion does set in, how hard is it to overcome? (I really want to BREASTfeed (not EBM bottles) until at least one year--I do NOT want a great BFing relationship to end early.)
Again, I think if your nursing relationship is well established that you likely will not have a problem with her deciding she likes bottles better. My son developed a preference for bottles when we were first starting out (horrible breastfeeding problems/hospital stay, long story) and it was hellish getting him on the breast, but once he did and we established a great breastfeeding relationship he then wanted nothing to do with bottles. In hindsight, I wish we had kept up with one or two bottles a week so that he wouldn't reject them when I went back to work.

Quote:
3. I can pretty much work any 4 days I want but I have to "ask" work and can't change the days around once they're set. I'm hesitating between working Mon. through Thurs (=three day weekends, my schedule before DD) or working Mon. and Tues., Weds. off, working Thurs. and Fri., Sat & Sun off. I'm leaning towards the second option but would like input. Any thoughts on which is best, especially in regards to how easy it'll be to keep up my supply and storing EBM (we do not have a real freezer and can't afford one so I can't stock up much in advance, and no fridge at work so cooler packs--if I go with the 4 days on 3 days off option, can EBM last in the fridge from Thurs to Mon? Do I have to pump on Sunday for Monday? )
I definitely vote for taking Wednesdays off. That's what I did when I went back to work, and I think it made a big difference. It was much easier to get through two days of work knowing I had that day off in the middle to be with him, and I think it was easier on my baby as well. I thought it was fine for pumping/storing, too.

I think you'll be fine pumping on Thursday or Friday (whichever schedule you choose) for Monday; just make sure to keep your fridge as cold as it will go and put the milk in the back and you'll be good. You'll be able to smell the difference if it goes off.

Quote:
4. How well do babies "get" the concept of bottles when mom's not there and NO bottles when mom's there?
Mine did just fine. After our nursing relationship was firmly established, he preferred me to the bottle every single time.

Quote:
5. Do I really need to get her used to bottles first? Or can the caregiver do that (if she's willing)? Will the "new feeding method" really be an additional trauma to add to the separation, like some people have said to me IRL?
I very strongly recommend you start working on introducing a bottle sooner rather than later. I think it would be doubly traumatic to have a new caregiver and a new feeding method all at once. You will have much more peace of mind if you know your daughter has learned to switch back and forth between the two before you go back to work. If she refuses the bottle and you're at work and can't go to her, it will suck big time for both of you.

Also, different babies prefer different kinds of bottles. Don't invest in a whole lot of one kind - get one of several different bottles and nipples and figure out what she will take before stocking up. If she absolutely refuses bottles, then start working on teaching her to cup feed or sippy cup feed or whatever. Another good reason for planning ahead - so you have an alternate plan if bottle feeding doesn't work.

Quote:
6. Is it a good or bad idea to ask the caregiver to give her as little food as possible starting in the hour or so before I'm due to pick her up (that is, on demand all day until 5:30 or so and then as little as will satisfy her) so she'll be hungry when I pick her up? (But when she's really hungry, she nurses poorly and gets frustrated fast...)
I think that's a reasonable request to make....if she gets hungry her caregiver can give her enough to take the edge off but not so much she gets really full and won't nurse.

Quote:
7. Am I probably worring for nothing? Should I just go with the flow and deal with anything that comes up only when and if it comes up?
I don't think you need to tie yourself up in knots stressing, but I do think it's a good idea to plan ahead.

Quote:
8. Is there anything I seem to be overlooking?
Do you have a copy of Gale Pryor's book Working Mother, Nursing Mother (or maybe it's the other way around)? I highly recommend it.

What kind of pump do you have? Have you gotten used to it, and does it work for you? Another good thing to practice on ahead of time. I have the Medela Pump in Style and it's pretty good; I left it at work and have an Avent Isis manual for home so that I didn't need to lug the pump back and forth. I also had extra horns so that I didn't have to worry about washing them every evening.

Do you have a private office at work where you can pump? Can you lock the door? If you don't have a private office, have you talked to your boss about how to handle the logistics of pumping? Do you have nursing clothes you can wear to work - I found it easier to do that so I didn't have to get more undressed than necessary.

HTH!

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#6 of 6 Old 03-10-2003, 01:43 PM - Thread Starter
 
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I'm feeling much better now and less worried.

I'll check out the book if I can find it at an English bookstore here in France.

I don't have a pump yet but the Avent manual one is on order and should be in tomorrow... and I'm looking into renting an electric one (France is great, BTW, social security'll reimburse half the rental fee! yipee!!).

Yes, I have a private office with a door (no lock but no one enters without knocking when I close the door) at work but I'm not sure I should pump there since the windows look out on an inner courtyard and give my colleagues a great view of everything in my office. But people are more relaxed about BF, it seems, here and I work for an NGO that works with developing countries so most people are even more relaxed about it...
We do need to talk about the logistics at work but French law requires them to let me (one hr per day in two half hour sessions... and they'd even have to welcome DD, I believe, if someone was to bring her to me to BF).

Nursing clothes to wear to work... great idea!!! And wonderful excuse to order nearly everything in the motherwear catalogue (not that I really need the excuse but still...). Actually, I usually wear jeans and a t-shirt to work so I don't need much more than a few casual tops...

Thanks again, I feel ever so much better and more relaxed about the whole thing.
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