postpartum breastfeeding concerns

Breastfeeding and Going Back to Work

Breastfeeding Career Mom

Returning to work after having a baby can be one of the most challenging transitions for a new mom. You may be feeling anxious about being away from your little one and wondering how he will fare in your absence. One gift you can give to your baby as you return to work is to continue to provide him with the incomparable nutritional and emotional benefits of breastfeeding. This may seem like an extraordinarily daunting task, to continue to provide milk for your baby while at work, but many women do so successfully and with great reward to both baby and themselves. Here are a few tips to ease the transition back to work and help you and your baby continue to have a thriving nursing relationship.

1. Get a good pump and get to know it well

While a hand pump may be fine for occasional pumping needs, if you are planning to return to work and will be pumping regularly, you want something that works efficiently and effectively. The best option would be to get a double electric or a hospital grade pump. There are several ways to obtain a breast pump including purchasing one yourself, renting one from a hospital or going through your insurance company. Many insurance companies today provide full coverage for a breast pump with no out of pocket cost to you. Once you receive your pump, review the directions, learn how to use and clean the parts and start practicing using it before you return to the office. Don’t be discouraged if you are not producing much milk at first. A baby’s sucking is the most effective means of extracting milk but your body will become accustomed to regular pump use and begin to produce more consistently.

2. Get a hands-free pumping bra

A hands-free pumping bra is an invaluable investment when it comes to comfort and convenience while pumping. This will allow you to continue to do work if you wish, make phone calls, eat your lunch, read a book or any number of other activities while pumping that you cannot do if you are stuck holding the flanges.  

3. Introduce your baby to bottles BEFORE you return to work

While you should wait until you’ve established a good breastfeeding relationship with your baby before giving a bottle, it is important to introduce bottle feeding before you return to work.  Some babies will easily adapt to the bottle while others may be less accepting of the change.  Don’t worry if your baby does not take to it right away, keep trying and know that they will eat if they are hungry. Consider having the caregiver who will be watching your baby while you are at work practice giving the bottle as well. Your baby may actually be more willing to take a bottle from someone other than you as it can be less confusing.

4. Discuss your plans to continue breastfeeding with your boss

In accordance with an amendment made to the Fair Labor Standards Act of 1938, you have the right to a reasonable break time to express milk for your baby for up to 12 months in a private place that is not a restroom. Although this law only applies to companies with over 50 people, all employers should be respectful of this right. Let your boss know when and how often you will need to take breaks and find out what accommodations they have available both for pumping and your milk storage.  

5. Establish a pumping schedule and routine

If you are returning to work when your baby is only a couple months old, you will want to pump every time you would have fed your baby. This is because you want to maintain your milk supply and let your body know that you still need to produce at the same frequency. Once your supply is more established, you may be able reduce the number of pumping sessions per day. Pre-schedule your pumping sessions and put a reminder on your phone or in your Outlook calendar to prevent missed sessions, engorgement and leaks. Be sure to allow yourself 20-30 minutes per pumping session as you will need time to clean the parts and store your milk after you finish. If you struggle to letdown with your pump, have pictures or videos of your baby on hand to help ease the process. It’s also smart to have snacks and water available to stay hydrated and nourished.

6. Choose a breastfeeding supportive caregiver

Finding a caregiver who understands and values the importance of breastfeeding and breast milk is an important part of returning to work. Be sure to educate your caregiver on how to handle, thaw and warm breast milk and what safety precautions to take in terms of making sure the milk stays fresh. Share the importance of holding your baby and lovingly offering a bottle in your absence to ease the transition of not being around mom. Consider storing your milk in small amounts (approximately 2-4 ounces) that can be thawed individually to minimize having extra that is wasted. Any milk that has been thawed and placed in the refrigerator should be used within a 24 hour period or discarded. It may be helpful to build a small stockpile of milk in your freezer for the caregiver so that there is always back-up on hand.  

For tips on storing human breast milk, see "Storing Human Breast Milk"

7. Maximize your time together with baby by breastfeeding often

When possible, nurse your baby right before you leave for work and right when you return to continue nurturing the breastfeeding bond. Consider sleeping near your baby at night so that you can nurse comfortably if needed. Often babies who are separated from their moms during the day will nurse more frequently at night. This is called reverse cycling.  Consequently, you may find that your baby actually eats less during the day with the caregiver than he does at night with you.  Any amount of breast milk you can continue to give your baby when you return to work is better than no breast milk. Make a commitment to yourself and your baby to try to continue exclusively breastfeeding for the first 30 days and if you find you are unable to produce adequate supply, you can always choose to supplement with formula. If you find yourself feeling discouraged or overwhelmed by the process of continuing to nurse your baby when returning to work, remind yourself of the tremendous physical and emotional benefits of breastfeeding. And always, as with everything in motherhood, find other moms to connect with who are on a similar journey. Sharing tips and support for one another during your transition back to work can be a saving grace during this stressful time. For questions about breastfeeding or other pregnancy and infant related topics, contact Health Foundations to schedule a free consultation with a midwife and tour of the Birthing Center.


mastitis Mastitis is inflammation of the breast that can occur in breastfeeding women.  This condition can be caused by an allergy, infection, or an obstruction.  While mastitis is the most common in the first 2 to 3 weeks of breastfeeding, it can occur at any time during lactation.  Approximately 1 in 3 (other sources say 1 in 5) postpartum women in the West will experience mastitis.

This condition often comes on abruptly and often affects only one breast.  It may last for a few hours or up to a week or so.

Symptoms of mastitis include:

  • Breast area that is warm, hot, sensitive and may be painful
  • Red or reddish streaks on the tissue of the affected area
  • Fever of 101.3 or more
  • Chills
  • Generalized aching
  • Flu-like feelings

What causes mastitis?

Sometimes the cause of mastitis is unknown.  Possible causes or contributing factors can include:

  • Plugged ducts
  • Cracked or damaged nipples, which let germs in
  • Ineffective or infrequent nursing or pumping
  • Pressure from a baby carrier or a bra
  • Fatigue
  • Being “run down”

Other effects of mastitis, which can help indicate illness include:

  • Decrease in milk supply from the affected breast temporarily
  • Expressed milk that looks like strings or grains of thick, fatty milk; lumpy, clumpy milk (this is safe for baby, but some moms like to strain this out.
  • Milk may contain more sodium and chloride, making it saltier—baby may refuse or resist the breast due to this temporary change in flavor.
  • In more serious cases, milk can contain mucus, pus, or blood.

How to prevent mastitis

  • Breastfeed or pump frequently
  • Fully drain the milk from your breasts while breastfeeding
  • Allow baby to completely empty one breast before switching to the other breast
  • If baby nurses for only a few minutes on the second side (or not at all) begin on that side for the next feeding
  • Alternate the breast you offer first at each feeding
  • Regularly change the position you use to breastfeed
  • Ensure that baby is latching properly
  • Take good care of yourself-- get enough rest, eat well, and drink enough fluids

What do to if you suspect mastitis

If you feel you may be experiencing mastitis or a plugged duct, please call or page the midwives if you are a current client.  A visit to determine the cause of your symptoms and potentially a prescription for antibiotics (if infection is present) and/or a recommendation for over-the-counter anti-inflammatory medication may be in order.

There are also many things you can do at home to help treat mastitis.

  1. Apply cold or heat: apply a cold pack (frozen peas work great) or a heat pack or compress, whichever feels better to the area, 20 minutes on then 20 minutes off and repeat.  Hot showers and soaking (with the affected breast immersed) in warm water with Epsom salt can also help.
  2. Empty the breast often:  frequently nurse or pump or hand express (at least every 2 hours) on the affected side to keep the milk moving.  (Don’t neglect the unaffected breast)
  3. Rest: it is so important to rest as much as you can.  Rest means lying down sleeping or resting for as much of the day as possible.  Get help around the house as much as possible
  4. Eat well and stay hydrated, drinking plenty of water throughout the day
  5. Go braless if possible
  6. Massage:  some call this the “bag of marbles” massage.  Cup your affected breast with both hands, fingers interlaced, and massage as if you were rolling marbles around in a bag.  You can also rub the affected area in a circular motion with 2 or 3 fingers.  You can massage as baby nurses, toward the nipple, to help with milk flow and clearing out obstructed ducts.
  7. Natural remedies: speak with your midwife to see about the appropriateness of using raw garlic (2-5 cloves per day), Echinacea tincture, Oregon Grape Root tincture, Propolis tincture, and/or vitamin C
  8. Raw potato or cabbage leaves:  applied to the breast.

After mastitis has resolved, it is common for the area to be red or feel bruised for up to a week longer.

Additional Resources on Mastitis: