BREASTFEEDING FOR WORKING MUMS

TRAVELLING TOGETHER,BEING APART

LOGISTICS

WORK OPTIONS

• Timing of the return– In Singapore, maternity leave is 16 weeks

• 1st 8 weeks at a stretch then subsequent 8 flexible• Eligibility: Baby is Singaporean, mum married and

employed >90 days

– Consider extending to 6 months(recommendation from AAP exclusive 6 months of breastfeeding)

• Helps with bonding, getting enough rest and establishing a regime for breastfeeding

WORK OPTIONS

• Working hours

– Part-time vs full time• Dependent on $ situation, work environment

– Consider rearranging timing of work• Shorter, more frequent breaks to pump, longer lunch to return to

nurse (baby to be brought to work place for nursing), starting and finishing earlier (allowing to spend more time with baby when baby is awake)

• Day of return– Start of the month/week– Start towards end of the week easier

CAREGIVER ISSUES

CAREGIVER OPTIONS

• Family– Spouse– Grandma/grandaunt– Adv: Loving relative, inexpensive– Disadv: difficult to establish common

philosophy abt care-giving

CAREGIVER OPTIONS• Individualized care

– Nanny- at own home or at nanny’s home– Individual baby or with siblings or other children– Adv: more attention, less likely to catch ID,

more flexible arrangement, KIV household chores

– Disadv: expensive, days nanny is on MC, need to have a gd understanding of nanny’s background

CAREGIVER OPTIONS

• Infant care centre– Adv: establish routine, no concerns if teacher

is on MC– Disadv: more likely to catch ID, less flexibility

if PR are late, limited spots

CAREGIVER HANDOVER

• Preparation phase– Visit the nanny’s house or sch to familiarize

with the environment– Discuss your preferred mode of caregiving– Discuss your desire to maintain BF

CAREGIVER HANDOVERHanding over◦Discuss and familiarize the care with the feeding

regime◦ Specific instructions:

Always hold the baby during feeding- choking, human contact

Thawing and warming of EBM

Trial run◦ Suggest to start 1 week prior to returning to work◦ Start with a few hours or half a day

EXPRESSED BREAST MILK

INSURANCE PUMPING

Adequate store prior to starting work◦ Suggest starting 1month before returning back

to work.

CHOICE OF BREAST PUMPExpressing methods◦Hand pump

Option: preferred for getting more EBM, more convenient, quieter and more natural, pump not working or not available, target certain areas of blocked ducts

Especially valued in the initial period for colostrum◦Machine pump

Collection kit◦ Single vs double milk collection kit

CHOICE OF BREAST PUMP

• Types of breast pump– Clinical grade pump

• Piston-driven pumps• Recommended: total EBM, need to ensure a gd

supply

– Near- clinical grade pump• Recommended: still nursing but separated almost

everyday

CHOICE OF BREAST PUMP

• Types of breast pump– Electric pump

• Heterogenous group• Run on batteries or electricity from wall socket,

semi-automatic suction assisted by user’s fingers• Disadv: lack of stimulation for let down• Recommended: occasional user

CHOICE OF BREAST PUMP

• Types of breast pump– Hand-operated pump

• Adv: better control of site of drainage, cheaper• Disadv: may not drain as well, single sided-time

consuming

EXPRESSING BREASTMILK REGIME

• Maximize nursing and expressing to maintain supply.

• Nurse as late as possible before work and as soon as reaching home. Discuss and plan with the carer so that baby is not full on mummy’s return

• Aim: to pump as frequently as nursing ie up to Q3H

EXPRESSING BREASTMILK REGIME

• Tricks of the trade– Multi-tasker vs the relaxed mum– Multi-task: hands-free kit and dual pump– Relaxed mum: surfing the net, looking at

baby’s photo– Rest, eat well and drink plenty of fluids

STORAGE OF BREASTMILK

• Sterilizing equipment– All breast pump equipment should be sterilized– Steam sterilizer vs boiling vs microwave– Seal/pack equipment well for travel

• Storage options– Bottles: plastic or glass– Milk bags

HANDLING OF EBM

• Transportation– Cooler bags with ice pack

• Storage of EBM– Refrigerate EBM at 4C : 48H– Air-con room at 25C: 4H– Frozen EBM freezer of refrigerator: 3months

(store in small aliquots to reduced wastage)– Frozen EBM in separate deep freezer -19C:

6months

HANDLING OF EBM

• Preparation – Refrigerated EBM: warm up in lukewarm

water to the desire temperature (some babies can take cold milk)

– Frozen EBM: thaw either in water or by placing it at the normal compartment of the refrigerator.

– Frozen EBM needs to be consumed within 24H of onset of thawing and cannot be refrozen

TOUGH TIMES

• Bottle strike– Introduce the bottle after 3/52 old once

breastfeeding has been established and continue 3x/week

– Many types of teat available• Silicone vs latex teat• Wide neck vs ordinary teat• Rounded vs orthodontic shaped• Other: spoon feeding, syringe feeding and sippy

cup

TOUGH TIMES• Bottle strike

– Tips• Use EBM• Hold the baby away from carer and bounce baby

while walking and feeding• Nurse for awhile then slip in the bottle• Have someone else bottle her• Offer freq: when BB is hungry and not hungry

TOUGH TIMES

Nursing strike◦ Usually when baby is BF well and suddenly refuses to

nurse◦ Not to be confused with baby-led weaning which is

gradual◦ Causes

Mummy: different smell(changed soap etc), under stress Baby: discomfort (teething, OM, stuffy nose) Mummy and baby interaction: change of nursing pattern(eg

restarting work), reacted strong after being bitten and baby was frightened

◦ Solution EBM in the meantime with a good artificial teat with lots of skin

to skin contact

TOUGH TIMES

• Refusal of frozen milk– Usually occurs due to a soapy smell from fat break down in

excess lipase– Can consider scaling it-bringing milk almost to a boil then

immediately freezing it– Can consider “sneaking” it in via cereals or mixing with fresh

milk

• When you forget your equipment – Familiarize with the equipment available (disposable kit sets and

bottles)

BREASTFEEDING FRIENDLY WORK PLACE

BACK AT WORK• Location

– Ideally: private, quiet and clean– Range of options: depending on availability and

comfort level– Room with a lock, nursing room, bathroom (if there is

no other option), screen covering work station

• Storage– Refrigerator in pantry– Personal mini fridge– Cooler bags

BREASTFEEDING RESOURCES

BREASTFEEDING RESOURCES

• Internet

BREASTFEEDING RESOURCES

• Books

• Support groups