Breastfeeding and working
The women we spoke to faced a number of general decisions about going back to work, including whether or not to go back to work at all; when to go back; how many hours they would work; what kind of work they would do and where; and what childcare options were available to them. All of these decisions were in turn affected by the financial position of their family and government provisions for maternity leave. Because they were breastfeeding, they faced further difficult decisions about whether or not to combine continued breastfeeding and working outside the home, and if so how to manage the practicalities of this. Some women felt under pressure to stop breastfeeding before they and their baby were ready or to give up their right to return to work.
In 2001, the World Health Organization issued a global public health recommendation which said that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.
Returning to work does not mean that you have to stop breastfeeding. The NHS has produced a leaflet that answers common questions about working while pregnant and breastfeeding. In other European countries, breastfeeding breaks or shorter working days are available to women who are breastfeeding.
Returning to work was an emotive topic for everyone. Many of the women we spoke to went back to work not by choice but through necessity. However, some clearly enjoyed their job and intended to return and some changed their mind after their baby was born. Many, who could afford to, extended their maternity leave or changed their working arrangements (for example to part-time, self-employed or outside normal hours) so that they could stay at home with their baby for longer. A few said that they could not leave their baby because they needed to know what and how much he/she was eating and drinking.
She loved being a mum so much that she delayed her return to work for as long as she could.
I kind of hear a little bit of a reticence still about that.
There is a bit of a reticence about going back to work, I've got to work because, I've got to earn money, and one day, at the moment I live with my mum, but one day we want a house of our own, and we want nice things, and so I've got to, I've got to work, I've done the sums and I've got to work two days a week and so, Grace will have to understand that I'm trying to provide a better future for us, and there's nothing I can do about it. If I could wave a magic wand and win the lottery I would and I would never work again because I'd spend the whole time looking after Grace. But I can't, and there's lots and lots of women in that position so I've found a nursery that I like, I'm never going to think, 'Yeah this is brilliant, and it's better for Grace to be in here than with me', but sometimes you've just got to get on with it and, and find the best you can for your child and then think, 'Well they're going to have to, at least in the short term, go to nursery', and do everything to make them happy.
She preferred to stay at home with her children as her own mother did and was dreading going back...
I'm dreading going back to work, partly because I know he's nearly a year but I still feel like my place is to be with him, because there's so, he's learning, he's taking on everything, you can tell him 'clap, clap, clap' and he will for you, you can sing him songs and he knows the songs, we go swimming together, we go to mother and toddler groups together, he's a bi-lingual baby because he's being taught Welsh and English, and he will be educated through the medium of Welsh so there's so many things going on that I feel that I should be there with him, but unfortunately these days, having a mortgage and even providing the roof over [laughs] your head is a joint salary in order to do that so we both have to work and I've had a year off. My preparations for going back to work have been to see my manager to say I am returning, I have problems getting childcare for him because my cr'che at work is so over-subscribed. So he won't be able to be on the same site as me till he's one and a half, so the finding other suitable childcare has been a pressure and a nightmare. The not being with him is the bit that I can't quite emotionally come to terms with because somebody else is going to be feeding him his solids and I just can't imagine what that will be like not being with him for all those hours in the day, because we've always been together and even through the problems of breastfeeding we've always, together, in the car together, off to the hospital together, you know, it's like my little mate's not with me any more so it's very, it's very upsetting but it's something that's got to be done. But to be quite honest with you if there was a choice I would not be returning because I really feel my place is with him, and I would dearly love to have another child and I think my place is at home, because my mother was at home for our years up until we were eleven years old and went to secondary school. And we did so many fun things, you know, we learnt to read newspapers, we learnt about cooking, we were always round the kitchen table, they're very old traditional ideals [pause]. The things that I'm talking about can sound quite old and traditional and perhaps aren't particularly modern but I felt always that I had an extremely happy childhood and we weren't a very rich family, and just my father worked, and my mother stayed at home, but I know that that's not the position that I am the major bread winner, my husband is a freelance worker which means he goes from contract to contract so there isn't always the guaranteed income that my job and my salary provides for us as a family, so I know I have to return, but I have nightmares about it.
Nearly all of the women said that returning to work was stressful and talked about how hard it was to be separated from their baby. Trying to combine work and breastfeeding was also stressful for many people. Women talked about having to get up early to fit everything in before going to work. Many said that they became tired and their social life suffered. A few managed it without too much trouble through a combination of part-time work, advanced preparation such as expressing and storing breast milk, and just generally being very organised.
She went back to part-time work and left expressed breast milk for her son. It was easy for him...
How old was your baby when you went back to work?
How did you handle that? What, you know, how did you arrange it? What, what did you do?
Ah, it was pretty easy and pretty difficult, and I explained the two things. It was pretty easy because I'd only work five hours a week, that is to say, one Saturday morning, and one Tuesday evening, which wasn't much. So he was on his own for two hours at the very beginning, and, so in that sense it wasn't that difficult because it wasn't extensive periods of time for the two of them doing something he wasn't maybe feeling pretty sure about. And on the other hand, because for me it was very difficult to leave them, I had two hour classes and every time I had a class I phoned three, four times to see if they were doing okay. 'Cause it's a very difficult thing to do, and also because my Mum was here at the time, so when I said in my classes maybe, maybe sooner than a month my Mum was here supporting [husband]. And, so, I think my Mum has played his Mum's role as well, and, and she was a great help for him, and the four of them because they were, the four of them [includes her father] taking care of Luca while I was working giving the security of doing it on his own later when he had to do it on his own, and, and I think that's the way I managed and it was difficult because any time you have to leave your baby, even if it is with his Dad, my God, its like you're just tearing your heart apart, it's not that you don't trust your, your husband or your partner, it's that detaching from them is a difficult job to do. And I don't know who's more dependent, if the baby or you, I still don't know, because I think I'm very, let's say baby dependent [laughs] yes, it's very difficult to leave them but I was confident he was able to do it and it was only two hours.
So did you leave expressed breastmilk?
Yes I did.
How did you express the milk and when?
At the beginning it was very, it was pretty fresh milk, an hour before going to work I expressed.
By hand or by pump?
Electric or hand pump?
Hand pump. The first time I did it was quite, quite difficult, you have to, get to know how to manage your pump, but afterwards it was easy and you have to wait for the moment in which your breast is kind of fullish so, you can, you can get the milk easily. But after then I started working more nights so I had to do it in advance, and I barely ever freeze the milk, I know it's possible to do it and I know it's ok but I preferred to do, give the fresh milk, so I leave three or four bottles, I knew they were more than what he needed, for the time he had to be on his own, well I mean without me but, but it was mainly fresh milk.
And how did he feed that to the baby when you were gone?
He was fed with the bottle.
Through a bottle?
Through a bottle yeah.
So he didn't have any trouble taking the bottle?
No and I guess because I had to use the nipple shields, so he was used to the rubber and so, he didn't have a problem, my Mum was actually very surprised yeah, he ha
She got a bit panicked about going back to work until she realised that she would be at home...
So will he be in a cr'che?
Yeah he's going to be in the same nursery my daughter goes to, for three day, three full days.
So will you be able to get to him and do that feeding like you did with your daughter?
No, no unfortunately because my husband doesn't work for the hospital any more we can't get a place at the hospital nursery, although I have applied and there is a chance that I might get in, but so he's going to a nursery out here now rather than.
Away from where you work?
Away yeah, so there's no way I could come back to feed him, so and he doesn't have breastmilk at lunchtime he'll just have it mid-morning and mid-afternoon so I'll just leave a bottle and, I have contacted HR [Human Resources] at work and asked them for a room to go and express milk and somewhere to store it and they're looking into getting a room that they I can lock, there's a problem where our offices are none of them lock from the inside so, and I'm not prepared to go and express for him in the toilets 'cause it's, you know, it's his lunch it's not very.
So what sort of response have you had to that request?
Very positive, they haven't managed to locate anywhere yet, and I've actually suggested a few places and asked them to look into it, I've got, I've bought myself a cool bag to, you know, the ice packs just to, to keep it in so if there isn't a little fridge I can use to store it in I can always keep it cool myself, and then just put it in the fridge as soon as I get home it'll be fine, but I'm sure, I'm sure they'll be able to find me somewhere in the hospital.
Today is Thursday, you're going back to work on Monday?
Just talk me through all the feelings
The women employed a variety of feeding arrangements to accommodate their work situation. Some weaned their baby before the date of their return to work or waited to return until their baby was on solids and not breastfeeding so frequently during the day. Some continued to breastfeed when they were at home and provided a bottle of expressed breast milk or infant formula for their baby while they were apart. Many women expressed and stored breast milk in preparation for their return to work. Some women found expressing breast milk came fairly easily, especially if they had a good electric pump, but some found it difficult and tiring (see 'Variations of the breastfeeding experience'). Several women did not like expressing or were unable to express breast milk.
She regrets weaning her first baby to return to work but says that she will not make the same...
I can hear the regret obviously it's very, very strong.
How do you deal with that? How do you come to terms with it?
My way of coming to terms was it, with it was by not doing it again. that was my, the only thing I could do, I wasn't going to beat myself up about it and I can't, you know, at the end of the day I had a happy healthy baby and I can't, I can't complain about that, and everybody, if ever I did feel down, if ever I'd said, 'Oh I wish I hadn't stopped' that's exactly what everybody would point out to me is, you know, it's you that's feeling this not the baby,
Maryam used mixed feeding when studying at university. She breastfed her baby before leaving the house, and on her return from uni, and in between the baby was fed on infant formula.
Okay and what time sort of did you feed him in the morning or?
I feed him before I go to Uni.
Breastfeeding and when I come back immediately before I even take off my coat I feed him the milk…
And what motivated you to keep breastfeeding at the same time as sort of giving them the bottle?
Because really they told me is good for the children as well, yes and that’s what motivated me. And it’s easy, it’s easy and it’s cheaper you don't have to buy, yes so it’s easier so that’s why.
Easier because when you bottle-feed it’s more time consuming?
Yes and more time consuming you have to clean, you have to wash and sterilise the bottles and all this, so that’s why.
Okay so it’s not a, to be taken lightly. How did your friend sort of, you had friends that were also doing the same mix feeding?
Yes I had but really most of them they were doing the mixed feeding because of school or because when they go outside they can’t breastfeed their children in the bus that’s what made them to bottle feed their child.
A few women expressed during their work breaks, stored their milk in a refrigerator at work and then transported it in a cool bag. This maintained their supply and prevented problems with engorgement and leaking. Expressing at work raised practical issues such as finding a quiet, private room, having sufficient breaks and being able to refrigerate the milk*. Some employers were more supportive than others. One woman described how she had to explain her rights to her employers. They were willing to help but the woman had to take the lead (see 'Thinking about the breastfeeding environment').
A few women were able to breastfeed during breaks if their baby was in a crèche nearby or they could get home. One was able to take her baby with her to work, and another mentioned a friend who had done this.
She wanted her daughter to gradually get used to a bottle before she returned to work.
Because I'm concerned that when I go back to work it'll be harder for her, so I'd rather she got used to the bottle now, I'm quite happy if she wants more breastmilk in the form of expressed, I'll do that for her, if she doesn't take to formula but, she has to get used to me not being here, some, someone else is going to have to feed her, you know, whether it's a member of my family or my partner, someone's going to have to feed her and it, it might not necessarily be me. And if she's still attached to the breast when I'm at work it's not going to work, and it's to be more stressful for her, more traumatic.
How old will she be when you go back to work?
She'll be just about to hit twelve months.
And how do you feel about that?
I don't want to go back to work I'd like to stay at home, I wish I could stay at home, I've been lucky though 'cause I've had, I would have had nearly twelve months with her so I've been very fortunate.
So how do you feel about going back to work?
I feel, that I don't want to go back to work, I'd like to stay at home with her, I feel fortunate that I've had the time I've had with her, I'm aware that, things could've been different I might have to have gone, I might have had to have gone back within three to six months, but we were able to stretch it, because after six months it's unpaid, so it's pretty tough, but it was well worth it, because, this isn't time I can get back, these are memories that are going to be, you know, priceless basically, so it's pretty special for me, so I've, I just try and hold on to that really when I go back because bills have to be paid, but at least I've had this time with her, so.
She got a good breast pump for double pumping when she went back to full-time shift work, pumped...
Yes I went off to work full-time.
How did you manage that?
With difficulty, in fact when I first went out, back to work after having him I went back on shift, an early shift started at half past five in the morning, a late shift finished at ten past ten to midnight, in the evening, and that was hard work, that was really hard work.
Did you set up a routine of any sort?
To a certain extent I pumped, because I work in a factory, every two hours is a forced break if you like, the bell rings and we all go out to break and so every break I was pumping. And, I was pumping at home as well, there are several things that I wish I'd known when I started and I found doing the same when I went back to work with my daughter much easier because I knew these things, I knew to express in that first morning feed so you feed on one side, you express on the other at once.
Because each one stimulates the milk production in the other and he had much, much more and I wish I'd done that with my son but I didn't, and I think I would've struggled a lot less. I wish I'd have bought my expensive breast pump earlier, I bought it about half way through my son's feeding during the day when I was back at work.
What advantage does your expensive breast pump have over an inexpensive one?
It's a double.
So again you're stimulating both, each side is stimulating the other, my cheap electric one, is great, it works, but it's one, and it's just one side.
So it's more time-consuming?
It's more time-consuming and I was finding it very hard to stimulate let-down, very, very hard to get let-down, in fact I almost always wasn't and I was just getting dribbles all the time and not adding up to what he needed, and as soon as I phoned La Leche League and they said, “I think you need an expensive double breast pump” and I got it, and bingo, let-down.
How did you know?
Because the quantity of milk tripled [laughs] quite simply.
Could you feel the let-down happening?
No I couldn't.
Could you visually see the increase in milk flow?
Yes, yes I could definitely see that. But I didn't feel it, I did the second time around as I say with my daughter then it was, in, in some ways I think I was more aware with her so I was looking out for can I feel let down coming, and so I could.
And what did it feel like?
Tingly, like that tingling down the back of your spine when you, someone you love is giving you a massage.
Yeah, yeah rather nice [laughs].
And a tightening in the chest?
No, no, just a tingling that, I knew what was going on.
So, so I just want to get this, this going back to work routine straight, you fed in the morning on one side, pumped on the other, every two hours at work during the day…
Some women decided to introduce bottles of either expressed breast milk or infant formula to their babies in preparation for their return to work. In some cases, this went smoothly but several women said that they had great difficulty getting their baby to accept a bottle. Some said that their baby would take a bottle from someone else if they were not there but preferred to breastfeed if they were.
She did not consider working and breastfeeding. Giving up breastfeeding was an emotional time for...
Just kind of I wanted to have just a little bit more, have, you know, have a night out and someone be able to baby-sit, and just have a bottle just for that odd occasion, and also, I think because I was going to be going back to work so kind of feeling that it was the right thing to do start to gradually introduce bottles and not just be one hundred percent, it was kind of like I'd cracked the breastfeeding thing, it was working really, really well and now it was to gradually to take steps to sort of, like the transitional progress over into bottle feeding, because it was kind of imminent me going back to work that that would have to happen, in no way, shape or form did I think that I could possibly return to work and continue with full breastfeeding.
What made you think that?
I don't know I just, to me it wasn't, it wasn't something that I could even consider I don't, to me it just wouldn't, the two didn't work, to me the whole breastfeeding experience was being relaxed, being at home with my child and being there for my child, and I kind of think if I couldn't have done it that way then it wasn't the right way for me, you know, and it was kind of the weaning stage and introducing, you know, the beginnings of weaning so it all seemed to be the right time to gradually, not give up completely but to, to gradually start changing the pattern of things, and the fact that I was able to express milk so easily it was still my milk, but she wouldn't take a bottle, she would not take the bottle, it was horrendous we tried for weeks and weeks and weeks, we tried every single different teat, every different kind of bottle, we couldn't get a bottle into her, it took weeks and weeks and weeks, and in fact I think it was finally when I actually had to go back to work that it was a case of her having to take a bottle that eventually we just persevered and I think it was my husband's grandma that got her in the end, to take the bottle so, that was, that was. I have a friend who actually did breast and bottle right from the start and that kind of looking at her and the way she coped that, that was a good thing and that worked for her and obviously it was quite an emotional time for me because I enjoyed breastfeeding and my baby was telling me that it loved breastfeeding, yet it was other issues and other factors telling me that you had to have a plastic teat put in your mouth and learn to suck on that [laughs], I mean it was, you know, it was a difficult time but ah, not nearly as difficult as getting her to breastfeed in the first place so [laughs], I, yeah it, it kind of all happened eventually, it all coincided with weaning and me finding out I was pregnant again and probably I think I gave her a last breastfeed about six months, and that was when eventually I was, I was doing it so little that my milk just naturally dried up anyway, so she would just have a little suckle and then she'd have to have milk, formula milk afterwards anyway so it kind of just then I realised that that was it and you know, it sort of stopped then.
One woman spoke of a difficult situation when trying to cope with her lactating breasts in a working environment.
Her breasts became so full during a meeting that she had to go and express some milk. Eventually...
With a hand pump, yes I did because I went back to work when he was six months old, and I was still partially breastfeeding at that point and so I need to, to be continuing on with, with stimulating my supply of milk, and I remember [laughs] several incidents, sort of at work, trying to express milk and transport it on the train and.
Oh, I remember going to have a meeting with, with my boss before I actually returned from maternity leave in the preamble to going back and, it was a meeting with some quite senior people in a hospital, it was with a couple of chief executives from the NHS, and I was absolutely full of milk and I, you know, I had to go off into the Ladies and try and decant some of this milk off, while they were sorting out the tea and coffee. And as these things happen of course, you know, I spilt it and started leaking and, it was not an ideal situation but it was just the stage my body was at really, I wasn't quite at the point where the supply was reducing down. So yes I have, I have some memories of, of that and then with my little boy he did have milk from a bottle, expressed milk, I think probably from about four months, but only very occasionally when I wasn't literally physically there. I think I had one night at the theatre once and I left my mum with a bottle of expressed milk, that sort thing, but it didn't happen very often and I actually found expressing a real phaff [laughs], I didn't get into a very good routine with it at all.
And how did he take to the bottle?
My little boy took to it okay I think because we introduced it relatively early, we didn't have any problems with him on that score.
Right. So you went back to work at about six months?
Yes just part time.
How did you organise that?
We, in terms of breastfeeding I basically weaned him off breastmilk, pretty soon after I went back to work, because my work is not local, it's around the country and it means me being away from the house for twelve or so hours a day, on the days that I did work, and so it just wasn't practical to be trying to keep my supply going with such a sporadic sort of working pattern, and I figured I'd given him the first six months of breastfeeding which for me was, was the most important thing really and that any advantages beyond that were, were sort of diminishing in terms of the benefits he would get, so my decision was to just stop. I went back to work when my little girl was six months old, again'
And how did you manage that?
By that time I was actually working a period of notice out, so I was only, I was only working sort of two days a week to finish my contract, because I then went self-employed which was more flexible for hours. And so it wasn't as if I was going back to a very, very sort of busy time at work it was actually going back to serve three months notice, and whilst I was busy it, it was a different sort of pace really.
Right. So did you give your notice and decide to go self-employed because it was more flexible for the family, because it was easier to work that way?
It was a variety of reasons, it was mainly to allow myself to determine when I worked and to give myself the freedom to work le
*Footnote: Expressed breast milk should be refrigerated or frozen as soon as possible after expressing or kept in a cool bag until it can be refrigerated. It can be kept in the refrigerator for up to five days and in the freezer for up to six months. Further practical information on breastfeeding and working, and storing and transporting breast milk can be found via our pregnancy resources.
Last updated September 2015.