One of the biggest concerns for moms going back to work is that they won’t have enough milk for their baby while they are away. This needs to be tackled in two parts. Part 1 is about making sure to use the pumped milk wisely and not putting extra pressure on mom to pump more. Part 2 on how to maximize pumping at work is coming soon!
First let’s talk about the person caring for the baby. Above all, don’t let them waste your milk! A warning to moms leaving their babies with daycare providers, grandmas, and sometimes even dads: Everyone wants to soothe your baby, and without lactating breasts, they will want to use the pumped milk you left them. They will want to use WAY TOO MUCH. They will waste milk. They can’t help it. They see you nursing your baby when he or she needs something, and it always works. So they feed when they see a need. It is only natural to think a bottle will ‘fix it’. They also don’t know your baby like you do. They won’t know the little body movements that signal certain things. They don’t know their sleepy cues. They will interpret them as hunger—at first. But soon they will figure them out, with practice, like you did. They will learn what their patterns are, what their body language says, and will find their own way of meeting their needs without breastfeeding. This might take a few weeks. (Remember how long it took you to learn to breastfeed?)
However, in the meantime, here are a few strategies. First, bottle the milk in small amounts. If you believe your baby will eat 3-4 times a day during the time you are away, send 6 bottles with half the milk for each feed, or alternatively, send 3 bottles with the correct amount, and 2-3 more with just an oz. Here’s why. When a care provider heats up milk, they need to feed it to your baby. If baby doesn’t take it all, they often throw the rest away. BREASTMILK IS TOO VALUABLE TO THROW AWAY! So give them an out. If the baby seems to need a feed sooner than the typical schedule, have them offer the tiny bottle and see if that helps get baby to the next bigger feeding. They can always grab another if needed.
Example: Baby takes 4 oz approx. at each feed, about every 3 hours. Send 3 bottles with 3-4 oz, and 3 bottles with 1 oz each. That is 12-15 oz, which is a reasonable amount for a baby away from mom for 8-9 hours. Or you can send 6 bottles with 2 oz each, and see how the care provider uses them. That way if they heat up a bottle and don’t use the whole thing (missed a sleepy cue!) they will only waste an oz or so. Second, teach them to bottle feed in a way that supports breastfeeding. We call it Paced Feeding and it supports all newborns, but specifically breastfed babies who also take bottles while mom is away. Here is how to do it: Sit baby upright in a supported position. Offer the bottle nipple like the breast. Don’t push it into baby’s mouth but use the nipple resting against the upper lip and the bottle collar resting against the chin to trigger an open mouth reflex. Then roll the nipple in against the upper palette, which will likely trigger a sucking reflex. Here is the key; don’t angle the bottle upward. Keep the bottle horizontal, or at least keep the milk in the bottle level (approximately). As baby takes breaks, needs to breathe, or pauses to grin at you (!!!!), lower the bottle so the milk doesn’t flow in. Then resume when baby is ready.
I know what Grandma will say! They were taught that babies get air if the bottle is angled down. But the small bit of air is breathed out through the nose if the milk flow isn’t gushing into the baby’s mouth. If they are glugging away, they will swallow a ton of air trying to gulp the milk down at a fast past. Plus, they will likely drink more milk than they need if they are gulping. Don’t you? One more thing; watch for stress cues. Babies will flare their fingers, get the ‘big eyes’ look, purse their lips, or sometimes avert their gaze if they are drinking too fast or stressed by the feeding. If your care providers know what to look for, they will learn your baby so much more quickly. Here is more info on what we call ‘Baby-Led Bottlefeeding’: http://nurturedchild.ca/index.php/2010/12/10/baby-led-bottle-feeding/http://www.second9months.com/bottle-feeding-your-baby-sets-the-pace/ And some great info here for many of those bottle-feeding questions. http://www.breastandbottlefeeding.com/faq.html Remember that bottle feeding is difficult to plan out like breastfeeding; it is not the same. And for a daycare situation, keeping the milk at a safe temp and keeping the bottles clean and baby bacteria-free is a huge concern. So give them options until they figure each other out. (And try not to get mad at your mother-in-law for feeding baby so much. It is her love for baby coming out…she just can’t quite bottle it like you can!)