Dr Lisa J. Orchard is a Senior Lecturer at The University of Wolverhampton. Lisa specialises in cyberpsychology and specifically the psychology behind social media use. Here she discusses the subject of her talk for our conference in October – the impact of social media on breastfeeding.
A recent trend on Tik Tok sees the reaction of breastfeeding infants and toddlers when shown the sight of their mother’s breast. Their eyes light up in glee, as they crawl or toddle over for a snuggle and feed. An adorable sight; but what are the implications of the clip being shared on social media? Perhaps the video will attract a series of likes, shares and comments. Will this make the mother feel supported and empowered? Will she receive any negative comments, which could be detrimental to her confidence? What happens when a teenage girl stumbles upon the video? Perhaps she’s never encountered breastfeeding before. Will this be a positive introduction to seeing how a baby is fed?
The hashtag “normalisebreastfeeding” has been used over the last decade across social media to counteract some of the negativities surrounding breastfeeding. This cyberactivism demonstrates that there was always a hope that social media could be used in a positive manner to benefit breastfeeding promotion and support. This makes sense – social media is our ‘go to’ when finding new information or looking for someone to talk to, which is exactly what new parents need. The “new normal” of COVID-19 has meant an even stronger reliance on technology than ever before. However, to make the most out of social media, we need to take stock of content in order to understand its effect. We also need to consider who is using social media, as this will determine what content is seen.
Let’s start with the breastfeeding mother, who may actively search for breastfeeding support groups and information pages. How does she decide what group to look at? What kind of information does she see? What does she find useful? How accurate is the information? Now let’s consider other users, who may only encounter breastfeeding incidentally, through the sharing of a newspaper article or the viewing of a breastfeeding social media influencer. How often do they encounter breastfeeding content? Do negative comments impact on their opinion of breastfeeding? Do they learn about the benefits of breastfeeding from infographics and memes shared by friends?
Dr Wendy Nicholls and I have embarked on a research project to try and answer some of these questions. In our first study we conducted a review of research already looking at social media and breastfeeding to see what has already been found. The research so far suggests that breastfeeding families enjoy social media and find it useful for information and support. However, social media support does not always result in improved breastfeeding rates. Within our research we consider why this may be and suggest that it could be due to the content being seen. From looking across the studies so far, we can make suggestions about ways to improve this content. For instance, it is important for breastfeeding mothers to feel that information is credible and trustworthy. Furthermore, having relatable role models is important. People want to see other people like them breastfeeding.
Our second study is looking at one specific type of content – the breastfeeding selfie, aka the brelfie! We have been interviewing breastfeeding mothers who share brelfies to better understand what mothers think about brelfies and why they feel they are important to share. By finding this information we can hopefully understand the impact of this content and think about how we can use them more effectively.
Social media undoubtedly poses risks for breastfeeding, and not all content will be positive. However, if we understand the types of content available and how they may impact perceptions of breastfeeding, we can work on improving positive content, and minimising the risk of negative content.
We look forward to hearing more at our virtual conference on 24th October. Got your ticket? Click here:
In May 2020, researchers from Swansea University and Imperial College conducted research in collaboration with the Breastfeeding Network to explore families’ experiences of breastfeeding support during COVID-19.
Click the image to read the full report:
The following summary has been taken from the report, the full findings will be published in a journal later this year.
COVID-19 and lockdown has been a challenging time for breastfeeding families. Many have stopped sooner than they planned. Although this is unfortunately a common issue even outside of the pandemic3, many blamed a lack of support and lockdown experiences upon their decision to stop.
We know that breastfeeding works best when women receive high quality practical and emotional support from professionals and peers including in the community1. This support had to change once lockdown was in place, with breastfeeding charity organisations making rapid alterations to the way they delivered their service.
Some women were fortunate to be able to access this, evidenced by the multiple, varied queries they had answered during this time, covering both practical and emotional support needs. The majority of those who accessed this support found it useful and wanted it to stay, albeit alongside the benefits of face to face support once possible. For these women, their experience was positive, giving them easy and rapid access to support from the comfort of their homes. Notably, some women accessed this support over and above health professional support during the pandemic. It is clear that breastfeeding organisations provided a valued and needed service at this time – a finding reflected in similar previous research exploring the impact of the Australian Breastfeeding Association during this time4.
Unfortunately, two further groups of women did not have the benefit of this support including those who did not realise it was available, and those who accessed it but either struggled or had a strong preference for face to face provision. These women found a lack of in person care challenging, struggling to convey issues or with technology, or simply wanted the reassurance of someone in the room. It is likely these experiences are not equal; those with more resources and fewer challenges at home will find accessing different sources of support in during difficult times easier.
We found that women who did access charity support when they needed it were more likely to still be breastfeeding at the time of completing the survey compared to those who did not. To some extent their ability and willingness to seek support will in itself have supported these mothers’ ability to continue breastfeeding, most likely reflecting high motivation. However, given what we know about the impact of breastfeeding support for new families1, the range of queries posed to teams, and the positive experiences from some women in this survey, it is evidence that charity breastfeeding organisations have played an important role in ensuring mothers could continue breastfeeding through lockdown.
In terms of where we go from here, the good news is that online breastfeeding support services are working well for many women, helping them to breastfeed for longer. However, many challenges and questions have been set, with some of the answers likely outside the control or remit of organisations offering support. Namely:
- How do we ensure better promotion of availability of online breastfeeding support so that more families know they can access it?
- How do we ensure these organisations are well funded to be able to meet the needs of more women?
- How to we enable all populations to access online support, including those who may not be able to afford technology or high-speed internet connections?
- What is needed to recommence face to face breastfeeding support, given other public spaces such as restaurants and public spaces are open?
Given the known impact of breastfeeding upon population health5 and maternal wellbeing6, the government urgently needs to review its provision of care for new families, considering how it can ensure that more are protected in similar circumstances in the future. Although almost all mothers valued the option to receive online or phone support during lockdown, many expressed a wish for face to face support to continue. Recent press reports have stated that Health Secretary Matt Hancock wishes to encourage future virtual GP appointments unless clinical need, but caution must be urged in relying too heavily on a lack of in person support. It was clear mothers valued both the information they were being given, but also the warmth and connection from face to face support, and engagement with other mothers.
Finally, the impact of breastfeeding charities in supporting mothers practically and emotionally through this stressful period should be celebrated. They have served a community of new mothers, whom without their support may have had a much more challenging breastfeeding experience and likely a premature end to breastfeeding altogether. Their value and contribution must be recognised.
1. McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … & MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, (2).
2. Unicef UK (2020) Unicef UK Baby Friendly Initiative statement on infant feeding during the coronavirus (COVID-19) outbreak.
3. McAndrew, F., Thompson, J., Fellows, L., Large, A., Speed, M., & Renfrew, M. J. (2012). Infant feeding survey 2010. Leeds: health and social care information Centre, 2(1).
4. Hull, N., Kam, R. L., & Gribble, K. D. (2020). Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association. medRxiv. [preprint] – doi 10.1101/2020.07.18.20152256
5. Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., … & Group, T. L. B. S. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.
6. Brown, A. (2018). What do women lose if they are prevented from meeting their breastfeeding goals? Clinical Lactation, 9(4), 200-207.
7. BBC (2020) ‘More Zoom medicine needed’ in NHS says Hancock https://www.bbc.co.uk/news/health-53592678
In this blog, Kirsty and Geraint Davies explain how they used shared parental leave so Kirsty could return to work while continuing to breastfeed their son, Evan.
My son Evan was born in May 2015. I went back to work January 2016 as a deputy headteacher when he was 8 months old.
My husband is in the military (he was actually featured in Baby London a couple of years ago talking about SPL [shared parental leave]!) We confused everyone I think within our work places as we were one of the first to use SPL, as it came in for babies born from April 2015, however it was very easy to sort.
Evan was exclusively breastfed from birth and he never took a bottle or drank milk from any other source. To be honest, I did worry when I returned to work but I needn’t have. I use to breastfeed him before work (sometimes waking him up – much to my husband’s annoyance!), I would feed as soon as I got home and overnight as he normally would, whenever he woke up. On the days I didn’t work, weekends and holidays, I fed as ‘normal’ and responded to his and my own needs. Although Evan did not drink the milk, I did pump at work for my own comfort and as it could be used for food etc.
Evan breastfed until he was 22 months old, tandem feeding with his brother for a couple of months. We have since had two more children, both exclusively breastfed and I am now only feeding my youngest (8 months old). We have not done SPL again, not because we didn’t enjoy it or it didn’t work out, but just because of how timings of various things panned out. My husband loved having the opportunity to be at home with Evan. He says, “With SPL we got time to bond. It brought me and my wife closer; I saw things from her perspective and, similarly, it showed her life from my perspective. It made us more rounded parents.”
It’s great to hear of a family who have been able to continue their breastfeeding journey, and have used shared parental leave to their advantage.
Unfortunately there are no additional obligations for employers to make allowances for breastfeeding mothers returning to work as part of shared parental leave – breastfeeding employees are entitled to have somewhere to rest, and the HSE suggests it’s best practice to provide a private room for expressing breastmilk, but this is not a requirement. For more information on shared parental leave and breastfeeding from Maternity Action, click here:
For more information on how to arrange shared parental leave, click here:
For our guest blog by Dr Ernestine Gheyoh Ndzi on shared parental leave and breastfeeding, click here:
To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:
Statement issued by:
- Breastfeeding Network
- National Childbirth Trust
- Association of Breastfeeding Mothers
- UK Association of Milk Banks
- Lactation Consultants of Great Britain
- La Leche League GB
- Local Infant Feeding Information Board
- World Breastfeeding Trends Initiative
- Better Breastfeeding
- Baby Feeding Law Group UK
- Best Beginnings
- Swansea University
- Nursing Matters
- GP Infant Feeding Network
We want the new government to invest in the health of women and children by supporting and protecting breastfeeding.
The new government needs to prioritise the first 1001 days of a child’s life, from conception to age two, to enable children to survive and thrive. How an infant is fed and nurtured strongly influences a child’s future life chances and emotional health. Importantly, if a woman breastfeeds there are substantial health benefits for her – having impacts on her future long after breastfeeding has stopped.
Independent, practical, evidence-based information and support is essential for every family. Supporting women with breastfeeding can go a long way to protecting children and mothers from a wide range of preventable ill health, including obesity and mental health problems.
This window of opportunity cannot be missed for the future health outcomes of mothers and the next generation. In addition to well documented health outcomes, supporting breastfeeding will also contribute to a stronger economy – potential annual savings to the NHS are estimated at about £40 million per year from just a moderate increase in breastfeeding rates.
Support for breastfeeding is also an environmental imperative and recognition of the contribution breastfeeding can make to avoiding environmental degradation should be a matter of increasing global and political attention.
In the UK, the majority of women start to breastfeed but breastfeeding rates drop rapidly – our continuation rates are some of the lowest in the world and are even lower amongst women living in deprived areas, where increasing rates could make a real difference to health inequalities. Support for all women, parents and families with breastfeeding falls short of what is wanted and needed.
Women tell us they encounter difficulties with the public perceptions of breastfeeding out of the home. Families tell us they are still regularly exposed to conflicting messaging and marketing for formula milks that drowns out advice from healthcare professionals. Women tell us they receive little to no help with infant feeding and that their health visitors, midwives and doctors often have little training or knowledge about breastfeeding and limited time to support them. Recent cuts in health visitor numbers and breastfeeding peer support services mean many women may be left without the support they need however they choose to feed their infants.
Despite robust evidence showing that investment in breastfeeding support and protection makes sense, politically breastfeeding has been viewed by governments as a lifestyle choice and so left to parents to work out for themselves. For too many women, trying to breastfeed without support, or stopping before they want to, is deeply upsetting and the situation is made worse by fragmented care, and poor and often conflicting advice from those they are seeking to support them. To ensure an increase in breastfeeding rates, to help reverse obesity rates and to reduce widening health inequalities will require significant investment in breastfeeding.
It is essential that our new government prioritises breastfeeding and invests in its support and protection.
We call on all political parties to commit to the following actions, if elected:-
- To appoint a permanent, multi-sectoral infant and young child feeding strategy group and develop, fund and implement a national strategy to improve infant and young child feeding practices.
- To include actions to promote, protect and support breastfeeding in all policy areas where breastfeeding has an impact.
- To implement the Unicef UK Baby Friendly Initiative across community and paediatric services, building on the recommendation for maternity services in the NHS Long Term Plan.
- To protect babies from harmful commercial interests by bringing the full International Code of Marketing of Breastmilk Substitutes into UK law and enforcing this law.
- To commission, and sustainably fund, universal breastfeeding support programmes delivered by specialist/lead midwives and health visitors or suitably qualified breastfeeding specialists, such as IBCLC lactation consultants and breastfeeding counsellors, alongside trained peer supporters with accredited qualifications.
- To maintain and expand universal, accessible, affordable and confidential breastfeeding support through the National Breastfeeding Helpline and sustaining the Drugs in Breastmilk Service.
- To deliver universal health visiting services and the Healthy Child Programme by linking in with local specialist and support services.
- To establish/re-establish universal Children’s Centres with a focus on areas of deprivation, offering breastfeeding peer support.
- To make it a statutory right of working mothers and those in education to work flexibly as required and to access a private space and paid breaks to breastfeed and/or express breastmilk and manage its safe storage.
- To commit to resourcing for charitable organisations who play a key role within the health agenda working at a national and local level to support families and communities with infant feeding.
- To support the commitment to undertake an Infant Feeding Survey which builds on the data previously collected in the Infant Feeding Survey 2010 (now discontinued). To implement the recommendations of the Becoming Breastfeeding Friendly (BBF) study.
Case for Action
- Breastfeeding benefits all babies, and studies have shown that just a small increase in breastfeeding rates could cut NHS expenditure considerably. It is vital to invest in breastfeeding support in the early months and this will reap rewards in the future that are likely to exceed the initial cash flows associated with putting proper support in place.
- A UNICEF report states that “no other health behaviour has such a broad-spectrum and long-lasting impact on public health. The good foundations and strong emotional bonds provided in the early postnatal period and through breastfeeding can affect a child’s subsequent life chances”.
- Evidence has also demonstrated that a child from a low-income background who is breastfed is likely to have better health outcomes than a child from a more affluent background who is formula-fed. Breastfeeding provides one solution to the long-standing problem of health inequality.
- Research into the extent of the burden of disease associated with low breastfeeding rates is hampered by data collection methods. This can be addressed by investment in good quality research.
- Laurence M. Grummer‐Strawn Nigel Rollins, (2015), Impact of Breastfeeding on Maternal and Child Health. https://onlinelibrary.wiley.com/toc/16512227/2015/104/S467
- Borra C, Iacovou M, Sevilla A (2015) Maternal Child Health Journal(4): 897-907. New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions.
- Brown, A, Rance J, Bennett, P (2015) Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of Advanced Nursing72 (2): 273-282
- Li R, Fein SB, Chen J, Grummer-Strawn LM, (2008) Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics 122: S60-S76
- Joffe, N., Webster, F., & Shenker, N. (2019). Support for breastfeeding is an environmental imperative. BMJ 2019;367:l5646 https://www.bmj.com/content/367/bmj.l5646
- McAndrew F et al (2012) Infant Feeding Survey 2010
- NHS (2019) NHS Long term Plan https://www.longtermplan.nhs.uk/
- National Institute for Health and Care Excellence (2013) Postnatal Guideline NICE, London https://www.nice.org.uk/guidance/cg37
- National Institute for Health and Care Excellence (2012) Improved access to peersupport NICE, London
- Rollins N, Bhandari N, Hajeebhoy N, et al (2016) Why invest, and what it will take to improve breastfeeding practices? The Lancet387 491-504
- Wilson AC, Forsyth JS, Greene SA, Irvine L, Hau C, Howie PW. 1998 Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study. BMJ. Jan 3;316(7124):21-5.
- Brown, A, Finch, G, Trickey, H, Hopkins, R (2019) ‘A lifeline when no one else wants to give you an answer’ – An Evaluation of the BFN’s Drugs in Breastmilk service. https://breastfeedingnetwork.org.uk/wp-content/pdfs/BfN%20Final%20report%20.pdf
For further info, contact CEO@breastfeedingnetwork.org.uk
What’s it like being a student and a new parent at the same time? In this #MakingItWork real life story, Jenni tells us how she juggled study, part time work and breastfeeding.
“I was 20 when I got pregnant, 21 when I had my little girl and began our breastfeeding journey! I was in the middle of my foundation degree which I was going to night classes to finish – I was also working full time in Burger King while doing placements for my course, and moving house! I found that there wasn’t much support on breastfeeding and I went into it pretty blind. When my baby was 2 months old I returned to night classes, I had a bottle refuser so was actually bringing my little girl to class with me and then leaving her with my mum when possible and running over every 3 hours to feed her so I ended up missing out on a lot of course content. Then when she was 7 months I went back to work in Burger King, returning home on my lunch break to fill my little one with her favourite drink! I passed my course however! I was able to graduate from Stranmillis and get myself a new job in a day nursery, little one is now able to take a cup, however still nurses to sleep every night.”
It’s brilliant that Jenni was able to complete her course, and that she was sometimes able to bring her daughter to class in order to continue breastfeeding. But it may not always be a straightforward process – many student parents feel that they are, at best, overlooked by their college or university, and that more adjustments and allowances could be made. This article in the Guardian states that “Sixty per cent of student parents have considered leaving their course, a number which rises to 65% for single parents.”
Education institutions should make the same types of provisions as employers for women who are returning to study and wish to continue breastfeeding. A good first step is to talk to your place of study as soon as possible, telling them that you intend to continue breastfeeding after your return. For more information on the types of allowances that should be made, check out this blog post: https://www.breastfeedingnetwork.org.uk/breastfeeding-mothers-returning-to-work-top-5-tips/
It’s worth taking maternity and/or sex discrimination legislation into account too. The NHS/UNICEF Start4Life booklet, “Breastfeeding After Returning to Work or Study” states:
“The law protects students against maternity discrimination. This means that you are protected against unfavourable treatment because you have given birth in the last 26 weeks or are breastfeeding a baby under 26 weeks. Your course provider must not treat you unfavourably because you are breastfeeding. Unfavourable treatment could include refusing to allow you to take part in the course, refusing certain benefits or services or treating you differently. If your baby is over 26 weeks old it is likely to be direct sex discrimination if you are treated less favourably than you would have been treated if you were not breastfeeding.”
You can find more information on this subject here (breastfeeding information starts on p.17): http://www.ecu.ac.uk/wp-content/uploads/external/student-pregnancy-and-maternity-implications-for-heis.pdf
In summary, returning to study shouldn’t be a barrier to breastfeeding, and vice versa. As one student stated in the article quoted above, “Student parents make fantastic students. You can’t balance a degree and the overwhelming job of parenting without being hardworking and resilient. I’m even more determined to succeed now I’m studying for my daughter’s future, as well as my own.”
To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:
In this #MakingItWork case study, Emma tells us how she went about discussing adjustments to her work pattern with her employer.
“My company weren’t really informed regarding my rights however they were so accommodating about whatever my needs would be that I initially didn’t have to think about what my rights were. I’m now into my sixth month of being back at work full time and still exclusively breastfeeding (baby is 14 months old). My employer makes time for me to pump through the day however the nature of my job requires me to be away from home. This is where I have had to do my own research regarding my rights whilst breastfeeding in full time employment as my company was expecting me to be away quite a few consecutive overnights which I couldn’t accommodate due to breastfeeding.”
It is down to each individual employer to decide what adjustments they will make for breastfeeding mums returning to the workplace, though there is guidance in place from the Health and Safety Executive (HSE) and European Commission, as well as organisations such as ACAS.
The HSE states:
Employers have certain obligations towards their employees once they have been notified in writing that she is a new or expectant mother. When an employee provides written notification (regulation 18 of MHSW) to her employer stating that she is pregnant, or that she has given birth within the past six months or that she is breastfeeding, the employer should immediately take into account any risks identified in their workplace risk assessment. If that risk assessment has identified any risks to the health and safety of a new or expectant mother, or that of her baby, and these risks cannot be avoided by taking any necessary preventive and protective measures under other relevant health and safety legislation, then employers must take action to remove, reduce or control the risk.
If the risk cannot be removed employers must take the following actions:
- Action 1 – Temporarily adjust her working conditions and/or hours of work; or if that is not possible
- Action 2 – Offer her suitable alternative work (at the same rate of pay) if available, or if that is not feasible;
- Action 3 – Suspend her from work on paid leave for as long as necessary, to protect her health and safety, and that of her child.
It can be argued that stopping breastfeeding before the mother and child are ready could present a risk to their health (since breastfeeding has a number of proven health benefits – see here, here and here), so if an employee wishes to continue breastfeeding her child, her employer should take action to adjust her working conditions to allow her to do so.
The employee may also wish to consider requesting flexible working in order to accommodate breastfeeding. More details on how to do so can be found here: https://www.gov.uk/flexible-working
Employers can find more information and guidance on our website, including details of how to join BfN’s Breastfeeding Friendly Scheme. Click here: https://www.breastfeedingnetwork.org.uk/more-information-for-employers/
To read more about Making It Work, BfN’s campaign for breastfeeding mothers returning to work or study, click the image below:
Gemma Scott is a registered midwife and health visitor, and currently works for Plymouth City Council Public Health Team. Since her work focuses on children and young peoples’ health, she was familiar with some of the challenges she might face when returning to work as a breastfeeding mum – but what happens if you find it difficult to express milk when you’re away from your child? As she discovered, it needn’t spell the end of breastfeeding.
Some of the most common questions I see mothers asking about returning to work are,
How much breastmilk should I leave with my child?
How often should I pump?
I don’t have enough expressed breast milk, do I need to switch to formula?
My own experiences of returning to work whilst both my children were still feeding (around the clock!) and both around 9 months old, suggest these issues might not matter as much as you would think
Personally, I could never pump a huge amount of milk no matter how hard I tried. I have spent a whole week pumping a measly 100 mls for my daughter! And do you know how much of that precious liquid gold she drank? ZERO, choosing instead to have cups of water, solid food and cuddles with her nanny instead. I’ve tried, pumping and hand expressing religiously in office spaces, cafes, supermarkets, the car and everywhere else in between, terrified that my supply will dwindle whilst away from child, all to no avail. So, as you can gather, none of this stuff worked for me, …but something did, as we continued through our breastfeeding journey well into their toddler years.
Instead, I’ve learned that some good questions might be,
Who or what is my support system?
How can my support system adapt to support me on my return to work?
So, who or what was my support system? Well, it was completely a team effort and it began well before the babies came along.
Preparing my employer and particularly my immediate colleagues for the fact that I would be breastfeeding on my return to work was so important. The ‘what’ of course, was an HR policy which supported me as a breastfeeding mother – so do find yours and if there isn’t one, start asking some questions! Alongside this, during pregnancies I made sure that my work mates knew how important breastfeeding was to me, and how I might need to manage that on my return. In my case I did make it very clear that I would need to go out of the office to either express or feed my baby during regular breaks.
I kept in touch with my colleagues during maternity leave. I took opportunities to bring baby in to work to for events and occasional meetings when I could and so, my children became part of my work identity. I believe that this made it easier for my work system to adapt around me and be empathetic to my needs as a parent. I can recall a number of corporate events where I attended with baby in a sling, who was of course then passed continuously around everyone in the room. I mean, who doesn’t love a cuddle with a baby?!
It wasn’t only my employer who was prepared for the need to adapt and support us, but my partner’s also. By asking to flex his hours around our family well before baby arrived, he was able to work a shorter week and to be at home more as needed. By being provided with the necessary IT and diary considerations, he was supported in supporting me. On his days at home if I wasn’t able to get away from the office for some reason, he would often bring baby to me for a breastfeed. Working in a fairly male dominated sector, he was initially reluctant to request this change to his schedule presuming that it would not be approved or, that it wouldn’t be a priority; but of course it was, so do ask!
By also having additional childcare close to work, I was able to organise my day around visits for breastfeeds, never being further than a 5 minute drive away. There were times when I would arrive and baby would be too busy to be interested in feeding, or fast asleep, but to arrive and see that they were happy and settled that was always good enough for me. It wasn’t long before myself and baby were ready to be separated for a little longer, but the transition felt like a process that we were both very much in control of.
Of course looking back, I was very lucky! I had good relationship with my employer, as did my husband. We had childcare from someone we knew and trusted. We had choices. I know unfortunately that this is not the case for lots of families, but some of the questions we asked and the steps we put in place, might be just a bit easier than the challenges women like me face with pumping, storing milk and being physically away from baby for the day.
We know that given the right support baby and mum will adapt around each other, it’s actually up to everyone around us to make sure it happens.
As part of our #MakingItWork campaign, Emma Pickett (IBCLC and chair of the Association of Breastfeeding Mothers) gives her take on the process of returning to work as a breastfeeding mum – from the practical to the more emotional aspects.
The first few weeks are often a blur for new mums. The learning curve is steep and you survive day to day – remembering to shower and put food in the fridge for yourself if you are lucky. For those mums still in the middle of that blur, the thought of the eventual return to work can be one that provokes anxiety.
You can’t imagine how it will feel to leave this new special person in your life.
How do you people cope with drop-offs to childcare and getting back to work after potentially several night-wakings?
What do you do if you don’t want to give up breastfeeding?
As a breastfeeding counsellor and lactation consultant, I’ve been supporting breastfeeding mums on their return to work for the last 6 years and there are a few things that are worth bearing in mind.
Here are my SIX top tips for returning to work as a breastfeeding mum.
1. Don’t think about it.
OK, now I don’t mean that too literally. My message is just that if you are going to take 6 months, 8 months or a year off work and you spend several months of that stressing about the return to work, you will be seriously missing out.
STOP yourself thinking about it too much. If you stare at your gorgeous three month old and think fleetingly, “How can I ever leave you?” (which is how nature very much wants you to feel), that is fair enough. But if you spend chunks of your maternity leave feeling anxious and worrying about practicalities, you will be wasting the special times you do have together.
This time is precious. Your baby now is not going to be the same person when you return back to work. They will sleep differently, feed differently, and interact differently. You will not be leaving THIS baby but an older one. So get your childcare sorted (which you may well have thought about in pregnancy anyway) and other than that, there’s not too much more to do! If you intend to express milk at work, it’s a good idea to write to your employer about 2 months before you go back to work to talk about arrangements. And then just carry on as normal. If your 4 month old baby won’t take a bottle and that starts you panicking because you have to go back to work at 8 months, don’t think about it. An 8 month old baby can breastfeed when you are with them in the morning and evening, take a sippy cup, drink from an open cup – you will have options. And a four month old baby that refuses a bottle may not if you try again after leaving it for a few weeks. It’s very easy to set yourself into a panic when the truth is that things usually work out with the right information and the right support.
2. As mentioned, speak to your employer.
The recommendation is that you inform them that you will be returning to work as breastfeeding mum so they have a chance to assess your health and safety and what provisions you may need. Your employers are required to keep you safe. They also have a legal requirement to allow you to ‘rest’ as a breastfeeding mother. Sadly, in the UK, there is not a clearly established legal right to express breastmilk at work and it’s important you talk to your employer so they have advanced warning and you can come to an arrangement. Some women need to have break times re-organised or a room found. Although there is no ‘legal right’ the VAST majority of employers understand that it is in their interests to try and meet your needs and provide you with facilities. Your morale matters and a baby receiving breastmilk is less likely to suffer from illness meaning less time off work for you. There are health and safety executive recommendations and many employers understand the benefits of supporting you as much as possible. However, employers will be more likely to be accommodating if you give them warning and explain your needs clearly.
3. Talk through your schedule with a breastfeeding counsellor or lactation consultant.
Drop-ins are not just for people with problems with positioning and attachment. It’s really common for a mum to come along a few weeks before their return to work to talk about how they hope to organise their feeding and pumping schedule and how to organise things practically. I’ve included some typical scenarios later on.
4. Practise pumping.
Is the breast pump you are using a home something you are familiar with? Do you have a backup if you need to pump at work? Is it worth sourcing a double pump if time is an issue or even hiring a hospital grade electric breast pump for a few months which can just stay at work? You’d be looking at paying around £45 a month (http://www.ardobreastpumps.co.uk/breastpumps_for_hire)
There are tricks such as preparing the breast using massage and warm compresses. And we know that women who finish a pumping session using hand expression techniques can increase their output considerably.
It’s also not a bad idea to build up a bit of a freezer stash before you go back. If you start pumping for one extra session each day and storing that in a freezer bag (store them flat and build up layers of thin flat bags which defrost more easily and take up less space), you will have some wiggle room if you need it. It’s not entirely predictable how pumping will go at work and some women find that their pumping output decreases towards the end of the week and then a weekend of normal breastfeeding boosts it back up again. If you have that freezer stash, it will take away some of their anxiety.
5. Get your kit.
So you need a pump and some bottles and some breastmilk storage bags. What else? Surprisingly not much. You don’t need to store freshly expressed breastmilk in the fridge at work if you don’t want to. You can have a freezer block and an insulated bag and put any expressed milk in there. It is fine in that for 24 hours. So if you store it like that at work, put it in the fridge when you get home, then that milk can be given to your baby’s carer for the next day.
It’s also really important to note, you don’t need to wash and sterilise the pump between pumping sessions. Breastmilk is fine at room temperature for up to 6 hours. So you certainly don’t need to wash a pump between your 11am pumping session and your 2pm one. Lots of working mums use a technique called ‘wet-bagging’, putting a pump in a plastic bag between sessions and then putting it back in the fridge. Then simply take it out next time and wipe any wet parts with paper kitchen towel if you don’t fancy cold drips against you! This also saves precious time.
6. Breastfeed when you can.
Your supply is more likely to be maintained if you breastfeed when you get the chance. Is your childcare near work or home? Could you visit your baby at lunchtime? Could you work from home for one day a week for the first few weeks? You could breastfeed early in the morning, then once more at drop-off, once more at pick-up and again at home later in the evening. Those 4 feeds would be enough breastmilk overall for a baby of 8 months or more. You may not need to be carrying bottles back and forth. And breastfeeding at the weekends and during holidays will help to boost your supply.
Here are the stories of three mothers I have supported (names and some details have been changed):
Carla is going back to work full-time at 6 months. Her son is an enthusiastic exclusive breastfeeder and she’d like to avoid using formula if she can. When her son is 4 months old, she writes to her boss (she is a PA in a law firm) and explains she would like to express her milk at work. Her boss explains the company procedure of having a small office set aside for pumping and there is also a fridge available. Carla explains she intends to express around 3 times in the working day and one of those times will be during her lunch break. Her boss is fine with that. She has a double electric pump which she starts using from 4 months and she gives her son a bottle every other day to get him used to it. She finds he prefers to sit a bit more upright and usually takes 3-4oz from the bottle.
She starts solids around 10 days before she goes back to work and he takes small amounts initially and Carla knows his breastfeeding schedule will remain unaffected for a while. The week before she starts work, they visit the nursery together and he has a few hours there. He then has two trial days where Carla practises her expressing schedule and the nursery workers give him a bottle and some solids.
On her working day, she breastfeeds him as normal at 6am. She drops him off at nursery at 7.45am and offers again and he takes a small feed. At work she expresses at 11am, 1.30pm and 3.30pm. She collects her son from nursery at 6pm. He is keen to breastfeed when she arrives and they breastfeed at nursery. She breastfeeds him again at home at around 10pm as a dreamfeed. He wakes once at around 2am and she breastfeeds him again.
While he is at nursery, the carers give him bottles and offer solids and he usually takes around 12oz in total while they are separated. As he has 3 good breastfeeds in addition to that in 24 hours, Carla isn’t worried. Carla expresses more milk at work than her son takes in a bottle at the moment. Over the next few weeks, she moves to expressing only twice. Carla ends up offering exclusive breastmilk until 12 months and then she gradually introduces cow’s milk.
Phoebe is returning to work at 10 months. She is a graphic designer and works from home with some client visits necessary around London. Her daughter breastfeeds around 4 times in 24 hours and enjoys solids which she started at 6 months. Phoebe doesn’t enjoy pumping and finds it difficult so would rather avoid it if possible. She finds a child-minder who lives near her home. Phoebe breastfeeds at 8.30am and drops her daughter at the child-minder. If she is working from home she visits at lunchtime for another breastfeed. She then collects her daughter at around 4pm and takes her home to breastfeed at 6pm and around 11pm. While her daughter is at the child-minder, she eats solid food and drinks water. The child-minder doesn’t give her milk. When Phoebe has a client visit, she sometimes hand expresses for a few minutes into a plastic bag when she can grab a private moment. This is just to stay comfortable when she feels particularly engorged. This will help to reduce her risk of blocked ducts and mastitis and help to maintain her supply. She doesn’t keep the milk. Phoebe continues breastfeeding her daughter until she is 18 months old. At the end she is only breastfeeding in the morning and evening and Phoebe doesn’t feel the need to use any hand expression when they are separated.
Catherine is returning to work at 8 months. Her son breastfeeds around 6 times in 24 hours. He started solids at 6 months. He doesn’t particularly like bottles and usually only takes around 2oz max. Catherine finds that he will take more milk from an open cup called a doidy cup. He will also more likely to take it if she mixes the breastmilk with ripe banana and makes a smoothie! Catherine gets through a lot of bananas! She works 4 days a week (and at 12 months will go back to being full time). Catherine is a teacher. Her headteacher has struggled to find her a private room for pumping but has given her the key to the medical room and if that is in use, she uses a stock cupboard and she has told staff that when her scarf is on the door, please knock! Usually the medical room is empty. Her colleagues have agreed to relieve her of playground duty while she is breastfeeding. She breastfeeds her son at 5.45am and again at 7.45am at the child-minder. She arrives at school at 8.15am. She expresses at 10.45am during morning break. She expresses for 10 minutes. She expresses again at lunchtime for 15 minutes and at around 4pm for another 10 minutes. She has to use a double pump as her pumping time is restricted. She remains at school for meetings and lesson preparation and collects her son at around 6pm. She breastfeeds him at 7pm and 10pm. He wakes to feed between 1-2am and Catherine is happy for that to continue for the time being as he feeds and goes back to sleep quickly.
With the child-minder, her son takes around 3oz of breastmilk in his smoothie, 2oz mixed into a porridge and another 1-2oz from his doidy cup. She also makes sure his solids contain good sources of fats and calcium. Sometimes she struggles to pump in her breaks as she really needs to continue working. She finds herself dipping into her freezer stash and as time goes on, the child-minder sometimes uses formula to make up the porridge. On the weekends and on her day off, he breastfeeds more frequently.
There are many women who effortlessly combine breastfeeding and working. If it sounds hard, remember that in the USA there is no statutory maternity leave and women often return to work after just a few weeks. However they have 16% of babies exclusively receiving breastmilk at 6 months and the UK manages 1% (http://www.cdc.gov/breastfeeding/pdf/2012BreastfeedingReportCard.pdf).
Working and breastmilk are not incompatible. With modern electric breast pumps and using breastfeeding support available locally and through the National Breastfeeding Helpline, it’s never been easier. However if we could get the statutory right to pump at work it would certainly help. Contact your MP if you feel the right to express at work (as exists in 92 countries throughout the world) is something UK mums should be entitled to.
This article was originally published on Emma’s blog, here, and is reproduced here with her permission.
In the first of our #MakingItWork real-life case studies, Jade tells us about the issues she faced when returning to work, when her daughter was 9 months old.
“I returned to work at my local special needs school. During my back to work meeting, I discussed my need for expressing breaks and a place to go, I was told “I’m sure there is a bathroom you can use” by the assistant head teacher. Obviously I made her aware this is unacceptable and I require a private area to use. It was arranged that I use the medical room, my half hour expressing break was interrupted on more than 4 occasions, one of these times causing me to spill the milk I had spent time pumping. I then fought for 3 more months to find a room every day, despite there being a whole school full, I was told it was not possible to book out a meeting room, or have the same room each day. So on my lunch break every day I would traipse around the school, find an empty room, stick my “expressing mother” sign on the door and do my thing.”
Unfortunately, this isn’t an uncommon story. The law does not currently allow a simple, straightforward right to breastfeeding breaks, though employers are required to provide a place for breastfeeding mothers to rest. The Health and Safety Executive and guidance from the European Commission recommend that employers should provide:
- access to a private room where women can breastfeed or express breast milk;
- use of secure, clean refrigerators for storing expressed breast milk while at work, and
- facilities for washing, sterilising and storing receptacles.
The ladies toilet for example is never a suitable place in which to breastfeed a baby or collect milk.
ACAS guidance also gives the following advice to employers when asked to consider additional breaks for breastfeeding:
“Employers should consider providing short breaks for breastfeeding or expressing milk, weighing it up against the likely impact it might have on the business. Employers should be careful not to discriminate against breastfeeding employees. If employers are unable to grant additional breaks, they could consider slightly extending normal breaks for the employee such as a mid-morning coffee break or leaving earlier in the day to minimise any disruption to the business.”
Each employee will need to have a discussion with their employer – preferably in advance of their return to work – but hopefully this guidance will be helpful in these negotiations, and helping your employer to understand your needs and their obligations.