Breastfeeding and Your Career: It's Possible!
by Nona D. Andaya-Castillo, IBCLC
Marites Sobeng, a life insurance agent, Pam Magallon, an event organizer and Joanna Llabres, a flight stewardess, are among many mothers who combine their career, motherhood and breastfeeding successfully. Despite their demanding jobs that take them away from home for 2-5 days, they were able to exclusively breastfeed their babies and were able to sustain breastfeeding beyond three years.
The World Health Organization (WHO) and many medical professional organizations like the American Academy of Pediatrics recommend exclusive breastfeeding for the first six months of life and continued breastfeeding up to two years and beyond. Exclusive breastfeeding means the baby does not need anything but breastmilk. (I suggest to my patients who have family histories of allergies to extend exclusive breastfeeding up to seven months if the baby has no problem in weight gain. Many of them have done so successfully.) In 1986, amidst the massive sales and marketing of formula milk, the WHO declared: The use of follow-up milks is not necessary. Instead, as soon as the baby is ready to eat at six months, mothers are encouraged to prepare babyfoods using indigenous vegetables, whole grains and fruits.
With these recommendations, social and family supports are very critical in meeting the demands of motherhood and career. After all, mothers have the right to work and workers have the right to motherhood. A father plays a crucial role in ensuring that his wife breastfeed their baby. He and other members of the household can either undermine her determination or boost her morale to sustain breastfeeding. Innocent comments like “Maybe the baby is not getting enough milk”, “Are you sure you have milk?” or “Do you already have milk?” can devastate a woman’s confidence that will lead to worries and breastfeeding problems.
At the workplace, a mother has the right to breastfeeding breaks. International standards now recommend 14 weeks paid maternity leave as well as the provision of daycare so mothers can bring their babies to work. Hopefully, mothers can unite together so that we can lobby for these international covenants to become part of our national laws.
At the personal level, we have to understand the intricate way on how our bodies produce breastmilk, what can trigger or stifle its production and use this knowledge to help our body respond to our need to breastfeed.
Breastmilk production starts from the brain, the pituitary glands produces the prolactin and oxytocin the two hormones responsible for the production and let-down of breastmilk. That is why it is so important to relax during breastmilk expression. I usually explain to my patients how our bodies respond to stimuli this way: Let us imagine that you are inside your room and somebody is sautéing in the kitchen. When the aroma of the garlic, onions and tomatoes wafts into the room; when we hear the sizzling of the dish; or when we imagine what the dish looks like; we start to salivate, our stomach grumbles and we feel hungry.
This response is very similar in breastmilk production. I call the stimuli the 6S: the Suckling, the Sight, the Scent, the Skin and the Sound of the baby can prompt our body to produce milk. I clearly remember a time when I was breastfeeding and I heard another baby cry inside the bus, immediately, I felt my breasts throbbed and I had a letdown.
The sixth S is spirituality: if we believe in our body’s tremendous capacity to nurture, heal and regenerate as perfectly designed by God, if we trust His promise of abundance and His assurance that no one will get hungry, then we can produce the all breastmilk our baby needs.
The simultaneous stimulation of the senses will help us during milk expression when we are at work. Here are some tips:
The Academy of Breastfeeding Medicine (ABM), an international organization of doctors who are avid breastfeeding advocates and experts in assisting mothers to breastfeed developed the following pointers in ensuring problem-free storage of your precious breastmilk.
Breastmilk Home Use for Healthy Full Term Infants
Storage Containers
1. Hard-sided containers, such as hard plastic or glass, are the preferred containers for long-term human milk storage. These containers should have an airtight seal.
2. Plastic bags specifically designed for human milk storage can be used for short term (less than 72 hours) milk storage. Use of plastic bags is not recommended for long-term storage as they may spill, leak or become contaminated more easily than hard-sided containers, and some important milk components may adhere to the soft plastic and be lost.
General Guidelines
1. Hands must be washed prior to expressing or pumping milk.
2. Use containers and pumping equipment that have been washed in hot, soapy water and rinsed. If available, cleaning in a dishwasher is acceptable; dishwashers that additionally heat the water may improve cleanliness. If a dishwasher is not available, boiling the containers after washing is recommended. Boiling is particularly important where the water supply may not be clean.
3. Store in small portions to minimize waste. Most breastfed babies take between 2 and 4 ounces (60-120 ml) of milk when beginning with an alternative feeding method. Storing in 2-ounce (60 ml) amounts and offering additional amounts if the baby is still hungry will prevent having to throw away unfinished milk.
4. Consider storing smaller size portions [1-2 ounces (30-60 ml) each] for unexpected situations. A small amount of milk can keep a baby happy until mom comes to nurse the baby.
5. Several expressions throughout a day may be combined to get the desired volume in a container. Chill the newly expressed milk for at least 1 hour in the main body of the refrigerator or in a cooler with ice or ice packs, and then add it to previously chilled milk expressed on the same day.
6. Do not add warm breastmilk to frozen milk because it will partially thaw the frozen milk.
7. Keep milk from 1 day separate from other days.
8. Do not fill the container; leave some room at the top because breastmilk expands as it freezes.
9. Label containers clearly with waterproof labels and ink, if possible.
10. Indicate the date that the milk was expressed, and the child’s name (for daycare).
11. Expect that the milk will separate during storage because it is not homogenized. The cream will rise to the top of the milk, and look thicker and whiter. Before feeding, gently swirling the container of milk will mix the cream back through again. Avoid vigorously shaking the milk.
12. The color of milk may vary from day to day, depending on maternal diet. It may look bluish, yellowish or brownish. Frozen breastmilk may also smell different than fresh breastmilk. There is no reason not to use the milk if the baby accepts it.
Milk Storage Guidelines
1. Milk may be kept at room temperature (up to 77°F or 25°C) for 6-8 hours. Temperatures greater than 77°F (25°C) may not be safe for room temperature storage. Containers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler.
2. Milk may be stored in an insulated cooler bag with ice packs for 24 hours.
3. Milk may be safely refrigerated (39°F or 4°C) for up to 5 days.6 Store milk in the back of the main body of the “fridge” or refrigerator, where the temperature is the coolest.
4. The type of freezer in which the milk is kept determines timetables for frozen milk. Generally, store milk toward the back of the freezer, where the temperature is most constant. Milk stored for the longer durations in the ranges listed below is safe, but there is some evidence that the lipids in the milk undergo degradation resulting in lower quality.
5. Above guidelines apply only to healthy, term infant; guidelines are different for hospitalized, sick or preterm infants.
Thawing or Warming Milk
1. The oldest milk should be used first.
2. The baby may drink the milk cool, at room temperature, or warmed.
3. Thaw milk by placing it in the refrigerator the night before use or gently rewarm it by placing the container under warm running water or in a bowl of warm water.
4. Do not let the level of water in the bowl or from the tap touch the mouth of the container.
5. Milk may be kept in the refrigerator for 24 hours after it is thawed.
6. Never use a microwave oven or stovetop to heat the milk, as these may cause scald spots and will also destroy antibodies.
7. Swirl the container of milk to mix the cream back in, and distribute the heat evenly. Do not stir the milk.
8. Milk left in the feeding container after a feeding should be discarded and not used again.
9. As with all foods, do not re-freeze breastmilk once it is thawed or partially thawed.
When thawed, breastmilk should be used within 24 hours. Please do not throw away excess breastmilk. Even a single drop is very precious. Here are a few suggestions on how to make use of it:
The World Health Organization (WHO) and many medical professional organizations like the American Academy of Pediatrics recommend exclusive breastfeeding for the first six months of life and continued breastfeeding up to two years and beyond. Exclusive breastfeeding means the baby does not need anything but breastmilk. (I suggest to my patients who have family histories of allergies to extend exclusive breastfeeding up to seven months if the baby has no problem in weight gain. Many of them have done so successfully.) In 1986, amidst the massive sales and marketing of formula milk, the WHO declared: The use of follow-up milks is not necessary. Instead, as soon as the baby is ready to eat at six months, mothers are encouraged to prepare babyfoods using indigenous vegetables, whole grains and fruits.
With these recommendations, social and family supports are very critical in meeting the demands of motherhood and career. After all, mothers have the right to work and workers have the right to motherhood. A father plays a crucial role in ensuring that his wife breastfeed their baby. He and other members of the household can either undermine her determination or boost her morale to sustain breastfeeding. Innocent comments like “Maybe the baby is not getting enough milk”, “Are you sure you have milk?” or “Do you already have milk?” can devastate a woman’s confidence that will lead to worries and breastfeeding problems.
At the workplace, a mother has the right to breastfeeding breaks. International standards now recommend 14 weeks paid maternity leave as well as the provision of daycare so mothers can bring their babies to work. Hopefully, mothers can unite together so that we can lobby for these international covenants to become part of our national laws.
At the personal level, we have to understand the intricate way on how our bodies produce breastmilk, what can trigger or stifle its production and use this knowledge to help our body respond to our need to breastfeed.
Breastmilk production starts from the brain, the pituitary glands produces the prolactin and oxytocin the two hormones responsible for the production and let-down of breastmilk. That is why it is so important to relax during breastmilk expression. I usually explain to my patients how our bodies respond to stimuli this way: Let us imagine that you are inside your room and somebody is sautéing in the kitchen. When the aroma of the garlic, onions and tomatoes wafts into the room; when we hear the sizzling of the dish; or when we imagine what the dish looks like; we start to salivate, our stomach grumbles and we feel hungry.
This response is very similar in breastmilk production. I call the stimuli the 6S: the Suckling, the Sight, the Scent, the Skin and the Sound of the baby can prompt our body to produce milk. I clearly remember a time when I was breastfeeding and I heard another baby cry inside the bus, immediately, I felt my breasts throbbed and I had a letdown.
The sixth S is spirituality: if we believe in our body’s tremendous capacity to nurture, heal and regenerate as perfectly designed by God, if we trust His promise of abundance and His assurance that no one will get hungry, then we can produce the all breastmilk our baby needs.
The simultaneous stimulation of the senses will help us during milk expression when we are at work. Here are some tips:
- Bring your baby’s used shirt and smell it.
- Record the sounds your baby makes and play it.
- Look your baby’s picture.
- Imagine your breasts like two waterfalls and picture your baby and your husband calmly swimming in the pool of milk under these falls. If you have older children, let them join the fun!
- Say a prayer of thanks for your baby and your milk. You can assure yourself by praying Psalm 23: The Lord is my shepherd; I shall have everything I need.
- Do deep breathing: six counts exhale, one count pause, six counts inhale, one count pause. During exhalation, try to take out all the stale air that has accumulated in your lungs due to stress and shallow breathing. During inhalation, try to fill your lungs to its full capacity. The pauses can give your lungs a chance to rest and absorb the oxygen you have inhaled.
The Academy of Breastfeeding Medicine (ABM), an international organization of doctors who are avid breastfeeding advocates and experts in assisting mothers to breastfeed developed the following pointers in ensuring problem-free storage of your precious breastmilk.
Breastmilk Home Use for Healthy Full Term Infants
Storage Containers
1. Hard-sided containers, such as hard plastic or glass, are the preferred containers for long-term human milk storage. These containers should have an airtight seal.
2. Plastic bags specifically designed for human milk storage can be used for short term (less than 72 hours) milk storage. Use of plastic bags is not recommended for long-term storage as they may spill, leak or become contaminated more easily than hard-sided containers, and some important milk components may adhere to the soft plastic and be lost.
General Guidelines
1. Hands must be washed prior to expressing or pumping milk.
2. Use containers and pumping equipment that have been washed in hot, soapy water and rinsed. If available, cleaning in a dishwasher is acceptable; dishwashers that additionally heat the water may improve cleanliness. If a dishwasher is not available, boiling the containers after washing is recommended. Boiling is particularly important where the water supply may not be clean.
3. Store in small portions to minimize waste. Most breastfed babies take between 2 and 4 ounces (60-120 ml) of milk when beginning with an alternative feeding method. Storing in 2-ounce (60 ml) amounts and offering additional amounts if the baby is still hungry will prevent having to throw away unfinished milk.
4. Consider storing smaller size portions [1-2 ounces (30-60 ml) each] for unexpected situations. A small amount of milk can keep a baby happy until mom comes to nurse the baby.
5. Several expressions throughout a day may be combined to get the desired volume in a container. Chill the newly expressed milk for at least 1 hour in the main body of the refrigerator or in a cooler with ice or ice packs, and then add it to previously chilled milk expressed on the same day.
6. Do not add warm breastmilk to frozen milk because it will partially thaw the frozen milk.
7. Keep milk from 1 day separate from other days.
8. Do not fill the container; leave some room at the top because breastmilk expands as it freezes.
9. Label containers clearly with waterproof labels and ink, if possible.
10. Indicate the date that the milk was expressed, and the child’s name (for daycare).
11. Expect that the milk will separate during storage because it is not homogenized. The cream will rise to the top of the milk, and look thicker and whiter. Before feeding, gently swirling the container of milk will mix the cream back through again. Avoid vigorously shaking the milk.
12. The color of milk may vary from day to day, depending on maternal diet. It may look bluish, yellowish or brownish. Frozen breastmilk may also smell different than fresh breastmilk. There is no reason not to use the milk if the baby accepts it.
Milk Storage Guidelines
1. Milk may be kept at room temperature (up to 77°F or 25°C) for 6-8 hours. Temperatures greater than 77°F (25°C) may not be safe for room temperature storage. Containers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler.
2. Milk may be stored in an insulated cooler bag with ice packs for 24 hours.
3. Milk may be safely refrigerated (39°F or 4°C) for up to 5 days.6 Store milk in the back of the main body of the “fridge” or refrigerator, where the temperature is the coolest.
4. The type of freezer in which the milk is kept determines timetables for frozen milk. Generally, store milk toward the back of the freezer, where the temperature is most constant. Milk stored for the longer durations in the ranges listed below is safe, but there is some evidence that the lipids in the milk undergo degradation resulting in lower quality.
- Freezer compartment located inside the refrigerator (5°F or -15°C) 2 weeks
- Refrigerator/freezer with separate doors (0°F or –18°C) 3 to 6 months
- Chest or upright manual defrost deep freezer that is opened infrequently and maintains ideal temperature ( -4°F or -20°C) 6-12 months
5. Above guidelines apply only to healthy, term infant; guidelines are different for hospitalized, sick or preterm infants.
Thawing or Warming Milk
1. The oldest milk should be used first.
2. The baby may drink the milk cool, at room temperature, or warmed.
3. Thaw milk by placing it in the refrigerator the night before use or gently rewarm it by placing the container under warm running water or in a bowl of warm water.
4. Do not let the level of water in the bowl or from the tap touch the mouth of the container.
5. Milk may be kept in the refrigerator for 24 hours after it is thawed.
6. Never use a microwave oven or stovetop to heat the milk, as these may cause scald spots and will also destroy antibodies.
7. Swirl the container of milk to mix the cream back in, and distribute the heat evenly. Do not stir the milk.
8. Milk left in the feeding container after a feeding should be discarded and not used again.
9. As with all foods, do not re-freeze breastmilk once it is thawed or partially thawed.
When thawed, breastmilk should be used within 24 hours. Please do not throw away excess breastmilk. Even a single drop is very precious. Here are a few suggestions on how to make use of it:
- Give it to older children.
- Give it to your lolo or lola. In Sweden, they discovered that when cancer cells come in contact with breastmilk, the cells commit suicide. They now conduct experiments giving breastmilk to adults stricken with cancer.
- Splash it on your face and let dry. You will feel your skin tighten and revitalized.
- Donate it to orphanages.