WORKING AND BREASTFEEDING
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Institute of Child Health
30 GUILFORD STREET
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and
Breastfeeding
Publication No. 58’
LA LECHE LEAGUE INTERNATIONAL, INC.
Franklin Park, Illinois
Working
and
Breastfeeding
Adapted from
THE WOMANLY ART of BREASTFEEDING
and
La Leche League NEWS
Edited
by
Mary Ann Cahill and Kaye Lowman
La Leche League International, Inc.
9616 Minneapolis Avenue
Franklin Park, IL 60131, U.S.A.
CONTENTS
Making Your Plans...............................................................
5
Getting Started......................................................................
6
How-to of Expressing Milk...................................................
7
Using a Breast Pump.........................................................
9
How, When, Where................................................................
9
When You Begin Working...................................................
10
Is It Worth It?......................................................................
12
A Word About Sitters.........................................................
13
Feedings While You're Away.............................................
14
When You're At Home.........................................................
15
More Than Milk................................................................
16
A Baby's Needs................................................................
17
Does It Pay to Work?................................................... ......
19
Will You Go "Stale"?.........................................................
19
Explore Your Options.........................................................
20
Some Mothers' Experiences.............................................
21
Gold In the Bank
Can a mother breastfeed her baby if she is going to be employed outside
of the home? Most assuredly, she can. It involves a bit more effort and plan
ning than if she were going to be at home with her baby but then many nurs
ing and working mothers have told us that the rewards of breastfeeding make
it all worthwhile. For your baby, there are all of breast milk’s health-giving
qualities. And you might find that when you return home from work, nurs
ing your baby will probably be one of the most restful and enjoyable
times in the day. As one mother said, “If you must work, nursing your
child will help both of you over the rough spots." Another working and
nursing mother observed, "I love being able to make the shift from the
workaday world to the world of family with the closeness of breastfeed
ing." To this, another mother added, “I wish I could tell all working mothers
how much easier, special, and joyful it is to breastfeed. I am surprised to
find that some people seem sorry for me and others think it is so coura
geous to do the perfectly natural thing."
“All well and good " you may be thinking, "but what about those times
when I'll be at work and must miss a feeding?" Missed feedings must be
reckoned with, of course, and this is when knowing a few facts about milk
production and some advance planning pay off.
Making Your Plans
You'll want to stay home with your baby as long as you can after he is
born. A mother and baby have a great need for each other at this time.
Princess Grace of Monaco, who breastfed all three of her children,
explained her views at a La Leche League Conference in 1971:
I have many duties and obligations of State, but my family comes first. I
would have liked to have breastfed my children fora much longer period
than I did. But, at the beginning, when they first needed me and I them,
State had to wait upon mother
As you await the arrival of your baby, you are probably thinking about
what you should tell your employer regarding your future plans. From
experience, many mothers insist: “Do not make any commitments before
your baby is born. Be very firm on this."
You do not want the specter hanging over your head of having to return
to a job by a certain date because of an agreement you made while still
pregnant. Most businesses give a maternity leave, and will hold your job
for you for a specified period of time after the baby is born. By all means
take advantage of it, and give yourself that time to assess how much you
and your baby need each other. For someone to expect you to promise
away your future and that of your baby before you even have a chance to
meet is tantamount to signing a blank check—no, it is worse.
5
Bargain for as long a maternity leave as you can possibly manage.
Rosemary Cogan, a nursing mother-physician from Texas, advises. "Beg.
borrow, ask the grandparents for money presents if necessary, but arrange
not to return to work for at least six to eight weeks after baby is born."
Three months at home with your baby is better yet. If you can stretch the
time to six months, you will probably have seen him to the time when he
begins to take other foods. Then, when necessary, the sitter can feed the
baby solids rather than give cow s milk, which is more likely to cause an
allergy. Of course, the longer you can stay home with your baby, the
longer both of you will enjoy the benefits of being together. An Illinois mother
tells how she won an extended maternity leave from her employer:
When our son. Phillip IV. was born. I joined a La Leche League group and
decided to breastfeed for six months. I asked my doctor to prescribe
breast milk as best for my baby. My company accepted this as a valid
reason for a six-month compensated leave of absence
Getting Started
In the early weeks, particularly, bottle-feeding methods are anathema
to breastfeeding. In those first months when you and your baby are
together, live the life of a breastfeeding mother to the fullest. These are
the days to dawdle, to relax and enjoy. Plans and arrangements for work
schedules, baby-sitters, and feedings when you are away may have to be
considered later, but for now put them on the shelf. The most important
need right now is getting as much rest as you can A happy, relaxed
mother and unlimited time at the breast are the basics for giving baby a
good start. A Houston mother advises, "Nurse as baby wants, with no
schedules and without worry about going back to work." In between
times of nursing and enjoying the baby, you’ll be treating yourself to
good nutritious things to eat and drink.
Mothers sometimes worry that the baby will not accept the rubber
nipple after he has only had the breast. They are warned that they must
give the baby at least a bottle a day "to get him used to it." A more valid
worry is that the baby will take the rubber nipple and reject mother. If this
happens, you are then struggling to get him back to where he was
supposed to be in the first place.
Judy Hayes, an Oklahoma mother, advises. "Do not make elaborate
separation plans other than arranging for good baby care. Do not try to
imitate your being away by avoiding nursings in advance or by trying to
substitute bottle feeding a time or two during the day. Mothers who have
tried such tactics find that they just don’t work. The baby will adjust better
and be less confused if all circumstances are generated by reality rather
than by pretense."
6
When breastfeeding is firmly established, and the time for you to go
back to work cannot be postponed any longer, then introduce the bottle
(filled with your milk, of course). But don't give it to the baby yourself.
Logical little person that he is, he may not accept mother's milk from a
bottle when mother herself is right there. Ask your husband or the sitter
to give it to baby. You don’t want to try this at a time when he is really
hungry, but you don't want to try it soon after a nursing, either. If all else
fails (meaning the baby refuses the bottle), the sitter can give the milk to
baby with a spoon. This is all the more reason why you'll want to keep
those early days back to work short. There are a great many adjustments
involved for both baby and you.
Try to locate a League group in your area. As a new mother, you're
bound to have questions. If possible, practice hand-expression or use
the pump for a while before the time when you must return to work. Ann
Lindsay of New Jersey tells of her experience:
When we learned that my husband would be laid off at the end of the
current academic year and I would have to return to work full-time. I
contacted Carol White of the Cranford League, to whom I shall be
eternally grateful. My husband would be caring for eighteen-monthold Tomek and five-month-old Merrillek during the day and teaching
at night. The fact that Daddy was there —not just a baby-sitter —made
the difference in the success of our role-switching venture.
I had mistakenly thought that because I had always had more than
enough breast milk for Merrillek, I would have no problem pumping.
But. as I discovered, there is quite a method to it. When i first started
pumping, three weeks before returning to work, I could get an ounce
or two. Three weeks later I could get eight ounces by using a pump for
fifteen minutes before I nursed the baby first thing in the morning. I
nursed him at 6:00 A M. while he was still asleep and again at 8:00
A M I pumped at 12 00 and 4 00 and got eight more ounces, which I
put in a jar in the refrigerator at work and then into a thermos for the
trip home. At home I immediately put the milk in the fridge, then
nursed and cuddled the baby.
How-to of Expressing Milk
The key to being able to breastfeed and work is learning how to
express your milk. The milk you collect at work can be given to your baby
by the sitter, and. of course, no other milk or formula is as good as yours
for your baby. Expressing milk also keeps your breasts from becoming
overly full. By regularly taking milk out, you'll maintain your milk supply,
as well as your poise while you're on the job (Overfull breasts might tend
to leak when you least expect it!)
7
Another thing to be careful about is the possibility of a breast infection.
You are —at least for a while—in a much more susceptible situation in that
regard. The added stress of working, and the uneven nursing schedule
make it more likely that you’ll get a breast infection if you don't take really
good care of yourself. Keeping the breasts emptied regularly will help to
avoid this problem. Extra rest is also essential, and so is a good diet.
Any effort to remove milk from the breast must attempt to duplicate
what takes place when baby is nursing at the breast. Thinking about your
baby, or, if possible, holding and/or nursing him while you pump will help
stimulate the let-down.
Hand-expressing your milk is convenient, economical, and clean—and
not at all difficult once you get the hang of it. Don't worry if nothing comes
out the first few times. You will soon get the knack. Watching someone
else do it may help you understand how to hand-express, but you will
eventually learn on your own exactly what technique works best for you.
Wash your hands before expressing your milk. Have a clean, sterilized
container ready—preferably one that is not too large. Use a plastic one,
since important immunological components of the milk can stick to the
sides of a glass container and are thus lost to the baby. Cup the breast in
your hand with your fingers just back of the areola (dark area), thumb on
top and other fingers underneath, supporting the breast. Squeeze your
fingers together rhythmically while pushing back towards the chest wall.
Don't slide your fingers along the skin. Rotate your hand around the
breast in order to get at all the milk ducts that radiate out from the nipple
After you have worked on one side for three to five minutes, repeat the
process with the other breast; then do each side once more. This
changing back and forth gives the milk more of a chance to come down
the ducts, and you will be able to get a bit more each time.
There is a knack to hand-expressing, but a little practice will get the desired results.
8
Using A Breast Pump
Several of the hand breast pumps are quite effective and convenient.
A cylindrical hand pump designed in Japan is one of the most efficient.
This is distributed in the United States by Happy Family Products. (See
Appendix for information about obtaining these and other pumps.) Another
effective hand breast pump is the Loyd B Pump, designed and distributed
by a League father. It is hand-operated with a trigger action which you
squeeze, similar to that found on spray attachments sold for some
household cleaning products The Ora Lac pump operates by suction
obtained by a tube the mother puts into her mouth. The milk goes directly
into acollection bottle.This pump is also effective. Of the many types of
hand breast pumps available, the least effective and least comfortable is
the type with the little glass jar and a rubber bulb which you must
squeeze. These are widely available, but we do not recommend them.
How, When, Where
Most mothers take advantage of their breaks at work to express milk. If
you make it a point to nurse the baby just before you leave home, the
chances are the baby will not be hungry again for a while, and your
breastswill not be overly full beforeyour break. But anytimeyour breasts
are getting uncomfortably full, take a few minutes off and express just
enough milk to relieve the fullness. Under the circumstances, you may
not be able to save the milk, but your first concern is to avoid a plugged
milk duct.
To make things easy for yourself, be sure to wear the proper clothing.
Two-piece outfits are always a good choice. Save the dresses that open
in the back for some other time
For your regular milk-collection session, try to locate a spot where you
can relax and have privacy An office you can commandeer for fifteen
minutes is ideal, or perhaps you II find an unused room —a storeroom, for
instance At first you may not be able to express a great deal of milk, but
the amount usually increases quickly as you become more adept with the
procedure.
Any sterile container can be used to hold your milk, although those
made of hard plastic are considered better than glass bottles. The sterile
plastic bags that fit into nursing bottles are convenient since they're
ready to use. and it's a simple matter to take a fresh one each time you
express milk. Mothers find that small amounts are convenient at feeding
time. There is less waste, since the sitter can tailor the amount given to
the baby more easily. If you are due back from work shortly, but the baby
is hungry at the moment, the sitter can warm one or two small packets of
milk (by holding them under hot running water) to take the edge off
baby's hunger. The smaller amount will not spoil his appetite for the milk
he'll soon get "straight from mom "
Each little bag or other container of milk must be closed securely. If the
bottle liners are used, they should be placed into a rigid container such as
a jar or heavy plastic cup for added protection when you place them in
the refrigerator or freezer.
9
The milk that you express must be kept cold at all times. Many places of
business have a refrigerator on the premises Wouldn’t the manager of the
cafeteria agree to donate the use of a small spot on a shelf in the
refrigerator for your unusual but most worthy cause9 If no refrigeration is
available, you can do as many other resourceful working mothers do and
bring a large thermos jug filled with ice from home in which to store your
containers of milk. For the trip home, you will need ice or an insulated
bucket to keep the milk at a safe, cool temperature, ready for the sitter to
give to the baby the next day If you must keep the milk longer before
feeding it to your baby, it should be frozen. If you want to store milk more
than a week or two. it must be quick-frozen and kept at 0° Fahrenheit
(Unless your refrigerator has a dual temperature control, the freezer sec
tion will probably not be that cold. In that case, you should store the milk
in a separate freezer.)
When You Begin Working
Your best move is to minimize the amount of time you will be away from
your baby. An eight-hour workday presents more than twice the problems
of a four-hour one. Your baby’s need for you compounds itself as time
goes on. even when he is cared for by someone as familiar to him and as
loving as his dad Two or three half days a week is a far better way to
break into the new routine than the usual forty-hour workweek Even if
your employer does not usually hire part-time employees, ask about the
possibility You have nothing to lose and much to gain
Investigate the possibility that you and another mother can share one
job, thus giving yourselves more flexibility and freedom. Sharing a job
means that two people divide the hours and responsibilities of a position
usually filled by one person. While serving in the Virgin Islands, Linda
Murphy found that she and another RN, ’who was the other half of my
position,” accomplished "more than the work of one and a half persons”
by splitting the work load. "And we had less absenteeism,” she adds.
Is there a chance that you can nurse the baby during your lunch hour9
Some mothers are able to go to the baby, while in other instances the
sitter brings baby to mother. It can be a most refreshing break for both.
Anthea Fraser with the Singapore Breastfeeding Mothers Group was
usually, but not always, able to come home for lunch, which was then
lunch for herself and her nursing baby She advises the mother who may
sometimes be delayed to “keep your own private milk bank, if you have a
freezer compartment in your fridge. Immediately before leaving for work,
I used to express any surplus milk into sterilized containers for freezing.
This was given to my daughter on a spoon when I was unable to return at
lunchtime."
10
Of course you can breastfeed
your baby even if you return to
work Folk singer Buffy SainteMane continued her career af
ter her baby Dakota Starblank
et was bom. yet they still en
joyed the closeness of breast
feeding.
Virginia Martin of Louisiana worked out a system for pumping and storing
her milk that provided for all of baby Virginia's needs while her mother had
to be away at work.
About halfway through my second pregnancy, it became necessary for
me to return to work. I knew I would have to go back again soon after
the baby was born. I am a dietician, working in one of the hospitals in
Lafayette Knowing how much better breast milk would be for my baby
than any substitutes, I thought, "Even though I have to work, why should I
deprive my baby of the very best that I can give?” I decided to see if work
ing and nursing was a possible combination.
I worked up until four days before my baby was born, had an unmedi
cated delivery, nursed my second daughter, Virginia, on the delivery table,
and was able to walk back to my room with my husband. I felt wonderful
and ready to tackle the world
I had taken two months’ leave. By the time I had to return to work she
was on a fairly regular schedule. I was able to nurse her before I left for
work in the morning and to leave enough expressed milk for her mid
morning feeding. During the morning I would take my coffee break and
express enough milk for her afternoon feeding. I was lucky in that my
schedule was flexible enough to allow me to go home for an hour at noon
so that I could nurse her then (and have a little "loving time” for her big
11
sister). In the afternoon I would again take a break to express enough milk
for the next morning s feeding. The afternoon bottle was enough to hold
her until I came home in the evening and could nurse her again. When she
was almost six months old, she was trying to eat anything she could get
her busy hands and brand-new teeth into, so I started some solids.
At nine months old. she still nurses morning, noon, and night, though
she has dropped the in-between bottles She is eating table foods right
along with the rest of the family.
I realize that working and raising small children is not the best combina
tion. but I hope I can give some encouragement to mothers who do have
to return to work while their children are small They need not necessarily
deprive them of the benefits of breastfeeding.
Is It Worth It?
In telling her story, one mother from South Dakota, Kate Hanlon.
answers this question best:
I have been able to work full-time and continue nursing my baby daughter.
Erin, without too many problems. I learned to master the breast pump
and have had no sore nipples or plugged ducts, and my daughter is fed
the best At work. I usually express my milk midway through the morning
and afternoon It helps to relieve some fullness and stimulates my breasts
so my milk supply doesn't diminish. My babysitter is a veteran nursing
mother of four, and she offered a lot of encouragement
I do get discouraged at times. I am always running late, we eat hurry-up
meals of peanut butter or fried egg sandwiches I am tired all the time, my
house is a mess, and half my garden vegetables go to waste before I can
get to them However, each Friday at five o'clock I am so relieved that
another week has gone by and Erin is still my nursing baby The things
that don't get done don't seem worth it anyway, and we get by
I am grateful to my sister. Frances Mach, who is a La Leche League
Leader She has been all my support and has provided me with brewer s
yeast, a breast pump, fabric nursing pads, and countless fact sheets and
books in addition to encouraging advice and phone calls If it hadn't
been for Fran. Erin would not have been breastfed, and she and I would
have missed out on a great beginning.
Another mother. Cissy Zigler of Georgia, worked as a flight attendant
while she continued nursing her baby. She explains:
Because my husband and I were divorced during my third month of
pregnancy, I was determined to "make it" on my own with my baby.
Although many doubted me. my family and LLL gave me tremendous
support and encouragement.
Adam was born by cesarean. Nursing him was so peaceful, relaxing, and
easy after having had surgery. But no sooner had we settled in at home
than I had to start planning for my return to work as an airline flight
attendant —I had only ninety days leave after his birth. Luckily I only had
12
to make three trips a week. I always chose night trips so I would miss only
one or two feedings.
Until Adam started solids at six months, I used a breast pump every three
or four hours while away I would put my milk in plastic disposable
nursing bags and pack them in ice until I got home, when they would go
into the freezer to be used while I was on my next flight.
Everyone has wanted to know how I've done it and "Isn’t that hard?" I
just tell them — loving my baby so and giving of myself in this special way
is the most beautiful, wonderful, and rewarding thing I’ve ever done
Nothing is too difficult when love is the guiding force.
A Word About Sitters
If your work situation is such that you will need a sitter for some or all of
the time you are working, proceed slowly, and with great caution, before
making this important decision.
Four-month-old Lauren Brohawn discovers the fun of the great outdoors with her father. Michael.
(Photo by Mary Loewenstein-Anderson.)
Can you arrange for a family member to take over this responsibility? Your
husband comes to mind as the first choice, if he is available. He is already
13
familiar to the baby, and the element of change for the baby will not be quite
so great. A loving grandmother or an aunt who truly enjoys babies and who
is already familiar to the baby are also high on the list of choices. A motherly
neighbor may enjoy caring for a little one for a short period during the day.
Most people, though, are not so lucky as to have a family member or
friendly neighbor available as a sitter and must look further They must
also be more concerned with references and interviews. If the sitter is
new to the baby, by all means have her come to the house a few times so
the two of them can get acquainted before you begin working. You can
then also tell her that you are nursing and explain in detail how you want
the baby fed. what his likes and dislikes are. what his sleeping pattern is,
and. very important, the fact that you do not want your baby to be left to
cry.
When choosing a sitter, you are looking for someone who will give your
baby as nearly as possible the same single-minded devotion and care
that you would give him yourself—someone who knows babies—who
understands their needs. Will she sing to him9 Talk to him9 Rock him
gently to sleep? Keep him dry and comfortable and always close by9
If the sitter comes to your home, baby will be in familiar surroundings.
which is good. If you have a two-, three-, or four-year-old that you were
thinking of sending to nursery school, consider instead leaving both
children with the sitter. They’ll be company for each other, and you'll find
that big brother or sister will be so reassuring and protective to the baby
that it will warm your heart. The sitter may do some light housekeeping or
meal preparation for you, which will be a help, but remind her that this is
always secondary to baby’s needs
Feedings While You’re Away
Mothers usually instruct the sitter to give the baby breast milk if it is
available and supplement, if needed, with whatever the doctor has
prescribed, only after the supply of mother s milk is gone You’ll be better
off if the sitter gives the fewest number of bottles possible Juice, when it
is introduced, can be given by spoon or cup. As much as possible, you'll
want to satisfy baby’s sucking needs at the breast.
A common concern when pumping has to do with quantity. How much
is enough9 You’ll want to have some idea of the amount of milk to have
on hand for the sitter. When you and your baby are together, you can, of
course, be blissfully unconcerned about the number of ounces he takes
at each feeding. There is always more milk coming along, and any time
the baby is hungry or needs the soothing comfort of a snack, you simply
put him to your breast.
As you prepare for going back to work, estimate the amount of milk to
collect by checking on a container of formula for the recommended
amount for a baby of the same age and weight as your own.
14
If your baby is three or four months old, or older, you might want to
consider asking your doctor if you could start some mashed banana
instead of introducing formula.
Don’t be surprised if you find yourself calling from work frequently to
find out how your little one is doing. It’s good for all of you to stay in touch,
so phone as often as you can. Perhaps the sitter has a question that you
can quickly answer.
When You’re At Home
If you and baby are separated for a considerable length of time, give
special attention to your homecoming. Starting a neW job, or even taking
up where you left off in the old one, is a very tiring thing for a new mother.
You may find yourself absolutely undone by the end of the day. Meal
preparation or household chores are best kept to a minimum for the first
hour or so after you get home. Barbara Van Horn of Pennsylvania,
suggests. "If mother doesn’t get home until suppertime, she can try to
prepare part of the meal in advance, since this will be the time baby wants
to nurse and cuddle She (as well as the baby) may need to nurse. This is a
potentially hazardous time if hungry husband and perhaps older children
press for a meal. The baby may be asleep, of course, but then that hardly
ever happens the hour before supper, whether mother is working or not!"
Time will be a most precious commodity in your life. When a woman
combines mothering and working, she must be a miser with her time.
Don’t overlook the trusty baby carrier to help you catch up with household
work and keep the baby close to you. It has proved a blessing to all of us
at times And don’t be surprised if your baby becomes something of a
'night owl,’ wide awake, bright-eyed and busy in the center of family
activities, where, naturally, he is the center of attention. Some working
mothers tell us that they deliberately encourage an up-at-night, downduring-the-day sleeping pattern for the baby. The family enjoys the
baby’s company, and the baby sleeps for longer periods for the sitter.
Don’t overlook the many benefits of taking your baby to bed with you
at night. The baby benefits nutritionally; and the extra nursings stimulate
the production of milk. No pump or hand-expression is as efficient as a
baby at the breast in keeping up the milk supply. Not only will night feed
ings allow for frequent, effortless feedings during the night, but both of
you will benefit from the extra closeness of being nestled together for
several hours. Many working mothers have told us that they feel this ex
tra contact with the baby during the night helps to establish or maintain a
close mother-infant relationship.
When there is change in the routine, a mother’s breast responds
accordingly. Gail Saxton of Utah recalls her return to work when her
baby. David, was ten months old:
The week before my first workday came and David was still nursing
several times each day and a couple of times during the night, with both
15
of us really loving it. As the time neared, I realized that we would not be
able to end this relationship. I felt that we would be able to handle it,
since my husband would be with David and his three sisters most of the
time. At the end of the first day. one very top-heavy mother and her baby
nursed all evening and all night long. My milk supply soon adjusted to
the increased stimulation at night.
Oblivious to the cares of the world. Rebecca Howard and twelve day-old Elizabeth enjoy
that special blissful sleep that comes when you are snuggled close to someone you love
When you have a day off work, nurse your baby on demand Many
mothers tell us that it is “only mother” on weekends —no bottles or
supplements, even though these may be used when mother is at work. A
great deal depends on the baby's age. the length of time the mother has
been working, and the extent to which milk, juice, or solids replace breast
milk at other times. Some mothers feel that they can regulate their milk
supply to some extent by the amount of fluids they drink. They increase
their intake of nutritious beverages as the workweek comes to an end
and then continue to drink as much as they can while at home. On the
afternoon or evening of the day before they again go back to work, they
cut back on fluids. They claim that when they are drinking more, they
have more milk, and the supply lessens as their intake of fluids lessens.
Whatever you do. do not let yourself become too full nor too tired. Take
your baby to bed, nap, and nurse. Enjoy being with your baby.
More Than Milk
The greatest difficulty for you and your baby is the separation from
each other that working entails. Being away from mother is a serious
16
disruption in a young child's life. Our plea to any mother who is thinking
about taking an outside job is, “If at all possible, don't." Please consider
all the alternatives before making the decision to leave your baby. Many
mothers, motivated by knowing that no one else, no matter how qualified or
highly paid, will love and nurture and care for their precious newborn as
they would, have found alternatives to the forty-hour workweek, or have
managed to avoid returning to work until much later when the baby/child
can more easily handle the separation.
The mother-baby relationship has fascinated the scientific community
for a long time, since a child's early years hold the clues to his future
behavior as an adult. Society stands to gain or lose, depending on the
soundness of the mother-baby attachment. As more mothers asked
questions regarding mother-baby separation, we searched out studies
on child development.
Scientists hold that the child’s initial one-to-one relationship with his
mother is the foundation for emotional growth. From the security of the
baby's ties to his mother he learns to relate to others. “The only true basis
for the relationship of a child to mother and father, to other children, and
eventually to society," Dr. W. Winnicott, a pediatrician from Great Britain,
says, “is the first successful relationship between mother and baby."
A Baby’s Needs
Can a baby be “trained” to accept others and not always expect mother
to care for him? Won't this make him more "independent"? No, say the
experts. A baby's need for mother is not a habit; it's biology.
In her book Oneness and Separateness, Dr. Louise Kaplan, psychologist
and Director of the Mother-Infant Research Nursery of New York
University, explains that an infant does not have an identity of his own at
birth. Baby is in a state of oneness with his mother. Based on her work in
mother-infant research, Dr. Kaplan states, “From the infant's point of
view, there are no boundaries between himself and mother. They are
one." The child must negotiate the move from oneness with his mother
into separateness and a sense of individuality. It is a second birth that
unfolds gradually in the first three years of life. Maintaining the early
mother-baby relationship is extremely important to the successful
completion of this journey.
The young child who is separated from his mother exhibits all of the
classic symptoms of grief. He may cry unconsolably or withdraw into
unnatural quietness. Regarding this separation anxiety, Humberto Nagera,
Professor of Psychiatry at the University of Montana, points out “When
the child is confronted with the mother's absence his automatic response
is an anxiety state that on many occasions reaches overwhelming propor
tions. Repeated traumas of this type in especially susceptible children
will not fail to have serious consequences for their later development."
17
When women who plan to work ask Dr. Jack Raskin, a University of
Washington child psychiatrist, how they can be sure that their children's
needs are also met, his answer is:
Only with difficulty. Even when parents have a great deal of time and
energy to devote to caring for a young child, it's a hard job When both
parents work, the limited time available to the child and the other pressures
on the parents can make it very hard to meet the child’s needs.
The stakes are high, and ultimately the happiness of the child and of the
parents will hinge on the quality of love and care the parents provide the
child
Dr. Raskin speaks of the ways in which a child acquires the skills and
strengths needed to handle the stress that occurs in everyone's life. "The
key," he emphasizes, "is the child's close, unbroken attachment in the
early months to the people who care for him. Too much disruption of
this." Raskin says, "embeds in the personality traits that can be destructive
for a lifetime."
Cornell University's Uri Bronfenbrenner, an authority on child develop
ment, has said, "Children need enduring emotional involvement from
people who are irrationally attached to them. In plain language, someone
has to be crazy about kids, and it's best if it is the same someone. When
this need is met. a child has the equipment to live up to his potential "
Says Dr. Raskin, "All thestrengths in the growing child that allow him to
cope with hard times and frustration, that allow him to play, go to school,
and work, come from his involvement with people."
Kaye Lowman returned to her
part-time community relations job
after the birth of her baby and found
that baby Came was easily accepted
as "part of the decor " Kaye's
work continued as usual without any
need for mother and baby to be
separated. (Photo by Paddock
Publications )
18
A Canadian, Donna K. Kontos. PhD, consultant psychologist, comments,
“There is at present no known substitute for a family environment for
child rearing.... Prolonged maternal separations cause distress to the
child. All the research and all of the literature tell us that the best thing for
an infant is to have a consistent good mother around most of the time.”
Another psychologist, Dr. Joyce Brothers, recognizes the pressures on
young mothers to work, yet notes, “I realize that the economic necessities
of life often force us to do things differently than we would like. But when
it comes to child raising, I am convinced that a woman should make every
possible effort to spend the first three years with her child. It does make a
tremendous difference.”
Does It Pay to Work?
It is easy to think of take-home pay as ‘pure profit.” Many costs
involved in working are overlooked, and some quick calculations of
expenses versus income yield surprising results. There is the cost of a
working wardrobe and transportation expenses getting to and from work
each day. When you spend the day on the job, you probably prepare
more expensive convenience foods or eat out more often. Figure out
what child care for an infant would cost you. Then sit down and approximate
how much money these things add up to and subtract this amount from
your income You may very well find that there would be little net gain if
you continued to work after the baby arrived.
When tallying up the funds that will be available to you if you stay
home, consider the likelihood that you will drop into a lower tax bracket
after you stop working. The tax savings alone may be substantial. Many
mothers find that it doesn't “pay” for them to work outside the home.
Will You Go "Stale”?
If you enjoy your job, and the stimulation that comes with working, you
may wonder how much of a challenge you'll find at home with just you,
baby, and the four walls. Look for some unexpected and delightful
surprises. "I was certain that I'd be bored to tears,” was Shirley Callanan's
first reaction to the prospect of staying at home. This Utah mother said
she was “anxious to work on some kind of a part-time basis.” But after her
baby was born, she wrote, "I really didn't know what to expect of
motherhood or how I would feel, and it's hard to describe the feelings that
flowed through me those first few days, weeks, and months of my
daughter's life. I was needed by this tiny person; I knew I could not leave
her with someone else, no matter how loving.”
Like many mothers-to-be. Jean Smith of New York says that she could
see no reason why she would not want to work after her first child was
born. She describes how her attitude changed:
19
To work or not to work? For me. that had never been a debate. After our
baby was born, and I had rested sufficiently, of course I would return to
work I had taught for thirteen years and was employed during the
pregnancy. No baby was going to change my lifestyle. He would just
have to fit in. I had planned to nurse —my mother had I would quit at six
months—my mother had. Besides, that was long enough to be tied
down.
So I told myself, my husband, and my colleagues. Surprisingly, no one
argued with me or tried to change my mind (Later, my husband told me
that his heart had stopped when I told him my plans. He had not been
pleased, but didn’t want to argue with a pregnant and determined wife!)
I quit teaching in December; baby was due in February. I had two months
to sit around growing bigger and clumsier, justifying to myself the need
to return to work so that my brain wouldn't die after being dormant After
all how could diapers, spit-ups. and screeches be a challenge9 Challenges
were found in the hallowed halls of higher education
Then, on February 19. at 12 07 AM . after a twenty-hour labor, my
husband and I delivered Jason Gerard At midnight, in the back of my
mind swirled those ideas of getting this birthing over witn and taking up
my old routine. At 12 10AM . as I was holding Jason in my arms. John
and I crying and blubbering about the incredible miracle of creation I
knew, at that very moment, that my destiny had changed paths Although
it took me until April to say it out loud truly I knew then that I would be a
full-time mother.
Instead of that being the end of my story, it was really the beginning,
because, since I had been a career woman for so many years, my new
lifestyle, philosophy, and attitudes confused my friends who were fulltime career women with children So I became devoted to LLL meetings
I loved them! So did Jason1 There I found other mothers who had chosen
to stay at home—gladly not begrudgingly. There I found other mothers
who. at various times in their lives, came to know that an infant, a toddler.
and even a newborn, are fascinating and very social Creatures who
will respond from day one if someone (hopefully mother) is there to
initiate the relationship
Explore Your Options
More and more mothers are able to combine working and keeping
their babies with them, given compatible conditions on the job, much deter
mination. and help from their husbands and families. Many school buses
make their runs with mothers behind the wheels and their babies securely
in car seats behind them. Taking care of other mothers’ children is a timehonored way to bring in extra income, although such women are pitifully
underpaid, we feel, when other workers earn several times more than a
"sitter” overseeing a young life. In a society where women regularly work
outside the home, Pia Olsen of Denmark manages to be with her young son
20
by being a day-care mother in her home. Pia is one of many mothers who are
determined to be with their young children.
Many kinds of office work can be done just as well at home, so you
might be able to interest your employer in having you do part-time work
at home, coming into the office just long enough to pick up and deliver
your work. It's this kind of flexibility in the working world that could be of
great help to more families if it were more readily available to the trained
woman who is also a mother.
If you are a good typist, get in touch with several different companies
or secretarial services about free-lance typing at home, or run an ad in
the newspaper. If you have a specialty like art, writing, photography, or
public relations, you can develop a free-lance clientele and work out of
your home Giving music lessons is another good option. Or, if you are a
teacher, contact local schools about tutoring in your home. Another
possibility, take baby along with you to your job. Given the right circum
stances. an increasing number of women are finding that mothering the
baby is compatible with their jobs.
Some Mothers' Experiences
Barbara Sullivan of Washington taught for a year at The Little School
with baby Rachel as part of the classroom scene, much to the delight of
the four-year-old pupils. A mother whose children attended the independ
ent elementary school, Linda Steveley, tells of a conversation she had
with Barbara before her baby was born. "She and I spent some happy
times talking about birth and mothering and, of course, breastfeeding,"
Linda recalls "At the time, her plans were indefinite; she knew she would
not want to leave the baby every day when she went to work, but she was
reluctant to give up teaching altogether.”
21
Linda relates that the next time she saw Barbara, it was autumn, “and
there she was at school, tiny Rachel snuggled close in her carrier! I saw
that Barbara’s room now had a rocking chair and a few baby things.
Rather than detracting from the normal classroom routine, as some
feared, having the baby at school has added a new and valuable dimension
to the children s experience.’’
As her baby’s first birthday drew near, Barbara confided to Linda that
she would not want to be at school unless she could have Rachel near,
but she also realized that a toddler in the classroom would require a
tremendous amount of energy. Barbara s final decision was to take a
leave of absence for the coming school year and continue to enjoy being
with her baby.
From Oklahoma. Jackie Settlemyre tells of her experience in going
back to work after her baby was born:
Being a working mother before Jamie Jo's birth, I knew that there was a
strong possibility that I would have to return to work again. But I had
already made up my mind that she would be breastfed. I had faith that
when it was time to return to work all things would work out I had very
strong feelings about leaving her to work, and mixed emotions about
whether it was worth it.
As J.J. approached five months of age. the opportunity to work was
available As I began to discuss the job with my prospective employer. I
felt I should express my natural and most important reasons why I felt
breastfeeding came first. By being honest with him and talking freely
about how much I wanted to continue to breastfeed. I found a very
receptive man He was interested in my feelings and admired my con
victions about the needs of my baby
After I explained that immediate withdrawal from a breastfed baby is
neither recommended nor healthy for mother or child, my employer
suggested working only part-time and bringing baby with me for those
few hours. I was thrilled1 Not only would I be providing those necessary
extra dollars, but I wouldn’t be separated from my daughter.
Carol Cicalese of New Jersey is one of the growing number of mothers
who are finding it possible to successfully incorporate a baby into the work
place.
When I was married only one month and holding a good job. I was not
prepared to find myself pregnant. But pregnant I was, knowing very little
about babies. My mother encouraged me to visit the local LLL in hopes
I would nurse her grandchild. Though I wasn’t very enthused. I finally
attended a meeting. What a god-send! Immediately, I changed my ideas
on the whole pregnancy, realizing that it was important to be a mother...
and to be a good mother.
My son, Dominick, is now four years old. I nursed him for ten months,
continuing my office job and taking him along. We now have another son.
David, who is four months old. I am still working at the office—occasionally
at home, and David is completely breastfed.
22
Even though the schedule is busy, the children have adjusted to it well.
Dominick especially enjoys the office, where he plays with the farm ani
mals and sees the big excavating machinery and trucks. The baby gets
plenty of attention from everyone. But, no matter how busy the office work
becomes, there is always time to nurse and love the baby. In fact, he gained
one pound per week for the first six weeks, tilting the scale then at fifteen
pounds; and at four months he weighs twenty-one pounds.
I want to offer a special thank you to Marie Nielson, LLL Leader, who
gave me the confidence I needed to succeed as a working, nursing mother.
Dee LeClair, a California mother, found that her six-week-old daughter,
Jennifer, was not only accepted but welcomed into her college classroom.
She was able to leave her two older children with a mother's helper for a
few hours each day, but Jennifer, at six weeks, was much too young to leave,
even if she could count on her to go three hours between nursings. With
the instructor’s permission, Jennifer went to school with her.
I nursed her right before I left for class, at 10:00 a m., and she usually
fell asleep in the car and stayed asleep until about 11:30, at which time I
nursed her on the left side while taking notes with my right hand. She
would then either go back to sleep or stay awake and sit quietly in her
infant seat. She was not a disturbance to the class. Quite the contrary-
most of my classmates enjoyed seeing her and made a special point of
talking to her, holding her, and admiring her. She was the most popular girl
in class! Furthermore, the nursing in class was managed very easily.
Babies
need continuing.
ongoing care and affection from
one person in order to thrive.
Providing a reassuring hug or a
soothing touch when baby is
feeling bewildered or unhappy is
what mothering is all about
(Photo of Veronica Castillo and
Sebastian by Richard Ebbitt.)
23
Gold in the Bank
As the 1980's emerge, many young women are opting to put their
careers "on hold" when the baby arrives. They see motherhood as a
special season in their lives, one that they do not want to miss. The
working world will still be there two or three, five or ten years from now.
Stay-at-home mothers of young children often see themselves resuming
their working careers once their children are older. They view the time at
home as a short period, "a sliver of time" when gauged against the many
years that they can, and probably will, work outside the home.
When it comes to leaving your baby, be as cautious in your decision
making as you would be with a major investment—the investment here is
this critical period in your life and that of your baby. The early months and
years set the course for the rest of your child’s life, and they can never
be recaptured. And as Dr. Marilyn Bonham, the psychiatrist who wrote
Laughter and Tears of Children, reminds us,"The outflow of (a mother’s)
love and affection for the very young child is pure gold in the bank."
APPENDIX
Breast Pumps
There are a number of electric and hand-operated breast pumps available, both for sale
and rental. The most commonly known companies are:
Egnell
765 Industrial Drive
Cary, IL 60013
Happy Family Products
12300 Venice Blvd.
Los Angeles, CA 90066
Medela
457 Dartmoor Drive
Crystal Lake, IL 60014
Loyd-B Breast Pump (LOPUCO)
1615 Old Annapolis Road
Woodbine, MD 21797
Ora Lac
9256 8th NW
Seattle, WA 98117
Breast Shields
Plastic, two-piece breast shields are available from LLLI for use by mothers with flat or
inverted nipples. They can be worn during pregnancy or between feedings after the baby
is born.
Baby Carriers
Information needed to make your baby carriers, baby slings, etc., is contained in the
L Baby Carrier Packet. The packet also contains a number of advertisements from
commercially available baby carriers and backpacks.
LLLI Information Sheets and Reprints
Over 20° '"formation sheets, reprints, and booklets are available from local LLL groups
ano trom LLLI. These cover many aspects of breastfeeding and child care. Some are
wri
y octors and other health professionals; others are written by experienced
e1^ral ?r'ce ^'st (No. 501) will be sent on request. Please enclose a
stamped, self-addressed business size envelope. For information in languages other than
English, ask for the Translations List (No. 508).
24
ABOUT LA LECHE LEAGUE '
La Leche League International is a nonprofit organization founded
in 1956 by seven women who wanted to make breastfeeding easier
and more rewarding for mother and child.
La Leche League offers information and encouragement primarily
through personal help, to those women who want to nurse their
babies. A Professional Advisory Board comprised of thirty-nine
consultants offers advice and assistance when necessary.
La Leche League is the world's largest resource for breastfeeding
and related information, distributing more than three million
publications each year, some of which are now available in
nineteen languages. Some of the information in this booklet is
taken from THE WOMANLY ART of BREASTFEEDING, which
is a basic how-to book. Revised and expanded in 1981, it has
helped countless mothers through almost any nursing crisis; the
revised edition includes 250 first-person stories and over 125
photographs and cartoon illustrations.
For further information, we urge you to locate a La Leche League
group in your area. If you don't find a listing in your telephone
book, write or call our LLLI office in Franklin Park, Illinois
during regular business hours from 9 a.m. to 3 p.m. Central Time.
The number is (312) 455-7730.
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