25 Mar

Breastfeeding and going back to work

In that chaotic blur of cuddles and tears that is the first few weeks with your baby, when you’re taking it one feed at a time, it’s possible that you might miss your working day. The luxury of time to sit at your desk and think, drink a cup of tea while it’s still hot, chat with other adults about matters non-baby, oh those were the days!

And as your baby grows and you settle into your new roles, perhaps the thought of work recedes for a little while; but towards the end of your maternity leave, you have to start making decisions. Whether you will go back or not; would you need to apply to change your hours; what sort of childcare you might need… and if you’re still breastfeeding, how on earth are you going to manage that?

During pregnancy and in the early weeks of motherhood, my assumption was that I would stop breastfeeding at six months, ready for when I returned to work at seven months. I interviewed several childminders and chose the one I was most comfortable with, and her assumption was also that I would be providing formula for him during the day. I arranged the date I would start back at work; and, all this in place, proceeded to wean from the breast.

Only I had failed, yet again, to consider what my son would agree to. Not only did the little terror categorically refuse to eat food of any sort, lips sealed head turned and expressing RAGE with every part of his being; but he was also absolutely not prepared to countenance the nasty bottle I kept trying to tempt him with. It was distressing for both of us. It was distressing for my partner, when he tried to give a bottle. It was a disaster.

Dani says of her daughter,

it never occured to me that she wouldn’t be ok when I returned back to work when she was a year old … it resulted in us both getting very upset & her wanting to feed even more, probably as reassurance more than anything, but I knew she had to be ok to go without when the option wasn’t there & I didn’t know how to prepare her for that without stopping the majority of feeds in the day.

Both Dani and I eventually made the decision not to wean, but to follow our babies’ lead and carry on breastfeeding when we returned to work. In practical terms, by six months in my case and a year in Dani’s, our milk supplies would have been robust enough to cope with a more chaotic feeding pattern, so for example I could feed my son on my days off and at night, and needed to express for the first few weeks back at work.

Ann tells what it was like to arrange to express at work:

My company bought a reclining garden chair for me to sit in, and put it in the shower room (which isn’t as bad as it sounds), it was actually quite pleasant …Except expressing takes ages. I was hand expressing. Every day. For two hours at the beginning to get the 400mls of milk A needed every day.

But two hours was difficult to fit in when I was working on two projects, and I was leaking if I didn’t manage to get away at the right times to express, so I had constantly sore boobs.

Then [I had to work] on site, and the medical room only had a mag lock, and you couldn’t lock it from the inside once you were in, and anyone who had a pass could walk in. And it was also used as the Muslim prayer room. And yes, I was walked in on. Twice.

My bottles of expressed milk in the office fridge caused some raised eyebrows. Ann sensibly recommends putting them in an opaque make up bag. It’s useful to know that expressed milk will keep at room temperature for a few hours, and longer in a cool bag, so you can take it home, refrigerate it, and send it with your baby the next day. If your baby will drink it, which mine did not.

My childminder was frankly horrified, and found it very hard to look after a baby who did not eat a thing from drop-off to pick-up. With my head full of going back to work, I feel I took my eye off the ball and failed to see that for my baby, it wasn’t just the milk he was going to miss, it was me.

In a similar situation, Dani actually made the decision to stop working altogether:

I handed my notice in at work, using the remainder of my annual leave I’d accrued on maternity leave to cover my notice period & once I took the pressure off to reduce her feeds, we came out of a 2 month long fog. I felt happier, L seemed happier & I accepted that was how it was going to be. What I didn’t count on was a childminder who wasn’t to be beaten & she wanted to give L another week.

With a few changes, L settled in and Dani did go back to work. She says I think that letting her do it at her own rate was what helped her eventually be ok without. There is hope for those mummies with boobaholic babies, L shows it can be done!

But babies develop and adjust to change at different rates, and Ann, no longer expressing but still feeding all night, feels that they are not there yet:

I want to continue, but at 17.5 months, I’m desperately tired, and have been horribly ill, and I’m honestly wondering whether it’s worth continuing or not.

None of these decisions are easy, and all come with a payload of guilt, one way or another. If you’re in the tiny percentage of mothers in the UK still breastfeeding beyond six months, it’s hard to access relevant support. It may feel like your peers have all stopped feeding long ago, or that the groups you’ve been going to are mainly focused on feeding newborns; in any case once you’re back at work you no longer have access to the drop-in groups and the whole thing can be very isolating. I retreated very much into online support from various forums where being a ‘toddler-feeding weirdo’ was a point of pride; now I meet such people all the time through my work, and make an effort to put them in touch with each other, so the peer support can continue. If you find yourself reading this and wondering where the help is coming from, or asking yourself who is going to understand, please get in touch, or call one of the breastfeeding helplines, where most of the counsellors answering calls will be or have been, like you, in that tiny percentage.

NCT Breastfeeding Line 0300 33 00 700 7 days a week 8am–midnight

Ann writes at beta parent and is @pixeldiva on twitter.
Dani is @boo_bowglin on twitter.

03 Nov

Book Review: Complementary Feeding: Nutrition, Culture and Politics, by Gabrielle Palmer

Palmer’s ‘The Politics of Breastfeeding’ was a hugely influential book for me as a breastfeeding counsellor, opening up a far wider picture of the subject than I had ever seen before. ‘Complementary Feeding’ has done the same thing with the subject of introducing solid food and feeding infants and young children on food other than milk.

The title itself raises the huge issue of what we call this process, which many people refer to as ‘weaning.’ As Palmer explains, this is in fact the term for cutting down on milk, which may well be a consequence of introducing solid food, but is not, in fact, the same thing. This confusion of the terms leads to parents and healthcare professionals having a drive to reduce a baby’s milk intake long before he or she is developmentally ready to do so.

I particularly enjoyed the book because it reinforced my own approach to talking about the introduction of solids, with the focus being on education and exploration rather than on filling the child up with non-nutritious cereal-based or pureed foods to the exclusion of milk. She even pinched my throwaway remark that food is a great, cheap educational toy that comes in lots of lovely colours and textures, and can be played with at the table while the rest of the family gets on with their meal!

The book starts with an overview of the inequalities in global food entitlement, a subject I had not considered before, but which became highly topical this morning when research comparing the average English diet with diets in Scotland, Wales and Northern Ireland, suggested that if they all stopped eating deep fried Mars Bars, they would, amazingly, live longer. Of course, the research does not say this at all, but identifies food entitlement inequalities in less affluent populations in the UK, but that does not make such a good headline.

It goes on to look in greater detail at the evolution of the human diet, and cultural variations, as well as innate factors such as the drive for nutrient-dense food (hence the preference for salty, sweet and fatty foods), and the inbuilt appetite control mechanism that allows baby-led complementary feeding to become the natural progression from baby-led breastfeeding. I learned some interesting facts about human consumption of animal milk (most humans do not produce the necessary enzyme to digest milk, beyond infancy, but northern Europeans have evolved to do so), and was interested, but (I admit) slightly revolted by the discussion of feeding insects and molluscs to small children. My cultural prejudices are pretty well embedded!

Finally, Palmer suggests some processes for change, including an examination of the language used around feeding children; and compares the effects of wartime rationing with a frankly disempowering US initiative to provide poorer families with food but not with information about nutrition or food preparation.

For me, one of the most important conclusions of the book is that malnutrition exists in affluent cultures as well as in the developing world, because parents are driven to cut back on milk and give commercial or home-made processed foods to their children, often before the children are ready to move on to a solid diet. Also, that spinach is not particularly good for children; as Palmer writes, how wise they are to refuse it!

This book was a free copy kindly sent by Pinter & Martin publishers, and can be obtained from them here.