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Dear Lactation Consultant:
I am going back to work next week. I wasn't supposed to return until my baby is 4 months old, but due to some uncontrollable problems at the office, I have no choice but to go back at 6 weeks postpartum.
I have a great milk supply, my son is breast feeding like a champ and his dad gives him a bottle daily without any difficulty, so we are ready to return to work and continue breast feeding. Rationally and intellectually that's it! But I was not prepared for this and I am a nervous Nelly. We have hired a babysitter until we get into day care at work and she has already spent a week with the baby. I have so many questions and concerns. Where do I begin?
Monika Levin
Valley Glen, CA
Dear Monika:
Take a deep breath and realize that you have done everything to prepare yourself for this day. You have probably been thinking this through since before your baby was even born. It's just that the day has now come sooner than expected and your heart is beating faster as Monday arrives.
Print a list of important names and numbers for your babysitter, including all cell and work numbers, numbers of neighbors, friends, relatives, the pediatrician and any emergency numbers (you do live in earthquake country). Also, make sure a neighbor you are comfortable with has a copy of that list as well.
Then print another list that has information pertinent to your baby at his age. This list will have to be updated as the baby grows. Information to include in this list:
A: Feedings
- 1. Times for feedings
- 2. Amount in bottle for each feeding (you may choose to defrost the breast milk each evening and prepare the bottles yourself)
- 3. Baby's position for feedings
- 4. Burping baby
- 5. Make certain that the sitter understands that you may call to say you are coming home early and that the last bottle of the day will not be given so you can breast feed instead, or if you have to stay late at work another bottle may need to be prepared and given.
- 6. Discuss keeping the baby upright for 15-20 minutes after each feeding to avoid spit-ups or discomfort.
B: Sleep Schedule
- 1. Discuss where the baby sleeps
- 2. Discuss how the baby goes to sleep (does he need to be rocked? Is he a self-soother? Does he take a pacifier? Does he get swaddled? What about the temperature in the baby's room? Do you play music? Does someone stay in the room for a while until he falls asleep? Remember this is your baby and not the sitter's, so the sitter must adapt to your routine. You can always be open to ideas or suggestions that might work better, but the sitter should not try something new without your permission first.
C: Diaper Checks
- 1. This may seem silly to discuss with a baby sitter, but include how often you want the baby's diaper checked. With the new diapers that include the yellow stripe that changes to blue when soaked, it is easy to forget to be diligent and wait until it is saturated before changing. This can lead to a baby with a very tender bottom.
D: Walks
- 1. You live in sunny Southern California and we're past June Gloom, so make certain you discuss the time of the day it's appropriate to walk, how your baby should be dressed and protected from the sun (no sunscreen until 6 months of age-SEE the article on SUNSCREENS on the Gentle Nurturing website), how long the baby should be out, the parameters you would like the babysitter to use as boundaries, whether or not you would prefer she check in with you, etc. Make certain the sitter always has a phone with her when she takes the baby out and make it clear she is not to use it for personal calls at any time when she is caring for your baby.
Once your list is complete there is still important information that will help the transition to work a smooth one.
You want to maintain your milk supply by pumping at about the same time the baby will be getting the bottle. California Assembly Bill 1025 states that you will be given a location (other than a toilet) where you can pump, but it does not spell out everything you might need so you have to discuss your pumping requirements with your employer and depending upon who your boss is and how understanding she is, you may find sympathy and cooperation (or not.) Anyway, you should use a top of the line electric pump and a hands free bra for comfort and ease. Pump every time the baby eats for 15 to 20 minutes. Storage should be in a self contained fridge in your office (to keep out curiosity seekers) or in a cooler with blue ice.
If you find that your milk supply is not being maintained to meet the baby's needs, contact a lactation consultant in your area for suggestions to increase your supply. And whenever you are home, spend time snuggling and nursing your baby, which will help your supply as well as take away some of the guilt feelings that come with returning to work.
And, know that you are doing what is right for you, your family and your career and soon enough you will learn to balance being MOM and a career woman.
Good Luck!
--Leslye Adelman, IBCLC
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