by Jack Newman, MD, FRCPC
This is not an information sheet on all the ins and outs of working outside the home and breastfeeding. This sheet provides information on how your baby can be fed when you are not with him. It is addressed in particular to the mother who is returning to paid work when the baby is about 6 months of age or older. Mothers in Canada have the right to 52 weeks maternity leave. You should take full advantage of this time if it is at all possible.
Remember that there are costs to returning to outside work (transportation, clothes, daycare) that may cancel any benefit of increased income. If you cannot take a full year, take at least 6 months, better 7 months (from the point of view of ease of continuing breastfeeding while away from your baby). Your baby will never be this age again.
1. Babies must learn to take a bottle so that they can be fed when the mother is not there.
Why not an open cup? It is true that some exclusively breastfed babies will not take a bottle by 2 or 3 months of age. Most, who have not taken a bottle, and even some who once did accept a bottle will not take one by the time they are 4 or 5 months of age. This is no tragedy, and there is no reason to give a bottle early so that the baby knows how.
If your baby is refusing to take a bottle, do not try to force him; you and he may become very frustrated and there is just no need to go through all this. If the baby is at least 6 months of age when you start back at outside work, the baby quite simply does not need to take a bottle. If he is even 3 or 4 months, he does not need to take a bottle. He can be fed liquids or solids off a s
poon and by 6 months of age he can be taking enough so that he will not be hungry during the day. Furthermore, he can start learning to drink from a cup even by 1 day of age. The cup can be an open cup and is best not to have a spout (a "sippy" cup is, essentially, a bottle).
If, however, he has not got the hang of the cup by the time you must leave him, don't worry, he can take fluids off a spoon, or his solid foods can be mixed with more liquid (expressed milk, water). Obviously, if the baby is to be taking a fair amount of a variety of foods by 6 months of age, he may need to be started on solids by 5 months of age. However, some babies prefer to wait for their mother in order to drink something. This is fine; many babies sleep 12 hours at night without drinking or eating at all.
2. But getting the baby to take a bottle surely won't hurt.
Not necessarily true.
Some babies do fine with both. The occasional bottle, when breastfeeding is going well, may not hurt. But if the baby is getting several bottles a day on a regular basis, and, in addition, your milk supply decreases because the baby is breastfeeding less, it is quite possible that the baby will start refusing the breast, even if he is older than 6 months of age.
3. Babies need to drink milk when the mother is not at home.
Three or four good breastfeedings during a 24-hour period plus a variety of solid foods in goodly amounts gives the baby all he needs nutritionally, and thus he does not need any other type of milk when you are at your outside job. Of course, solid foods can be mixed with expressed milk or other milk, but this is not necessary.
4. If the baby is to get milk other than breastmilk, it needs to be artificial baby milk (infant formula) until the baby is at least 9 months of age.