Breastfeeding and High-Pressure Job


Dear Lactation Consultant,
Hi. I am 22 weeks into my very first pregnancy. Ive just started leaking colustrum in the past few weeks and only occasionally I'll wake up with spots on my shirt, mostly out of the right nipple. My question, or more dillema is, I am a Registered Nurse and I work overnight in a busy emergency department. I plan on going back to work 4-6 weeks after delivery because my husband is a student and is home during the nights and most days. He will be able to schedule his spring classes in the afternoons so I'll be able to get some sleep during the day.

I really want to breastfeed and have purchased a Medela dual breast pump but I'm worried that I won't have time to pump at work because I'm there for 12 hours and there are times when I don't even get to stop and eat because everyone, including the charge nurse, is busy with patients and ... well.. emergencies!

I'm wondering if doing the breast/bottle combination would work for me but then I'm worried about leakage at work for 12 hours if I'm not able to pump at work. I figure I could breastfeed while at home and pump any extra but use formula for when I don't have enough breast milk or when I'm at work. But I know it's hard for the baby to switch back and forth and maybe they won't take one or the other.

And then the problem with possible leaking at work when I'm already leaking now at just 5 months.

Any advice or input you could give me on this matter would be much appreciated. I have to go back to work after the delivery because my husband is a student I'm the primary income.

Thanks a lot.

Hi Ashley,
Congratulations on your pregnancy!

Your question is somewhat tricky, and it's an issue that thousands of women run into in jobs like yours where it is difficult to take time out. My main concern is that if you go 12 hours without emptying your breasts, you might end up with an infection. And at 4-6 weeks postpartum, I'd be worried that going 12 hours would also cut back on your supply. So let's think strategy. There are a couple of different ways that you can go.

  1. You might think about ramping up the time you are there gradually so that you don't suddenly go from 0 hours to 12 hours. Can you start back with a shorter shift?
  2. Can your husband bring the baby to you at least once during your shift?
  3. Check out your hospital to make sure there is not a pumping station. A lot of hospitals have them. And then you can talk with your supervisor about how you might arrange to use it.

To stop leaks, you might want to check out a product called Lilypadz. They are silicone breast pads that actually inhibit leaking (and you only need one pair since they can be reused). [I have no financial arrangement with this company.]

I'd be happy to continue to brainstorm with you about some other strategies. Good luck!
-- Kathy Kendall-Tackett, PhD, IBCLC

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.