When Maternity Leave Ends...How To Have Continued Success with Breastfeeding

Since this isn’t Europe, with extended maternity leave times of up to 12 months, most mamas return to work at least part-time between six and twelve weeks after the birth of their babies.  For those who are breastfeeding, this can be a daunting experience, but with proper preparation, it is absolutely manageable.  You can have continued success with breastfeeding and pumping, allowing your baby to continue to have breast milk for as long as the two of you both want it to happen.  That’s not to say that there still will not be tears; when returning to work myself, I definitely cried.  As time passes, though, it becomes easier, I promise.

Above all else, I recommend getting a good breastfeeding relationship started prior to attempting to use the pump, unless there is a medical necessity for pumping sooner.  To illustrate this, my first child was born early at 37w5d.  She was jaundiced, and a sleepy nurser.  She would latch, nurse for thirty seconds or so, and fall asleep.  The key to removing her jaundice, though, was to nurse.  So, to help her with getting milk, I started pumping for her at 5 days old, and gave her 1 ounce of pumped breast milk at the end of every nursing session.  Pumping that early on, though, eventually lead into an oversupply situation for me, which will be discussed in a future article.

Let’s start with the most basic of questions, one I hear frequently, that being some variation of how much milk needs to be frozen ahead of the “the big day.”  A lactation consultant that I worked with after the birth of my second child gave me this wise piece of advice, “Not much.”  Ideally, the milk that you are making is exactly what your baby needs at the specific age and stage of development.  That’s not to say that milk pumped when he was 3 months old won’t be useful to him at 6 months, but it is definitely different in nutritional value and fat content. 

When pumping, ideally, you’d like to just keep up with your baby.  For that first week back, you’ll need a “starter stash,” but again, it may only need to be a day or two of frozen breast milk.  Presuming that you return to work on a Monday, you could use frozen milk on Monday to provide for your baby, but on Tuesday, you could use a combination of milk that was freshly pumped on Monday, and through the week, use less and less frozen milk.  Sometimes, by the end of the week, you will have excess milk, and that would restock your freezer supply.  In other words, there is no reason to stress out if you have a small freezer stash prior to your anticipated return to work date. 

Now with that established, let’s rewind a bit to discuss pumping, and what you’ll need to be as efficient and comfortable as possible.   When you decide you are ready to try pumping (ideally plan to do this about 4-6 weeks before you return to work), get out your pump and its instruction manual.  Read through the instruction manual, and set things up to make sure you are comfortable with the parts and the function of the pump.  If you were not sized at the hospital with a lactation consultant, definitely check out this link (http://www.medela.com/IW/en/breastfeeding/good-to-know/right-size-of-breastshield.html) first from Medela to figure out which size breast shield fits you best.  Not all women will be comfortable using the included (with Medela pumps) 24mm breast shield.  Having the wrong size breast shield can sabotage your success at pumping before you ever get a chance to get started!

While you certainly can simply hold the breast shields against your breasts during the pumping process, many mamas find that it is more comfortable to invest in some type of hands-free device.  While not all women can multi-task during pumping, for those that can, taking time from the workday to pump does not decrease productivity.  I have used two different options for hands-free pumping.  The first is a bra that goes over your nursing bra (with the clips undone), and has an opening in the fabric to slip the breast shield into that holds it in place.  One such brand name of this type of product is Simple Wishes (http://www.simplewishes.com).  The bra is highly adjustable with both Velcro sizing and a front zipper, allowing for a customizable fit. 

A second option is a device that goes fully within your nursing bra, and collects breast milk in a slightly different manner.  In some ways, it almost looks like the funnel part of the breast shield was turned “inside out,” and set inside a cup.  As there is not a traditional breast shield, there is also not a traditional collection pouch or bag!  With the Freemie (http://www.freemie.com), the milk collects inside the cup, inside your bra, and the only exposed portion of the device are the two thin hoses that come out from underneath your shirt to attach to the pump tubing.  When finished pumping, you simply remove the collection cups from your bra, and pour the milk from the collection cup into a pouch or bag for storage.   

When you begin pumping, prior to returning to work, I personally recommend pumping once daily, or even every other day, depending on the length of your maternity leave.  Typically, you will feel the fullest, and have the most milk, after the first morning nursing session.  This can vary if your baby wakes several times during the night, of course.  Waiting 30 minutes to one hour after that first nursing session (long enough to change a diaper, cuddle a bit, and set up the pump) will also increase the amount that you may be able to pump.  It’s important not to focus necessarily on the ounces that you pump initially.  That can be a significant hang-up to pumping mamas, and a stressor that may ultimately negatively affect milk production.  Pumping should last usually about two minutes after you stop seeing milk flowing freely into the breast shields (after the end of the let-down), but some women will have a second let-down in any given pumping session.  These pumping sessions may not initially result in an entire extra feeding of expressed milk, but will be the beginnings of what you use for your “starter stash” described above. 

Returning to work can be a daunting process for a new mother; there is so much emotion involved in the actual separation from your baby in addition to the desire to continue to provide breast milk.  However, with the right pump, properly fitting breast shields or other collection device, and some way to pump hands-free, pumping at work is entirely doable and can be done without much interruption to your regular workday.  In the next part of this series on returning to work, more information will be given on collection, storage, and usage of expressed breast milk.    

Breastfeeding in Art: A Primer

Neptune Fountain, Giambologna

You've probably seen this image before, since it's been enjoying recent popularity as used in the meme "CALM YOUR TITS."  To anyone but a nursing mother, the concept for this fountain probably looks pretty ridiculous. I know I would have thought "Oh please, milk doesn't squirt out like that...." After a few impressive milky arcs across our living room, however, I see this mermaid and am reminded only that I need to go buy more nursing pads.

On the other hand, the Art History student in me is instantly intrigued: "Ooooh, a Giambologna? What period of his career was this?" So, it seems only natural that my first post is all about Breastfeeding in Art! However, since not everyone wants to approach painted and carved boobs from an academic perspective, I'm endeavoring to keep it light. Which leads me to another amazing fountain:

Artemis Fountain, Gillis van den Vliete

I'm thinking this would be a super-useful anatomical evolution for moms of multiples. Meet Artemis (or Diana), Fertility and Earth Mother goddess of the Ephesians. She was such a big deal that her temple was one of the Seven Wonders of the Ancient World, and this many-breasted portrayal of her was one of the most common. What I find most interesting about this is how being a lactating mother was actually the symbol of her fertility. To the ancients, being a mother was more than giving birth: it included the continued nurturing of children, as well.

The Origin of the Milky Way, Jacopo Tintoretto

Speaking of the ancient Greeks, they had the most amazing myth for the creation of the Milky Way: Athena brought her half-brother Heracles to Hera to nurse, but he suckled so strongly that it caused Hera pain, so she pushed him away (Too bad she didn't have Kellymom to tell her baby Heracles was probably just cluster-feeding and that her pain would subside as his latch improved....). Her milk then sprayed across the heavens and formed the Milky Way. I had no idea the Milky Way was actually named for mothers' milk! Add it to the list of things breastmilk can do: generate celestial formations.

Isis suckling Horus, Cairo

Though the myths are ancient, however, much of the surviving art that depicts them is relatively new: the above images date from the Renaissance. What about breastfeeding imagery that is contemporary with ancient mythology?

Egyptian goddess Isis was worshiped as the ideal wife and mother, commonly invoked in healing spells which were meant to draw on the properties of her milk. She is often depicted nursing her son Horus, whom you might recognize as the god with the hawk's head in his adult form (You think baby's teeth coming in are bad? Just wait until he gets his beak....). Ancient Egyptian sculpture is somewhat famously symmetrical, full of parallel and perpendicular lines, not quite the soft curves we associate with later art. However, that feature does make it pretty iconic, so keep that in mind for comparison with some other nursing sculptures....

Yashoda with the infant Krishna

Getting away from the Western tradition made me curious to see breastfeeding in Eastern art. Fortunately, there were a couple of nifty examples, like this sculpture of the Hindu god Krishna being nursed by his foster mother Yashoda, from 12th-Century India. The blurb I read about this figure says that it is "a subject rarely represented," which I take to mean that despite the abundance of breasts throughout Indian art, nursing is not frequently depicted.

Yotsuya Kaidan, Tsukioka Yoshitoshi

Similarly, I found only one image of a breastfeeding mother in Japanese art. This is an illustration from the Yotsuya Kaidan Ghostly Tales, apparently a very famous Japanese horror story. (Warning: this is about to get super-creepy.) In the tale, ghostly corpses return to both take revenge and enjoy pleasures they missed in life, including a mother who returns to nurse her [living] baby. Gross. There's also a wet-nurse in the story, though, so since this character appears to be decidedly alive, I'm just going to say that's her.

Jumping back to Western art, there's this pretty significant Christian holiday coming up that centers around a baby and his mother, and here, there was absolutely no shortage of breastfeeding imagery, including this painting by no less a master than Leonardo da Vinci, himself!

Madonna Litta, Leonardo da Vinci

The breastfeeding Madonna actually has a name: Maria Lactans or Maria/Virgen de la Leche. Since the resurgence of breastfeeding imagery in general online and in publication, she has become quite the hot topic. The argument is that the reluctance to show Mary with the infant Christ at her breast is to remove a vital part of her identity. Furthermore, some scholars argue that Mary's life-giving milk parallels her son's life-giving blood, further elevating the role of breastfeeding in her importance to modern Christians. On the other side of the argument are those who claim that the symbolic significance of the nursing Madonna is exaggerated due to the current "trendiness" of breastfeeding. I think it's pretty fascinating, but then I'm an art nerd, so if you're interested in reading more, check it out here.

Among the numerous examples of Maria Lactans, I also found this first example of breastfeeding art created by a female artist:

Madonna and Child, Artemisia Gentileschi

You may or may not have heard of Artemisia Gentileschi, but suffice to say that she's known for her depictions of violent murder (Judith Slaying Holofernes), rather than of motherly tenderness. Still, this was apparently one of her first (possibly the first of) paintings she completed without assistance from a man, so it's interesting and not very surprising that she chose a scene to which only a woman can truly relate.

Louise Nursing Her Child, Mary Cassatt

Like Gentileschi, Mary Cassatt was a rare woman in a man's art world, but unlike her Renaissance predecessor, she is best known for her scenes of mothers and children, and so was really in her element drawing and painting sweet images of nursing babes. What I really love about Cassatt's breastfeeding art are the subtle, personal details to which every mother can relate: the baby's hand cupping her mother's breast, or playing with her face. This nursing pair completely ignores the viewer, making the bond between them so much more palpable than in the previous examples.

Charity, William-Adolphe Bouguereau

Besides Mary and other mothers, another figure who frequently appears throughout art history as a nursing woman is the allegorical character of Charity. The image is so common, in fact, that if you ever see a breastfeeding mother in a piece of Western art and it's NOT Mary, you can probably hazard a guess that you're looking at Charity. If she's got two or three infants crawling all over her, you can be absolutely certain. In the example here (which, full disclosure: I picked because it's Bouguereau and I LOVE his work), none of the babies seem to be latched in the right spot, as they're more arranged to hide the goods. Some Victorian patrons were a bit squeamish about breasts, depending on to whom they belonged and what they were doing, but it still would have been clearly understood that these were nursing children.

Landmark for Breastfeeding, D.E.

Finally, here's a piece of modern art depicting a breastfeeding mother you might recognize....

Who's that? Why, it's none other than Angelina Jolie, nursing twins! Completed in 2009, this sculpture sparked some controversy when it was unveiled, less for any offense caused by an image of a woman breastfeeding than the fact that the woman in question is a celebrity. I'm just gonna jump out here and say that I think this is kind of awesome, especially since Angelina's using a football hold on her little nurslings. What really strikes me about this sculpture, though, is that it's SO symmetrical, and full of parallel and perpendicular lines..... just like the Egyptian sculptures of Isis nursing Horus. I think it's no accident that this modern artist, Daniel Edwards, depicted Angelina in a very similar pose to that of a goddess: it's a clear statement about his view of breastfeeding mothers, at once consistent with images of nursing throughout history while at odds with modern sensibilities that suggest it should be hidden.

If you're interested in seeing more breastfeeding art, make sure to check out our Pinterest board (I went a little crazy with the pinning....), and see some of the resources I've listed below. And please, let me know in the comments which of the pieces featured here is your favorite!

Breastfeeding in Art
Maria Lactans
Female Breast as Charity
Lactating Fountains

Wordless Wednesday: Breastfeeding in Art

The First Latch...my Adventure begins!

It was Tuesday, March 5th at 5:38 AM that my nursling entered the world and my adventure began...But let's go back a few months prior.

I had always planned to breastfeed and naively I didn’t know about the obstacles I may face. Yes, I had talked to friends and read breastfeeding books, but I didn't realize how complex nursing a baby could be. My limited knowledge of breastfeeding left me thinking “it's natural, the baby will know what to do.” But what I found is that she knew what to do, but I didn't.

Our first latch occurred within the first 20 minutes of her birth. I remember the first moment I felt her warm, new to the world body against my chest....it was an intoxicating feeling. We were able to enjoy the critical early moments of skin to skin.

 After my daughter had her vitals check, she was weighed, measured, diapered and swaddled. The most amazing labor and delivery nurse brought her back over to me and said “Are you ready to breastfeed?”...I felt ready, I was text book ready, but so many questions popped into my mind.

“What would it feel like?”
“Would I be able to nurse her in public”
“When would my milk really come in”

The nurse helped me cradle my daughter in my arms and guided her towards my breast. She opened her mouth wide...like she knew just what to do. And she did. I felt right, and loving. But it wasn't comfortable.

It was awkward, not her suckling, but the hold. I struggled to hold her, guided her head and manage my breast at the same time. My breast kept slipping under my arm and she would get frustrated. Then I met the 2^nd most amazing nurse, a nursery nurse. She suggested “The football hold”.

Ah ha! Suddenly it all came together. I could support her and felt comfortable with the position. The football hold is still our favorite (although not easy for nursing in public but I will share my tips another day!), and as we approach the 9 month mark I am looking forward to the next chapters in our breastfeeding journey and sharing them with you and all the amazing ladies on this blog!

What were your first breastfeeding moments?

All you need is... Support

I learned really quickly after my daughter was born that in all my research and knowledge about breastfeeding, no one mentioned how important support was. No, not bra support, personal support. I was so lucky that my significant other supported my decision to breastfeed or at least attempt to breastfeed, and he even went to classes with me and did his own research. He was there in the hospital with me after an emergency C-Section delivery and supported me the entire time.

My first night as a mom, I was already ready to quit breastfeeding. She latched perfectly and ate and ate and ate and ate.... She loved to be connected, but after 3 days of not sleeping, from being uncomfortable at 41 weeks pregnant, and then not being able to sleep in the hospital, the long nursing sessions were wearing on me.

My fiance was great. He encouraged me, and got me snacks and water and anything I needed to get comfortable while nursing. He shooed visitors out of our room so I could feed our daughter without having to cover. Even now, 8 months later, he helps me find places when we are out in public to feed her without being exposed to every one. He'll stand in front of me if I feel like she won't allow me to be discreet.

e's not the only one who I found supported me: I have had women come up to me when I am trying to feed her in public, who say that they appreciate seeing a new mom breastfeeding her baby, and to keep up the good work. I have also had the opposite: people who stare and make rude comments about how I should stay at home or take "the show" to the bathroom. Sometimes, hearing that gets me down, hurts my feelings, but then I think of how "Breast is Best," and I'm a stubborn chick. I know that if I hadn't had the support of these people around me, I wouldn't have a healthy, happy, and chunky 8-month-old who has never had a drop of anything but breastmilk.

I am working on getting a support group started in my community. We live in a small town and many new moms are also single moms who don't have the support of a significant other or family members. I hope to reach out to them and be the support that I feel all new moms deserve. I hope that I can help new and not-so-new moms feel supported though doing the community support group and contributing to this blog.