Maximizing Your Maternity Leave

Whether you will have 6 weeks, 6 months, or something in between for you maternity leave, you’ll want to use the time getting to know your baby, finding your rhythm of being “mommy” to a new little blessing, and be preparing for the time when you return to work.  Many new moms spend this time worrying about who will take care of their child, how they will express milk, wondering whether they will have enough milk to express, and so forth.  And some things you read and hear encourage new moms to express from the very beginning and practice giving your baby bottles each day.  Even more stress!

While there are some things you will want to do to prepare for your return to work, the most important thing you can do during this time is bond with your baby, get to know your baby, and fall totally in love with your baby.  You need to get breastfeeding off to a good start and not have to worry with pumping and giving bottles in the beginning.  So, until 3 weeks before you return to work, it is a good idea to not spend time worrying about pumping and bottles or teaching your baby to drink from one!

Several weeks before you return to work, though, you will want to familiarize yourself with your pump, learning how to operate it, clean it, and store your milk.  Never throw milk you pump away but you also don’t need to give all the milk you pump to your baby right now.  You are still home with her so enjoy these moments of cuddling and nursing before you return to work.  This milk can be frozen for the future when you do go back to work.

You will also need to give thought as to how you want your baby’s caregiver to feed your baby your expressed milk.  Do you want to give a bottle?  Cup?  Sippy cup?  Make sure to talk about your desires with your baby’s caregiver beforehand.  Many moms and caregivers choose to use bottles for their convenience but the other options should be explored.  Make sure to educate your baby’s caregiver on how to give a bottle if this is what you choose to do.

Finally, don’t worry about your baby “taking a bottle” from you.  Many babies refuse to take a bottle when their mothers are around.  They know what they want and prefer and therefore won’t drink from a bottle when you’re around.  When you are away, though, these same babies will take a bottle from someone else.  Your baby may also “reverse cycle” and drink less milk while away from you throughout the day and take in more while with you in the evening, night, and morning before work.

Ultimately, you want to feel comfortable with how your pump works and how to store your milk before you return to work.  You will want to feel comfortable with your caregiver and share with her your desires for feeding your baby while you’re away.  But, as you plan and prepare for your return to work, make sure to enjoy these precious moments while you are with your baby.  Enjoy nursing at the breast while planning for the time you are away.  Try not to stress and worry about it.  You are mommy to your precious little one and if you are exclusively nursing your baby at one month old then you have the milk to feed your baby at six months and beyond as well!

Reverse Cycle Breastfeeding

Reverse Cycle Breastfeeding

Reverse cycle breastfeeding is when a baby changes his/her nursing schedule to be able to breastfeed more when he’s with his mother and eat less/sleep more when he’s away.  It occurs quite commonly when a mother returns to work.  Whereas her baby had nursed frequently throughout the day while they had been together, he now sleeps more during the day and nurses more frequently throughout the evening and early morning hours  to make up for the time away from mom during the day.  It can be a coping mechanism for babies to be able to tolerate being away from their mothers for long periods of time.

Reasons Babies Reverse Cycle

  • Return to work
  • Newborns who have not yet established a circadian rhythm with their sleep patterns
  • Toddlers who are easily distracted throughout the day and involved with all that is going on around them
  • Mothers who are overly busy during the day (frequently happens around holidays) and there is not much time for nursing throughout the day.

Tips for Handling Reverse Cycle Breastfeeding

Reverse cycling can be challenging when a mother returns to work as she is now working outside the home and usually not as free to nap and be with her baby as before.  However, breastfeeding is relaxing in and of itself and mothers should look at the extra time nursing when together as a good excuse to relax and rest.  Bed sharing or co-sleeping throughout the nighttime will also help a mother maximize her sleep while still frequently nursing her baby.

Babies are incredibly resilient and reverse cycle breastfeeding is just one testament to this fact.  If your baby is reverse cycling, it can be helpful to look at it as a positive characteristic.  Your baby is able to go with the flow of the day’s schedule and then snuggle with his favorite person in the world when you are together in the evenings/night/early morning. He is able to adapt to taking in just the basic requirements while away from you, waiting patiently for the most nutritious and best-tasting food ever made while in his mama’s arms at night.

What is the Best Bottle for a Breastfed Baby?

I am often asked, “What is the best bottle for my breastfed baby?” Every bottle manufacturer seems to claim theirs is the best and they always tout how theirs is most similar to feeding at the breast.  And while some are

Bottle feeding my preterm baby

Bottle feeding my preterm baby

better than others, there’s no perfect bottle.  There are some things to look for in a bottle, though.  Here are 5 tips for finding the best bottle for your breastfed baby:

  1. Narrow teat doesn’t necessarily mean wider latch
    While breastfeeding, it’s important for baby to have a wide latch – hence why we call it “breast” feeding and not “nipple” feeding. In an effort to portray bottle feeding like breastfeeding, manufacturers created the “wide mouth” bottle supposedly so babies could have a nice, wide latch even while bottle feeding. However, wide-mouth bottles are so wide that many babies end up with a very shallow latch.  The best way to find a teat that your baby can have a wide latch on is to test out several and see what works best for your little one.
  2. Select a slow-flow nipple.
    Breastfeeding has bursts and pauses in its milk flow.  There are times during a feed when a baby is getting lots of milk (during the milk ejection reflex when you “let down”) and then periods where there is a pause.  Bottle feeding, on the other hand, tends to have a constant flow.  Finding a bottle with the slowest flow your baby will allow is especially helpful if your baby switches between bottle and breastfeeding. The best way to find a slow-flow nipple is to try out several by turning the bottle upside down and watching the rate at which milk flows out.
  3. Bigger is not necessarily better.
    A breastfed baby from 6 weeks of age until solids are started takes in roughly the same amount of milk in a 24 hour period. (Typically between 25-32 oz a day.) If your baby eats around 8 times a day, that would be roughly 3-4 oz of milk each time.  (Of course sometimes a baby eats more and other times less – just like we might have a larger meal or a snack.)  Find a bottle that suits your needs – there is no need to get a larger bottle thinking your baby will consume more and more breast milk as the weeks go by. (You may be interested to read this article if your caregiver says your baby needs more milk.)
    Is there a best bottle for breastfed baby?
  4. Find a bottle you can pump directly into.
    If you’re a working mama you already know the word b-u-s-y all too well.  Anything you can do to simplify your life is essential.  There are many bottles that will attach directly to your pump and save you extra steps.  If this makes your life easier, definitely consider this as you make bottle purchases.
  1. Don’t break the piggy bank.
    These days bottles range from a few dollars to $40 or more! There’s a lot to think about, but if your baby is breastfed, then the majority of his/her feeds will come at your breast rather than the bottle anyway. There are many good bottles out there, that won’t break the bank.  It may take buying several and trying them out – or better yet checking out a friend’s stash so you can confidently purchase just a couple – but an affordable bottle can be found. For a breastfeeding mom who’s returning to work, it is not necessary to consider buying a bottle with a steep price tag.

    You may also be interested in reading My Baby Won’t Take a Bottle, How to Pump Effectively, Breastmilk Storage and Transport, and How to Give a Bottle.

Baby Won't Take Bottle

My Baby Won’t Take a Bottle

Returning to work after having a baby can be a stressful time for a mother.  Many moms today find that they’ve just hit a stride breastfeeding and mothering, only to have everything turned upside down as they now must find a caregiver, pump milk, and return to work either part-time or full-time.  In their preparations, one big hurdle for many moms is having the reassurance their baby will take a bottle. And if their little one doesn’t, and mom finds herself crying, “Help! My baby won’t take a bottle!” it causes much anxiety and stress thinking about what will happen when maternity leave is over.

Try not to push a bottle or worry about your baby taking one.
This is hard, I know.  As moms, we want to have everything sorted out and know our babies will be fine if we have to be away.  But, many babies will take a bottle from someone other than their mother when their mother is not around.  Babies are smart and know what they like.  Many will refuse a bottle when their mom is near because they prefer to breastfeed.  However, when mom is gone, survival sets in and they will take a bottle when they get hungry and mom is not there.

There is no need to introduce a bottle early-on in maternity leave.
Research confirms that most babies will accept a bottle regardless of when it is started. 1  Thus, starting a bottle at one month does not make it easier for a baby to accept than starting at 3 months, 6 months, or whenever it is necessary.  In fact, starting a bottle before breastfeeding is well-established can interfere with a mother’s milk supply and a baby nursing effectively at the breast.  From a bonding and breastfeeding perspective, there are many benefits to waiting to introduce a bottle until later rather than earlier.

Maternity leave is too short to spend it worrying.
There are always going to be things to worry about in motherhood.  But maternity leave (in the US especially) is so short, the best way a mom can spend this time is enjoying her baby, nursing her baby at the breast, and soaking up lots of cuddles and skin-to-skin time together.  Worrying won’t change the “bottle status” and introducing bottles earlier won’t help baby accept them any quicker than right before maternity leave ends – or even waiting for your baby’s caregiver to give the first bottle.

Realize many babies reverse cycle while away from mom.
This means they essentially change when they are feeding – consuming the majority of their calories during the evening, throughout the night, and morning while they are with their mother.  Then, during the day while with a caregiver they don’t need nearly as much (if any) milk. You can find more information about reverse cycle breastfeeding here.

But what is a mom to do if her baby absolutely refuses to take a bottle? Below are 10 tips to assist you in feeding your baby while you are away.

  1. There is more than one method to give a baby expressed milk. If you have tried everything and your baby’s caregiver has tried everything while you are away, perhaps a bottle is not the best method to give your baby milk.  Expressed milk could also be given via spoon, sippy cup, regular cup, etc.
  2. Delaying your return to work, even by a week, can make a difference.  Babies grow and develop by leaps and bounds every single week.  What a baby can’t (or won’t) do one week, she may do easily a week later.  Every bit of time helps so delaying your return to work, even by a week, could be hugely beneficial to helping your baby take a bottle.
  3. Find a caregiver near work.  This allows your last breastfeed before going to work to be later, your first breastfeed after work to be sooner (do them both at the caregiver’s location) and might mean you could stop by during lunch or a break to breastfeed.  Depending on how long your baby is with a caregiver and/or the age of your baby, she may not need much (if any) more milk throughout the day.
  4. Not all bottles are created equal.  Experiment with different ones, trying different shapes, sizes, and materials to find one your baby is comfortable with.
  5. Try walking, dancing, or swaying while giving your baby a bottle.  Some babies like this rhythmic motion which can calm him and help him more willingly try a bottle.
  6. Try giving a bottle when your baby is calm, or even sleepy.  Waiting until your baby is fussy and hungry, then trying to introduce something new can be a bad combination.  If your baby is with her caregiver and refuses a bottle, the caregiver could give some of the milk with a spoon or cup to take the edge off the hunger, then try again when baby is calmer.
  7. If your baby is 6+ months old, offering solids is a good way to feed baby while you are away, without her having to take a bottle. Many moms find that their babies eat solids with their caregiver and nurse frequently while mom and baby are together – waiting until around a year old to really eat more solids while at home.
  8. Though it can be tiring if your baby reverse cycles, remember this too shall pass.  By the time your baby is a year old she should be able to manage without any expressed milk or bottles while away from you.  She will certainly be eating more food alongside nursing too, so it won’t seem like you are spending all your time together breastfeeding.  Parenting, in general, during the first year is tiring, especially while working.  Though each day may seem like it will last forever, looking at the big picture you know the first year will go by all too soon.
  9. Consider safe bedsharing.  Especially if your baby is reverse cycle breastfeeding, bedsharing will allow your baby to nurse as often as she likes without you having to be up and down all night – which can really wear a mom out who then must get up early and go to work the next morning.  (Safe bedsharing includes a flat mattress – not couch or waterbed; no smoking or drugs of any kind; no other children or pets in bed; partner who is supportive; covers that are not too heavy for baby; and baby not swaddled).
  10. Remember nursing won’t last forever. In fact, it will be over before you know it!  And you will probably look back and miss this precious time in your life.  Your baby is not the problem and breastfeeding is not the problem – it’s just the demands of life and you are doing the best you can to make everything work.  Use the time you have together nursing your baby to relax, escape from your hectic day, and enjoy these moments while she is still young.

How to Pump Effectively

How to pump effectively and efficiently is extremely important so you spend the least amount of time behind a pump as possible.  If you are returning to work or have other children, your time is limited!  Learn what steps to take to maximize output in minimal time.

How frequently you express depends on how much milk you require.  If your supply is established and you are returning to work, you will need to pump to make up for the times your baby eats while you are away.  Learning how pump effectively is an essential time saver.  If you are jut starting pumping and trying to build your supply, make sure to read about building your supply pumping.

Not only is it important to empty your breasts when you pump, but how you do this is also critical.  Effective pumping is key.  One study found that a good quality double electric breast pump was able to remove 99% of milk in the breasts within the first five minutes of pumping for most mothers. 1  Not only is a double electric pump going to increase output, but choosing one that has intermittent suction of 50-80 cycles per minute and an adjustable vacuum ranging from 50-250 mm Hg is important.  Also, make sure the vacuum is comfortable.  A strong vacuum that causes pain is not helpful to milk expression!  However, research also shows that using breast compressions while pumping will increase milk output.2  This is important to note since some moms notice a drop in their supply when they pump (versus nursing at the breast).

Breast compressions can easily be done while pumping.  Either use a hands-free pump (you could even cut small holes in a nursing bra to allow your pump flange to be held in place by your bra) or sit high enough that your pumping bottles can rest on the counter while you use your hands for breast compressions.  As you are pumping, gently massage spots on your breast working from your chest forward to your areola.  Hold down until you feel the area soften with milk expression and then work on another area.  Continue breast compressions while you pump until your breasts feel very soft and no more milk is being collected by your pump.

If you are still concerned about the volume of milk you are expressing, following pumping with hand expression can further increase milk output.  In fact, Morton et al found a 48% increase in milk production when breast compressions while pumping followed by hand expression were incorporated! 3

If you just have a few minutes here and there while away from your baby, it may be easier to hand express.

Mixed Feeding – Using Formula & Breast Milk

Mixed Feeding with Formula and Breast MilkMany mothers decide that while they want to provide breast milk to their baby, they won’t be able to provide enough milk for full or exclusive breastfeeding.  There are a variety of reasons for this: low milk supply, higher order multiples, early return to work or other separation from baby where mother is unable to pump adequate amounts, desire for others to help feed baby, etc.

Breast milk is unique and unlike any other mammalian milk or infant formula.  Any amount of breast milk a mother is able to provide her baby is a wonderful gift and should be celebrated.  There are many health benefits for both a mother and baby.  Even some breastfeeding will help with maternal-infant bonding and decrease feeding costs, visits to the doctor, time off work for illness, allergies, and health care costs both in the short and long term.

It is completely possible to have mixed feeds; here are 5 tips to help you succeed.

  1. Establish your milk supply
    During the first six weeks following birth a mother’s body is laying down prolactin receptors (hormones intimately involved with milk production) that will affect her milk supply for the duration of breastfeeding.  If her milk supply is built up strong in the beginning, it will be easier to decrease her supply and maintain lactation.  Conversely, if she never develops a strong supply in the initial weeks following birth, she may be forced to supplement which could further reduce her supply.  It is common for this cycle to continue until a mother is no longer producing any breast milk for her baby.
  2. Allow baby time to attach well to breastfeeding
    The sucking action at the breast as well as flow of milk is different at the breast and with a bottle.  To demonstrate this, try placing your clean index finger half-way in your mouth and notice what your tongue does.  Now, place that same finger all the way back in your mouth to where the hard and soft palates meet – just before you “gag” – and note your tongue movement.  Breastfeeding is similar to your finger being in the back of your mouth, and a baby’s tongue will extend down and out past his bottom gum line.  Alternatively, when a bottle teat is placed in a baby’s mouth his tongue bunches further back in his mouth.  A disorganized suck and/or nipple preference can develop if babies are introduced to an artificial teat (whether bottle or pacifier) before breastfeeding is well established.  Just as importantly, the flow of a bottle nipple is constant whereas a baby at the breast must suck-suck-suck to have a let-down which lasts a minute or two and then there’s a pause before another let-down. These subtle differences can cause confusion in babies until breastfeeding is well established.
  3. Slowly decrease the amount of breastfeeding sessions
    Once you have developed a strong milk supply, you may now choose to slowly introduce formula.  It is best to eliminate only one breastfeed every 2-3 days so that your body adjusts to making less milk.  Introducing formula more quickly and eliminating breastfeeding sessions more than one at a time could lead to engorgement, plugged ducts, mastitis, or even a breast abscess.
  4. Continue to nurse enough to maintain supply
    Watch your body closely and if you notice your milk supply diminishing more than you need it to, add in another breastfeeding session.  Every woman is different and even each breast on the same mother has different amounts of milk.  While one woman may easily maintain milk just nursing once or twice a day, another mother may need to nurse three or four times a day minimum to maintain a milk supply.  If your supply does begin to decrease, make sure to eliminate some of the formula feeds and increase breastfeeding sessions to help build up your supply.
  5. Have partner give bottles while mom breastfeeds
    Many moms who partially breastfeed find it easier of they are responsible for breastfeeding and then baby’s father, family, or friends give the formula feeds.  This is not a must, but it can make it easy for your baby to associate mom with breast milk. This is also a matter of convenience – breast milk doesn’t require mixing, heating, cleaning bottles, etc. so if mother is available to feed it just makes sense to feed baby in the most convenient way possible.

Whatever strategies you find that work for you and your situation, you have much to be proud of providing your breast milk for your baby.  Every drop is a gift and should be celebrated!

Breast Milk Storage

Breast Milk Storage & Transport

What type of container should I use to store my milk?

If your baby primarily gets his nutrition from your breast then the type of container you use is really not that important.  However, if most of his nutrition comes from expressed milk, then it is important the container you use keeps as many of the nutrients as possible.

While this is important, there is not a lot of research about the best type of container to store your milk.  Both glass and plastic that is free of polycarbonate (BPA free) are suitable.  Whichever you choose, make sure that they have tight-fitting lids (rather than one that has a nipple/teat).  Some experts recommend glass as the ideal container for freezing milk because it is the least porous, giving the best protection for nutrients in expressed milk.  However, many moms like the convenience and practicality of milk storage bags.  It is easier to store more milk because they take up less room, and there is also less to wash since they are disposable.

Studies have shown that both glass and plastic containers retain more nutrients in expressed milk than stainless steel containers.1

 Which type of containers should I avoid using for storing milk?

Bottle liners should not be used to store milk because they are too thin.  Thicker, milk freezer bags are typically not recommended for preterm/hospitalized babies but are fine for healthy, full-term babies.  One study found that antibodies decreased by 60% and milk fat content was reduced in milk frozen in thinner bags however this study did not test thicker milk storage bags.2   Nor have these results been duplicated.

How should I clean milk storage containers?  Is it necessary to sterilize them?

You should clean milk storage containers with warm/hot soapy water and let them dry before expressing milk in them.  This, along with washing hands, is enough to thoroughly clean pump parts and storage containers.  Unless you have a preterm or hospitalized baby it is not necessary to sterilize your pump parts or milk storage containers.

Where should I store my milk – fridge or freezer?

Where you store your milk depends on when you will use it.  Breast milk can be used from the refrigerator for up to 8 days after expression.  However, 5 days or less in the refrigerator is optimum.  If you are unsure, smell the milk.  Milk that is spoiled will smell sour.  Milk in a separate freezer door on your refrigerator will keep 3-4 months and 6-12 months in a deep freezer.  Always use oldest milk first from the freezer.  The fresher the milk the better.

How much should I store in each container?

It is best to store milk in 2-4 ounce batches, which is about how much a baby will drink at each feeding. 3   Alternatively, you could store a small quantity of milk in 1-2 ounce batches until you learn how much your baby will drink at each feeding.  Smaller quantities can be defrosted more quickly and this amount is good if your baby needs a little extra at one feed.

Make sure to write the quantity, date, and time on each batch of milk.  If milk is combined from multiple pumping sessions, write the oldest date/time on the batch.  Freeze milk in tightly-sealed BPA-free plastic, glass, or milk freezer bags.

How long can I store my expressed milk?

The column on the left shows the location of the milk.  The top row shows the state of the milk.

Mature Milk Storage Times for Full-Term Healthy Babies at Home
Temp. RangeDuration
Room Temperature66° - 72° F
19° - 22° C
6-10 hours
(4 hours if 77° F)
Insulated Cooler59° F
15° C
24 hours
Refrigerator32° - 39° F
0° - 4° C
Up to 8 days
Freezer Compartment in RefrigeratorVariable
0° F
-18° C
Up to 2 weeks
Freezer Compartment with Separate DoorVariable
0° F
-18° C
3-4 months
Deep Freezer0° F
-19° C
6-12 months
Taken from LLLI “Expressing and Storing Milk” & Breastfeeding And Human Lactation (2010) by Riordan J. and Wambach K., p. 439.

Taken from LLLI “Expressing and Storing Milk” & Breastfeeding And Human Lactation (2010) by Riordan J. and Wambach K., p. 439.

How do I transport my expressed breast milk?

Breast milk is a living substance and has amazing properties that can actually gain beneficial microflora when left at room temperature.  If you will be home to refrigerate your milk within 4-10 hours (depending on the heat of the day) after pumping, you could leave it at room temperature until you arrive home and can put it in the refrigerator.  However, once breast milk has been refrigerated you cannot leave it out for long periods without spoilage.  Therefore, once you refrigerate your milk, you should only take it out when you are ready to feed your baby.  If it has been refrigerated at work, you should transport it home in a cooler with a reusable freezer ice pack or ice to help maintain the cool temperature of a refrigerator. Refrigerate or freeze the milk as soon as possible.

If the milk you are transporting is frozen, it is important it does not begin to thaw.  Ensure there is plenty of ice, dry ice, or ice packs to keep it frozen in the cooler during transportation.  Place this milk in freezer as soon as possible.

How should I defrost frozen milk?

The best way to defrost frozen milk is in the refrigerator.  Once frozen milk has been defrosted, it should be used within 24 hours.  Never refreeze defrosted milk.  If you are unable to defrost milk in the refrigerator then you can run the frozen milk container under cool water for a few minutes or place the container in a pan of warm water.  Never heat milk on the stove or in the microwave and make sure that water doesn’t seep into the lid while it is defrosting.  Once defrosted, milk should not remain out of the refrigerator unless it is being fed to baby.


Introducing Solids

Introducing Solids

dsc2When to start giving solids to your baby is an important issue as is knowing how long to breastfeed your baby. There is a lot of conflicting advice. . . not to mention grandparents and parents who just can’t wait to give their new little blessing a spoonful of food.

How can you know your child is ready?  And what are cues that your baby gives that may not actually mean he is ready for solids?

There are several common cues that are mistaken to mean a baby is ready for solids.  Many parents believe that a baby waking more often is one of these signs.  Though sometimes this is the case, with this cue alone it is more likely to be other factors such as teething, a growth spurt, or illness.

Due to a baby’s immature gastrointestinal system it is important to wait until around the middle of the first year before introducing solids; this will also help minimize his chances of developing food allergies.  Around this time, though, many babies are also teething and going through growth spurts.

Teething can be very painful and cause restless sleep, tears, lots of comfort nursing (because it feels good on their gums!), and a complete change in his typical routine.  Growth spurts may mean needing more milk, but not necessarily solid food.  Regardless of the reason, research shows that introducing solids to a baby before six months will not help him to sleep longer.1

Other parents are told that since their baby is so big, he will need solids earlier than other babies.  This “cue” couldn’t be further from the truth.  First, big or small, a mom who is feeding her baby on demand will nearly always be able to make enough milk – and not just for a big baby, but for twins and triplets as well!  Also, breast milk is protective against obesity later in life so it is even more critical to continue to exclusively breastfeed a large baby until he is ready for solids.2

Conversely, parents may believe that their small baby needs solids earlier to help her grow.  Calorie for calorie, breast milk is one of the richest, most nutrient-dense foods a baby can eat.  Introducing solids, which may cause total breast milk consumption to decrease, would not help a small baby increase in weight.

Finally, many parents believe that a baby grabbing food off their plates and bringing it to his mouth means he must be hungry and ready for solids.  However, this is what babies do with just about everything they come in contact with at this age – food or not.  Books, toy cars, paper, cords, etc. are all fair game.  It’s how they explore their world, as well as being a way to bring some relief to gums that are preparing to cut teeth.

Just because they grab food and try to put it in their mouths doesn’t necessarily mean they are ready for solids.  Instead, parents need to look at all the readiness signs for starting solids in their totality and then decide if they feel their child is ready.  When in doubt, it won’t hurt to wait a few extra weeks or a month for a healthy, full-term baby either!

So what are signs that your baby is actually ready to start solids?  You should notice the following in your baby:

  • He is able to sit up – unassisted
  • He is interested in food, grabbing it from your plate and trying to put in mouth
  • His tongue no longer automatically thrusts food right back out
  • He is able to chew his food (this does not mean he has teeth though; babies can gum around food to “chew” it quite effectively)
  • He has developed the pincer grasp – ability to pick up food with his thumb and index finger

As parents, you will notice these signs as well as the overall attitude of your baby.  If you notice these signs before six months, it is still recommended by the World Health Organization, American Academy of Pediatrics, Health Canada, Australian National Health and Medical Research Council, and others to delay solids until six months.  There is no harm in waiting longer in a healthy, full-term baby.  In fact, many babies will not be ready for solids until 7-8 months or later.  Follow his cues.  Remember, the first year of life his primary nutrition should come from breast milk!

For further tips on starting solids, click here!

Equipping Caregivers


Pumped milk can

Milk can be labeled so the bottles are not mixed between babies.

When equipping caregivers it is important to choose someone that you are comfortable with and that will work with you to honor your desires for caring for your baby while you are away.  There are many issues to be discussed including diapers, nap times, daily schedule, adult-to-baby ratio, when you can pop in to visit, whether she is comfortable with you nursing at drop-off and pick-up, starting solids, potty training, and more.  One of the most important issues you will need to discuss is feeding your baby.  Whether your caregiver has decades of experience taking care of little ones or is brand new, you will need to share with her your desires and discuss how feedings will go.  The following are five issues you will need to consider.

  1. How to Feed Baby (Feeding Method)
    Since you are not around, your baby will be taking milk from some other source than nursing at your breast.  The most common feeding methods are a bottle, cup, spoon, syringe, and/or sippy cup.  While many moms assume caregivers will use bottles this does not have to be the case.  Whatever you choose, it will be up to you to educate your baby’s caregiver as to how to use your preferred feeding method.
  2. How to Give a Bottle
    Since bottles are most common, we assume everyone knows how to give a baby a bottle.  However, many babies are fed a bottle in a way that does not take into account all factors.  A bottle, when turned upside down, drips even without a baby sucking.  So, a baby could be full but still have to gulp or swallow milk just by the nature of how the bottle is given. In contrast, a baby must suck at the breast to elicit a letdown of milk.  When nursing, there are natural pauses in the milk flow as the baby must wait for the next let down of milk.  Please read these bottle-feeding tips for how to educate your baby’s caregiver in bottle feeding.
  3. How Much Milk Your Baby Will Need
    Knowing how much milk your baby drinks while she is away from you will help you plan how much milk to give to your caregiver.  It will also help your caregiver know how often she will need to feed your baby.  Make sure you know how much milk your baby drinks in an average day.
  4. What if my baby’s caregiver says my baby needs more milk?
    There are two things to consider.  First, breastfed babies, unlike formula-fed babies, take in roughly the same amount of milk during months 1-6.  Babies grow faster during months 1-3 than 4-6 and smaller babies exert a lot of calories just to maintain their body temperature.1  Breastfed babies take in an average of 25% less milk than formula-fed babies.2  So, it is probably more of a matter of educating your baby’s caregiver as well as working with her on how to give a bottle.Secondly, there are times when your baby goes through a growth spurt.  These don’t last long and your baby will often nurse more frequently when with you during the evening, night, and early morning.  Don’t worry about these growth spurts.  Your body is amazing and milk volumes adjust according to your baby’s needs.  If your baby begins to eat more while away from you for a few days, try to pump more often as well.  A growth spurt won’t last long and then you can drop this additional pumping session when the growth spurt is over.
  5. Bringing Milk to your Caregiver
    Make sure to send more milk than you think your baby will need during the first few days/weeks as you figure out a routine of how much milk your baby will drink while away.  Be sure to label your milk with time, date, and quantity so your baby’s caregiver can easily see which milk to serve first as well as measure the correct quantity to offer at each feeding.  Finally, don’t worry if your baby refuses to take a bottle from you.  Babies are smart!  Many times babies will refuse expressed milk when mom is either the one trying to give it or is simply nearby because they prefer to have milk at the breast.  When you are away, though, these same babies will take expressed milk from their caretaker.  Also, remember that it is common for babies to reverse cycle which means they may decrease how much milk they take in during the day while away from mom and then nurse more frequently in the evening and at night to make up for what they didn’t take in during the day.

How Often Should I Pump?

How Often Should I PumpHow often you should pump depends on if you are trying to build your milk supply or maintain your supply.  If you are attempting to build your milk supply while separated from your baby, please read this article.

When you have established your supply but will be separated from your baby during a feed(s), you should pump anytime your baby eats.  If your baby is taking in 4 bottles during the day while away from you, you should pump four times.  Pumping for 15-20 minutes on both sides (until you have a strong supply built) is a general guide.  However, you only need to pump until you get the required volume.  Many moms find that with an established milk supply 5-10 minutes of pumping is usually sufficient.

Some women are not able to pump as often while at work.  Here are some tips to allow you to pump more frequently:

  • Keep a refrigerator in your office/classroom/workspace.  Don’t worry about cleaning/sterilizing your pump each time you use it.  Just keep it in your fridge between sessions and then take the pump home to clean and sterilize at the end of each day.
  • Get a bra that will allow you to pump hands free so you could pump while working
  • Even if you can’t pump a full session, pumping a little is better than not pumping at all.  You may find that it is easier to pump more frequently but only for 4-5 minutes per session.
  • Use breast compressions while pumping to increase the milk volume you get in a shorter amount of time.
  • Try pumping at drop-off and pick-up to minimize the time you are apart from your baby.