This is a topic near and dear to me as I am a breastfeeding single mom of a
four month old in the process of returning to work (gotta pay that mortgage
as I am the only source of financial support for myself and my babe).

Just a few semi-random thoughts:

In my practice with primarily latino rural moms (migrant farmworkers), I have
noticed the moms who continue to successfully breastfeed already do this!
 Seems to be a culturally accepted norm to do primarily nighttime
breastfeeding and cosleeping.  The interesting thing is that these moms also
use bottles very early with their babies but tend to continue breastfeeding
well past 6 months, many over a year (this would make an interesting study I
think).

On a more personal level nighttime feeding combined with a slow return to
work (I'm trying out 4 hours of clinical work at a time along with consulting
from home) seems to be working.  However there are several factors that I
think make it successful.

1. I have stopped listening to people ask me, "is your baby sleeping through
the night?", "what do you mean your baby is not sleeping through the night?"

2. My outside work is less than 10 minutes from my home-works great if one
lives in a small town.

3. My baby comes along with me for work meetings, conferences and other
activities that do not have direct patient care involved.

4.I tend to be a light sleeper but can survive on snippets of sleep. I think
of motherhood as the ultimate "on call" experience.  As for sleeping while
baby is feeding-this works when my infant is feeding quietly (NOT, my guy is
the ultimate squeeling, guzzling, gurgling feeder!).  However I do find that
I do fall back asleep once he has latched on after 5 or so minutes.

5. I left a full time clinical practice due to the total lack of support for
breastfeeding from my colleagues.  As a pediatrician, I have far more
flexibility in choosing work situations (and the fact that I can live
comfortably on a part time work schedule and had great disability insurance
is something many working women could only dream of).

I still think that more advocacy is needed so that women who choose to breast
feed and work have more emotional, moral and PRACTICAL support.  There is a
lot of juggling, creative planning and assertiveness that has to be involved
on the part of the mom.

Using all of the techniques I learned from growing up in the Civil Rights and
Peace Movements (advocacy, persistance and Mau Mau- ing when absolutely
necessary:) ).

Mimi

Pierrette Mimi Poinsett MD FAAP
Modesto CA