On Thursday, Oct 2, 2003, at 02:21 Australia/Perth, Alicia Claesson, 
UND Nursing Student wrote:

> My name is Alicia Claesson, and I am a nursing student at the 
> University of North Dakota.

Welcome to Lactnet!
I'm a family doctor in Perth, Western Australia, and I've been 
exclusively pumping for my non-latching son for nearly twelve months.

[snip]

>  Wyatt (2002) explains that to be successful at breast feeding and 
> working, the mother needs five things: a breast pump, a private room, 
> adequate breaks to pump, a refrigerator to store the milk, and most 
> importantly, a supportive employer. All of these needs must be 
> addressed prior to returning to work. Mother’s must be prepared to 
> pump while at work to maintain their milk supply. I am hoping that 
> with more education and planning, mothers will be prepared and 
> committed to continue breast feeding after their return to work. I am 
> wondering what more we as nu
> rses can do to increase the amount of breast feeding women in the work 
> place.

Whilst advocating for supportive work environments and better 
legislation, there is a lot we can do in the meantime to help 
individuals. Here's my take, mostly from personal experience:

Number zero (I've gone back to this one, having taken it out and put it 
back in again): can the mum nurse, at least sometimes? Can the nanny or 
stay at home dad bring the baby in to nurse once or twice during the 
day? Can she duck out to daycare to nurse at lunchtime? Can she work 
from home sometimes? Does she really, really have to go back to 
full-time work right now?

Number one: the pump. Many mothers are given a cheap electric single 
pump (often manufactured by a formula company) as a "gift", or they 
have trouble seeing the value in investing in a hospital-grade rental 
or good quality double electric retail pump. Many of these women are 
therefore more or less doomed to pumping failure even in the most 
supportive environment. Good pumps cost money, and women often need a 
fair bit of informing and encouraging to realise that their investment 
is going to be worth it. People will blithely spend thousands of 
dollars on disposable nappies, but balk at a few hundred for a good 
pump. But that's another rant.

Number two, and usually overlooked by LCs and nurses giving advice in 
my experience: a hands-free pump bra, either a commercial version or 
homemade. If a mum can enjoy and look forward to her pump time by using 
it to read a good book, or check personal email, or something else 
enjoyable, she won't be dreading her pumping and watching the horns (a 
recipe for no let-down, for me!) If she is very busy and needs to keep 
working, she can hook up with the handsfree bra, put a big shirt over 
the whole thing, and just keep on taking phone calls or writing or 
shuffling papers. If pumping at home, with a bit of extra tubing, she 
can also feed her baby, amuse him/her, and even change a nappy. Pumpign 
handsfree also allows her to compress and massage to get more milk out, 
stimulate more let-downs, and reduce the chance of blocked ducts. This 
made an ENORMOUS difference to me. Why did I have to go out and find 
this information by myself on the internet?

Three: the right fit of flanges. Again, no-one told me there were even 
different sizes available, let alone that I would be vastly more 
comfortable in a different size. This very basic information is just 
not being made readily available to pumping mums.

Number four: a refrigerator is great, but not essential. Women who are 
on the road can store their milk in a cooler with blue ice. Even a sink 
isn't essential - buy multiple sets of horns, or get a bigger cooler 
and store the milky horns in there with the milk, or rinse the horns 
out with bottled water. Some women feel more comfortable with 
pre-packaged "antibacterial" wipes, but fresh breastmilk is plenty 
antibacterial for me - and there is no way to get the wipes into the 
crevices of most pumps, anyhow.  Bottom line: almost all practical 
barriers to pumping at work can be overcome, so long as the mum is 
well-informed and well-motivated.

Number five: correct information on milk handling and storage. I use 
the LLL guidelines. Many women are still being told that their milk 
lasts only two or three days in the fridge, or one hour at room 
temperature. Along with this - ways to be sure that the day care 
provider isn't throwing away milk unnecessarily or overfeeding the baby 
when other means of comfort are needed.

Number six: support. If a woman doesn't have support at her home and 
workplace (or even if she does), she will need ongoing mother-to-mother 
support to keep pumping in the long term. It's very easy to feel like 
you're the only person in the world to have this particular experience. 
  If their LLL or similar is pumping/working-friendly, that's perfect. 
If not, or if they don't have time to go to meetings, there are plenty 
of online support groups with a huge amount of accumulated information 
as well as psychological support available. I'm happy to give links by 
private email.

Lara
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