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How to combine breastfeeding. How to balance work and breastfeeding

The period associated with the birth of a baby and child care for most women is the most pleasant and serene - especially when you do not have to think about anything more important than the health and well-being of the baby. In a number of countries during this period, women are provided with financial support from the state for a more or less long period.

But in some cases, women still have to interrupt parental leave ahead of schedule or combine motherhood and work (study) without a vacation period.

Whatever the reasons that force you to start work (study) in the infant period of a baby's life, your milk still remains the most valuable food that you can offer your child. Therefore, having decided to continue breastfeeding your baby, try to plan the process in such a way that it is as comfortable as possible for both the baby and you.

Why do I need to return to work from maternity leave?

A sober assessment of the need for such a step and possible solutions to emerging problems will help you cope with the guilt that can sometimes arise in mothers who are forced to leave their baby in the care of other people sooner than they would like. You can confidently support yourself with the thought that your milk is indeed the best food for your baby, that all your efforts are aimed at his well-being and your love and affection for the baby will not weaken during forced absences.

Each woman has her own motive, leading to a period of absence from home. Whatever it is, the nursing mother must admit to herself that it is justified, necessary, real and feasible.
Here is an approximate list of questions, the answers to which you need to consider before making a decision to go to work (study):

At what age should my child be away from home?
How often will I be away from home?
How long will each break last?
How much time will be spent on the road?
Will I be able to change my mind if I realize this experience is not right for me and my baby?
Assess the readiness of management to provide you with time off and short vacations that you will inevitably need during periods of illness of the baby.

What rights do I have?

According to Art. 258 of the Labor Code of the Russian Federation, working women with children under the age of one and a half years are provided, in addition to a break for rest and food, additional breaks for feeding the child (children) at least every three hours, lasting at least 30 minutes each. At the request of the woman, breaks for feeding the child (children) are added to the break for rest and nutrition, or in a summarized form are transferred both to the beginning and to the end of the working day (work shift) with a corresponding reduction in it (her). Breaks for feeding the child (children) are included in working hours and are payable in the amount of average earnings.

You can also work part-time, in which case you will still be entitled to child care allowance up to 1.5 years. If you leave for a full-time job, then this right will not be preserved.

According to Art. 259 of the Labor Code of the Russian Federation, sending on business trips, engaging in overtime, night work, weekends and non-working holidays of women with children under the age of three years are allowed only with their written consent and provided that this is not prohibited to them in accordance with with a medical certificate issued in accordance with the procedure established by federal laws and other regulatory legal acts of the Russian Federation. At the same time, women with children under the age of three must be informed in writing of their right to refuse to be sent on a business trip, to engage in overtime work, work at night, weekends and non-working holidays.

Who will be with my child during my absence?

Exactly so, and not “who will notice me as a child?”. No one can replace you, because mom is exactly you. Despite this, you can fully ensure that even in your absence the baby is provided with the most optimal care, inspection and compliance with the regime.
Determine for yourself what criteria you accept for the person who will care for your child during absences:

Will it be someone close or will it be a babysitter?
Will this person always be nearby (you will live together) or will he come during your absences?
Who will be able to replace him in case of illness and other situations?
Do you have enough trust in this person?
How do you assess his willingness to follow your requests and advice?
Does he share your position on continuing to breastfeed and care for your baby despite going to work?
What kind of help is he ready to give you, and what is not?

What exactly should be discussed in advance with the one who will replace me during my absences?

Establish a trusting relationship with a person willing to help care for the child.
Write down all the points that are important to you, especially those related to the organization of feeding and the daily routine.
Determine the procedure in case of force majeure - prolonged crying of the baby, illness, poor health of the caregiver.
Once and for all, define acceptable and unacceptable actions in relation to the child and care for him.
Teach your chosen method of feeding with expressed milk, the method of calming the baby, the features of performing procedures for caring for the baby.
Discuss the undesirability of using breast substitutes in your absence (bottles, pacifiers, other means for sucking), but keep in mind that in the case of long absences from a child of the first six months of life, it is far from always possible to completely do without pacifiers, because the child needs to be satisfied sucking reflex.
Make a plan of expected actions and discuss it with the child's guardian during your absence. It is convenient to present the plan in the form of a table in which regime moments can be reflected. This will be clearer and more convenient for both you and the caregiver.

How to help a child adapt to mom's absences?

Try to help your child get used to your assistant by arranging meetings with him in advance, forming a positive perception of him.
Consider a daily routine that best suits the age and individual needs of the child. For example, the breaks between feedings for a child of 2 weeks and 1.5 years are completely different, so the approach to organizing the daily routine will be very different.
Determine the baby's nutritional needs and for suckling, sleep and wakefulness.
To provide the carer with all means of caring for the baby in excess.
Try to organize several “training” absences, evaluate possible scenarios for the development of events, and think over options for overcoming them. For example, who will leave the house first: a departing mother or a baby who is taken for a walk? What will be the actions on each side in case of sudden crying on the threshold?

What should mom pay attention to?

Plan your time: how many hours you will spend at work, how many - with the child, how many - in keeping the house in order (household affairs) and, of course, personal time, at least half an hour daily.
Learn how to properly ask for and accept help both in caring for a child, and in work, and in doing household chores.
Assess your readiness to breastfeed your baby more often in the evening and at night
Decide which methods you will use.
Find out if there are opportunities for pumping in the workplace, think about where, when and how you can use these opportunities?
Think about what you should always have on hand to make pumping comfortable and productive.
Find out if your employer is willing to give you pumping breaks (guaranteed by the labor code).
Create a supply of milk at home (breast milk bank).

Your desire to be the best mother to your child, to provide him with natural nutrition for the period required for him, can not be limited to the period of “exceptional home neighborliness”. An active mother who realizes herself in various areas of life, and even more so if she is forced to work or continue her studies - this can increasingly be heard about nursing mothers who competently and thoughtfully organize their stay separately from the child. Skills, worldly tricks, sound recommendations and pitfalls of upcoming absences are best discussed in advance with women who have had similar experience or.

Grown up children will certainly be proud of their purposeful, successful, educated and career-successful mothers, regardless of the method of feeding in the first years of life. But close communication with the baby during breastfeeding and the preservation of feeding with expressed milk are mutually beneficial to the health (both physical and psychological) of mother and baby and add a lot of unforgettable pleasant moments to the infancy period.

Chistova Julia, lactation consultant

(edited by Polina Novoselova, lactation consultant)

It is necessary to understand the situation and make every effort to maintain breastfeeding:

Carry out control weighing at least 4–5 times a day (the child must be weighed before and after feeding, in the same clothes) to clarify the amount of sucked milk and the degree of its deficiency.
Keep a daily feeding diary.
Switch to a free feeding regime, with obligatory night feedings.
During feeding, apply the baby to both breasts. Express the rest of the milk.
Use breast pumps that will stimulate the mammary glands and increase lactation.
Consult a doctor who, if necessary, will prescribe drugs, herbal medicine to increase lactation.

When, despite all the measures taken, the introduction of supplementary feeding is necessary, then feeding becomes mixed.

When and how to add the mixture?

Mixed feeding is understood as feeding with breast milk, if its amount is at least 1/5 of the daily amount of food.

The introduction of supplementary feeding is stressful for the child, so the transfer to mixed feeding should be justified and carried out gradually, replenishing the missing amount of breast milk.

Currently, there is a wide choice of modern infant formulas that take into account the peculiarities of metabolism, digestion, as well as the child's age-related needs for macro- and microelements, vitamins and energy.

The composition of the "initial" mixtures is maximally adapted to breast milk. Modern technologies make it possible to create products containing almost all nutrients in amounts close to their level in breast milk. By improving the quality of the protein component, its concentration was reduced to 1.2–1.4 g/100 g. The lipid component is formed from mixtures of vegetable oils. The content of vitamins and minerals in mixtures corresponds to the physiological needs of children in the first six months of life. Also, the composition of the "initial" mixtures may include taurine, L-carnitine, oligosaccharides, probiotics, polyunsaturated fatty acids, which are found in breast milk.

Subsequent mixtures contain more protein (1.5–2.1 g/100 g). The energy value of these mixtures is higher due to the higher content of carbohydrates and protein. Products contain vitamins and minerals (iron, calcium, phosphorus, magnesium, etc.) in accordance with the age needs of children in the second half of life.

In the nutrition of healthy children of the first year, adapted fermented milk mixtures can be used. These products are prescribed at the risk of developing alimentary-dependent conditions, dysbiotic disorders, decreased appetite, and frequent respiratory diseases.

Along with traditional artificial milk formulas for feeding newborns, there are therapeutic formulas for children with intolerance to cow's milk protein, lactase deficiency, impaired absorption of fats, a tendency to regurgitation, for premature babies. Remember that only a doctor can prescribe curative and fermented milk mixtures after examining the baby and making an appropriate diagnosis.

The choice of an artificial mixture is a responsible decision, the health of the baby depends on it, because the nutrition of the baby at an early age forms the metabolism, which affects his health for the rest of his life.

Be sure to consult with a specialist before choosing a formula for your baby. Self-selection of an artificial mixture can lead to negative consequences for the health of the child.

How to prepare milk formula?

The first thing to do when buying baby food is to check the expiration date. Read the instructions carefully before preparing formula for feeding your baby.

Pay attention to:

term and conditions of storage of an open jar with a mixture;
proportions of water and dry powder;
the amount of powder for children of different ages.

Always wash your hands thoroughly with soap and water before preparing formula. Water for the preparation of the mixture must be boiled. This also applies to special bottled children's water. The temperature of the milk mixture should be 36-37 ° C, as with breast milk. To obtain such a temperature, you need to pour boiled, cooled to 50-60 ° C water into a bottle. Using a measuring spoon, measure out the desired amount of milk formula, being sure to remove the excess. Pour the powder into water and stir quickly until completely dissolved. Close the bottle tightly and shake well. Before feeding, pay attention to the temperature of the mixture.

Prepare formula for one feeding only. The fact. that milk formula is a nutritious product, and therefore, it is a favorable environment for the reproduction of microorganisms. In this regard, the remaining mixture after feeding must be poured out.

After feeding, thoroughly wash the baby's dishes and sterilize them. For convenience and save time, purchase a sterilizer - a very convenient and necessary thing for mom. In a few minutes, it will effectively destroy germs in baby dishes and pacifiers.

Infant milk formulas are divided into:

"Initial" - from birth to 6 months of life (marked with the number 1).
"Following" - from 6 to 12 months (marked with the number 2).
In addition, in the nutrition of children of the first year of life, mixtures "from 0 to 12 months" are used.

How to enter the mixture?

You need to start feeding your baby with breast milk. Feeding on demand. The baby must be fed from both mammary glands and only after that offer a mixture that is introduced into the child's diet gradually, over 5-7 days. On the first day, the baby is offered a mixture in a small volume - no more than 1/3 of the recommended amount of feeding by age. Within a week, if the child feels well, there are no allergic reactions, dyspeptic disorders (regurgitation, vomiting, diarrhea), the volume of the mixture is gradually increased. You can give only infant formula in one of the feedings. This scheme is convenient for moms who need to be absent daily for several hours.

Basic rules for mixed feeding

Feeding regimen at the request of the child.
Use adapted formulas for feeding your baby.
Always strictly follow the instructions for use of the mixture on the package.
After feeding, hold the baby upright for 5-10 minutes to expel air that the baby can swallow during feeding.

What is the volume of feeding with mixed feeding?

When calculating the daily nutrition for the baby, you can rely on the following calculations:

from 10 days to 2 months, the daily amount of food is 1/5 of the child's body weight;
from 2 to 4 months - 1/6 of body weight;
from 4 to 6 months - 1/7 of body weight;
from 6 to 12 months, the daily amount of food is 1000 ml, including complementary foods.

Approximate number of meals per day:

the first week of life - 7-10;
1 week - 2 months - 7-8 feedings;
2-4 months - 6-7 feedings;
4-9 months - 5-6 feedings;
9-12 months - 4-5.

We determine the volume of one feeding.

To do this, you need to divide the daily amount of food by the total number of feedings.

Example: a child of 1 month of life weighs 4200 g, eats 7 times a day. Per day, he should receive: 4200: 5 = 850 ml of food (breast milk + formula if necessary). The volume of one feeding with seven meals a day will be: 850: 7 \u003d 120–125 ml.

The pediatrician will help calculate the optimal amount of infant formula. It will take into account the individual characteristics of the child, his state of health and the maturity of the digestive system.

How to feed?

During feeding, take the baby in your arms, while taking into account that the position should be comfortable for both the baby and yourself. You can correctly position the child as follows:

The position of the head of the newborn is slightly higher than the body. It is best to bend the arm at the elbow and place the baby's head on the bend.
During bottle feeding, the position of the baby should be approximately the same as during breastfeeding.
The bottle should be held slightly on an incline, but the nipple must be filled with formula.
Never leave your baby alone while bottle feeding.
Do not leave a bottle in your baby's mouth when he is sleeping.

At each feeding, continue to attach the baby to both breasts.

Feeding regimen at the request of the child.

Regularly carry out control weighings to determine the amount of artificial formula supplementation.

Use adapted formulas for feeding your baby.

Buy artificial mixtures only in large shopping centers and specialized stores or pharmacies. Always pay attention to the integrity of the packaging, expiration date and storage conditions of the product.
Always strictly follow the instructions for use of the mixture on the package.
Always wash and sterilize children's dishes thoroughly.
Hold your baby upright for 5-10 minutes after feeding to allow air to escape that your baby may swallow while feeding.

When is there not enough milk?

Criteria for lactation sufficiency:

The child calmly, rhythmically sucks the breast, swallowing, while one feeding takes about 20 minutes.
After feeding, the child independently releases the breast and maintains the usual interval between feedings.
The child is gaining weight well. The increase for the first month should be at least 600 g, then in the first half of the year 750–800 g monthly.
With a sufficient amount of milk, the baby's stool is mushy, homogeneous, in the first month - after each feeding. By 4-5 months, the frequency of stools decreases to 3-4 times a day.
Urination frequency more than 6 times a day (can be up to 25 times a day). Urine is colorless and odorless.
You can think about the lack of milk:
If your baby has become restless, has ceased to withstand the intervals between feedings.
During feeding, the child makes mainly sucking movements, rarely swallowing.
You are unable to express your breasts after feeding.
The child is not gaining enough weight with the exclusion of other conditions that can cause this.
Urination less than 6 times a day, urine with a pungent odor.
Rare and hard stool.

Common mistakes that are made with mixed feeding:

unreasonable transfer of the baby to mixed feeding;
frequent change of mixtures that are used to feed the child. It is necessary to assess the individual tolerance of the mixture by the child. But you can not "jump" from one mixture to another every 1-2 days. Adaptation to a new type of food occurs within 3-5 days;
decrease or increase in the required volume of the mixture for feeding the baby;
the use of whole cow or goat milk, kefir for supplementary feeding of a child. Cow's milk and the milk of other animals can cause a lack of iron and other vitamins and minerals and contribute to the development of obesity;
Supplementary feeding in the form of milk formula is given before breastfeeding. You must first feed the baby from both mammary glands, and only then make up for the missing amount of nutrition with the mixture;
Attaching the baby to only one breast during one feeding. It is necessary to apply the baby every feeding to both mammary glands;
wrong position of the baby when feeding from a bottle. It is necessary to hold the baby in the same way as when breastfeeding to maintain physical and psycho-emotional contact. The position of the bottle during feeding is also very important: it depends on how soon the child will eat, whether he will choke and swallow air.

It has long been proven that breastfeeding is superior to formula feeding in all respects. Indeed, breast milk contains not only all the vitamins and important nutrients necessary for the baby, but also unique antibodies that can protect it from a number of infections and diseases that threaten newborns in the first months of their life.

How to combine work and a baby using a breast pump?

Modern breast pumps have become indispensable helpers for mothers who are forced to combine natural breastfeeding with milk expression due to early work. To choose the most suitable model, a woman must clearly understand how long she will be forced to be away from the child.

The most affordable and convenient device is a manual breast pump, ideal for occasional use. But it should not be purchased for long-term use. It is unlikely to suit most working mothers, and they will not call it practical.

Its main advantage is mobility, since you can take it with you when going to the store or for a walk. In addition, a manual breast pump will help to cope with excessive milk pressure in the breast or prepare it for feeding in the first months after childbirth.

Which breast pump should I buy for a working mom?

Sufficiently convenient and easy to use are universal breast pumps that can operate from the mains or from ordinary batteries. Their use allows you to turn pumping into a fairly quick and effective procedure.

The modern electric breast pump is easy to use, powerful and efficient. In addition, he leaves the woman's hands free so that she, if desired, can feed the baby from a free breast. Despite the high cost, such devices are in great demand by people who value time and are ready to pay more to save it.

If the main criterion for choosing a breast pump is its portability, then it makes sense to purchase a compact model for walks and trips, and use an electric one at home.

In some cases, the newborn needs to be supplemented with formula. But, even when supplementing the baby, it makes sense to keep breastfeeding as long as possible. How to do it right?

All expectant mothers know what is the best food for the baby. But it happens that you can’t do without supplementary feeding with a mixture. For example, the baby was born or underweight; mother has problems with lactation, mastopathy,; the mother is sick and forced to limit breastfeeding after taking medication; Mom needs to go to work or leave home for a long time. In all these cases, you will have to switch to mixed feeding - a combination of breast and artificial feeding, when the volume of the mixture per day is less than half of the infant's diet.

There are two main supplementation scenarios that allow breastfeeding to continue.

If the mother has problems with lactation, the baby is premature or weighs little

In this case, the mixture should be given every 3 hours, but always after applying to the breast. Before a night's sleep, it is necessary to give the crumbs both breasts and only then supplement it with a mixture. At night and especially in the morning, the baby is fed only breast milk - this is important for maintaining and stimulating lactation.

There are several ways to calculate the amount of mixture needed for a baby. The first is according to WHO standards. A baby up to one and a half months should drink milk and / or mixture per day in an amount of 1/5 of body weight; from one and a half to 4 months - 1/6 of the mass; from 4 to 6 months - 1/7; after six months - 1/8, but not more than 1000 ml for children under one year old. By weighing the baby before and after each feeding, you can determine exactly how much he does not eat up, and divide the resulting volume of the mixture into about 6 feedings. We get the amount of mixture that needs to be offered to the child every 3 hours.

The second method is the wet diaper method. You need to understand how many times a day the baby urinates (for this you will have to give up diapers for several days and replace them with diapers). Normally, a baby should have 12-15 urination per day. If there is not enough milk, the baby will urinate less often. Then supplementary feeding is introduced in a volume of 30 ml every 3 hours. If, against the background of such supplementary feeding, the norm is still not reached, add another 20-30 ml of the mixture to each feeding.

Experts advise not to use pacifiers and bottles with a nipple, but to supplement the baby with a pipette or with a spoon so that the baby does not forget how to properly attach to the breast. This is especially true for mothers whose milk does not flow like water, but comes out with difficulty - the baby will quickly realize that such efforts are not needed with the bottle, and may even refuse to breastfeed. Also, to maintain lactation, it is important that it is the mother who feeds the child with the mixture.

In a situation where there is little milk, the main task of the mother is to maintain and improve lactation, after which supplementary feeding is gradually removed.

If lactation is normal

When the problem is that the mother needs to go to work or just go somewhere regularly, and for some reason it is impossible to leave the expressed milk, the scenario for introducing supplementary feeding is different. In this case, the mixture is completely replaced first by one feeding, and then several. To avoid lactostasis, a nursing mother can express a little without stimulating the nipples.

Since in this situation the mother loses contact with the baby during the day, it is very important to continue to feed milk at night and to breastfeed on demand while being close to the baby. After all, breastfeeding is not only nutrition, but also moments of intimacy, tenderness, establishing a strong bond between mother and child.

A few more feeding rules

If doctors did not recommend otherwise, it is better to feed the baby with better adapted mixtures. Medicinal mixtures (lactose-free, hypoallergenic, etc.) are prescribed exclusively by a pediatrician or pediatric gastroenterologist based on the results of the analysis, and you should not give them to your baby on your own initiative.
If the baby categorically refuses to drink the mixture, you can first try to offer him expressed breast milk in a bottle or spoon.
There is no need to insist that the baby drink the entire amount prescribed by WHO (stick the bottle until you are blue in the face, offer the mixture every half an hour, give it uneaten at the next feeding). Focus on the needs of your child, not on the statistical norms of the population.
Supplementation should not cause negative emotions: feed the baby with a warm mixture, do not insist, talk affectionately with him during feeding.
If the baby is already 6 months old, perhaps the mixture should be replaced with complementary foods (cereals, mashed potatoes, sour-milk products).
Try to keep mixed feeding as long as possible, do not give up breastfeeding if you encounter any difficulties. After all, only in breast milk there is not only all the useful substances, vitamins and trace elements necessary for the baby, but also antibodies that increase its immunity.

If the baby is not gaining weight well, and mother's milk is not enough for him to be fully saturated, pediatricians usually advise breastfeeding and mixtures to be combined. The main question for a young mother is: how to introduce complementary foods with a mixture during breastfeeding in order to avoid unpleasant consequences - colic and bloating in a child? Another concern is whether the baby will drop the breast after tasting the mixture? During the first or second month of a baby's life, it becomes clear whether his mother's milk is enough for him or whether it is necessary to introduce complementary foods with a mixture. Usually the decision is made by the pediatrician who leads the child, based on the results of weighing and the well-being of the baby. Mom herself, by the behavior of the child, can understand that he does not have enough milk. If such a problem exists, the baby urinates less than six times a day, or his stool does not set (it is dense brown or greenish). After feeding, the baby does not want to let go of the breast, is not satisfied, is still restless. The baby continues to cry between meals. All these signs may indicate malnutrition and the need to switch to a mixed diet. Mixed feeding, in turn, can be an intermediate step in the transition to artificial nutrition, if the mother plans to go to work or for other reasons. The period when the mother combines breastfeeding and formula will allow the baby to gradually adapt to the new state. If there are no medical indications for starting a mixed diet, it is worth combining breastfeeding and mixtures no earlier than 5.5–6.5 months. At this age, the digestive system is already ready to start complementary foods, not only with mixtures, but with vegetable purees, and a little later with cereals.

It is necessary to give the mixture not before, but after breastfeeding, without taking a break. It is worth starting with microportions - about 10 ml, gradually increasing the volume. The first attempts to supplement the baby with a mixture should be done in the morning - you can track the reaction in as much detail as possible during daylight hours. Even high-quality fresh formula may not be suitable for your baby, depending on the individual characteristics of the organism. Formula feeding a baby can cause allergies and digestive problems in the baby. Pay close attention to what happens to the baby after feeding. Every nuance is important: whether the baby's stool has changed, how often he burps, whether he has become more restless, or, on the contrary, sleeps more than usual. A direct sign of an allergy can be a rash and redness on the body. If adverse reactions to formula after breastfeeding do not go away within a day or two, stop formula feeding and consult a specialist. When you find a formula that suits your baby perfectly, try not to change it. The mixture is prepared immediately before feeding. If it is dry, then it is bred strictly according to the instructions in boiled or special water for children's drink. Complementary feeding with a mixture is carried out according to the schedule, no more than 5 feedings per day. In the intervals between the main feedings, at the request of the baby, give him a breast. But this is the case if the problem is a lack of milk, and you want to keep the baby breastfed as long as possible. If the amount of milk increases, immediately reduce the amount of the mixture.

About choosing a bottle

An incorrect nipple can cause a baby to refuse the breast if he realizes that there is no need to make any effort when feeding. Choose a teat with minimal flow so that your baby doesn't feel the big difference between breastfeeding and bottle feeding. Another, better option is to skip the bottle altogether, especially if you plan to combine breastfeeding and formula for a long time. Give the baby food from a spoon, and at an older age - from a small mug.

About mixtures

When choosing a formula for mixed feeding, make sure it is suitable for your baby's age. Information about this is indicated on the packaging. It is better to purchase mixtures in pharmacies and specialized stores, where all the rules and storage conditions are guaranteed. Among modern infant formulas there are those that are indicated for babies with health problems: a weakened immune system, digestive problems, prone to anemia, colic or constipation. It is advisable to introduce the mixture after breastfeeding in consultation with a good pediatrician. He will also advise and guide you in the choice of food. Be sure to inform the doctor about the baby's reaction to mixed feeding, then the introduction of the mixture into the baby's diet will pass without problems.

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