Breastfeeding and Returning to Work as a Junior Doctor
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I have breastfed 2 babies while returning to work as a junior doctor.
With my first son I was hugely anxious about going back to work and had no idea how to make it work. I was certain I wanted to continue breastfeeding, but had no idea how to go about any significant separation with a baby who fed many, many times day & night.
I spent months “preparing” for this transition, which mainly involved a huge amount of stress for all involved. Firstly, I attempted to night-wean him as I felt I would be too exhausted if I was up feeding him all night. I reduced his day time feeds down to about 2. We practised my husband settling him for naps in his cot for months.
Once I was back at work (he was 14 months) all this stress fell away, and I realised we were both ok. I went back to feeding him responsively (sometimes constantly) when I was around, and he was quite happy with a cup of milk when I was at work. He went to sleep happily for my husband when I wasn’t around. My breasts adapted fine to the variable milk demand, without the need to pump. I quickly reverted to feeding at night when I realised, he still woke up, but just took significantly more time & effort to settle, and actually the exhaustion was far less with breastfeeding than without it, because I could get him back to sleep quickly and reliably.
I have recently returned to work after maternity leave with my youngest son, & the huge contrast this time is that I had the confidence in him and in my breasts that we would adapt as needed and be able to maintain our breastfeeding relationship with very little alteration. I went back to work (3 days per week) when he was 14 months. At this stage he fed multiple times day and night and I had never left him for more than an hour or 2, and never been out at bedtime/overnight. He has coped absolutely brilliantly despite this, and is generally happy when I’m not there, managing by upping his solids intake considerably! He takes water well from a cup too, and if he is asking for milk my husband or mum (who between them look after him if I’m at work) offer him oat milk from a cup, but he’s rarely very interested. They get him to sleep in the buggy/car/sling for his nap as when I’m at home I would usually feed him to sleep. He probably does feed a bit more at night on days I’ve been at work, but I barely notice this because he sleeps in bed with me, with my boob pointed at him and almost helps himself to milk overnight with very little input from me. I don’t ever check the clock, look at my phone or even open my eyes overnight, so despite multiple wake-ups, I’m well rested. The difference in my exhaustion levels compared to when my eldest was this age, and I was sitting up to feed him in a chair next to his cot, settling him in the cot and then trying to get back to sleep myself, is worlds apart.
I don’t pump at work as I really dislike pumping so ideally would choose to avoid it, and it’s just one less thing to do on a busy shift. However, I always have a pump in my bag & I know there is a room I could use to pump in if required, so I do have an emergency back up option. The first couple of days I worked I hand expressed a bit into a sink to maintain my own comfort & avoid mastitis, and since then haven’t needed to. On my return home my son shouts milk as my key turns in the lock and is trying to remove my top before I’ve shut the front door, so the fact my boobs are very ready to feed by then suits us both well!
When I work night shifts I am away from him for about 14 hours. We did debate “practising” for this by my husband doing some night settles with him beforehand but, after speaking to other women who have been through the same thing, felt it was likely that he would want me (my breasts) if he knew I was at home and this would increase stress, rather than reduce it. So we did no preparation & as the first shift approached I was more and more worried we’d made the wrong decision from this point of view and that it was unfair on him. That first night I put him to bed before I went to work, feeding him to sleep, and then left. I have to say, I was terrified as I drove off. I imagined him waking, realising I wasn’t there for the first time ever & screaming inconsolably for the rest of the night. However, when he first woke up, he wasn’t particularly upset, but was asking for me (MILK! MILK!). My husband told him I was at work, offered him a cup of milk (refused) and walked him around the house to show him I wasn’t there (a brilliant tip a friend gave me). After this he settled quite easily cuddled up to my husband who patted and sshh-ed his way successfully through the rest of the night. There were a lot of wake-ups, & my husband was tired, but had thankfully booked some annual leave for the days surrounding my first few sets of nights in order to get some rest himself. Things became easier after this, & my husband can now settle him easily – if I’m not there he knows there’s no milk & is quite happy co-sleeping with my husband. After a night shift I go to where he is (usually my mum’s) to feed him before I go home to bed, as I would be too engorged to sleep by this stage – it’s so nice to check in with him too, after a night away. I couldn’t have done this without the incredible support of my husband, who thankfully values breastfeeding enough to want me to keep feeding our boys, despite knowing that it was likely things would be tricky for a while when I first went back to work each time. Our confidence in his relationship with our children meant that we knew they would be OK without boob-access, as long as he was providing them with comfort.
Mainly I’ve learnt that boobs and babies are far more adaptable than most people would ever imagine and that, almost certainly, a return to work is no reason to stop breastfeeding. In fact, I think that breastfeeding has helped both my babies and me adjust more easily to the separation and given us a lovely way to connect on my return.
(The author took additional unpaid leave with both children after her accrued annual leave)
*Anon, but, if you want to connect with this mother reach out to me and I can connect you.
Want to read more about returning to work? Visit the La Leche League GB website breastfeeding support articles by CLICKING HERE (scroll down to find information about return to work and breastfeeding)
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