Making It Work
Finding a Caregiver for Your Breastfed Baby
From: NEW BEGINNINGS, Vol. 10 No. 6, November-December 1993, pp. 184-86
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.
How can I tell if a prospective caregiver is "breastfeeding friendly"? What kinds of differences can I help a caregiver anticipate if she has never dealt with breastfed babies?
Finding a suitable caregiver for your baby can be one of the most difficult aspects of returning to work. Choosing a "breastfeeding friendly" caregiver may be one of the best things you can do to ease your mind and soothe your soul when you are separated from your child.
I chose to take my baby to a day care center. I like the consistent availability of care and the supervision of the caregivers. I found a wide variety of attitudes regarding breastfeeding when I took my baby with me as we searched for just the right place. Though some centers were quite cozy and the caregivers seemed friendly enough, they often reacted with obvious discomfort when I began to nurse my son while visiting the centers.
One director asked me if I wouldn't rather nurse the baby in her office. Another caregiver said she didn't think it was a good idea to nurse in front of the other children (even though I was nursing him very discreetly) because they might go home and tell their parents.
Still another center told me they occasionally had families who breastfed. They showed me where the milk was stored in the refrigerator, then asked that I also bring some juice or cereal in case the baby wasn't satisfied with the breast milk. You can imagine my frustration!
Finally, my son and I found a center within a mile of my place of employment. It was clean and cozy, and when I walked into the "Cuddler" room I was greeted by a woman who had been there ten years—and she was one of those people who is a born nurturer (I wanted to ask her for a hug right then!).
She explained that many of the babies in the center are breastfed—at least while they are in the "Cuddler" room or "Snuggler" room. There were plenty of comfortable rockers and she explained that they keep a phone in the room so that they may call or page the mothers who work in the area whenever the baby is ready to nurse. Some mothers didn't even leave breast milk and bottles and had the center page them for each feeding. In addition, if mothers came to breastfeed their babies at lunch, a hot, home-cooked, nutritious meal was available to them at no extra charge. (These were some of the healthiest meals I've ever eaten.)
Needless to say, this center and its caregivers are extremely "breastfeeding friendly," and my son and I were very happy there. Lately we have been fortunate to take our children out of day care as they are staying home with my husband.
I suggest you start your search early and don't stop until you find what you are looking for. It can make the difference between your going to work with peace of mind or going to work feeling as if there is a boulder in the pit of your stomach. I've had it both ways, and I far prefer the peace of mind.
Oklahoma City OK USA
Over the past nine months since my daughter Ania began day-care at nine weeks old, our caregiver, Susan, and I have created a good working partnership. It is clear to both of us that, for a full-time working family, a caregiver is a partner to a successful breastfeeding relationship.
While I attribute our finding Susan partly to luck, my husband, Mike, and I had certain thoughts and priorities that helped us find the right person who would both care for Ania and help us continue to be a breastfeeding family. "Hindsight" does make this seem clearer than it did at the time. Here are some ideas Susan and I came up with during our lunch hours while I nurse Ania.
Good partnerships require each partner to have the necessary skills and knowledge to be able to communicate well, and be willing to "do what it takes" to accomplish an agreed-upon goal. Making a plan will help you focus your interviews with potential caregivers on whether they will be good partners. Part of developing our plan involved understanding what we did and didn't know about working and nursing, and realizing how vulnerable that made me feel.
Your Plan: Do you want to use breast milk exclusively or are you willing to have the caregiver supplement with formula? Will you be able to nurse at lunch or will the caregiver need a supply of breast milk for the entire day? How and when do you plan to express, store, and transfer your milk?
Assessing Your Knowledge: Do you know how to express, store, and handle breast milk? Is your feeding and pumping schedule flexible? If not, you may need to find a caregiver who has the knowledge and flexibility to "fill in the gaps."
Your Commitment: Know what your level of commitment is: your caregiver won't be likely to put out any more than you are willing to. Commitment is contagious; a high level will encourage both you and the caregiver when the going gets tough. There were times when Susan's encouragement kept Ania on breast milk.
The other half of the partnership is the caregiver: you will need to find out if a potential caregiver has the skills you need, is able to communicate with you, is willing to help you carry out your plan, and fits other considerations.
Skills: What does the caregiver know about breastfeeding? Did the caregiver breastfeed her own baby? Is she already working with breastfeeding/working families? How would the caregiver thaw frozen breast milk? You also want to know that she will not waste this precious food by thawing out too much at one time.
Ability to communicate: You want a caregiver to whom you can express your needs, concerns, and questions, and with whose responses you will feel comfortable. A good partnership will also depend on your caregiver communicating to you her needs in caring for your baby as well as how the baby is doing. At the end of each day, Susan provides a sheet describing Ania's day including her moods, feeding and sleeping times, diaper changes, and how much breast milk she had at each feeding.
Willingness: Will the caregiver accommodate your plan? This could mean not using formula or food to pacify baby and may be especially important when baby is hungry and you are arriving with full breasts.
Other Considerations: Does the caregiver have a good freezer or other appropriate facilities for milk storage? If you feed the baby at lunch, is there a comfortable place to sit and nurse? Visit the caregiver's facility and nurse there. I did this twice and found it helped me decide if Ania would feel comfortable with Susan.
Know that when selecting a caregiver, there may be tradeoffs. You may wish to have a caregiver with perhaps a minimal breast milk experience but a willingness to learn and accommodate you as opposed to someone who has dealt a lot with breastfeeding mothers but may not be open to your ideas.
Realistically, a caregiver is unlikely to have the personal experience of being a full-time working/breastfeeding mother (with her child in someone else's care). You need to be willing to hear if a potential caregiver cannot be committed to your plan and look elsewhere.
Finally, anticipating baby's needs is a lot easier with a good caregiver partnership. Based on my experience with Susan, your caregiver has a critical role in anticipating how much milk is needed, in what amounts it should be frozen, and (occasionally) when to come nurse (I have flexible lunch hours and now and then I nurse later in order not to wake up Ania from her nap).
Arcata, California, USA
I have been a family child care provider, caring for children in my own home, for more than six years. I have been accredited twice by the National Association for Family Child Care, and have nursed two sons of my own. I have a lot of contact with other caregivers. I love it when mothers come in enthusiastic about nursing! It makes it so much easier on the babies. Despite the extra planning, it makes things better for mother, too, physically and emotionally. Despite long hours in child care, the breastfed baby is still getting something throughout the day that only mother can give, and breast milk is best for the baby!
You should ask a prospective caregiver what her experience is with nursing. You need to be reasonably certain that this is not the sort of person who will sabotage your efforts to breastfeed by giving the baby formula behind your back or introducing solids too early because the baby seems hungry. This requires that the caregiver not only be familiar with breastfeeding and supportive of you, but that you and she can establish a relationship built on mutual trust and responsibility. Sharing the care of a child requires a lot of communication between parent and caregiver. Can you and she talk by telephone once or twice a day just to touch base? Can you drop by early without warning if you finish work ahead of schedule? Are fees, hours of care, holidays, sick child policy, etc., stated in advance and preferably written down? It's necessary to be clear about those things so that you and she can concentrate on making the transition go smoothly.
In my experience, formula-fed babies have more gastric discomfort and more spit-ups when they make the change from their home to mine than do breastfed babies. If a breastfed baby is fussy, the cause is obviously not what he is eating! Sometimes in the first days caregivers have a problem with new babies resisting the bottle, either because they are not accustomed to the bottle nipple or because they are "on strike." This is very stressful on the caregiver and may cause her to think she is not doing a good job or measuring up to your expectations. This is why honesty between the two of you is so very important. Caregivers I know just repeatedly offer the bottle until the baby learns how to accept it, and give the baby a lot of cuddling. This takes time and patience, particularly if other children are present. Depending on the age of the baby, this problem is usually resolved within two weeks.
Another problem I have noticed is that women often become alarmed if their milk supply drops when they return to work. I share with them that I experienced the same thing when my baby was hospitalized twice for a congenital kidney problem, and it is due to stress and change in routine. I find it's helpful if they know that it's not the end of the world, and that if they keep nursing and pumping and taking care of themselves with proper diet, fluids, and rest when possible, their body will adjust. As long as the baby is passing adequate stools and has plenty of wet diapers there's usually no big problem. In anticipation of this, it's best to start building your milk "bank" ahead of time so that you have a supply to fall back on.
To me, supporting a mother's ability to breastfeed her child is an important aspect of family child care. I nursed my youngest while doing child care and was so pleased to observe the preschool children imitating breastfeeding in their doll play. The mother who can get away during the day to come and breastfeed at my house is able not only to spend more time with her baby and breastfeed, but also has a pretty good idea of how things go during the day with all of us. I have also noticed that mothers of nursing toddlers and preschoolers appreciate being able to make nursing at my house part of their reunion ritual before they start the drive home. For single mothers, making breastfeeding part of the child care day has been especially important. They appreciate the support and understanding from me, and they don't have to feel pressured to nurse the minute they walk in their own front door.
Sadly, I've encountered more people who don't breastfeed than those who do. Some of the reasons given are long commutes, short lunch breaks, mandatory overtime, irregular shifts, and office atmosphere hostile to pumping and storing milk. One of my first clients was a single mother who was a saleswoman for a construction supply company. She was the only woman in her division, and all her clients were men. Her company was so hostile that she was not even allowed to mention that she had a child, for fear that clients might think she was soft and not totally dedicated to business. She worked irregular hours, and traveled great distances. When her son was barely two years old, her boss required her to go on overnight trips and to meetings lasting several days. She nursed her son till he was three. My admiration for her ability to do this is unbounded. She really showed me just how valuable breastfeeding is.
It's a shame that corporate culture still has the power to dictate to women how they may nurture their children. Most professional family child care providers whom I know actively support breastfeeding. We offer an important alternative for mothers seeking to nurse and nurture their infants while working in hostile corporate environments.
Janet M. Hill
Bergenfield, New Jersey, USA