Breastfeeding Help  - What to Feed the Baby When the Mother is Working Outside the Home 

Welcome, working moms! This isn't a comprehensive guide on juggling work and breastfeeding, but it's your trusted companion on feeding your baby when you're not around. Specifically tailored to mothers returning to work around the 6-month mark. In Canada, you're entitled to 52 weeks of maternity leave, so make the most of it. Remember, going back to work comes with costs (transport, work attire, childcare) that may offset your increased income. If you can, aim for at least 6 months, ideally 7 months (it makes continued breastfeeding while you're away easier). Your baby won't be this little again, so cherish this time.  

Let's Debunk Some Myths:

1. Babies don't absolutely need to take a bottle when the mother isn't around.

True. Bottles aren't the only option. Some breastfed babies don't take to bottles by 2 or 3 months, and many won't by 4 or 5 months. It's not a crisis! No need to force it. If your baby is at least 6 months old when you return to work, bottles aren't a must. Even at 3 or 4 months, they can sip liquids or solids from a spoon. By 6 months, they can manage without getting hungry during the day. They can even learn to sip from a cup as early as day one. Skip the spouted "sippy" cups if possible. If your baby hasn't mastered the cup by the time you return to work, don't fret. They can sip from a spoon or have solids mixed with liquids (expressed milk, water). Some babies prefer waiting for mom to return to get a drink, and that's perfectly fine; many babies sleep through the night without eating or drinking. 

2. Introducing a bottle won't necessarily hurt.

Not always. Some babies can handle both bottle and breast, occasionally. But if they're getting several bottles daily and your milk supply drops, they might start refusing the breast, even if they're older than 6 months. 

3. Babies don't need milk when you're away.

Correct. Your baby's good with three or four solid breastfeeding sessions a day, along with a variety of solid foods. No need for extra milk when you're at work. You can mix solids with expressed milk or other milk, but it's not obligatory. 

4. Babies older than 6 months don't have to switch to formula.

Absolutely right. For babies who breastfeed a few times a day and enjoy diverse solid foods, infant formula isn't required and may not be desired. Babies who haven't had formula before 5 or 6 months of age often dislike it because it tastes different from breastmilk. If you opt for an alternative milk, you can introduce homogenized milk at 6 months of age, as long as it's not the baby's sole food. In fact, if the baby's thriving with regular breastfeeding, some 2% milk or homogenized milk is sufficient, though still not obligatory. The notion of formula until 9 to 12 months is mostly a marketing ploy, and it doesn't consider babies who continue to breastfeed past 6 months. 

5. Babies don't need to drink milk for calcium.

You're spot on. Your baby can get calcium from cheese or yogurt if you're concerned about their intake. No need to drink calcium. Plus, breastmilk still provides calcium if they're breastfeeding. 

6. Follow-up formulas aren't a must for infants aged 6 to 12 months. Absolutely right. They're unnecessary and primarily benefit formula company profits. They're part of a marketing strategy trying to bypass restrictions on direct advertising of infant formula to the public (which are often ignored). In Europe, there are even special formulas for toddlers (1-3 years of age). People seem to buy anything! But these toddler formulas will probably appear soon. The bottom line is key.  In Singapore, I've seen formula labeled "from 3 to 7 years."

7. A breastfed baby at 4 months of age can get enough iron from breastmilk alone. You're absolutely right. A full-term breastfed baby gets all the iron they need from breastmilk. However, by around 6 months, it's wise to start introducing more iron than breastmilk provides. The best source is food, with meat being an excellent choice. It's not formula, and it's not infant cereals. 

8. Infant cereals aren't the best way to ensure your baby gets enough iron.

You're absolutely right. While infant cereals contain plenty of iron, most of it isn't well absorbed and may cause constipation in some babies. Additionally, some exclusively breastfed babies may not like cereals, and pushing them might lead to future feeding issues. The best way to ensure your baby gets enough iron is to continue breastfeeding and introduce solids in a relaxed, enjoyable manner at the right time (see the Starting Solid Foods handout). Typically, babies show interest in eating around 4½ to 5½ months. At this age, they can enjoy the same foods as the family, with few exceptions. No need to obsess over the order of food introduction or making your baby eat just one type of food each week. The easiest way to provide extra iron for babies aged 6 to 12 months is through meat, which is highly absorbable. Feed your baby solids in a way that makes eating fun, and they'll be fine with iron-containing foods. 

Questions? Email Jack Newman at drjacknewman@sympatico.ca, or Edith Kernerman at breastfeeding@sympatico.ca or consult: Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA) or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding; or The Latch Book and Other Keys to Breastfeeding Success; or L-eat Latch & Transfer Tool, or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.  See our website at www.drjacknewman.com.  To make an appointment email breastfeeding@ccnm.edu and respond to the auto reply or call 416-498-0002.

Handout  Toxins and Infant Feeding May 2008
Written and Revised by Jack Newman, MD, FRCPC 1995-2005

  This handout may be copied and distributed without further permission,
on the condition that  it is not used in any context that violates
the International WHO Code on The Marketing of Breastmilk Substitutes