Making It Work
Negotiating with a Caregiver
From: NEW BEGINNINGS, Vol. 16, No. 4, July-August 1999 pp. 143-145
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.
When seeking a caregiver for my now five-month-old son, I carefully selected one who was supportive of breastfeeding. However, my son is currently the only baby in this child care setting who is breastfed. His caregiver seems to be getting frustrated with the additional and different responsibilities of handling expressed milk. She also juggles her daily schedule to accommodate my need to nurse my son before and after work and sometimes at lunch. She has made some gentle comments about how much easier it might be if she could use formula occasionally for my son. What are some ways other working mothers have encouraged and maintained on going support from a caregiver for the breastfeeding relationship?
Finding a good caregiver is hard, and once your child and his care provider know each other, changing may be very difficult for him. Help your good caregiver recognize how your baby smells good and is healthy and growing well on the milk that you work hard to provide for him. She can come to appreciate that breast milk is helping his brain grow and that this time of exclusive breastfeeding is short, and will probably affect her for less than a year.
Maybe she just made the comment to test the waters, wondering if you are feeling stressed about your milk supply toward the end of the week and about having to make arrangements to nurse. Perhaps more communication will help. Tell her how you love to connect with your baby at lunchtime and how maintaining your supply during the week helps you to be able to nurse on weekends. Let her know how the immunities you pass to him in breast milk can keep him from getting sick. Maybe you have some allergies in your family that you want to avoid. Let her know how hard it is for you to be separated from your baby and how being able to provide your milk really helps you adjust. Let her know what your goals are and how giving formula might make those goals less possible. Ask her if she is willing to help you reach your goals. Let her know how much you appreciate her and how much you hope that you can work something out. Ask what arrangements are especially bothersome for her, and see if you can both adjust with a compromise.
You know what is best for you and your baby. Sometimes it helps to share what you know and to share your feelings in order to gain understanding.
I also chose a caretaker who had been a breastfeeding mother herself. However, she did not have any experience handling expressed breast milk, so I gave her careful, written instructions about warming and thawing. I attempted to do most of the work myself. The easier it was for her to prepare bottles, the less likely she was to have difficulty with our situation. When pumping milk for the next day, I prepared individual bottles in the amount my daughter usually took for her feedings. Additionally, on Mondays or when frozen breast milk was needed, I thawed it at home in the mornings prior to taking my baby to daycare. When my daughter was five months old, her caretaker surprised me with the news that she had accustomed my baby to receiving a bottle of cold breast milk—straight out of the refrigerator! She had slowly heated it less and less each week until she didn't heat it at all. This worked well!
Additionally, when I nursed my daughter before and after work, I tried to avoid disrupting my caregiver's schedule. If I was the last parent to pick up my child, I would ask if I could nurse in a little-used room of the house. If her caregiver needed to leave the house, I would nurse my daughter in my car. It was less than ideal, but the occasional inconvenience was worth it to help maintain a friendly working relationship.
My best advice is to work with your caregiver. If you help make using breast milk more convenient with already prepared bottles and work with her on any schedule conflicts, you will pave the way to a mutually supportive relationship. Good luck!
Having previously been a child care provider, it is my opinion that your caregiver may have some unspoken concerns. The special care that a caregiver must take with expressed breast milk is probably not much different from preparing formula. Might there be other problems brewing? Often the first comments are just the tip of thc iceberg, and there may be more things on her mind besides handling expressed milk. If your son is happy and thriving with this caregiver, do your best to keep the lines of communication open. If she's a really good caregiver, let her know how much you appreciate the extra care she takes and offer to do something special for her. She probably just wants to be recognized for her efforts. Good luck.
As both an experienced breastfeeding mother and an experienced child care provider, I have always felt that breastfed babies are more "work" than artificially fed babies but only because of the babies' expectations. Breastfed babies are used to lots of physical contact. The act of breastfeeding itself means contact, and frequent feeds reinforce the contact between mother and child. This means that the breastfed baby wants to be held more and may not do well on the "crib to the swing to the playpen" schedule common among some infant day care providers. As an experienced nursing mother, I automatically carried young babies a lot. When one of my child care children was about a year old, a friend of mine remarked one day, "Doesn't she hold her own bottle?" I had never even thought to try that, because I was so used to holding my breastfeeding babies. Well, at least until they could walk!
In this situation for a five-month-old, it would be helpful to know if your son is sleeping with you at night and how much expressed milk his caregiver is giving him during the day. A breastfed baby's suck is well-developed, and he can drain a bottle very quickly. This does not mean the baby is starving, it means the baby has a good suck. You could suggest that she feed smaller amounts of your milk in a bottle and then burp and walk your baby around or talk to him. He may need more holding rather than more milk in a bottle. If he is truly still hungry, he will let her know. If you are able to come at lunch, you might not need to leave any milk except for a frozen emergency bottle. If your baby sleeps all night, then he will want to drink more during his waking hours, making things more difficult for you, your baby, and your child care provider. Once your baby is ready for solids, his caregiver can feed him solids during the day while you breastfeed in the evenings and on weekends.
You have every right to choose the best nutrition for your son. Perhaps you could share a list of the advantages of breast milk with your caregiver. A pre-printed handout (maybe one from La Leche League?) may seem less confrontational and more matter-of-fact. She may not realize that the immunities alone allow her to have a healthier and happier child to watch during the day!
Another issue is why she thinks it's easier to feed artificial baby milk, instead of human milk. She would still have to mix the formula and then make sure it's the right temperature. If you have your expressed breast milk in two to three ounce portions, it would defrost quickly enough either under warm running water or by sitting in a bowl or pot full of hot water. For even easier defrosting, you could try plastic storage bags made for human milk, which you can freeze flat. A thinner frozen object thaws faster. Your caregiver may not be able to plan for what she needs far enough in advance. Depending how many mouths need to be fed at the same time, she might be too harried to think too far ahead. Being able to thaw your milk more quickly might help her out.
If this caregiver was truly supportive of breastfeeding when you first entrusted your son to her, she may just be feeling overwhelmed right now. If she can hold out for a while longer, soon she can be the person who begins feeding solid food to your son. Your caregiver might feel more comfortable feeding solid foods instead of your milk for one or two of the feedings he needs while in her care. Of course, this depends on when your son is ready for solids. Could you let her know in tangible ways how much you appreciate her caring for your son? How about giving her flowers on his six-month birthday? A cheerful note in the mail is another way to brighten someone's day. If you are a baker, you might even whip up a tasty treat every other week to share with her. I'm sure that when you start thinking of the various talents you have, you can come up with many more ideas. People are sometimes more willing to go out of their way for others when they know that what they are doing is truly appreciated.
Above all else, please remember that you are the mother here. What you decide for your child is non-negotiable. Your milk is the perfect infant food and made especially for your son. This is the one area where you have no doubt about what is best for your baby. Be firm, be polite, but don't back down!
I wish you and your baby many hours of breastfeeding happiness for years to come.