By
MWF Member Scarlett McNally, Consultant Orthopedic Surgeon & Director
of Medical Education East Sussex Hospitals NHS Trust, Mother of four, all
breast-fed till age 1, on-and-off
Breast feeding
The World Health Organisation suggests babies should be have breast milk exclusively
for the first six months, with further benefits after weaning until at least
age 1. Only a tiny minority of normal women achieve this. For many women doctors,
breast-feeding could make re-establishing work after a period of maternity
leave difficult. Many women doctors manage to continue breast-feeding on returning
to work, but planning ahead around the practicalities is essential.
How often?
• With hours reduced to 48 per week, it
should be possible to keep the late night feed, and perhaps the early morning
feed, as a breast feed.
• If you want to do more than this, you
can express and freeze the milk. (It takes 20 minutes, and you can store it
in the freezer at work, taking it home in an insulated bag at the end of your
shift.)
The regulations:
• The regulations covering pregnancy also
apply to breast-feeding. You are supposed to be allowed space and time to
express breast milk (or have baby brought to you to be fed). You are supposed
to have a risk assessment, and your employer should reduce risks that might
stop you breast-feeding. The BMA will help if you are a member. If you are
a trainee, beware of reducing your experience of unpredictable work, as you
may later have a difficulty getting that period of training recognised.
Expressing breast milk
• If you want to breast feed more than
just night and mornings or if you want to go away overnight to a conference
you will need a breast pump. Your milk supply is dependent on regularly feeding
or expressing. Your breasts will hurt if you do not feed or express as regularly
as you get used to. Your baby can also have the benefit of real breast milk
if stored and thawed later. There are electric (plug in and battery) or hand
pumps. Both are easy to use. If you want to take the milk home, you need special
freezer bags, an insulated bag and tablets (or another way) for sterilising
the pump afterwards. (If you are only expressing once a day, you can take
the pump home to sterilise again each day.) A quiet place to express should
be identified with your manager. You should also identify a freezer where
you can store the milk. It is not easy to nip back to the residences or find
a room to use your expressing machine between cases. I have always found the
special care baby unit very helpful. They can keep the paraphernalia in a
tub of Milton for you, and you can store labeled milk in their freezer to
take home later. You don’t need bras with zips in (just loosen an ordinary
bra strap). It takes about 20 minutes, and you can write up notes or read
while expressing. You might want to tell people that you are going to another
ward, as some men can’t cope with the thought of breasts and suction
machines even if they approve of working mothers and female surgeons/doctors.
Other personal tips:
• You MUST introduce the feel of a bottle
before the baby is 6 weeks old (eg one bottle/day of expressed or formula
milk), otherwise he/she will never take less than the real thing. (Midwives
don’t tell you this, in case you convert completely.)
• Many babies can mix-and-match. Mum’s
late home, I’ll have the plastic one now.
• You don’t need bras with zips in,
just loosen an ordinary strap.
• It is very difficult to produce enough
milk when you are working flat out. (I have always done night and morning
feeds, and expressed when I was on call at those times, to keep the supply
going.)
• There is no proven benefit in breastfeeding
beyond a year.
• You do not need to feel guilty if you
are not super-woman.
• If you have a breast pump and a baby
who will take milk (either expressed breast milk or formula) from a bottle,
you are no longer tied to the child, so you can go out occasionally.
• Exclusive breast-feeding is very hard.
No-one mentions this and this is probably why most women in the UK give up
breast-feeding after a few days. Unicef found only 7% of UK women are breastfeeding
exclusively at 4 months. For professional women it can be very hard to go
from being an independent dynamic career-focussed individual to being chronically
sleep-deprived and breast-feeding on demand so never getting out. So until
wet nurses come back into fashion, the breast pump, a babysitter and a freezer-ful
of expressed milk may be the best answer!
