By Eitan Kilchevsky, md

Breast Milk is undoubtedly the most perfect nutrition for infants for at least the first six to twelve months of life. Although most mothers elect to nurse their newborn infants, some prefer artificial substitutes. Mothers should be educated about the benefits of breast milk for them and for their infants; once the mother has made her decision regarding the type of nutrition for her infant, this choice should be respected.

One of the obstacles mentioned by mothers who elect not feed formula or stop breastfeeding earlier than “recommended” is the need to return to work within months after delivery.

For milk supply to persist, milk has to be expressed periodically. For mothers in some professions this is difficult to do (teachers in an elementary school, for example). In other cases the employers or co-workers are “not cooperative.” Cases of employees making derogatory remarks towards mothers who express milk after returning to work are all too familiar.

Enabling mothers who wish to continue breastfeeding after returning to work to do so is not only a medical issue (benefits to the infant and mother); it is also a financial issue. It has been shown that in companies where mothers were allowed to express milk, store it and later feed it to their infants, fewer and less severe infant illnesses and less maternal absenteeism were identified in the breastfeeding group.

It is therefore not surprising that Congress is debating a bill that will encourage employees to set up a safe, private and sanitary environment for women to express milk. The companies will be rewarded by a tax credit to encourage them to purchase or rent lactation-related equipment, hire a lactation consultant and promote a lactation-friendly environment.

Mothers who would like to continue nursing their infants after returning to work should be appropriately consulted. Popular myths interfere with the process. It is well known, for example, that babies do not have to learn to take the bottle so that they can feed when the mother returns to work. There is no reason to give the baby a bottle before the mother returns to work.

In addition, if the mother returns to work after six months, the baby can feed solids from a spoon and drink milk from a special cup (indeed they can!); the baby can then be nursed when the mother returns home. Although babies who nurse well will not be affected by one bottle a day, giving the baby several bottles a day (before the mother returns to work) may decrease milk production.

In addition, an exclusively breastfed baby does not need iron supplementation for the first four to six months of life; for these infants iron-fortified formulas are therefore not indicated during that period.

There are other issues to address when the mother who nurses her infant plans to return to work. These questions and others can be easily answered by calling the lactation consultants at the Danbury Hospital (797-7777) or local lactation services.

Dr Kilchevsky is a newborn health specialist with the Danbury Office of Physician Services and Danbury Hospital.