Expert: Sally Wendkos Olds - 6/18/2006

Question
Hi,
I am a nurse in an ICU and currently work night shift.  My baby is 6 months old and attends daycare.  My problem is supply!!!  I choose to work nights, midnight to 8am, rather than days, 8am to 4pm, because I feel I have more time to devote to pumping and I also feel less pressure from my co-workers, they have to watch my patients when I pump.  But working nights means that I am more tired, drink more coffee and am constantly switching my sleep pattern, as well as being off a nursing pattern.  In addition, my pediatrican recommends that she be started on foods 3x daily, which decreases baby to breast time.  Keeping my supply adaquate is an uphill battle and I feel frustrated and discouraged when I look at my overall collection of storage bags at the end of the day.  I am also starting to get a lot of "You STILL BF her!  Oh girl, you just need to give that up." from co-workers and family.  I don't feel that I or my daughter is ready for that.  She loves to BF and I love that she loves it.  Do you have any suggestions on how to maintain supply while trying to introduce foods?  Is it adaquate nutrition for her to eat foods at breakfast and lunch and then only nurse her in the evenings instead of eating food at dinner?  She would nurse at least once more before she goes to bed. Do you think that working night shift effects my supply?

Answer
Dear Sarah,

First, congratulations for giving your baby the best start in life by breastfeeding her! You deserve a lot of credit for managing to juggle your busy work life with your breastfeeding schedule, and it's great that you have done so well for this length of time.

As far as your supply of milk is concerned, you have to realize that when you pump, you get less milk than your baby does when she nurses, so don't judge your milk supply by your pumping output -- and don't get "frustrated and discouraged"! You are doing great!

Your plan to feed her solid foods at breakfast and lunch and then give her only breast milk at dinner sounds good. It's not how often she eats, but her total intake that matters. So if she eats well at two meals, that should be okay. Meantime, monitor her weight gain and her general appearance, behavior, etc. (I give suggestions for doing this in my book, see below.) She will probably be fine.

As far as your co-workers and family are concerned, I give good answers for them in my book, too. But the best one is to tell them that the American Academy of Pediatrics recommends breastfeeding to at least one year of age -- and as long thereafter as the mother and baby want to. In fact, the latest word from the U.S. Department of Health and Human Services is that NOT breastfeeding is a risk that mothers should not take!

I don't think that working night shift affects your milk supply in itself -- but I can appreciate the problems with constantly shifting your schedule. It has apparently worked okay for you up to now -- you deserve an extra pat on the back.

Good luck!

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.