Monday, June 23, 2008

So you want to pump and work... in France

Perhaps it is, ironically, because maternity leave is longer in France than it is in the US, but few mothers here breastfeed after they go back to work. Fewer still try to combine pumping and working: the assumption is that you must supplement with formula during the day. If you're feeling heroic, you may do your best to keep up a supply for mornings, evenings, and weekends, but even that is rare.

Although I have no official numbers, anecdotal evidence convinces me that French mothers wean far earlier than American mothers, whether or not they go back to work. When I passed the six-month mark I felt I'd already crossed into what is considered here to be extended breastfeeding. When our pediatrician filled out a mail-in government form at le Petit's nine-month checkup, I noticed that the "breastfeeding duration" box assumed that babies his age were no longer nursing, and my pediatrician was obliged to write "en cours" in the margin. I can only assume that any national statistics would show us as a blip, an anomaly.

So when I went back to work at nine months, I dreaded trying to explain to my colleagues why pumping milk at work was important to me, and I dreaded negotiating a discreet pumping location with my boss. I was so unsure of how I would be received that I almost let it drop and resigned myself to giving formula during the day, when an American friend of mine accused me of being a wimp.

Like so many things I've been scared to do, it turned out to be easy once I got over my fear and just did it. So to encourage other breastfeeding moms in France who are tempted to try it, I thought I'd share what I've learned.

1) Invest in the right material. It may be cheaper than you think, or even free. In France, you can rent a high-quality electric pump with a prescription from your doctor, your child's pediatrician, or even a midwife or hospital puericultrice.

Do not simply take your prescription to the local pharmacy, however, for they are likely to give you some ancient pump that will hurt your nipples, will not be efficient, and will make more noise than an idling deux chevaux. It will make you hate pumping and may make you worry unnecessarily about your milk supply. It is worth checking with your hospital to find out where you can rent a hospital grade Medela (I have the Medela Lactina Plus) . They may cost a bit more than the Sécurité Sociale will reimburse, but your mutuelle insurance company will likely cover the difference.

If you do not have access to a place to pump with an electrical socket, do not despair! When this turned out to be the case for me, I bought a Medela Harmony manual pump and I love it. Granted, at nine months, le Petit only took one bottle a day while I was at work, so I only had to manually pump for one feeding. More than two times a day would probably be rather tiring -- but there is a Medela pump with a foot pedal. (I love Medela products. And their baby bottles are BPA-free!)

Which brings me to --

2) If you want to and can afford to, take an additional parental leave. In France, we are lucky to be able to take up to three years of unpaid time off after the birth of a child and still be guaranteed to get the same or an equivalent job back. It isn't an option professionally or financially for a lot of women, but if you are in a position to consider it, do. I am happy to be back at work now, but I treasured the nine months le Petit and I got to spend together at home. And it was a lot easier to combine exclusive breastfeeding and working since he was well-established on solids. I was lucky that he took to eating solids well at seven months and started needing less and less breast milk, but there are no hard and fast rules. The best is to try not to stress, and to read the child to decide what's best. Do not push solids just because you have a deadline to go back to work.

I think the transition back to work is delicate, and every mother finds a different solution that works for her. You may be enjoying staying home with the baby, or you may be dying to go back to work and rejoin the world of adults, or you may be both at different times (often in function of how well you've slept recently). Honor your feelings. There are no right or wrong answers, and no reason for self-imposed guilt whatever your decision.

If it doesn't work, you can often readjust. Remember that a parental leave can be extended once, and can be transformed into part-time work. Make sure to read up on the formalities and discuss your options with your employer.

3) When looking for a place to pump, be creative. In the age of cubicles and open office spaces, it can be hard to find somewhere clean, private and discreet to pump. A common solution is the on-site infirmary, which many companies have for mandatory medical visits. I asked and it wasn't reliably available at my company most days of the week, but I discovered that the shower/changing room near the exercise room worked just as well. It is kept neat and clean and has a comfortable bench. I keep a bottle of hand sanitizer with me so that I can wash my hands well right before I pump.

4) Talk it over with your day care provider. Unfortunately, it is far from universal for day care centers to accept breast milk in France. If you live in Paris proper, you are in luck, for a city-wide directive requires all municipal day care centers to not only accept breast milk, but allow breastfeeding mothers who work nearby to drop by and nurse during the day.

I have no idea what our town's policy is, but I doubt they're so enlightened. Yet another reason I'm ultimately quite happy we were turned down at the crèche. Nannies and assistantes maternelles with home day cares are likely to be more open to the idea. Our wonderful nounou had no problem with it at all.

Note that you are likely to be questioned about how carefully you've ensured the temperature of the milk during transportation to and from work. The French are obsessed with la chaine du froid. I have access to a refrigerator at work, and I bought a great little backpack cooler and a couple of ice packs at Decathlon for the trip home. Voilà, the milk arrives chez moi nice and fresh.

5) People are more accepting, and less nosy, that you'd think. I expected my colleagues to comment on my odd decision, or notice uncomfortably when I disappeared briefly to pump in the afternoon. Most don't notice, and those who are in the know find nothing strange about my decision at all. If anything, they chalk it up to American eccentricity. Remember that being a foreigner gives you a lot of leeway to do things differently.

That's what I've learned so far. Le Petit is almost a year old now, and still enjoying his daily bottle of lait de maman at four o'clock -- and his tétée de retrouvailles when I pick him up, plus a morning and an evening feeding. He's growing well and has boundless energy, so I must be doing something right, right?

Of course, jobs and situations are different, and what worked for me will not work for everyone. I certainly don't mean to criticize moms who decide to supplement, either. Yet I find it a shame that pumping while working is an option rarely presented in France. Maybe I'm a pioneer. Maybe it will be easier for the next generation of moms to make the choice.

In the meantime, I hope something I've learned will be useful to another new mother, and if I can offer any specific advice (particularly about where to find a good Medela pump in Paris), feel free to email me.


Inzaburbs said...

This is great advice.
All the French mothers I have known, whether in France or not, have given up at 6 months. It's like 6 is the magic number!

Isabelle said...

The reason why 6 is the magic number is because the antibodies that the mother has in her breastmilk disappear after 6 months. So breastfeeding after 6 months is just for your pleasure (and the baby's).
Another comment about "short" breastfeeding in France is that pediatricians and specialists used to recommend the introduction of solid food much earlier than they do now (around 4 months old). That's why mothers would stop breastfeeding around this time.
Now they've realized that the introduction of solids at such an early age was causing a lot of food allergies, so they've decided to tell mothers to wait at least until the baby is 6 months old to introduce them.

Parisienne Mais Presque said...

@Isabelle, actually breast milk continues to contain useful antibodies for as long as you breastfeed (for a reference, It is certainly true that it is most important for newborns, for as the infant grows up their immune system matures. So at six months it is a less important "boost" than at six weeks, certainly, but it is still non-negligable.

That said, the main reason I continue to breastfeed is because it le Petit and I both enjoy it. :)

Mothers in the US used to introduce solids earlier, too. I'm glad the recommendations have changed, because le Petit wasn't all that interested in solids even at six months... I'm glad I didn't have to stress about it at four! And the fewer months I have to spend cleaning puréed spinach off of the floor, the better! :)

Isabelle said...

Thank you for the link Parisienne, although my kids are big now, I'm always interested in the new discoveries in the baby's world.
I have a cousin who is married to an American girl and they have a baby girl who is 6 months old. They live in London but often come to France for visits, and have made their first trip to the US with their baby 2 months ago. My cousin's wife told me that breastfeeding in public in France and London was not much of a problem, but in the US it was a different story. She had to buy a special cover that she puts around her and completely hides her breast and at the same time her baby's face while breastfeeding. Although I had never seen such a thing here, they call it "bébé au lait".

Parisienne Mais Presque said...

I have no personal experience nursing in the US, but I've heard that it can be pretty ridiculous how prudish people are about it. And yet as a culture we have no problem with half-undressed Britney Spears & Co making music videos for preteens. I don't understand it at all.

Here is an article I saw a while back about some of the sillier things people have come up with to cover everything up:
I guess it's a good thing that such products exist, but I sure wouldn't want to use one.

Isabelle said...

On the mamanana link there is another link for the "bébé au lait" web site!
You are right, it's a good thing that such products exist, but it should be your own choice to buy them and not the other people's opinion!

caramama said...

Good for you, working it out even though it's not the "norm" there! You should be proud!

I can speak to the nursing in public in the US... It's so frustrating that the word here is Breast is Best, but hide it when you do it! It took me months to get to the point where I would go without a cover (I had borrowed a bebe au lait from my sister), and even though I was doing it discreetly, my husband was still uncomfortable with me doing it. But we talked and I did it anyway and will nurse without a cover with future children. There is no better way (IMO) to get the people around me used to it than just doing it. I'm trying to be a pioneer too (but I'm not a foreigner).

Parisienne Mais Presque said...

@Caramama - I notice is that it is so important what kind of breastfeeding support you get from your family, especially when it comes to nursing in public and extended breastfeeding. Since my husband and my mother-in-law are supportive, I find it easier to throw off the what-will-they-think.

I was one of those moms who thought "oh, he'll be weaned by a year" and now I see that he's still such a little baby... and my mother-in-law keeps encouraging me in subtle ways to follow my instincts.

I think you're right, there's no better way to be a pioneer than to just go ahead and nurse in public. We need to reclaim our breasts as useful and not just decorative, darn it! :)