Dear Barbara and Kay,
I have a client who has returned to work. Her baby was born 5/6/11. She is a PhD at a university. She asked about pumping frequency at work and the effects on supply if she skips a pumping. We discussed the implications of regular milk removal. Breastfeeding is very important to her.
Her workday consists of many meetings with colleagues (all men). Her real question was how to tell her colleagues that she would need to step out periodically to go pump. She does not want to be perceived as not doing her job and would rather not tell them anything. I suggested that she pump before meetings and at breaks. She still feels as if she may be late returning to meetings after breaks and does not want to explain this to them.
Do you have any suggestions for this woman? She really feels as though she has no support at work.
BS, RN, IBCLC
Barbara & Kay Respond:
This is a challenging counseling situation, because it involves presenting this (obviously very bright) woman with enough information to make an informed decision with regard to maintaining her milk supply. We can confidently present evidence-based information on milk supply protection. Information on strategies to manage her lack of support for workplace accommodations requires that we explore perspectives and strategies, which may not have occurred to her.
Let’s talk first about the research on localized feedback control for lactation. Particularly in the early phase of lactation (the first 3-4 months) the milk supply is sensitive to down-regulation if milk is not regularly removed. This information can be presented in a non-judgmental fashion, and you can cite references. (See below.) Pumping sessions with an effective double pump can be short; even 10-12 minutes will protect most women’s supply. Buying extra flanges eliminates the need to wash up until she goes home. A discrete cooler with blue ice will keep her milk safe for about 15 hours and helps her avoid storing milk in a commonly shared refrigerator.
You can also talk to her about reverse cycle feeding, in which any missed expressions are made up by adding a pumping session or being willing to nurse the baby more during the night. Emptying the breasts 8 times per 24 hours will generally maintain full production. Many women do not feel that extra night time pumping or feedings permit them to get enough rest, so this issue should be gently explored and presented as merely another option.
We must also provide the information that if her milk supply does wane, she can begin to introduce formula, or (if the baby is over 4 months) start solids a bit early to protect the baby’s growth needs.
As Kay and I discussed our own experiences counseling working moms, our impression is that colleagues typically don’t want a lot of specific information about on-the-job pumping. However, it will not have escaped them that she has just had a baby. Many of them will have had partners/wives/friends who have dealt with this issue.
She may be concerned that it is “asking for too much” if she arrives a few minutes late for a meeting. It may help to point out that if a colleague (male or female) undergoes surgery, is recovering from serious illness, or has a sick child, people tend to be really kind, often sharing paid leave or temporarily shouldering more of the work load. Most people understand that a woman just back from maternity leave is in a similar recovery mode.
While we have heard of truly toxic workplaces where women have been shamed and ridiculed for taking pumping breaks, your client may be surprised how sympathetically many of her colleagues will view her situation. An absence of 15 minutes every 3-4 hours would probably go un-remarked. I doubt she really needs to offer an explanation. If there are complaints, we recommend discussing her situation with her supervisor and letting that person manage the other employees. Slipping into meetings a few minutes late will probably not cause people to view her as a slacker if she continues to pull her weight in other aspects of her job, and occasionally brings donuts in the morning!
The new health care law does protect the rights of many working women to pumping breaks. She should ask whether this affects her situation. Law and public policy cannot, of course, manage the embarrassment factor, but I often ask well-educated or powerful women the following questions:
What is the point of having worked to accumulate some personal power through education if you do not intend it to benefit your own child? What possible hope is there for less powerful women to receive those accommodations if powerful women are too timid to step up forthrightly to claim this right?
The baby’s needs rightly trump the sensibilities of our colleagues as well as our own discomfort at appearing to require temporary special accommodation. Integrating the maternal role involves being an advocate for our children, and claiming the right to pump milk for our baby is the first of many opportunities to learn how to be an effective parent.
The conversation we have with women on the more “political” aspects workplace pumping must clearly identified as an opportunity for sharing opinions. We think it is a permissible discussion. The ILCA Scope of Practice describes LCs as change agents in our communities. It is wise to conclude such conversations by acknowledging that only the individual woman fully understands what risks she faces in her workplace as the result of claiming pumping accommodation rights. Ultimately, the decision is hers to make. We always reassure women we will respect and support her decisions.
Hope these suggestions are useful to you in helping your client.
Barbara & Kay
Cox DB, Owens RA, Hartmann PE. Blood and milk prolactin and the rate of milk synthesis in women, Experimental Physiol 1996; 81:1007-1020.
Prentice A, Addey C, Wilde C. Evidence for local feedback control of human milk secretion. Biochem Society Transactions 17 1989; 17:122.