Pumping in the Healthcare Workplace

Pumping in the Healthcare Workplace

I had thought being a pioneer mom pumping breastmilk in an office was hard.  Then I saw what moms in healthcare professions have to deal with:   Chilly, inadequate, non-private spaces--and no time to pump.  Boosé’s focus group of moms in healthcare put it plainly.  “I couldn’t find a lactation room at my new hospital, so I used my own pump in the bathroom,” said one participant. (I will leave the awfulness of that to your own imagination.)  Another focus group participant said she had to make do with an empty exam room because the lactation room was in another building.  “While the exam rooms are spacious,” she said, “they do not have a lock on the door, so pumping in them is very nerve wracking.”  Plus, she could hear everything through the thin exam room walls, which is “not very relaxing either” (to put it mildly).   Another mom had a similar hike to get to the lactation room.  Instead, she opted to pump in an office shared with four other Nurse Practitioners and Physicians’ Assistants.  “It’s really the only way I have found to be able to pump in an efficient manner because I am able to write notes/chart on the computer while I pump,” she said. 

Exam Room

Finding an adequate space at work to pump in is one thing.  Catching that moment’s break to pump in the first place is another.  A focus group participant, working three twelve-hour shifts in a row while trying to breastfeed, resorted to pumping breastmilk in her car. “I wish I could pump every 3 hours,“ she said, “but it’s just not feasible with having patients all day.  I always pump on my drive in to work at 6am.  I then try to pump anywhere from 9-1030 & then again 1-230. Sometimes that doesn’t happen.  Like today. I didn’t get to pump until after 11.”

Time

Such obstacles to pumping in the healthcare workplace existed even before the COVID-19 pandemic and staffing shortages put hospitals and clinics on a wartime footing.  On the eve of the pandemic, the Huffington Post reported that since the Break Time for Nursing Mothers Act (or “Pumping Law”) was enacted in 2010, nearly a quarter of all complaints to the U.S. Department of Labor of violations of that law came from women in healthcare jobs.  Will, Why Moms in Healthcare Jobs Can’t Catch a Break—To Pump (Huffington Post, 10/24/19).  

The Pumping Law imposes minimal requirements: That an employer covered by the Fair Labor Standards Act (and that includes a hospital or business providing medical or nursing care for residents) provide to its non-salaried employee:

  1. reasonable break time to pump breastmilk for a year after the employee’s child is born, and
  2. a private non-bathroom space in which to pump.  

But the investigative report found that moms in healthcare disproportionately felt their employers were not complying with these minimal requirements.  Their claims to the D.O.L., the report stated, included “being denied access to a clean, private space, retaliation, and even terminations… The mothers also cited the consequences: a painful infection, mental health concerns and losing the opportunity to keep feeding their babies breast milk.”  Unfiled complaints in similar vein are compiled here: Gibson, Breastfeeding for Working Nurse Moms is Hard When Hospitals Aren’t Supportive (nurse.org, 5/10/19). 

It is understandable that a healthcare employer would struggle to accommodate the needs of breastfeeding employees, even without a pandemic staffing shortage.  A patient’s needs are individual, and how long that patient needs to be tended to can be hard to predict.  The professional tending that patient can’t hand the patient off to just anyone so that the professional can take a pumping break.  For Operating Room staff, the scheduling issue would seem to be even more complex.  How do you know how long a given operation will take so you can decide whether the anesthesia provider assigned to that operation will be able to take her requisite pumping break?  What if there are complications?  Should you assign the anesthesia provider to that procedure at all?  Or is it discriminatory even to ask that question?  A recent article in the peer-reviewed Cureus Journal of Medical Science attempted to crunch the O.R. scheduling numbers, concluding that when making room assignments for anesthesia providers who are breastfeeding, “relying on the average surgical times for procedures is insufficient.” Titler, et al, Percentages of Cases in Operating Rooms of Sufficient Duration to Accommodate a 30-Minute Breast Milk Pumping Session by Anesthesia Residents or Nurse Anesthetists (Cureus, 1/6/21). 

Surgery

Fortunately, there are some helpful tips out there for moms in healthcare.  A recent article directed specifically to breastfeeding mothers in healthcare professions advises that you start discussing your pumping plans with your healthcare employer early—before the baby is born.  And be prepared to educate your manager, too.  Eisley, Tips for Working moms in Healthcare Who are Pumping Breastmilk (Good RX Health, 11/12/21).  The author also suggests you have a dress rehearsal before you return to your busy healthcare workplace:  Go through a practice workday, including scheduled pumping breaks and setup and breakdown of the breast pump and the rest of your kit (including water bottle, images of baby, music, snacks, clean bottles/bags for milk storage, and a cooler bag with ice packs).  

SOURCES

Will, Why Moms in Healthcare Jobs Can’t Catch a Break—To Pump  (Huffington Post, 10/24/19) Why Moms In Health Care Jobs Can’t Catch A Break – To Pump | HuffPost Impact.   

Gibson, Breastfeeding For Working Nurse Moms is Hard When Hospitals Aren’t Supportive (nurse.org, 5/10/19) Breastfeeding For Working Nurse Moms Is Hard When Hospitals Aren't Supportive | Nurse.org

Break Time for Nursing Mothers | U.S. Department of Labor (dol.gov)

Titler, et al, Percentages of Cases in Operating Rooms of Sufficient Duration to Accommodate a 30-Minute Breast Milk Pumping Session by Anesthesia Residents or Nurse Anesthetists (Cureus, 1/6/21). Percentages of Cases in Operating Rooms of Sufficient Duration to Accommodate a 30-Minute Breast Milk Pumping Session by Anesthesia Residents or Nurse Anesthetists - PubMed (nih.gov)

Eisley, Tips for Working Moms in Healthcare Who are Pumping Breastmilk (GoodRx Health 11/12/21) Tips for Working Moms in Healthcare Who Are Pumping Breast Milk - GoodRx


READER COMMENTARY

Are you a breastfeeding mother who pumps at work in a healthcare setting?  What obstacles have you had to overcome in order to continue to breastfeed your baby after returning to work?  What strategies did you employ?  Your personal stories inspire!

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