news item: “Breast is Best” unless…

“you have to work.” Is the title of the article I saw a Facebook friend post the other day. The CDC (Center for Disease Control in America) has released its latest round of statistics on breast-feeding and overall the news is good. More women than ever are attempting to breastfeed:

“Over 75 percent of both white and Latino infants who were born in 2008 were breast-fed, while the number of black infants breast-fed the same year was under 60 percent.”

This is great, right? It is, it means that most women are at least attempting to breastfeed. But, the CDC followed up with those women at 6 months after birth and 9 months after birth and found that:

“..as of 2008, the overall percentage of babies still being breast-fed at six months was less than 45 percent. (Six months is the American Association of Pediatrics’ recommendation for duration of exclusive breast-feeding.)”

Why the drop off? For myself, breastfeeding got SO much easier about 4-5 months. We got our “groove” going and my Stella was going longer stretches between feedings. The author of the article says she knows why:

“Breast-feeding after you return to work is a tremendous pain in the ass for even the most privileged women…”

We all agree that rasing a child is the most important ‘job’ in the world. We have all sorts of laws that supposedly ‘protect’ the right of working women to pump in a secure environment without facing penalties, either explicit or the more sinister penalty, being quietly ‘mommy-tracked’, passed up for promotions, given less important files, cases,work, etc. The laws are good, but enforcement, and actually embracing them and supporting working mothers is not what is happening in most situations in this country.

This article is short, but speaks to a number of issues, breastfeeding rates in America, the disparity of those rates among women of different races, the issue of maternity leave, ways the CDC tries to encourage breastfeeding, access to lactation consultants, and issues with the WIC program (Women Infants and Children) that provides formula and food for low-income families. I hope you’ll read the article and chime in with your thoughts. I will chime in more in the comments, especially as I have worked with the WIC program through our foster care experience and can speak more on that issue as the article leaves a few details out. So, please read: “Breast is Best – Unless You Have to Work” and please comment with your thoughts and personal experience.

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Some thoughts/questions for you to consider:

If you are nursing and back to work, how is it going? Do you feel truly supported?

Do you have adequate access to a room to pump in, is it comfortable, clean, secure?

Did you give up nursing because it was too hard to work and pump?

Did you have access to a Lactation Consultant in the hospital? Did you have access after you left the hospital?

Have you ever felt ‘penalized’ in your job because you chose to pump milk for your child while at work?

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Comments

  1. In the very beginning, I was lucky to have a good LC at the hospital to helped me with Stella’s latch. Then when I got home, my neighbor is a WIC LC who I was able to text in the middle of the night when I had issues. That helped a lot!

    Beyond that, I’d have to say that I totally agree that it takes a ton of dedication to keep breastfeeding when you’re working outside the home. Because of financial necessity, I got a job when Stella was 8w old, and for the next few months, I pumped 3x/day. Thank God my job let me do that (I was definitely taking longer breaks than allowed – no way could I pump, clean the pump, and be back to work in my Federally mandated 15 minute morning and afternoon break – it was more like 30 min each time, and they were cool with that). Eventually I switched to 2x/day and then 1x/day, but it was a LOT of time away from my desk, AND I was in an empty “office” that had partial walls, so anyone walking by and my co-worker in the next office over could hear everything. It was kind of uncomfortable, but better than nothing I guess! Also, I work in a family practice medical center where they definitely appreciate the importance of supporting a BFing mother – I cannot imagine any of my previous bosses being as supportive of this. I truly don’t think we’d have made it to 6 months if I was still in one of my previous jobs.

  2. I have so many thoughts on this that I can’t even put together a coherent comment. I’ve been sitting here for a few minutes typing and then erasing.

  3. Thank you! Thank you! This is exactly what I needed to finally write on my blog about returning to work and breastfeeding. Please check it out!
    If you don’t have time to check out my blog, in summary, I have only been back to work a few days now and work understands the FMLA laws. They are supportive right now but I do worry about when it will become an inconvenience to them. I understand why many women do not make it past the 6 month mark. It is just adds more stress during the workday.
    My question is though: how do you working mommies pump hands free? I would love too and looking for suggestions.

  4. We had a great lactation consultant in the hospital. Then we moved to a rural area the day we were released from the hospital, and the closest one was an hour and fifteen minutes away. Which meant it was pretty much impossible to go see one with an underweight jaundiced infant who had to eat every 2 hours. I was very happy that La Leche League has phone numbers and you can talk to someone any day of the week. I had one call me on a Sunday and talk me through some issues I was having (this is code for I was crying on the phone to a complete stranger who reassured me my baby was in fact eating and I just needed to hang in there and it would get better).
    In regards to the WIC issues mentioned in the article. The article leaves out that there is an incentive that WIC gives to Moms if they choose to breastfeed. The incentive is they get food checks for themselves, so they can go and buy healthy food to feed themselves. WIC also requires that they take classes on how to properly feed a baby, when and how to introduce solids, and how to not over-feed a formula fed baby.
    When I worked for a national clothing brand my manager had to pump at work and her only options were to pump in our nasty dirty bathroom or to pump at her desk in the back office that was open to anyone walking by. I felt so awful for her, we would go on “door duty” and stop any of the other employees from going to the back offices when we knew she was pumping. But how degrading that she had to not only tell us she was going to pump, but then had to ask us to help protect her privacy and still worry that if we didn’t catch someone in time she could be walked in on.

    • Just FYI, I was never required to take any classes on baby feeding, and we had WIC the whole first year of Stella’s life. Weird? Maybe it’s b/c she was EBF and then I told her I didn’t want to start solids until 6 months?

      That’s awful about your manager. Ridiculous.

    • With the kid, we had WIC and a breastfeeding class before she was born along with a follow-up at 1 week and 6 weeks (and I think one would have been at 3 months but we moved) to get the bonus food for me which was really great. I think each state gets to set requirements for it and I know our county had a grant to support more breastfeeding so someone in the WIC office was a trained lactation educator (but not certified by the usual body who does that for some reason).

      And boo to pumping in an awful space. It’s no fun.

  5. This is tricky for me because I went back to work when Matthew was 12 weeks old, and quit when he was 19 weeks old. I was only back for 7 weeks, but my experience pumping was odd but acceptable to me. Our office had a lactation room, but it was in another building and the room was always taken – with no way to reserve it other than writing your name on a sheet of paper on the door. Well, that wasn’t so easy to do when I worked in another building, so I took my pumping to the bathroom. YES – the bathroom. It was weird at first, but worked out just fine. I was super clean about it and had a pretty effective process down for doing my mom duties, cleaning up, and returning to work. I used a hand pump because it was much quieter – and the hand pump worked great. I could pump both breasts, but one at a time, in 15-20 minutes and get 4-6 ounces in that time. For every lunch break, I drove the 15 minutes to daycare to nurse Matthew, cuddle him, and then drive 15 minutes back to work, stopping for fast food on the way. It worked for us. This was my ritual. Pump at 9:30, nurse at 11:30/12:00, pump at 3:00. I did this for 7 weeks straight and would have continued it for a VERY LONG TIME had I decided to stay at work. I was committed to breast feeding. I never once asked my manager if/when I could pump – I just did it. They knew I was a committed breast feeding mom and never mentioned it – other than my supervisor telling me once that he admired my committment to it.

    I think we can make it work, in most situations. I really do. Like Josey pumping in her semi-office where others could hear, I pumped in the bathroom where other female coworkers heard me. Male and female coworkers watched me put pumped milk in the company fridge and never batted an eye. I was discreet, but unashamed. I felt supported just in the fact that I never asked, and neither did they. It was a non-issue.

    I do understand that many women don’t have the same opportunity/freedom at work that I had, but not the vast majority of those who quit breastfeeding in the first 6 months. I can tell you that I am only one of two – of all of my IRL friends – who stuck with breastfeeding while working. Heck – I’m only one of two of my IRL friends who work and don’t work who stuck with exclusive breastfeeding. All of my friends quit for whatever reason, but not a single one of them quit due to limitations at work. Most of them quit before going back to work – and I don’t see that this study looked at that. It looked at birth, and then 6 months later. How many of those who quit did so before even returning to work? That’s what I’m interested in. Stories like these paint a picture that is slanted in one direction or the other, and don’t look at the whole picture.

    Bottom line to me is that it’s OK to quit. If it’s not working for you for whatever reason, do what’s best for you and your family and don’t feel bad about it.

    • Excellent point Courtney! None of my IRL friends continued with breastfeeding after working and most have them had stopped by the time the baby was 2 months. It is hard, pure and simple and you do have to find out what works for your family!

    • On the opposite hand, I do wonder how many quit before going back to work because they didn’t want to deal with the hassle / embarrassment / time commitment of pumping at work? (or because they didn’t have a good LC / support during the first few weeks when things are tough) I know that was the case for some of my friends. Also, I think a lot of women don’t think about the fact that it doesn’t have to be all or nothing – they could nurse morning/night but supplement with formula during the day. Obviously women quit for different reasons, but I do believe there is more we could do to support women who want to try to continue longer than they otherwise would have.

      • I wonder that too Josey, just knowing it’s looming and worrying about it. What if they knew they were going back to a really supportive and well equipped lactation room? Or what if we did have paid maternity leave for 6 months?
        I think the author was very clear that she was stating her opinion, not the research’s findings. I know many, many women who do not have a supportive environment in which to pump. Also, while I am very comfortable and open about breast feeding and pumping when I need to, a lot of women are very private about it and feel embarrased or worried having to pump in the work environment. Yes women quit for all sorts of reasons, but the amount of support you receive and encouragement really matters I believe. Some of my own relatives are “grossed” out by me nursing and luckily I’m strong enough to tell myself it’s their issue and if they don’t support me then they don’t need to be that important in my life. But I’m very strong willed and also have a very supportive husband. Not everyone has support, I think we could do more to encourage it, for those who want to breast feed.

        • I agree on the value of support. I pumped when I went back to school full time and after the kid was 6 months it was HARD but I had a bunch of women classmates who cheered me on. Without their cheering, I would have quit. We probably would have kept nursing at home as long as we could. I also had a mother, mother in law, and spouse who were all very supportive too so that helped so much more than I realized. Any time I wanted to quit they’d suggest I give it another week, and I changed my mind.

      • I mentioned this in my comment, but the reason I quit before work was because I was producing so little, and Chloe was starting eat more and more, it seemed like a lot of hassle for the little amount I was getting. If I go back to work this time, I am definitely going to give it a harder try at being successful.

    • Nearly all of my friends have breast fed to a minimum of 9m and the last weaned at two years. I would have been the odd one to formula feed an I’ve had a tonne of suppor to BF – makes it a lot easier.

    • Courtney, here is a link to studies looking at paid maternity leave rates per country and correlating breastfeeding rates: http://kellymom.com/blog-post/maternity-leave-bf-rates/

  6. I love feeding but have major issues pumping. The day Molly is in day care she has formula and I get one pump in that I give her that night or next day as a sup feed. I’ll be honest it is so much easier that way and I don’t have time to sit there pumping at work. I go back three days and start weaning then am I imagine by 10m she’ll be weaned. I also want to TTC2 and at the moment my cycles are not consistent while BF.

    The biggest issue is having to return to work. From an US perspective until you get to take longer mat leave and have better government support your rates will never improve.

    I have used the BF association and lactation consultant which were free services. The LC for when I needed to relactate and the ABA when I needed general help.

    I use my office and because I’m the first one to have to do this at work a bit of a bench mark bit we are redesigning our office with a conference room which will become a pump room in future for those that need it.

    It’s becoming more common but a long way to go.

    • Just to add having read all of your comments I honestly feel the RTW issue is the main issue as pumping is hard and time wasting and if you had a bad boss how hard is it to go every three – four hours and pump. But then people get a ciggie break with less repercussions……

      • Exactly – that’s what I was reminding myself. Other employees were constantly taking cigarette breaks or stepping outside to talk on the phone. Pumping was more impt than that!

  7. Firstly, I will say that I know if I have another baby and am working, the odds are low that I could make pumping work because pharmacy is a demanding occupation and you are demanded all the time. Most of the pharmacists I’ve worked with consider themselves lucky to eat sitting down for more than 5 minutes at a time and 20 minutes total, even with a 12 hour shift. Even in a union, cushy, hospital it wasn’t unusual for the pharmacist to get called back from a 30 minute lunch. It’s unfortunate but I get that it’s part of the job. Could I fight for the time and win? Probably but it would be difficult. Should pharmacists get a lunch break? Of course, but we haven’t organized to fight for one properly yet.

    I’ve had access to a lactation consultant in the hospital with both girls, and the same one after discharge at no additional cost (and an infinite number of visits too) so that’s been great. We didn’t actually ask to see the LC with Little Monster but we will be visiting within the week now that we’re home and somewhat established. The hospital where I recently delivered has a 75% going home breastfeeding rate and I think the LC really helps.

    I am confident that unless I worked a desk job in managed care with an office door I could shut and pump in secret, I would be sharply penalized for pumping at work because there’s a culture among pharmacists of putting the patient first and ourselves last. It’s a bad one but very pervasive. It’s one reason so many of my colleagues are having babies in school – we know we couldn’t nurse while working but as students we can, and all of my classmates who had babies last year are planning to nurse to at least a year (makes the lactation room a hot commodity).

    On the whole, I know that it’s both rare for working-class jobs to facilitate pumping at work and for women in those jobs to pipe up and demand being accommodated. I’m choosing to not look for a summer internship because I’m not at a place where I want to fight for pumping time/space, and I will regret the choice later career-wise, but I am glad I can choose to hang out with Little Monster while she’s little. It’s a privileged choice and I’m glad to make it and sad for all the women who don’t have one.

  8. emskyrooney says:

    I went back to work after having my son when he was 3 months- I was working 3 days a week, had my own office and even my own little minifridge so pumping was fine- easy enough to keep up with in the office although I had a hard time producing enough milk for him to take to daycare and we had to supplement some bottles with formula. At 6 months though my son wasn’t gaining weight as quickly as the dr. wanted him to be and I was encouraged to stop breastfeeding. Being a first time mom who was struggling with the pump and the whole routine I gave up pretty easily.

    This time around I went back to work when E was 3 months as well but only went back for 4 weeks before I was laid off. I knew it would just be a short amount of time I’d be at work and I planned to continue to nurse her as long as I could- definitely longer than the 6 months I’d made it with my son. I pumped and again had trouble getting much quantity from the pump t the office.

    At her 4 month appt. though she wasn’t gaining weight and I was told to immediately stop nursing her as I wasn’t producing enough milk. I didn’t give up and worked on increasing my supply instead, thinking it was a supply issue. A week later she’d lost more weight and so I stopped nursing her and we switched to bottles. She’s fine now but I HATE that I had to give it up.

    I had some major issues and words with my pediatrician about how he handled the whole thing and blogged about it here: http://emskyrooney.blogspot.com/2013/01/and-so-it-goes.html I was so shocked to not have the support for breastfeeding from my pediatrician that I had expected.

    All that to say that it’s not just workplaces that aren’t supportive sometimes…

    • We had the same issue with our pediatrician and I fired him and went to a family doctor. I think the crazy postpartum horomones helped me stand up for my baby and myself. Also I had a couple friends that had the same issue you, and I, had, a slow gaining baby, and they cheered me on and helped me through it. So sorry you had that experience, I found out that pediatricians usually only have a rudimentary knowledge of breast feeding as it is not covered very well at all in medical school.

  9. This is one of the main reasons why I quit my job while on maternity leave. I think my boss may have been supportive, but it would have been such a shlep to pump and go to daycare to feed and back. Much better to be at home! I think I would have switched to formula, my job was very demanding, and I just don’t know how it would have worked.

  10. I stopped pumping when I went back to work after 12 weeks. My supply was never great, and Chloe was starting to eat more that it didn’t seem worth it to go through the hassle of pumping at the office. That being said, my office is majority women and even though we don’t have many people, we crank out babies like it’s nobody’s business. Since I started working there almost 7 years ago someone is always pregnant and/or pumping. We have a designated room on both floors and a sign that they can post basically saying “do not enter.” The managers don’t make them feel bad for taking breaks, it’s just part of their daily routine. If I go back to work after this pregnancy and am more successful with breastfeeding, I do intend to pump at work. And about the lactation consultant, I had several people come in and help me while I was in the hospital, but Chloe would just not latch. She screamed bloody murder, and although I stayed calm and it didn’t upset me that much, I really do want to try harder and not give up so easily this time around.

  11. One more reason that I’m thankful that we get a full year of mat leave in Canada…

    There is no way that I would have been able to pump at work, even though there are laws that state I would have to be given time and space to do so. I worked for the ‘major’ bookseller in Canada as a manager and the way our store was set up, the only private place I would have been able to pump was in the public bathroom that was shared with our customers and the customers and staff from the big-name coffee place that shared our building.

    Not to mention that the way our staff was configured and budgeted, as a manager, I was where the buck stopped (often without back up). If there was an emergency, cranky customer, or just a general question, I had to be available to my staff (male and female).

    Given the challenges that I had with breastfeeding and pumping, it just would have been a nightmare for me to try to do so at work. And I take my hat off to anyone who can make the whole situation doable.

  12. I should have had the textbook breastfeeding experience. I had my heart set on it. Took a class before D was born and had a consult with an LC. Had D in a baby-friendly hospital; two of my nurses were LCs, and formula was never mentioned. D had an awesome latch and nursed with gusto. I had 9 weeks of full time leave and 4 part time weeks. I have an office with a door, allowing me to pump and work one handed.

    Except…

    I had low milk supply. D lost over 10% of his birth weight in 4 days. It was an LC who told us we needed to start on formula, first with an SNS (oh, I hated the boob tube!), then a Medela Calma bottle. I tried fenugreek, blessed thistle, oatmeal, brewers yeast; my supply allowed me to provide up to 1/3 of D’s intake; the rest is formula. Once I got over the initial grief, I was determined to make the most of my meager supply.

    D just hit 4 months, and I’m still nursing and pumping, but I don’t know for how much longer. He used to love nursing, find comfort in it; now, my low supply frustrates him and he cries for a bottle after a few minutes. It breaks my heart all over. He still nurses well at night, and I’m trying to savor that. I won’t pump at home; I’d rather spend my time actually being with my son.

    I feel do guilty and sad that I had every breastfeeding advantage and still couldn’t pull it off.

  13. Hey, if anyone wants to see some studies on the correlation between paid maternity leave and breastfeeding, kellymom has them. I love this website too bec of all the pro-breastfeeding resources. Here is the link: http://kellymom.com/blog-post/maternity-leave-bf-rates/

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  1. […] Chandra generated some great discussion with her post on the article “Breast is Best– Unless You Have to Work.“ […]

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