Is breastfeeding as a working doctor an impossible task?


I am a new mom to a beautiful 8-month-old girl, and I am breastfeeding. I am also a doctor at a large, well-known academic institution. The hospital where I work delivers several thousand babies a year, and highly encourages their new moms to breastfeed. They offer a postpartum consultation with a lactation consultant, keep the baby in the mom’s room 24/7 while in the hospital, and provide several other pro-breastfeeding initiatives.

I delivered my baby at the hospital where I work, and I felt very supported in my efforts to breastfeed. After maternity leave, I returned to work, breast pump in tow, with the resolution to continue pumping and breastfeeding for at least a year, as is recommended by the American Academy of Pediatrics. Ironically, this has proven to be one of the most difficult things I have ever attempted.

The Patient Protection and Affordable Care Act states that women with a child under one year of age should be given reasonable break time to express milk, as well as a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public. However, because I work in health care, I have to ask for help covering my patients when I take breaks. Not only is asking for breaks (especially from male colleagues) at times quite awkward, but asking for breaks is not a common thing, and is often frowned upon amongst doctors. Prior to having my baby, I had never asked for a break! Despite these mental hurdles, I got over my pride and asked for the help of my colleagues. Then there’s the next hurdle: where to go.

The hospital where I work is over 1.5 million square feet, and there is exactly one dedicated lactation room in the entire building. If you happen to be on another end of the hospital, it can take 5 to 10 minutes to get there. Add the 15 minutes it takes me to pump, the time to get back, and suddenly it takes 30 minutes. Unfortunately in medicine, even if you ask nicely and have the best colleagues, you just can’t take a 30-minute break; especially not twice a day, which is how often I need to pump.

Also, the one lactation room that is supposed to accommodate an entire hospital is, not surprisingly, frequently full. So instead, I try to find a place to go which is close to the unit I happen to be working in. Since I am a resident, each new month brings a new rotation, commonly in a different unit. The OR one month, ICU the next! In the beginning of each month, I, therefore, spend the first day asking around and hunting for the best place to quickly escape for my twice a day “break.”

Places that I have found to pump in have included, but are not limited to, empty isolation rooms (rooms where the patients with TB and Influenza stay), family consultation rooms, call rooms, locker rooms, and bathrooms. Yes, sadly, I have pumped while sitting on a bathroom floor more times than I can count. I told myself I wouldn’t do it, and I hate doing it, but many times it has come down to quickly pumping in a bathroom, or not pumping at all. I chose the bathroom.

Keeping up production once back at work and away from your baby is an issue many breastfeeding women face. I can tell you from experience that pumping on a bathroom floor does NOT help your production issues! Most of the moms I work with have stopped breastfeeding sooner than they hoped to because of difficulty pumping at work. Either they refuse (understandably) to pump in a bathroom, or production drops when they aren’t given a time and space to pump. Regardless how or why, I’ve talked to many new moms and have yet to meet a female doctor who was able to keep breastfeeding a full year as the AAP recommends. And it’s not for a lack of trying.

I highly doubt that my situation is unique. If I polled physicians at hospitals across the country, I’m sure the stories would be similar. I don’t blame hospital administrators. Unless you have been a working/breastfeeding mom yourself, or have witnessed someone close to you go through it, it is unlikely that you would ever think of lactating moms when designing a workplace.

Unfortunately our hospital, just like many other institutions in the country, is run by men. Mainly older men. People who have certainly never thought about needing to express milk to feed a baby. So even though it is an institution that strives to do the best thing for its patients by promoting breastfeeding, they fail to do the best thing for their employees. The elevators are filled with flyers announcing that this is a breastfeeding friendly hospital and offering times for free lactation consultations, yet employees are forced to pump while sitting in an empty isolation room or on dingy bathroom floors.

The ideal lactation room is not something fancy, spectacular, or even difficult to create. It is a room with a lock, a chair, and a plug. That’s all. It honestly doesn’t need to be bigger than a closet. Other things like a sink to rinse your pump parts or a locked cabinet to store your pump are great bonuses, but are not necessary. A private, convenient place to go and sit for 15 minutes is all most women would ask for.

New studies continue to emerge touting the benefits of breastfeeding. Breastfed babies get sick less frequently, meaning fewer sick days for mom or dad to stay home and take care of them. The benefits are so great that you would think that large companies, as well as society as a whole, would want to invest in helping young moms breastfeed as long as possible. Yet if a hospital, an institution centered around health and well-being, does not truly support its breastfeeding employees, how can we expect other businesses to do so?

Maisie Jackson is an anesthesiologist.

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