Monday, January 19, 2009

Pumpin' to Please

Now that I have your attention...

Whoever coined the phrase "don't cry over spilt milk" obviously never used a breast pump.

According to a recent New York Times article, a Minneapolis woman on a business trip diligently pumped her breast milk while she was away from her baby for 2 days. When she tried to take it home with her, however, a security guard at La Guardia poured the entire supply of white-liquid gold into the trash at the security checkpoint. The reason? 2007 Airline Regulations mandate that not more than three ounces of fluid could be carried on an aircraft, and that includes breast milk.

The report states that she wept profusely. Had I been that woman, I would have made sure that I was not the only one in tears, because I would have inflicted the maximum amount of pain on that insensitive*&#$%@ who dumped out my milk.

From personal experience, pumping is, at best, inconvenient, incredibly time consuming, physically taxing, and often painful. Combine that with constant sleep deprivation, the ceaseless requirements of baby-care, and the demands of a full-time job, you might fathom just what it may have been like for that woman to literally watch her hard-won efforts go down the drain.

Now for all of you guys (and some women, maybe) who may be thinking "icky poo", please consider the health advantages breastfeeding and the myriad conflicts of interest that make giving breast milk to infants untenable for mothers who work.

The American Academy of Pediatrics recommends breast milk as the exclusive food for the first six months of a baby’s life. Well-documented research links breast-feeding to the reduction and severity a variety of nasty diseases including: bacterial meningitis, diarrhea, respiratory-tract infections, ear infections, urinary-tract infections, sudden-infant-death syndrome, diabetes lymphoma, leukemia, Hodgkin’s disease, obesity, and asthma.

The A.P.A also asserts that breast-feeding rates in the United States are low, and the primary reason for this is that many mothers return to work after giving birth. Aside from taking baby to work, the only other option for providing breast milk is the mechanical expression of milk- a.k.a- pumping, and that means a great deal of commitment from both mommy and employer.

Pumping one 4oz bottle of milk, which is usually sufficient for a single feeding, takes anywhere from 30 minutes to ½ hour. If you are lucky enough to have a double-barreled unit, which I had, you can manage twice that much, but here his the caveat: the amount of milk you use is directly proportionate to the amount you produce, so unless you want a good amount of discomfort and not just a few articles of ruined work-wear, when your breast are full of milk, as they certainly will be every 3 or 4 hours, you'd better be prepared to empty them out.

I'm not citing research here; I'm speaking from personal experience and I assure you that pumping is not fun, but I certainly felt it was my obligation to protect my son from the chronic allergies, asthma, chicken pox, and a host of other childhood diseases that I suffered through as a formula-fed infant.

I certainly don't fault my mother for this ommission; in 1967 the benefits of breastmilk were under-researched, and doctors actually discouraged the practice. And, to my mother's credit she actually did try, but breastfeeding can be hard for some women, and as she received very little support she quickly resorted to formula.

When I gave birth in 2002, however, the benefits of breastmilk were well-documented, so I chose breastmilk as the primary source of food for my baby, and because I also worked full-time, that meant pumping.

When I was at home, I regularly fed my baby every two hours, which is the general recommendation for infants in the first 3 to 4 months of life. But a pump is different, so instead of a 15 minute session with my lovely child, which is usually how long a normal infant-feeding lasted, I spent 30 minutes to 1 hour (including set-up time) every 2-3 hours with my very uncute breast pump which, I assure you, did not look up at me with adoring eyes and fill me with the unfathomable joy.

The reason for the increased time is caused primarily by the physiology of breast feeding. A baby sucks and suckles with it's tiny mouth opening and closing, which results in the lightening-fast expression of milk. A pump is more like a tiny vacuum; powerful, but without the open/close motion, which slows the flow considerably. The 10 to 15 minutes that it takes for a baby to suck out a solid feeding can be double or even tripled when using even the best of pumps because you also have to account for machine set up, proper germ control, and often tricky attachment.

Like many career-track working mothers, I returned to work 8 weeks post-partum. With my own office, a large, mother-friendly company, and the blessing of an uncanny dexterity that allowed me to pump and work on my computer at the same time, I could close my office door, hook myself up like a cow to a mechanical milker, and produce milk, email, and disposition reports. The nurses’ office down the hall allowed me to store my milk (usually about 8 to 12 oz per day) in a special refrigerator. I had it good; other women are not so lucky.

Without the relative luxury of an enclosed office and a comfortable chair, women will face 2-3 pumps during an 8 hour shift sitting on a hard plastic chair or worse, a toilet seat. Many companies now offer lactation rooms with more comfortable seating, but since breastfeeding is not considered a disability under ADA, workplaces are under no such obligation to provide such accommodations.

The companies that are pump-friendly are usually less motivated by altruiism than concern for their pocketbooks. After 15 years in HR, I know of whence I speak. The larger a company is (think Motorola, Boeing, US West, and Cornell, all of which I was lucky enough to have been employed) the more afraid they become of losing money from costly lawsuits and trouble from the various labor unions. Even in those companies, however, a woman who works in a manufacturing area is usually going to be stuck pumping her milk in the ladies room, and because it will take her longer than the standard 15 minute breaks that most companies allow as paid time, she will most likely be clocking out to pump.

A Breastfeeding Promotion Act is currently under that will provide certain legal protections for the lactating and allow a tax credit of up to ten thousand dollars per year to companies that provide their employees with pumps or pump rooms. Progress, to be sure, but certainly not protection for a woman who must pump while on travel and then carry the milk onto an aircraft.

So what is the point of all of this? Two things: my has had none of the childhood illnesses I previously mentioned. He is also asthma-free, which alone made my five month ordeal at The Pump totally worth the difficulty. I'm not a doctor, so I can't say for certain that it was the breastmilk, but he got the recommened protection, and today he is a healthy child.

The second point is this: a woman's our ability to provide breast milk for her child even when she is absent from her child is just another example of how child's health issues are central to public health concerns. The solutions? Some are included in this post, but law makers have a long way to go to truly realize the barriers faced by working women who want to provide the best nutrition for their babies. The American dream is costly, and families who want it must pay for it in more ways than one, and it is the youngest and most vulnerable who stand to lose the most.


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