The United States Breastfeeding Committee has posted FAQ’s about the provisions in the new health care reform legislation for workplace support of breastfeeding mothers. They summarize the provision:
Section 4207 of the Patient Protection and Affordable Care Act (also known as Health Care Reform), states that employers shall provide breastfeeding employees with “reasonable break time” and a private, non-bathroom place to express breast milk during the workday, up until the child’s first birthday.
Employers are not required to pay for time spent expressing milk, and employers of less than 50 employees shall not be required to provide the breaks if doing so would cause “undue hardship” to their business.
Here’s the link. It includes answers to questions including what the law does (and doesn’t do), when it takes effect, why the law is necessary, and what employers will gain from providing breastfeeding support for their employees.
Going back to work while their babies are little is the reality for most mothers that I see. And while it is possible to feed a baby by cup or spoon or finger, most care providers really prefer to feed babies with bottles. So I’ve been trying to learn more about what kinds of bottles and bottle feeding methods best support breastfeeding. There isn’t a lot of good information out there. This new website, BreastandBottlefeeding.com, (and their book) is a start in the right direction. I found the book interesting and think it could be helpful to mothers that are trying to find the way to use bottles to maintain their breastfeeding relationship while they need to be away from their babies. I was disappointed at the lack of research-based information and references, though. It’s a thoughtful book but not heavily evidence-based — though that may not be the fault of the authors but just due to a lack of comprehensive research on this topic.
Check out this hiking adventure from Erin Lotz at Outdoor Baby where two moms forget a very important item on their Grand Canyon trip. Here’s a little bit of the intro:
We planned to hike to the river, spend a night, hike along the river, spend another night, and then hike all the way back. I think that was the itinerary. I was to procure three items that would be shared and were considered critical (as opposed to our shared pots and tent which were less critical). I was to bring a breast pump in order for us to “pump and dump” and therefore continue lactating for our breastfed one-year-olds. I was also to bring a coffee press mug for Kristine. Since she would be pumping and dumping, she could indulge in coffee on this trip — something she was looking forward to nearly as much as the hike itself. Finally, I was to bring one of the two dinners. Now remember, packing was somewhat haphazard.
Update (7/12/2009): Happy Bambino is now carrying both Hygeia and Pumpin Pals so we’ve got a local source for both products! They also started carrying Ameda pumps. Mothers in the Madison area now have easy access to all the major quality pump options. (Hooray!)
The majority of breastfeeding mothers that I see in the Madison area end up wanting a breastpump — mostly because they’re heading back to work while their babies are still small. Many of the pumps that are available are expensive — and some are expensive, uncomfortable, and ineffective. In the Madison area the only really good pump brand mothers can find easily is Medela. Medela makes very nice pumps and accessories (and supports excellent basic breastfeeding research) but their products aren’t perfect for every woman. Mothers use Medela’s Pump In Style all the time (and generally like it a lot) but it’s pricey — so many people buy used ones despite safety concerns. It would be nice to have more quality options. Competition among pump brands can only be good for mothers!
I’m feeling optimistic about two companies and hoping they’re readily available to Madison mothers soon:
One is the Pumpin’ Pal breastshields. Some mothers have a hard time finding a Medela shield that feels right. Pumpin’ Pal shields are a different shape that seem to accomodate a wide range of nipple sizes. They can be used with Medela pumps.
The other is a new pump manufacturer: Hygeia. The really cool thing that they’re offering is a double electric pump (the EnJoye) that is in the price range of a Pump In Style but is safe for multiple users and has a motor that is guaranteed for three years. Also, a mother can return one of their pumps if it doesn’t work for her — not just if it is mechanically defective. Unfortunately I don’t have hands-on experience with these pumps yet so I can’t be enthusiastic without reservations. But, like I said, I’m feeling hopeful that this will give mothers more options.
Jill Lepore goes on to look at what part of breastfeeding is the part that is important to babies’ well being: is it the breastmilk? or is it the interaction with mothers? And if it is (even at least in part )the interaction, why is pumping given so much priority?
Rhode Island’s Physicians’ Committee for Breastfeeding gives an annual award for the most “Breastfeeding-Friendly Workplace,” a merit measured, in the main, by the comforts provided in pumping rooms, like the gold-medal winner’s “soothing room,” equipped with “a sink, a lock on the door, and literature.” It appears no longer within the realm of the imaginable that, instead of running water and a stack of magazines, “breastfeeding-friendly” could mean making it possible for women and their babies to be together. Some lactation rooms even make a point of banning infants and toddlers, lest mothers smuggle them in for a quick nip. At the University of Minnesota, staff with keys can pump their milk at the Expression Connection, but the sign on the door warns: “This room is not intended for mothers who need a space to nurse their babies.”
Between 2004 and 2006, a National Breastfeeding Awareness Campaign included TV ads that likened a mother feeding her baby formula to a pregnant woman riding a mechanical bull: “You’d never take risks before your baby is born. Why start after?” No one seems especially worried about women whose risk assessment looks like this: “Should I take three twenty-minute pumping ‘breaks’ during my workday, or use formula and get home to my baby an hour earlier?”
My own thoughts (not as well-phrased as Jill’s) are that in our society taking care of a baby is low-status, can be isolating, pays little or nothing, and can be boring. Mothers that have to choose between working full time or taking care of their babies full time are left with an unhappy choice. They can see their hard-won careers go off-track, they can fall behind on professional skills, they can lose financial security or they can lose the precious time caring for their babies. I think as a society we find it easier to promote pumping than address these issues.
In the New Yorker, Jill Lepore writes about the pervasiveness of breast pumps. A few quotes that I found interesting:
Today, breast pumps are such a ubiquitous personal accessory that they’re more like cell phones than like catheters. Last July, Stephen Colbert hooked up to a breast pump on “The Colbert Report.” In August, the Republican Vice-Presidential nominee, Sarah Palin, told People that she has often found herself having to “put down the BlackBerries and pick up the breast pump.”
The traffic in pumps is brisk, although accurate sales figures are hard to come by, not least because many people buy the top-of-the-line models secondhand. (Manufacturers argue that if you wouldn’t buy a used toothbrush you shouldn’t buy a used breast pump, but a toothbrush doesn’t cost three hundred dollars.)
Pumping is no fun—whether it’s more boring or more lonesome I find hard to say—but it has recently become so common that even some women who are home with their babies all day long express their milk and feed it in a bottle. Behind closed doors, the nation begins to look like a giant human dairy farm.
Mothers like to read, do the crossword, eat lunch, go online, or do whatever while pumping. It’s hard to turn all your break time at work into just pumping time. To help women multitask there are lots of commercial and homemade hands-free pumping gadgets. This zip-front bustier is popular with a lot of women that I know. Pumpin Pal makes a sort of harness that you put on like a necklace — here’s a video that shows how to use their product. Another option is to cut small holes in an old sports bra to put the breastshields/horns through. A couple mothers have told me that the new Medela Freestyle pump is a great hands-free option (“I even washed my dishes while I was pumping!”). Finally, Catharine Decker came up with a really cheap (and pretty cool) way to use hair elastics and nursing bras to make a hands-free pumping system. Here’s a picture: