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News / Health / Health Wire

Breastfeeding at work is ‘mentally and physically taxing’ even in the best conditions

By Lizzy McLellan Ravitch, The Philadelphia Inquirer
Published: December 9, 2023, 6:00am

PHILADELPHIA — Breastfeeding has been a major part of psychiatrist Johanna Beck’s life for most of the last three years. It’s required careful planning, persistence, and three different kinds of breast pumps so she can express milk while continuing her work tasks and seeing patients.

“There is a big burden of pumping at work,” Beck said. “The way it gets better is visibility.”

Many parents choose to breastfeed because it’s recommended by pediatricians for its nutritional and illness-prevention benefits and to avoid the cost of formula-feeding. But balancing a job and pumping several times a day is a task that many describe as tedious and laborious, even under the best conditions.

“It’s hard. I’m exhausted,” said Alison Gruber, an OB/GYN resident. “It’s an extra step in my day that’s already quite busy.”

Even with a hybrid work setup and a lactation-friendly office, “it was still very mentally and physically taxing,” said Rebecca Barber, who works in social media advertising.

A federal law that took effect in April expanded workplace pumping rights. Previously, employers were only required to provide pump breaks and a private, non-bathroom lactation space to hourly workers, which meant about a quarter of U.S. women of childbearing age were excluded. Now, that right applies to exempt workers, an estimated 9 million more people, and employers can be sued for noncompliance.

Locally, too, lawmakers are seeking to expand access. Philadelphia Councilmember Katherine Gilmore Richardson proposed a bill that would require the city to create dedicated lactation spaces for city employees with electric outlets, a flat surface, and nearby running water.

But existing laws still don’t resolve the long list of challenges facing lactating workers.

Breast pumps and pumping accessories cost money. Expressed milk must be stored and refrigerated somewhere at work. Used pump parts must be sanitized or refrigerated between sessions. Lactating people need more food and hydration to maintain their milk supply. Missing a pump or delaying too long can cause painful swelling, leaking, and sometimes even infections from clogged milk ducts.

Then there’s finding the time — pumping takes 15 to 20 minutes on average, plus setup and cleanup. Stepping away from a classroom full of children or an hours-long surgery takes careful planning.

Lactation experts “tell you not to stress, that it can impact production, but it’s so hard not to stress,” said Meg Smith, a second-grade teacher. “It’s hard turning off your brain from work for a second and focusing on your family when you’re sitting in your workplace.”

Here’s how several Philadelphia-area parents say they made pumping work at work — or didn’t.

When space is tight, where can I pump and store milk?

Kerry, who asked to use her first name only to protect her future employment prospects, worked at a restaurant in the Philadelphia International Airport when she gave birth in May. She returned from leave in September.

She used the airport’s publicly available lactation suites to pump but often found the nearest one was occupied when she wanted to use it. A manager told her she was allowed only 30 minutes of break time per day, but “it could take me 10 minutes, 20 minutes for me to walk to another lactation suite for it to not even be available,” Kerry said.

Kerry struggled to find a space to wash and store her pump parts and store her milk. She was once reprimanded for leaving sanitized pump parts on a server station to dry, she said. After that, Kerry took leave from work and approached human resources about pumping accommodations.

In response, Kerry said, HR referred her to the pumping accommodations guidelines provided by OTG, the company that operates many airport restaurants. After getting HR’s answer, Kerry said, she still didn’t know where she would store milk and wash pump parts at work, so she felt unable to return. Kerry was eventually terminated for attendance violations.

Unite Here Local 274, which represents OTG employees at PHL, filed a grievance for Kerry, who is now unemployed.

“OTG is a family-run business that prides itself on partnering with its employees to accommodate the needs of its crew,” OTG spokesperson Richard Bamberger said. “Its company handbook as well as its operations adhere to all federal and state laws protecting breastfeeding employees.”

Angela Maldonado worked at Boule Cafe, an OTG airport restaurant, when she was pumping in 2022. Like Kerry, she had no break room at the restaurant and was not allowed to store breastmilk in the cafe’s fridge, she said.

Instead of the public lactation suites, Maldonado used one of the rooms operated by Minute Suite — a company that rents private suites to travelers and offers lactating parents up to 30 minutes for free. A friend of Maldonado’s works there and stored her breastmilk in the freezer as a favor.

Still, she said, “it was tedious.” She quit pumping at work after a few months, breastfeeding at home and supplementing with formula.

Can I pump while I treat patients?

Jefferson Health has lactation space available for employees, but OB/GYN chief resident Gruber prefers to pump in her department’s workrooms.

“I opt to be around people and continue with my work as I’m pumping,” Gruber said.

At first, Gruber was nervous about pumping at work, but she’s made it possible by communicating about when she’ll need to step away — such as leaving the operating room during a multi-hour surgery, while colleagues continue.

She also credits her gear: a powerful, portable pump about “the size of a big iPod” that costs about $180 and hands-free pumping bras that allow her to multitask. That’s a privilege, she noted.

“Something I think about as an OB/GYN all the time is that not all of our patients can buy pumping bras or any pump that’s out there,” Gruber said.

Beck, the psychiatrist, was also a resident when her first child was born.

“You can say ‘I’m going to pump at 7 a.m., 10 a.m., and 1 p.m.,’ but it doesn’t always work that way in a hospital,” she said.

The job can still be unpredictable, such as when a patient is in crisis and needs more time than expected. That can quickly derail a planned pumping session.

Two things allowed her to go on, she said: persistence and wearable breast pumps.

The wearable pumps are battery-powered, hands-free, and fit under her clothes so she isn’t stuck in one place while pumping. They’re not cheap, costing about $500 for a pair, but she figured that money would be spent on formula if she didn’t find a way to pump at work, and these allow her to meet with patients while pumping.

Now, as a fellow, Beck is in the hospital less often. She has a plug-in pump and a mini-fridge in her office, where she pumps milk for her second child, born this summer. She still uses the wearables sometimes, too.

“It’s really important to me to normalize breastfeeding, normalize pumping, and normalize being a mom generally,” she said.

Who will cover my class when I step away?

“We have a lot of women on our staff, and a lot of them have pumped at work before,” said Margo Seifert, a specialist teacher at Merion Elementary School in Lower Merion, Pennsylvania, who breastfed each of her two children for one year. “I’m probably one of the longest-pumping simply because I have a slightly more flexible schedule.”

Seifert works with students who need extra math support and was able to insert pumping breaks — as many as three per day — between scheduled student meetings. Her small, private classroom is equipped with a mini fridge, and she could simply lock the door and close a curtain on the window to pump.

Still, “It was a mental load … having to stop what I’m doing,” Seifert said.

When colleagues emailed her a request, “I’d say, ‘I can’t do it until my lunch break, I have to pump,’” and fellow teachers always accommodated. But when students knocked on her door during pump breaks, confused by her temporary unavailability, she couldn’t be as transparent. She knew some parents may not want her talking about breastfeeding to their children.

Meg Smith, who teaches second grade at Franklin Towne Charter Elementary School in Philadelphia, pumped three times a day for about six months last school year. At 9 a.m. and noon, another teacher would supervise her class while she pumped in a converted storage space outfitted with a table, chair, power strip, and mini fridge. For the 3 p.m. pump, students were gone, and she could stay in her own classroom.

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“My teaching team that I work with, all of them at the time had had kids in the past few years as well. They had been through it all, too,” she said. “In some careers it’s not even an option … so I do feel very lucky that my workplace was able to accommodate it.”

Pumping at this job is doable, but when will it be over?

Barber, who works at health care marketing company CMI Media Group in Philadelphia, pumped three times each workday until just a few weeks ago. “I work for a place that’s extremely supportive,” she said.

Her office, where she works about one day a week, has a nursing room with a mini fridge and couch. Other days she works from home.

Still, it wasn’t easy. She blocked times on her calendar but often ended up moving those around, and she always did some kind of work while the pump was on.

She has forgotten an essential pump part at home and had to go back for it. She once accidentally left her pump and breastmilk at the office and had to retrieve it the next morning before sending her baby to daycare. “It’s so much additional mental load,” Barber said.

Fae Ehsan, the development and communications manager for nutrition education nonprofit Vetri Community Partnership, pumped during work hours for about a year. She spends one or two days a week in VCP’s office, and the rest working remotely.

At the office, she pumped in a private room with a desk, chair, white-noise machine, and space heater. Other coworkers would sometimes use the space, she said, but always vacated it without question when she needed to pump.

“You can be your whole self here,” she said. “Having permission to be a parent out loud is really special.”

Given the organization’s work, VCP also has a sanitary kitchen. Ehsan could sanitize and dry her pump parts there, and had refrigerator space to store breastmilk. Free snacks are always available for employees, which was handy given her constant hunger from breastfeeding.

Even with a workplace that felt so welcoming to her pumping needs, Ehsan is relieved to be done now.

“It’s just really time consuming,” she said. “If I have to listen to a pump one more time, I’m going to scream.”

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