Breast Pumping in the Healthcare Workplace

Abstract

Background: Reasons women do not breastfeed, or shorten their breastfeeding journey, include the lack of paid leave and the challenges of breast pumping in the healthcare workplace. Despite the health benefits of breastfeeding for mother and baby, health care workers returning to work often struggle to breast pump due to lack of access to lactation facilities and lack of time and support. The aim of this needs assessment was to determine the extent of these challenges. Methods: A survey was created and distributed through social media forums from 2020-2023 to determine the extent of these issues. IRB exemption was obtained (Protocol #2010273689). Responses were obtained from 222 health care workers across the United States. Data were analyzed and comments were sorted thematically. Results: Survey respondents were from the Midwest 30% (66), Southeast 25% (55), Northeast 18% (40), West 16% (35), and Southwest 10% (22) with 222 total responses. Physicians (n = 191) made up 86% of the responses across 11 specialties, with 15 of them being residents or fellows. There were 50% of respondents who did not have nearby access to a lactation room although 96% used a breast pump while at work. Pumping occurred every 2-3 hours for 48% and every 4-6 hours for 48% of respondents. Pumping duration was 11-20 minutes for 53% and 21-30 minutes for 32% of respondents, with transit time and other logistics taking an additional 1-5 minutes for 33%, 6-10 minutes for 47%, and 11-15 minutes for 12% of respondents. On a scale of 1-5, where 1 was “Pumping at work did not affect the duration of breastfeeding at all” and 5 was “I had to stop breastfeeding because I was not able to pump enough at work,” responses were 1 (19%), 2 (23%), 3 (20%), 4 (19%), 5 (19%). Respondents (n = 106; 48%) have used a wearable breast pump. On a scale from 1 to 10, where 1 is “No, I CAN NOT do my job equally well when wearing a breast pump” and 10 is “Yes, I CAN do my job equally well when wearing a breast pump,” 49% of those respondents chose 10. In the free text comments, multiple respondents discussed pumping while providing clinical care using wearable pumps. One person pumped while performing a vaginal delivery, another during an intraoperative code, and another while placing lines for a patient with a Type A aortic dissection. Discussion: Lack of access to lactation facilities, long transit times, frequent pumping, and long pumping sessions can be time prohibitive challenges for many health care workers. Lack of support from colleagues, administrators, and patients can influence breastfeeding duration. Wearable breast pumps have mixed reviews but have allowed many women to pump while doing normal work activities. Although only 107 respondents (48%) have used wearable breast pumps, 148 respondents (67%) answered “Does a wearable breast pump affect your ability to perform your job effectively?” suggesting opinions instead of personal experience. “Nearby access” of lactation facilities was not defined. The scope of work may differ from health care providers who do telemedicine, see patients in clinic, or perform codes in the operating room. Improvements on this survey include specifying the states for each US region and clarifying the year when respondents were breast pumping, as culture has evolved with a greater emphasis on wellness and increased numbers of women physicians. Expanding data on trainees would identify issues related to autonomy and educational practices. Conclusion: Accessible lactation rooms are lacking in the healthcare workplace. On average, respondents pumped every 2-6 hours with the majority taking 11-30 mins with 1-15 mins for logistics. Wearable breast pumps may be a viable option for some women to continue work activities while pumping. Workplace bias against breast pumping is still prevalent and more work needs to be done to support breast pumping women.