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Denise Punger MD FAAFP IBCLC
Letter to a Local Business
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Dear [company],

A few weeks ago, I wrote a quick note to state that it was medically necessary for [my patient] to pump [at work]. Apparently this note was not clear enough. My apologies. As a Family Physician and Lactation Consultant my first preference would be that new mothers stay home (for a year!) so that their babies can be breastfed  exclusively from the breast.

When this is not possible the next best choice is to get the mother's milk through a bottle, syringe, or spoon. When this is not possible donated
mother's milk is the next preferred source. Formula is the last option.

Here is the current policies:
The American Academy of Pediatrics recommends:
Human milk is the preferred feeding for all infants, including premature and
sick newborns, with rare exceptions. Exclusive breastfeeding is ideal
nutrition and sufficient to support optimal growth and development for
approximately the first 6 months after birth It is recommended that
breastfeeding continue for at least 12 months, and thereafter for as long as
mutually desired.

The Surgeon General states:
Infants should be exclusively Breastfed for the first 4-6 months of life.
Preferably, or a full 6 months. Ideally breastfeeding should continue
through the first year of life.

The World Health Organization recommends:
Breastfeeding is an unequalled way of providing ideal food for the healthy
growth and development of infants; it is also an integral part of the
reproductive process with important implications for the health of mothers. 
A recent review of evidence has shown that, on a population basis, exclusive
breastfeeding for 6 months is the optimal way of feeding infants. Thereafter
infants should receive complementary foods with continued breastfeeding up
to 2 years of age or beyond.
The Healthy People 2010 goals are 75% initiation rates, 50% at 6 months, and
25% at one year. On the Treasure Coast some areas have the initiation rates,
we are far off from having the sustained rates, which are still low in my
opinion.

In reference to employment the AAFP states:
"Employment and Breastfeeding
...to the workplace, and an encouraging atmosphere will promote retention of
these valued In the past 30 years, significant demographic shifts have
affected childcare and, more specifically, lactation. Coincident with a
reduction in family size has been a progressively earlier return of mothers
to the workforce, as well as an increased percentage of families headed by
women and families in which both parents are employed. These demographic
changes have made breastfeeding more difficult to implement. In fact, the
most significant obstacle to breastfeeding duration is the mother's need to
return to work... the day-care industry has concurrently grown, fueled by
the early return of new parents to the workplace. Regardless of the quality
of the day-care facility, studies have documented an increased rate of
transmission of infectious diseases in these settings...
Employers can benefit when they promote a positive attitude towards
lactation...many new mothers bring skills and experience employees. Women
who feel their employers are positive towards their desire to continue
breastfeeding are often less torn between their child and loyalty to an
employer; such positive attitudes generally result in greater employee
productivity. Additionally, breastfeeding mothers lose less time from the
workplace because breastfed babies tend to stay healthier than their
formula-fed counterparts... Employers may choose to capitalize on their
pro-lactation policies. Such policies may generate customer approval and
favorable publicity in the community.
The logistics involved in promoting ongoing lactation vary from employer to
employer. Large employers with on-site day-care may simply choose to allow
breaks to be taken in the day-care center where the mother may breastfeed.
All employers should be encouraged to have a written policy about the
promotion and protection of breastfeeding in the workplace. Ideally,
employers should provide a dedicated space for women to nurse or express
breastmilk. Some employers may choose to offer their employees the option of
working part-time or telecommuting the first four to six months when
lactation is most time-intensive. A positive approach by employers goes a
long way towards assuaging concerns on the part of other employees. In time,
federal and state tax benefits could be offered to companies that implement
affirmative lactation policies for their employees.
Family physicians may encourage employers to provide the option of either a
postpartum leave of at least four months' duration; telecommuting, or any
other available option that could permit the breastfeeding mother to spend
more time with her baby.

A Breastfeeding-Friendly Workplace- Workplaces should provide the following:
1. A private room, or section thereof, for either expressing milk or nursing
a baby
2. A comfortable chair
3. Electrical outlet and small table for breast pump
4. Access to a sink to wash hands and equipment
5. Small, secure refrigerator for milk storage
6. Protected breaks every 3 hours for pumping (may be in place of other
breaks)
7. Non-harassment policy for breastfeeding mothers.

Human milk is the preferred feeding for all infants, including premature and
sick newborns, with rare exceptions. Exclusive breastfeeding is ideal
nutrition and sufficient to support optimal growth and development for
approximately the first 6 months after birth It is recommended that
breastfeeding continue for at least 12 months, and thereafter for as long as
mutually desired."

Hopefully, [company]can continue to work with their employees and the
community to be a part of the solution rather than be a part of the problem.
  Please feel free to call or email me if you have any further problems
about letting [my patient] provide breastmilk to her baby.
Sincerely,

Denise Punger MD FAAFP IBCLC
International Board Certified Lactation Consultant
Chairman, Treasure Coast Breastfeeding Task Force
Member, Academy of Breastfeeding Medicine
Member, La Leche League Associates


denisepunger@hotmail.com
(H)
(C)

References for these policies are easily found online at:
http://www.4woman.gov/Breastfeeding/bf.cfm?page=233

 
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Denise Punger MD FAAFP IBCLC
4640 S. 25th Street
Ft. Pierce, Florida, 34981
772-466-8884
Copyright 2005