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.
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
sufficient to support optimal growth and development for
approximately the first 6 months after birth It is recommended
breastfeeding continue for at least 12 months, and thereafter for as long as
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:
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.
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
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
and, more specifically, lactation. Coincident with a
reduction in family size has been a progressively earlier return
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
day-care facility, studies have documented an increased rate of
transmission of infectious diseases in these settings...
can benefit when they promote a positive attitude towards
lactation...many new mothers bring skills and experience employees.
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
Additionally, breastfeeding mothers lose less time from the
workplace because breastfed babies tend to stay healthier
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
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
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.
may encourage employers to provide the option of either a
postpartum leave of at least four months' duration; telecommuting,
other available option that could permit the breastfeeding mother to spend
more time with her baby.
Breastfeeding-Friendly Workplace- Workplaces should provide the following:
1. A private room, or section thereof, for either
expressing milk or nursing
2. A comfortable chair
3. Electrical outlet and small table for breast pump
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
7. Non-harassment policy for breastfeeding mothers.
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
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
about letting [my patient] provide breastmilk to her baby.
Denise Punger MD FAAFP
International Board Certified Lactation Consultant
Chairman, Treasure Coast Breastfeeding Task Force
Academy of Breastfeeding Medicine
Member, La Leche League Associates
References for these policies are easily found online at: