Adapted from “Handling Legal Calls: Pumping in the Workplace,” Northern LLLights, LLL of Minnesota and the Dakotas’ Area Leaders’ Letter, Winter 2014 Jo Hillard Carrane, Eden Prairie, Minnesota, USA

In a typical helping call, mothers bring the challenges they and their nurslings encounter when establishing breastfeeding relationships. Leaders are available to share information and reassurance to mothers in these situations. However, calls about external interference with the nursing relationship may leave a Leader feeling helpless. An unsupportive employer may be a major obstacle for a mother and baby already struggling with breastfeeding. It can be helpful to mentally frame these calls in two different parts: the legal questions and the breastfeeding questions. The breastfeeding questions are the ones a Leader can answer.

Practical pumping questions

Does the mother feel overwhelmed trying to provide enough pumped milk? You can discuss a normal amount to pump (two to four ounces total per session) and paced bottle-feeding so the baby doesn’t gulp milk too quickly. “Planning Your Milk Supply” on pages 268-269 of The Womanly Art of Breastfeeding (2010 edition) suggests that if a mother is away from her baby for nine hours (work plus travelling time), her baby will probably need about six 2-ounce (60 ml) containers of her milk each day. The Kellymom article, How much expressed milk will my baby need? has a milk needs calculator (for the exclusively breastfed baby).

Is the mother struggling to maintain an adequate milk supply at work? Or does she feel her milk supply has been affected? Babies between one and six months take about 19–30 ounces or 570–900 milliliters of breast milk (Kellymom, 2011) in 24 hours. In Breastfeeding Answers Made Simple 2010, Nancy Mohrbacher quotes 25–35 ounces or 750–1035 ml. Ask whether the mother is pumping as often as she would be feeding and discuss ways to pump more breast milk, such as looking at a picture of her baby, recording her baby’s cry to play back while pumping, and smelling an unwashed piece of her baby’s clothing. Some mothers find that meditation or visualizing a waterfall can help. Assure her that many women see a drop in pumping output as time goes on and that there are ways to increase it.

Maximizing pumping

Does the mother have a good pump? A high quality pump meets the mother’s needs and effectively removes the milk. Double electric pumps are most often recommended for mothers who experience regular separation from their nursling.

Does the mother know how to hand express? Hand expression in addition to (or sometimes instead of) the electric pump can maximize milk expressed.

Hands on pumping. Jane Morton, MD, of Stanford University School of Medicine in California, USA, has found that breast massage during pumping increases pumping output. See her video here.

Does she have a new pump for this baby? Or is she using a pump she used with an older child? If the mother is using a secondhand pump (other than a “closed-system” pump), she needs to be aware of hygiene cautions and concerns. Used pumps can be contaminated and unhealthy for mother and/or baby. There is also no way to know how much life is left in a secondhand pump. Has she had the pump tested to make sure it is still effective? Some retailers will test pumps, or some hospitals, clinics, or International Board Certified Lactation Consultant practices have that capability.  When a mother is dealing with the stress of pumping at work, the last thing she needs is a drop in supply due to an ineffective pump. See also “What about Used Pumps?” on page 296 of The Womanly Art of Breastfeeding, 2010 and “Are Used Breast Pumps a Good Option? Issues to Consider” by Nancy Mohrbacher, Leaven June-July 2004, pages 54-55.

Pumping logistics

How often does the mother plan to pump during the day? In an eight-hour working day most women pump during morning and afternoon breaks and during lunch. It can help to discuss what Nancy Mohrbacher, author of Working and Breastfeeding Made Simple, calls the “magic number“: the number of times a mother’s breasts need to be drained each day to maintain a full milk supply. Mohrbacher says, “Due to differences in breast storage capacity, some mothers’ ‘magic number’ may be as few as 4 –5 or as many as 9–10.” (Refer to The ‘Magic Number’ and Long-Term Milk Production.) An employed mother with a higher “magic number” may need to nurse more at home if she can’t pump frequently at work. Talk about ways to rest while night nursing and refer her to the chapter on working in Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family (LLLI, 2014). Also, it can be helpful to take advantage of breastfeeding just before leaving home and as soon as she arrives at day care after work, which has the added bonus of signaling her breasts to make antibodies to the specific germs her baby is exposed to during the working day.

What options does she have for a location to pump? A private space (that is not a restroom) with a comfortable chair and access to electricity, a sink, and a refrigerator would be ideal. However, sometimes an employed mother must be creative. Mothers have curtained off open work spaces and used white noise to mask the sound of a pump. Some teachers and other employees with limited private space have even used car outlet adapters and rigged makeshift blinds so they can pump in their vehicle. A cooler with cold packs can substitute for a refrigerator. Having an extra set or two of pump parts means a mother can use a clean set at each pumping and take them home to wash.

Caregivers

Is he or she familiar with handling human milk? Current milk storage guidelines and tips on usage are found at: http://www.llli.org/faq/milkstorage.html and a tear-sheet on milk handling is on page 493 of The Womanly Art of Breastfeeding? and online at http://www.llli.org/toolkit (Day care provider sheet—milk handling link, second page)

Has the mother talked to her caregiver about paced bottle-feeding? She can find information in The Womanly Art of Breastfeeding on pages 425–426, and a tear-sheet on page 491 or http://www.llli.org/toolkit (Day care provider sheet—paced bottle-feeding link)

When wearing your LLL hat, you are not an attorney, legislator, or mediator.

Questions about pumping and the law

The mother may also have questions about how she can still provide her own milk for her baby with a less-than-accommodating employer. When responding to any legal question, Leaders need to make it very clear to the mother that they do not provide legal advice. When wearing your LLL hat, you are not an attorney, legislator, or mediator. Leaders are there to support the mother. One of the more common legal situations is a nursing mother who returns to work and faces an employer and/or co-workers who are unhelpful and may even seem hostile to breastfeeding. Even in a supportive environment, returning to work can feel overwhelming for a new or experienced mother. Help the mother clarify her concerns by going over the issues.

We’re all in this together

One of the most helpful things a mother can do is to consider her approach to the situation. Very often, a mother is understandably angry about an employer’s lack of support and wants to know more about her right to breastfeed in the workplace. As a Leader, you can provide a friendly ear and listen to her struggles. Gently suggest going to her employer with a “we’re all in this together” and a “how can I help you to help me?” approach. Enquire whether the mother has yet had discussions with her employer regarding pumping when she returns to work. What accommodations are allowed, if any? Does the mother know why her employer thinks pumping at work will cause a problem? Has the mother discussed with her employer how she will still complete her work on time or if there are any opportunities to telecommute?

The mother can also explore available resources. Is there a human resources department? Is there an employee handbook that might discuss accommodations? Are there other mother allies who have pumped at the place of work in the past?

Ask whether the mother has discussed with the employer the benefits of an employee who is a breastfeeding mother. Breastfed babies tend to be healthier, which means the mother misses less work to care for her sick baby. Additionally, time is normally allotted for smokers to take breaks and pumping usually takes less time overall than smoking breaks. In the US, it may help for her to share with her employer the “Business Case for Breastfeeding” from the United States Department of Health and Human Services. This document outlines benefits and other information on lactation programs. Other countries or regions may have similar resources (check with your Area or Area Network).

Legal requirements

Finally, you can provide the mother with the legal resources. If the mother is convinced her employer is blatantly violating the law, you can gently suggest the mother document her situation and consult with legal counsel. Do not let her outrage talk you into making a legal conclusion on whether she has a case.

You can contact a Professional Liaison Leader for information about the laws in your province, state, or country. In the United States, refer to Workplace Support in Federal Law. In the United Kingdom, see Accommodating Breastfeeding Employees in the Workplace.

Often, with a little bit of conversation, creativity, and a good dose of determination, mothers can develop a solution specific to their situation. You as a Leader may be just the one to provide the tools and suggestions to make that happen.


For additional reading

Roddy, A. Gentling Baby to a Bottle: When a Breastfed Baby is Bottle-fed. Leaven 2009; 45(1):12-15.
Pearson-Glaze, P. How Can I Pump More Breast Milk? 2014 (accessed 2 March 2015).
Pearson-Glaze, P. Do I Need a Breastpump?  2014 (accessed 2 March 2015).
Colburn-Smith, C. and Serrette, A. The Milk Memos: How Real Moms Learned to Mix Business with Babies—and How You Can, Too. New York: Tarcher/Penguin Books, 2007.

Jo Hillard Carrane lives in Eden Park, Minnesota, USA, with her husband Andy, their children Mike (5), Joey (2), and stepdaughter Kenzie (15). Accredited in 2012, she is the Area Professional Liaison for LLL of Minnesota/Dakotas, USA. In addition to La Leche League, she works as a jury consultant. 
mary_francellMary Francell is the mother of three breastfed children. She has been a La Leche League Leader for 20 years and is currently Area Professional Liaison for LLL of Georgia, USA. Mary is studying to take the International Board of Lactation Consultant Examiners (IBLCE) exam this summer and plans to open a private lactation practice.

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