Lactation Narration

The introduction to The Womanly Art of Breastfeeding specifies that “in addition to talking about breastfeeding, we’ll deliberately be using the word nursing because to us it means a connection that’s more than just the milk.”  When people talk about the “benefits of breastfeeding,” they are often really talking about the benefits of breast milk feeding.  What I mean is that we talk a lot about the nutritional value of human milk, the antibodies and immunities in breast milk, or the decreased risk for various medical conditions when babies are fed breast milk or when mothers lactate.  (See this list for examples.)  With such a focus on the milk, exclusively nursing or exclusively pumping are often considered synonymous, because both are feeding breast milk.  Even the word “breastfeeding” implies that it’s just about the feeding.

For a lot of people these days, breastfeeding is just about the feeding, about the milk.  And of course, the milk is really important!  But for me, breastfeeding is about much more than just food.  Breastfeeding has been one of the most wonderful and worthwhile experiences of my life, and it has been a major part of my relationship with my kids through toddlerhood.  I didn’t know it would be that way before I did it – I thought I’d nurse for about 6 months – for the immunities and because I though “that’s what people do,” and because I didn’t think it would work to nurse and also pump and work full-time.  When I decided to breastfeed Munchkin, it was just about the milk.  But once I became a nursing mother, it meant a lot more to me than I had imagined it would or could – it wasn’t just a feeding method, it was a parenting method.

When I say that I think breastfeeding is about more than just the milk though, people have accused me of being a bottle-hater and saying that bottle-feeding parents don’t love their children as much as those who breastfeed.  I would never say that bottle-fed babies are loved any less.  I’m am saying that breastfeeding can fulfill multiple functions in addition to feeding.  But I’m not saying that those other functions can’t also be carried out by substitute methods, the way that the bottle substitutes for the feeding function of breastfeeding.  Not only do bottle-feeding moms use these methods, but so do breastfeeding moms, and dads too!

A bottle can be used to satisfy hunger, sometimes thirst as well.  A pacifier can satisfy the need to suck for comfort.  Hugging and holding satisfies the need for closeness and warmth.  There are other opportunities for skin-to-skin contact.  Parents find many times for gazing into their child’s eyes.  Parents can find a variety of methods for helping their babies fall asleep besides nursing.  Parents can also find a variety of methods for re-connecting with their babies after a separation, or after meltdowns, tantrums, or punishments are over.  Parents can find other ways of comforting their child after shots, boo-boos, and other upsets.  There are other ways to alleviate air pressure in the ears on an airplane.  And, of course, parents find many ways of bonding with their babies.

I certainly would not say that babies who are not breastfed are not getting these needs met.  What I am saying is that breastfeeding can serve the purpose of meeting all of these needs in our family (and probably more), not just hunger.  Breastfeeding is a parenting tool that I can use for a variety of purposes besides just feeding.  I don’t see why it should be seen as offensive to bottle-feeding parents to say so, but that is often how it seems to be taken.

Imagine that I have a plain cell phone that just makes calls, and you have a smart phone that also sends emails and takes pictures and plays music.  When it comes to making calls, we can both get the job done.  And I can still send emails with my laptop, and take pictures with my camera, and play music with my iPod – I just need more gadgets to fulfill those purposes than just my phone.  That certainly doesn’t make me any more or less of a person.  And you can still use your laptop, camera, and iPod too, in addition to or insead of your smart phone if you choose.  But there’s no reason to pretend that a smart phone has no more functions and capabilities beyond just making calls, even if we consider making calls to be its primary function.

You often hear people say that their baby is using them as a “human pacifier,” as though the Nuk was the original and the breast was the substitute.  Some people worry that nursing to sleep or night-nursing are “bad habits”.  Some people think their babies should only nurse at certain planned intervals.  I think it’s because people often just put a big “should” on using the breast as a milk container, to satisfy hunger only.  I think that we have such a bottle-centric culture now that we think of breastfeeding like a “human bottle” – nothing more than a different feeding vessel.  I just disagree with this frame of mind.  Breastfeeding can be so much more than just a feeding method!

And I think that this notion that food should be the only purpose of breastfeeding is the root of many of the obstacles that nursing mothers face these days.  It can lead people to schedule nursing, which can lead to decreased milk supply, or even failure to thrive.  It can lead people to think “Baby shouldn’t be hungry again ALREADY!” and doubt their milk supply and start to supplement.  It can lead people to think they need to use a pacifier so that their baby won’t rely on them for comfort sucking, which may contribute to a poor latch for some babies or decreased milk supply for some mamas.  It can lead people to be stressed out about night nursing because they think that their baby shouldn’t “need to eat” in the middle of the night anymore.  It can lead people to believe that toddlers shouldn’t nurse anymore because they can acquire their nutrition elsewhere.  And it can also lead people to think poorly of nursing in public, because they think the mom should just schedule her outing around her baby’s feedings, or else just pump a bottle.

Food is the primary function of breastfeeding, but it is not the only function of breastfeeding.  I think it minimizes breastfeeding to imply that it is only about the food, and therefore equivalent to the bottle.  And I think that this cultural attitude makes it harder for breastfeeding mothers today.

Munchkin was born in May 2006.  I took “maternity leave” (aka 12 weeks of unpaid FMLA leave), and when I came back to work, I went to HR to ask where I should go to pump.  I work in a hospital.  You would think they would have a lactation room, wouldn’t you? They said there were no facilities, and that I should ask my supervisor to find me a space.  Lucky for me, I have a good relationship with my supervisor and he was completely supportive of my doing whatever I needed to do.  Also lucky for me, my supervisor has worked here for 30+ years, knows everybody, has tons of connections and a good bit of power, and everyone likes him and is willing to help him out.  So, he was able to find me an unused office to pump in.  And when that office became occupied, he found me a second office, and then a third, and then a fourth as time went on.  Eventually, he got permission for me to use the “OD rooms” – the rooms where the on-call doctors can sleep – and that was a great set-up that I was able to use for the remainder of my pumping time with Munchkin.

Though I had a boss who was willing and able to help me out, I know that not everyone is so fortunate.  Another co-worker on my hallway had a less than amicable relationship with her boss and didn’t feel comfortable asking him to find her a space to pump.  Not knowing what else to do, she decided to pump in the bathroom. The bathroom doesn’t have an outlet though, so she could only use a hand pump.  After a few weeks her milk supply was greatly decreased and she decided to switch to formula.  Another co-worker told me that her supervisor let her pump in a supply room where the door didn’t fully close and people were constantly in-and-out of it.  She also only lasted a few weeks. Some supervisors want to help, but don’t know how to find a suitable space.  I decided that our hospital ought to have a lactation room, so that anyone who wants to pump will have a place to do so regardless of the approachability or level of power of her supervisor.

I wrote up a proposal for our hospital to create a designated space for a lactation room.  I also offered that we could just designate an existing space, such as the OD rooms, that could serve a dual purpose, and just give pumping moms authorization to use that space, but for some reason that wasn’t agreeable to the administration.  I submitted my original proposal on October 17, 2006. I was told that I should hear a response of some kind within 2 weeks.  Two weeks went by and I heard nothing, then 4 weeks, then 12 weeks.  Finally, on Feb 22, 2007 (18 weeks, if you’re keeping track), I got this response:

“Your suggestion was given full and careful consideration.  However, due to the lack of space within the hospital, your suggestion has been placed on the project planning list.  Projects on this list will be re-addressed once off-site leases are acquired and additional space is identified within the hospital.”

In March of 2007, I contacted my congressman’s office about the issue, and they were very supportive.  They said they would contact the hospital and encourage them to find the space for a lactation room.  I highly recommend contacting your member of congress – I think that’s what really got the ball rolling.  Within a few days, I heard a new response:

“We have thoroughly searched throughout our building to see if there is a room we could currently re-designate as a lactation room.  Unfortunately, our current space shortage is significant enough that doing so would require evicting someone from an office at a time when we have no offices in which to place newly hired employees and not enough exam rooms to ensure efficient clinic operations.  We do definitely plan to create a dedicated lactation room once we have moved staff and programs to our new off-site lease and have added two modular buildings.  This additional space will be activated in the fall of 2007.  Until that time, our current practice of using locker rooms and private offices will continue.  It has been our experience that our supervisors have been supportive of the needs of nursing mothers and have worked with the staff to identify private areas for their use on an as-needed basis.  While this is not ideal, we believe it should be tolerable for the next several months until we have additional space available.  Thank you for your interest.”

By fall of 2007 I was no longer pumping for Munchkin, but I continued to followup on the lactation room proposal on principal.  Here is part of the response I got on September 13, 2007:

“I expect it to be at least another 6-7 months before we can move functions to the off-site lease…   We definitely still have the lactation room on our list of space needs and will create one as soon as things start to clear out.  I am sorry it has taken so long.”

A year later, I found out that I was expecting Sweets.  I followed up again, saying that I would be in need of a lactation room again in another year’s time, and would it be ready for me by then.  Here is the response on August 8, 2008:

“We expect to award the off-site lease this week and move to the new space in January.  We have this need on the list of priorities for vacated space, and are thinking through the best central location for use by staff.”

January came and went.  In March, I was thinking ahead to my approaching due date and asked again for a progress report.  March 6, 2009:

“The lactation room location has been identified on 5B…  …Probably in May.”

In April, Sweets was born and I went out on “maternity leave” again with no idea if the lactation room would be ready when I came back to work.  I continued to follow-up from home.  May 7, 2009:

“Probably mid to late June when Ward moves.”

In August, I was preparing to come back to work.  I asked again whether the room would be ready by the time I came back.  August 19, 2009:

“The room will not be ready Monday but should be ready after next week. I am still working on receiving and having carpet installed. It will not be installed until sometime next week. There is a chair and small table on order for the room. They should be here in 4 to 6 weeks.  I do have some furniture that can be placed in the room on a temporary basis.”

I came back to work in August and used the OD rooms to pump, as I had 3 years earlier, but I had hope that a real lactation room would be ready soon.  September 1, 2009:

“Hello – the room appears to be done – it just needs to be cleaned, and to have a small table placed and a chair.  If [XXX has] temporary furniture, please go ahead and put into the room.  [XXX] will have the paper towel and soap dispensers hung.  I’ll ask [XXX] to do the final cleaning and hang a sign.”

On September 3, 2009 I took it upon myself to go check out the new room and see what still needed to be done.  There was a temporary bench chair and table, a sink, outlets, and a locking door, so that was good enough for me!  They had basically converted an old supply closet by adding carpet and a sink.  I used the room to pump that day for the first time!  It took three years from the time I first proposed the lactation room until it became a reality! And while it was far too late for me to use the room to pump for Munchkin, it was just in time for me to use it for Sweets!  See the top picture to see what the room looked like that day.

I found a bookshelf that the Volunteer Service let me use, and I bought some used books to stock it with.  I also started bringing in magazines, including New Beginnings and Mothering, and others took the initiative to bring in their own magazines too – Parents, Parenting, Baby Talk, and occasionally others.  I brought LLL series sheets too.  I brought a clipboard and a notepad so that users could write notes to each other.  I brought in a bulletin board which I originally used to post notices and series sheets, but we decided later to use it to post pictures of our kids.  Here is what the lactation looks like now, a year later.

After a year, the lactation room is getting a lot of use.  At first, we would all lock the door while pumping and wait our turn outside.  But now we leave the door unlocked and you can often find us pumping two at a time, or sometimes even three together!  We now have a folding chair and a small table to accommodate two users at a time.

I’ve had an MD mom tell me that she was asked to come back early from her maternity leave to round and that the only reason she agreed to do so was because they told her that we now have a lactation room.  We have two moms in the room who use it to pump, but also use it to nurse their babies once a day when their nanny brings the babies during their break time (they share the nanny).  We have one mom in the room who uses a wheelchair and finds the room to be a very tight fit due to the smaller than standard door, but she is able to manage as long as we keep the floor clear for her, so we have rearranged some of the furniture.  All in all, we are finding the room to be small and crowded sometimes, but we are very thankful that it is there for us.

In the year that we’ve been pumping in this room (yes, I’m still pumping for Sweets), healthcare reform has created a new mandate that would require the hospital to provide us a lactation room by law anyway.  Hopefully that will make the process easier for other moms who want a lactation room in their workplace, and it won’t take three years for them to get it done!