(this one's much nicer than the bathroom I pumped in)

The other day, I pumped milk in a public restroom. I was out of my normal routine, and there was no one to ask for better accommodations within a reasonable timeframe.

My choices were either the bathroom or the industrial kitchen, sitting on the cold cement floor in the dark, or skip pumping and become engorged. The bathroom was a single stall, with an electrical outlet, toilet with a tank and closing lid, and a cement floor. I chose to pump in the bathroom, and I will never do it again.

Yet many women find the bathroom the only private place to pump milk at their workplace, like the woman in Ohio who was fired for her unscheduled pumping breaks  (see the CNN video here, including discussion of using the restroom to pump). Before I tried it myself, I thought it would be unpleasant, but I didn’t realize how unsanitary it can be. Let me present to you my analysis of the disgusting details I hadn’t considered before I was faced with this experience myself.

Bathroom surfaces are filthy.

We all know about the aerosol effect of toilet flushing right? You may not see or feel it, but the contents of the toilet spray out with every flush. The little bacteria-laden droplets go airborne. Here is a quick video showing the spray out of a toilet bowl. It is safe to assume that all surfaces surrounding the toilet are coated with droplets of urine, fecal matter, and bacteria or mold present in the toilet bowl.

Pumping in the bathroom is a juggling act.

While pumping in my home or in the office, where I have plenty of clean space, I hardly think about this, but here are the dilemmas I went through in the bathroom at each step of pumping :

1. Where to place the pump: The toilet in this particular bathroom had a tank with a level top, so that’s what I used, although it was  small. Most public toilets don’t have this feature. Alternatives would be resting on the toilet paper rolls, or (if your pump has long tubing) on the floor. There’s no good option.
2. Where to sit: This bathroom had a lid that covered the toilet bowl, so I closed it and sat on it. Most public restrooms don’t. You’d have to sit directly on the toilet seat. People pee on the toilet seat. Maybe you could stand up. I don’t know about your breast pump, but the tubing on mine won’t reach that far.
3. Assembling the collection pieces: Between leaning forward to pull pieces from my pump bag, pressing the flanges into the connectors, turning around backward to plug everything into the pump, I found it difficult in this small space to assemble the pieces without brushing my arms or the tubing against some surface of the bathroom. And where do you set down the first side while assembling the second side?
4. Where to set down the bottles/bags full of milk: At some point you have to set the bottles/bags down while you button up and pack everything away. In my office, I place the bottles full of milk on my clean desk until I’m ready to carry them to the refrigerator in the break room. In the restroom, I guess the best option is to put it in your lap and hope it doesn’t fall into the toilet or onto the floor.

Other mothers might experience it differently, depending on what kind of pump and case you have. Mine doesn’t have any special holders or compartments that helped with bathroom pumping.

It ties up the bathroom for others who need it.

Especially if there’s only a single-stall restroom available. A pumping session takes longer than your typical bathroom break, and it’s hard to rush. It’s awkward to walk out and face the other women lined up, waiting for you.

It’s unpleasant and uncomfortable.

This isn’t the worst thing in the world, but still, who wants to spend all their break time in the bathroom? It smells bad. It’s ugly. Whether pumping standing or sitting on the toilet, it’s hard to relax, which can inhibit the milk ejection reflex.

Sanitary lactation space should be a working mother’s right.

In many US states, it is a right. Several states have breastfeeding laws that require employers to provide facilities for pumping milk, “other than a toilet stall” which you can see in this compilation of state breastfeeding protection laws. Women should not have to pump in a bathroom to provide food for their babies. Some workplaces may not have the luxury of setting aside an entire room for pumping, but there must be some space that could be partitioned off when the pumping employee needs it.  I have been in two offices that used cubicle dividers to create a small pumping room. The room I pumped in while on jury duty was actually a  large closet adjacent to the restroom, and that worked fine.

If you are a mother who pumps milk in a bathroom, please don’t be offended. I commend you for enduring the unpleasant surroundings to provide the best food for your baby. I realize that, where there are no laws to mandate a designated pumping area, you might not have any choice. Maybe you’ve found a way to keep everything clean and you’ve got the routine down. But you should be entitled to a better space.

Moms, have you had to pump milk in a public bathroom? How did it work out for you?

After a month of full-time work, I’ve been forced to find ways to cope. Like other working mothers, my days are packed and I wish I had more time with my baby. A month ago, I wasn’t sure I could handle it, but it’s getting more comfortable. Here are a few tips that I want to share- the things I didn’t start out with and have discovered along the way.

Use a hands-free pumping device.

It has revolutionized my pumping experience. The first time I tried one, it was awkward to put on, and in the time it took to get it secured with the pump parts in the right place, I could have been done pumping. So I didn’t start using one consistently until a few weeks ago. After using it a few times, I was able to put it on in seconds. It helps me pump within my allotted break time since I can pump and eat at the same time. I can also read books, write emails, and blog. (Yes, I am pumping as I write this). And I noticed a surprising result: I get more milk.  Apparently, the milk flows better when I can sit back and relax. Some people find these a waste of money because they can rig up their own version like this one (I haven’t tried this, so let me know if it works for you). Here are a couple examples of hands-free pumping bras that I know of, at Easy Expressions and Simple Wishes.

Don’t waste time washing the pieces after each use.

I made this mistake at first, and it was cutting into my work time. Instead, between pump uses, you can just grab all the pieces, stuff them into a clean bag and put them in the refrigerator or insulated bag with your ice packs. (I do a quick rinse first so the milk doesn’t get stuck in the hard-to-clean places). I only do a full washing with soap and hot water at the end of the day, and I leave all the parts in my office until the weekend.

Enjoy it.

Pumping is the only time I have to myself during the day. That’s why I can’t bring myself to be productive during this time. No going online and paying bills, scheduling appointments, or catching up on my job-related work. I often look forward to the days when I don’t have to pump, I can socialize with my coworkers on breaks, and not worry about lactation accommodations at conferences and special events. But for now, I enjoy these few minutes to get away and breathe. I may even find myself missing it some day.

For a great collection of posts on working and breastfeeding from other bloggers, check out the September Carnival of Breastfeeding on working and breastfeeding. Scroll down to the bottom of the post for the links.

What suggestions or questions do you have about pumping at work?

My related posts:

Life after maternity leave

Back-to-work nursing strike

When I went back to work full-time last month, my baby nursed fine in the morning and nights during the week. But for the first 2 weekends, he decided that the breast was no longer a normal part of his daytime routine.

After 5 full days of working, that Saturday he refused the breast. He seemed interested and latched readily, but after two sucks he would pull off angrily, pushing away from me with all his strength. I coaxed him back to try again, with the same response. This went on, to varying degrees, all day. Sometimes I was able to get him on. Sometimes it was a struggle, but I got him to eat a little.

That weekend was a hard one for me. I was frustrated with my baby. And I was worried that my milk supply would start dropping if this continued. I think my anxiety and frustration only made it worse.

So what was this all about? A partial nursing strike? A protest of my absence? A newly developed preference for the bottle? A desire to spend his limited time with Mommy in active playtime instead of nursing? Maybe all of the above?

The next weekend, we took a different approach. I tried all kinds of variations in the routine to see what might help.

• I gave up on trying to nurse more often. I imagined that we’d make up for our time apart over the weekends, with frequent spontaneous nursing. Some babies love the chance to nurse whenever they can get, but not this one. He just isn’t interested in the breast when he’s not hungry.  Makes sense, doesn’t it?

• Take advantage of naptime when he’s sleepy and mellow. He nurses well just before falling asleep.

• Pump after nursing a couple times a day. This doesn’t improve his nursing, but it does help to protect the milk supply when his nursing isn’t good for a long period of time.

• Don’t force it. When I offered the breast and he refused it, I moved on and tried again 15 minutes later.

• Try different positions. I tried strapping him into his Ergo carrier with my bra open, and just waited. Sure enough, he discovered the breast, latched himself on, and ate while I walked around.

He’s nursing just fine now. My milk supply dropped for a week or two, but I’m back to pumping the usual amount at work. It is a reminder to me that mothering is never an exact science, and the rules are ever-changing. Some of this is trial-and-error, maybe with a little intuition thrown in. And these strategies that seemed to work for us might not work for other babies!

Has anyone else had a similar experience? Dealt with a nursing strike? Did going back to work affect your breastfeeding during the time you were at home? What worked for you?

This month, my breast pump and I went back to work full-time, AND we were summoned to jury duty for a week-long trial. I have lactation accommodations on my mind!

Returning to work, or plans to return to work, is a common reason mothers cite for weaning early from the breast, supplementing with formula, or never breastfeeding. Breastfeeding rates in the US drop sharply at 3 months, which corresponds to when most women exhaust their maternity leave and return to work.

It doesn’t have to be this way. I came across this study a couple years ago in grad school because one of the co-authors was my advisor. It makes sense that if an employer offers support and makes it easier to pump at work, the employees will breastfeed longer. But this study demonstrates the tremendous extent to which employer support, accommodations, and education, can encourage employee breastfeeding.

A study of WIC employees and breastfeeding

The researchers surveyed employees of the WIC Program (aka The Special Supplemental Nutrition Program for Women, Infants, and Children) at several sites in California. You may already know of the WIC Program. Nearly half of all infants born in the US receive WIC benefits. WIC is the #1 purchaser of infant formula in the United States. Yet, in recent years, it has also become the country’s largest breastfeeding education and support program. It turns out that WIC is also an excellent supporter of breastfeeding among their own employees.

The study results were astounding. Here is what they found:

• 99% of the WIC employees in the survey initiated breastfeeding.
• The average duration of breastfeeding was 10.2 months.
• 87% breastfed to at least 6 months, and 68% breastfed to 12 months or longer.
• More than 48% never introduced formula.

Now, these numbers may not sound impressive to many readers of this blog. We know that babies should be breastfed for at least a year, and exclusive breastfeeding (no artificial milks) is best. By these standards, the study subjects fall short.

But compare these numbers to recent national averages. 36% breastfeed to 6 months. Fewer than 20% of mothers breastfeed for a full year, and the number who exclusively breastfeed this long without introducing formula is far lower.

And consider the background of these mothers who are employed by WIC. 80% are paraprofessional staff, with a high school diploma or equivalent. They are working full-time. In my experience, many WIC paraprofessional staff are, or have been, WIC participants themselves. In the US, breastfeeding is inversely associated with education and income levels. The more education, and the more money she makes, the more likely she is to breastfeed. Mothers who have not been to college, earn low to moderate wages, and work full-time have tremendous barriers to breastfeeding and not surprisingly, have some of the lowest breastfeeding rates. The WIC employees who participated in this study confound the expected trends of breastfeeding cessation.

What keeps these WIC employees breastfeeding?

• On-site breast pumps and pumping facilities. Many WIC agencies provide high-quality, hospital-grade breast pumps for employee use.

• Breastfeeding support groups and an environment of support. Most WIC agencies employ at least one International Board Certified Lactation Consultants (IBCLC) and WIC breastfeeding peer counselors. Some agencies offer employee breastfeeding support groups, and many offer such groups to the community. WIC employees who are breastfeeding have access to help and support on-site.

• Breastfeeding education. WIC staff receive regular and ongoing training in breastfeeding for the purpose of assisting their clients with breastfeeding. Staff are made aware of the risks of formula use and the benefits of exclusive breastfeeding. This on-the-job training impacts personal decisions about intention to breastfeed and motivation to continue.

The researchers conclude, “It is clear that full-time employment and breastfeeding can be compatible given appropriate worksite support.” This type of support obviously works. But WIC is a maternal-child health organization with ample resources to support breastfeeding employees. Could these strategies be implemented at other types of work sites?

I could see a very large organization providing pumps for their lactation rooms (some already do!!) And perhaps arranging a support group for breastfeeding employees to meet periodically. But I imagine a big part of what worked so well for the WIC employees in this study was the culture of breastfeeding: the training and reinforcement that is inherent in the work of their jobs.

Can this be duplicated somehow in other, non-breastfeeding-related workplaces? How far should an employer go to provide support for breastfeeding employees? Moms, what has your experience been with working outside the home and breastfeeding/pumping? What makes for a great employee breastfeeding support system? I would love to hear your thoughts and experiences.

Other Carnival of Breastfeeding Posts:

Breastfeeding Moms Unite:   Breastfeeding At My Family Daycare

Momnesia The Book:   Sorry, Facilities Guy

Marshins:   Taking Your Working Boobs To Work

Strocel:   Working and Breastfeeding a Toddler

The Marketing Mama:   Working and Pumping

Motherwear Breastfeeding Blog:   Breastfeeding and working is possible, and you can make it work

Chronicles of a Nursing Mom:   Do  You Really Need a Pump?

Vanderbilt Wife:   I Think This Officially Makes Me a Mommy Blogger

BabyREADY:   What About Breastfeeding When I Go Back To Work?

Stork Stories:   My Breast Pump and I Didn’t Get Along and guest post at Breastfeeding Mothers Unite: Ask an LC: What About Pumping?

Breastfeeding Mums:   Breastfeeding and Working in the UK

Blacktating:   The 5 Biggest Mistakes Working and Pumping Moms Make

Mum Unplugged:   This is a Breastfeeding Office

Best For Babes: Beating the Employment Booby Trap

My World Edenwild:   Nursing Mothers Need Workplace Support

Initially, I dreaded the return from maternity leave to part-time work. I thought of how much I would miss my baby, wondered how I would manage to get myself ready and out the door on time in the morning. I imagined breaking down crying in front of my coworkers from the stress of it all, and I worried that my milk supply would diminish.

But it wasn’t bad. I found some ways to juggle my time, continue to provide breast milk, and spend quality time with my son. I’ve gotten used to this, and I like my part time schedule. I pump 3 times during a full work day to maintain my milk supply and provide milk for the bottles.

A few things that helped me transition from full-time mommy to part-time work:

• Pictures of my baby in the office

• Adding a lamp with soft lighting. When I turn off the fluorescent overhead lights and turn on my lamp, it’s a different world in my office, one that helps me relax and feel comfortable as I pump.

• Phone calls home while pumping. My son loves to “talk” on the phone, and I love to hear his babble and button-pressing.

• A great babysitter. We have similar values and she loves spending time with my son. I know that he is safe and well-nurtured during the day. She helps with housework during his naps, so my husband and I come home to a clean kitchen and have more time to spend as a family.

Next Step: Working full-time

Now that I face a new transition to even more time away from home, I’m having those same fears I faced a few months ago. Working part-time is one thing, but full-time? How will I have time to get anything done at home? Will I miss all of my son’s upcoming milestones. . . his first steps, new words, new games?

I have weighed the options, and the bottom line is, with my husband in full-time graduate school, we need my income. I enjoy my career. The expense of full-time babysitting is going to hurt, but still leaves us enough to live on. My job is a full-time position, and that fact would be difficult to change. So back to work it is.

My Full-Time Work Survival Plan includes the strategies above, plus:

• Cooking and freezing meals over the weekend, so we can skip weeknight cooking and spend more time together.

• Getting up EARLY before my son awakens. This will be tricky, as he’s an early riser. It will take some discipline to get to bed early to get enough sleep. But getting ready for work once he awakens is slow and stressful. I think the time to start getting ready in peace will be worth it.

• Exercise. I’ve let this slide lately, but even though it takes time from my day, I sleep better, feel more energy, and it makes me happy. Oh, and I discovered that a few minutes of stretching and yoga poses before pumping at work helps me make more milk.

• Buy baby food. When starting solids, I made all of my son’s foods. Then I discovered jarred food. They make his dinner prep quick and easy, so I picked the most nutritious ones and stocked up for weeknight meals.

• Lots of weekend nursing. To help my milk production keep up, I’ll nurse him more often than he’d normally take a bottle. I don’t think he’ll object!

If you are a breastfeeding mom preparing to work outside the home, I’ve found a couple good resources. The first, Nursing Mother, Working Mother, is a book I have flipped through but haven’t read. And I just came across another called The Milk Memos that I would love to read. . . someday. When I have more time.