“We felt we needed a policy that says, ‘It’s OK to take breaks; you don’t have to push through. In fact the rest of the team wants you to successfully breastfeed,’ ” Pesch said.
Having pediatricians create the policy made sense. It’s a women-dominated specialty and they often discuss the importance of breastfeeding with parents.
“As a pediatrician, we do a lot of counseling about breastfeeding,” said Dr. Heather Burrows, a pediatrician at Mott Children’s who helped develop the policy. “We live it in our professional as well as personal lives. It feels comfortable and natural to me to have those conversations.”
The policy has four components: dedicated times to pump during shifts; a formal place to pump; a specific area to store milk; and an “open culture” around lactation for colleagues.
The team wanted to adopt a policy already in use at another hospital or health system but couldn’t find any, so it was developed using the personal experiences of the pediatricians at Michigan Medicine. “We were really thinking about what our own needs were. I myself am a mom of three young girls,” Pesch said.
Most institutions likely haven’t created formal policies on this subject because “most of the people in leadership positions haven’t had to pump,” Burrows said. Healthcare leadership roles are still largely held by men.
The policy was shared in a pediatrics department faculty meeting at Mott Children’s about a year ago. Pesch said physician leaders were supportive but some expressed discomfort with broaching the topic. Pesch explained that residents are less likely to ask for the time to pump so leaders must be clear that it’s supported. The hierarchical structure of medicine usually means trainees don’t advocate for themselves openly.
“It took some explaining about why it’s better to talk about it than not talk about it,” Pesch said.
A handout was also created with scripting to help leaders bring it up naturally in conversation with physicians who recently had a baby.
Mott Children’s already has lactation rooms in the neonatal intensive-care unit that physicians can use to pump, but any space that is private will work, such as a cubicle. “It doesn’t have to be expensive or fancy,” Pesch said.
The policy suggests that for every four-hour block spent on clinical duties, the physician gets a dedicated 15-minute break to pump. The policy also includes a stipulation about milk storage to help combat the stigma that breast milk isn’t like any other food product and therefore can’t be stored in a fridge used by colleagues. “There is this misconception that because it’s a body fluid, it’s like a biohazard. We wanted to have it in writing that it could be stored where physicians store their other foods,” Pesch said.
The departments of surgery, anesthesiology and OB-GYN have followed suit and adopted the policy.
