NR 506 RN as Healthcare Policy Leader Discussion

Breastfeeding in the Workplace

One area that society can improve on is the acceptance of breastfeeding in the workplace. Breastfeeding not only has benefits for the baby but also for the mother (Kozhimannil, Jou, Gjerdingen, & McGovern, 2016). Babies will experience reduced rates for conditions including GI infections, SIDS, diabetes, and obesity (Kozhimannil et al., 2016). Mothers can also gain benefits by having a decreased risk for postpartum depression, diabetes, arthritis, and even some cancers (Kozhimannil et al., 2016). The recommendation is for mothers to only breastfeed for the first six months of the child’s life (Kozhimannil et al., 2016). In recent years, the number of women breastfeeding has increased, but the number of women who continue the practice upon returning to work does not support this trend (Kozhimannil et al., 2016). When women were asked why they were not breastfeeding, returning to their full-time job after maternity leave is the primary reason (Kozhimannil et al., 2016). Even though the government has mandated that places of employment allow mothers frequent breaks to breastfeed during the day, there are issues with having adequate space for women to pump besides a bathroom, facilities to store expressed milk, and a lack of workplace support (Kozhimannil et al., 2016).

I have seen some of my coworkers experience these trials when they return as new mothers. We have an office space that is the unofficial breastfeeding room. In one instance, a mother was in the room when a physician came to the floor; he was upset that he could not use that room to chart. Even though there were plenty of other spaces with computer access, he caused somewhat of a scene. Most places of employment have policies for breastfeeding, but the execution of those policies might be problematic (Anderson et al., 2015). An open line of communication between the mothers and employers should exist to ensure that the mothers have what they need to continue with breastfeeding upon returning to work (Anderson et al., 2015).

Breastfeeding is a health practice that can have lifelong benefits for children; a mother should have complete control when deciding if she wishes to breastfeed. Not having approved time or sufficient space to pump while at work are not valid reasons that should prevent any mother from breastfeeding. We should advocate for procedures to be in place so that the choice of whether to breastfeed is simple for those mothers who wish to continue this practice when they return to work. In the past, some of my coworkers have confided that they were sometimes scared to complain about problems with breastfeeding at work because they did not want to cause any friction. They had already been absent from work due to maternity leave and did not wish to raise any concerns asking for special treatment. No mother should feel this way. We, as a society, should do a better job supporting our mothers.

References

Anderson, J., Kuehl, R. A., Tschetter, L., Drury, S. M., Schwaegerl, M., Yoder, J., & … Lamp, J. (2015). Policies Aren’t Enough: The Importance of Interpersonal Communication about Workplace Breastfeeding Support. Journal Of Human Lactation, 31(2), 260-266.

Kozhimannil, K. B., Jou, J., Gjerdingen, D. K., & McGovern, P. M. (2016). Access to Workplace Accommodations to Support Breastfeeding after Passage of the Affordable Care Act. Women’s Health Issues: Official Publication Of The Jacobs Institute Of Women’s Health, 26(1), 6-13. doi:10.1016/j.whi.2015.08.002

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Mothers having the means and understanding from their employers when it comes to breastfeeding can become an issue. Majority of work places have existing policies in place regarding breastfeeding and pumping, but not all places have adequate locations for mothers to take their allotted breaks to pump. Some staff members make the mothers feel less than because they need to pump. I am for mothers being able to breastfeed at work. Having the location and support of the place of work is something that should be a guarantee for mothers at their workplace. Breastfeeding not only has benefits for the child, but for the mother as well (Kozhimannil, Jou, Gjerdingen, & McGovern, 2016). The medical recommendation for mothers to breastfeed is for the child’s first six months of their life (Kozhimannil, et al., 2016). If a woman chooses to stop breastfeeding her child, it should be completely her decision not based on not having the services available to her at her place of work.

Very good post. I can relate to what you said about having the time and location to pump while at work. When I had my first daughter I was working in the Intensive Care Unit. I was only able to breastfeed her for about 5 or 6 months, because I was not allowed the time to breastfeed her at work. Of course no one came right out and said “no you can’t” but coverage was very limited and often times I didn’t feel that it was safe for me to leave my patients. When my now 21 month old was a baby I experienced the same type of response while I was in ICU. I would call to get coverage and someone may come an hour or sometimes three hours later. I remember times where I just wanted to cry because I was so frustrated and because I was kind of in pain to be honest. The times when I was able to pump, I was often interrupted which was so very frustrating. Doctors, housekeeping, other nurses, and even family members on a few occasions would come into the break room when I was trying to pump. I never felt like I had privacy. Other nurses would get annoyed because I actually got to “take my breaks.” Anyone who has ever pumped knows that that is not a break. When I took my new job as an Instructor RN, I had a whole new experience. I could now pump whenever I wanted and I had a private office where I wasn’t worried about being interrupted. Having had both experiences, I think breastfeeding mothers definitely deserve their privacy. Of course, I wouldn’t ask for special treatment and I think they should limit their times where they pump, but they should be allowed the time and space. When I worked a 12 hour shift I would try to pump once in the morning, at lunch, and once in the afternoon. I felt that was reasonable, as technically we were allowed two 15 minute breaks and a lunch break. I wish that people wouldn’t shame mothers who try to breastfeed as it is already such a selfless and time consuming thing.

I agree with you about the importance of working mothers being able to have a clean and safe place to pump and store expressed milk for their babies. We built and moved into a new hospital a few years ago and there were lactation rooms built into the new facility. They are set up like a small break room with a sink, microwave, refrigerator, TV and seating. For a while there was a problem with non-breastfeeding mothers using the rooms as a break room, but that problem as since been solved with a door passcode that general employees do not have access to.

One problem that I have noticed is that there are no additional break allotments for employees that need to pump. Currently, they have to pump on their 15 minute breaks and their lunch. This doesn’t seem right to me. I feel that they could be allowed an additional 15 minute break so they don’t have to eat while they pump. Our hospital being a small-community one, is like a big family, so people will cover for them, sort of off the record. However, when they are off the unit, we are out of compliance with your nurse/patient ratios and on busy days it can be pretty challenging to let them go several times a day. One of our doctors flies from Illinois one week/month and works a 7-day stretch. Her husband comes with her because they have a 6-month old baby. He brings the baby to the hospital several times/day for her to nurse. They make it work, but it is such a challenge. Life while our children are infants is already so challenging with sleep deprivation and it is a shame that trying to make breastfeeding work can be so hard for some working mothers.

I couldn’t agree more then with your post. The facility that I work with takes breast-feeding serious and we have a dedicated room for pumping for our nurses and physicians to utilize during the shift to be able to pump in a clean , quiet area. there is also a refrigerator that they may store their breast-milk in till their shift is over , as long as it is marked appropriately. We as a facility are responsible to have these resources in place for the breastfeeding mother’s who return to work. Mothers seem to find a lot of barriers to continue breastfeeding once returning to their place of employment (Ashley & Levy, 2017). Sometimes the barriers out way the benefits especially if the mother is made to feel uncomfortable and feels as if she has just returned back to work and doesn’t want to make a fuss (Ashley & Levy, 2017). We should encourage mothers to breastfeed and be able to back it up with all the positive results from breastfeeding compared to bottle feeding, even if the mother only breastfeeds for 6 months (

Ashley, T. I., & Levy, G. R. (2017). Breastfeeding: Factors That Affect Initiation and Duration of Breastfeeding. CINAHL Nursing Guide.

“As a health policy professional leader, communicating with lay audiences is an important skill in promoting the health of the community for master prepared registered nurses. Develop a concise position statement reflecting the research findings and recommendations by experts as they relate to workplace support for breast feeding mothers, medical marijuana services in the community, genetic testing or applications of stem cell research, transgender care, abortion, end-of-life care, or a community service administered by Family Nurse Practitioners (if you pick this one be specific about the type of community service the FNP would work in or manage).”

I chose breastfeeding because I am a new mom and I have struggled with breastfeeding in the workplace and publicly. Breastfeeding in public is somehow still causing raised eyebrows as strangers give breastfeeding mother’s unwanted stares. A concise position statement reflecting the research findings and recommendations by experts as they relate to workplace support for breast feeding mothers is “The promotion of breastfeeding is an important public health intervention with many benefits for the mother and baby.” Breastfeeding is less expensive than formula feeding and can contribute to significant health care cost savings short-term and in the long run. For example, various benefits for the baby and mother, this includes decreasing infant’s infection, illnesses and maternal’s health outcome like postpartum weight decline, reduces diabetes, metabolic, cardiovascular risk, and reproductive cancers (Dieterich, Felice, O’Sullivan, & Rasmussen, 2013).

However, employers in workplace must give full support for breast feeding mothers. “Section 4207 of this law requires employers nationwide to accommodate women who wish to breastfeed at work by allowing for reasonable breaks for breastfeeding or expressing breast milk each time the mother needs to do so until the infant is 1 year of age” (Smith & Pravikoff, 2017). It is recommended that employers must provide a private location for breastfeeding that is not a bathroom, nevertheless there is not a room dedicated to breastfeeding at my work at Kaiser Permanante hospital so I was pumping in the break room hiding in the corner. Research indicates that the attitudes and level of knowledge of health care providers who support women learning to breastfeed can directly impact the ability of a mother to successfully breastfeed (Smith, Javanparast & Craig, 2017). Nurses and other health care providers should support each woman’s choice of infant nutrition, whatever she choses and assist her to select and utilize the best infant nutrition available. In 1991, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) established Baby Friendly Hospital Initiative (BFHI), Ten Steps to Successful Breastfeeding in the USA and the principles of the BFHI have been shown to increase breastfeeding initiation rates among participating hospitals when compared with national averages (CDC, 2013). The Affordable Care Act (2010) requires new health plans to cover prenatal and postpartum breastfeeding counseling and supplies (CDC, 2013). Hopefully, with all the laws supporting breastfeeding mothers it should meet the goal of Healthy People 2020 “aims to increase breast-feeding rates to 82% “ever breast-fed,” 61% at 6 months and 34% at 1 year; exclusive breast-feeding goals are set for 44% by 3 months and 24% at 6 months” (Healthy People, 2020).

References

Centers for Disease Control and Prevention (2013). Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies. Atlanta: U.S. Department of Health and Human Services. Retrieved from https://www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdfLinks to an external site.

Dieterich C.M., Felice J.P., O’Sullivan E., & Rasmussen K.M. (2013). Breastfeeding and Health Outcomes for the Mother-Infant Dyad. Pediatr Clin North Am. 60(1): 31–48.

Smith J., Javanparast S., Craig L. (2017). Bringing babies and breasts into workplaces: Support for breastfeeding mothers in workplaces and childcare services at the Australian National University. Breastfeeding Review. 25(1): 45-57. 13p.

Smith N., & Pravikoff D. (2017). Breastfeeding: Working Mothers (United States). CINAHL Nursing Guide, EBSCO Publishing, (Evidence-Based Care Sheet – CEU), Database: Nursing Reference Center Plus

NR 506 RN as Healthcare Policy Leader Discussion