When Barbara Doherty, 32, returned to her job at John Hancock Mutual Life Insurance Co. last year three months after having a baby, she encountered a modern woman’s dream.
Like a growing number of companies, the Hancock provides a “mother’s room,” where Doherty used a company-funded electric breast milk pump three times a day — 20 minutes per session — to express milk for her infant son. She then stored the milk in a refrigerator and took it home at night for the babysitter to give her son the next day while she was at work.
The arrangement not only kept Doherty’s milk supply flowing — if breasts aren’t emptied frequently, the milk supply dries up — but eased her anxieties about being a working mother.
“You do feel pulled in different directions,” says Doherty, who lives in Medfield. “Because I felt I was doing something positive for my child, it helps you feel more focused and productive at work.”
At long last, the corporate and medical establishments are beginning to find ways to help, rather than thwart, breast-feeding.
Last month, the American Academy of Pediatrics, in its strongest statement yet, issued a virtual manifesto on behalf of breast-feeding, saying, “Human milk is the preferred feeding for all infants, including premature and sick newborns, with rare exceptions.”
Because even small amounts of formula can sabotage breast-feeding — some babies find it easier to suck from a bottle than the breast — the academy added that “no supplements [water, glucose water, formula and so forth] should be given to breast-feeding newborns unless a medical indication exists.”
The pediatricians went on to urge hospitals and employers to do all they can to “protect” breast-feeding — and in some places, they are.
Many hospitals, for instance, now offer not only breast-feeding classes, lactation consultants and rooming-in of infants with their mothers, but also have stopped giving out samples of formula unless a woman asks for them, because many women felt this undermined their commitment to breast-feed.
And employers are discovering that buttressing a woman’s desire to breast-feed after she returns to work is not just humane personnel policy but good business as well.
Five years ago, Medela, Inc. of McHenry, Ill., believed to be the nation’s leading manufacturer of electric breast pumps, had not sold any of its $600 machines to companies, says company spokeswoman Debra Kurtz.
Today, it has sold pumps to 300 companies, and 75 of the firms also buy Medela’s full package of prenatal classes and lactation consultants.
All of which seems to pay off, for the employers as well as their working mothers.
Two studies supported by Medela show that in companies offering lactation programs, babies who were breast-fed had 36 percent fewer illnesses than those who were bottle-fed, and their mothers experienced 27 percent less absenteeism.
For every dollar spent on lactation programs, the “payback is close to $3,” says spokeswoman Kurtz, because babies are healthier and moms are absent less.
The payoff certainly seems clear at Hancock insurance in Boston, where an average of 300 employees are pregnant every year and 30 percent breast-feed. The company estimates that since its inception in 1993, the mother’s room has saved about $60,0000 in time lost because of sick children.
And it’s relatively easy to arrange.
All an employer must do is “allow, in an 8-hour day, at least two 15-minute breaks and a private area in which a woman can pump,” says Donna M. Norris, a nurse and lactation consultant for Harvard Vanguard Medical Associates, a group practice of doctors and nurses who provide care to members of the Harvard Pilgrim Health Care HMO.
Because electric pumps are much more efficient than hand pumps, the lactation room should have access to electricity — a bathroom stall won’t do — and privacy.
(While the pump itself is shared, each woman has her own attachable kit and tubing so that her milk never comes in contact with any surface touched by another mother’s milk.)
It also helps if employers provide a small refrigerator to store pumped milk, says Jill Landauer, spokeswoman for Work Family Directions, Inc., a Boston-based firm that helps companies adapt to workers’ needs.
“Certain companies are quite progressive in this area,” says Jennifer Swanberg, a senior research associate at the nonprofit Families and Work Institute in New York. “They see it as a real low cost way to help working moms.”
But not all. In some firms, women pump milk in boiler rooms or bathroom stalls and find their own ways of refrigerating it until they go home.
And some face worse hassles.
In Maryland, Alenthia Epps, 36, a correction officer in a state facility, was put on leave without pay after pumping milk for her infant daughter during her lunch break. The prison objected to her bringing an unapproved object — the breast pump — on the premises, said her husband, Leon, 27, last week.
Epps said his wife argued that the prison allowed people to smoke, “whereas during her break, all she wanted to do is pump so she could have milk for her child and keep her milk up. It was like saying she couldn’t do something healthy for her child.”
Epps finally got her job back when the governor’s office intervened, a governor’s spokesman said.
In Michigan, a mother sued her company for not allowing her to pump milk anywhere on company property, including in a car in the parking lot, according to U.S. News & World Report. She reportedly recently settled out of court.
Despite the lingering corporate squeamishness and resistance, the medical arguments for breast-feeding are powerful.
The pediatricians’ academy, for instance, noted that breast-feeding provides many health advantages “while significantly decreasing risk for a large number of acute and chronic diseases.”
Among other things, human milk decreases the incidence and or severity of diarrhea, lower respiratory infection, earaches, bacterial infections including meningitis, urinary tract infections and many other diseases.
It also may protect against sudden infant death, insulin-dependent diabetes, Crohn’s disease, lymphoma, allergies, ulcerative colitis and other digestive problems. It has also been linked to a possible enhancement of intellectual function.
Despite such advantages, women should not be made to “feel guilty if they can’t breast-feed,” says Judy Norsigian, a co-author of the “Our Bodies, Ourselves,” book on women’s health.
And for many women in this country it does prove impossible. An estimated 59.4 percent of American women breast-feed their newborns, a rate lower than in many other industrialized nations. By the time the baby is six months old, only 21.6 percent of American mothers are still nursing.
Part of the problem, lactation specialists say, is sheer lack of time, especially for women who go back to work soon after the baby is born. Newborns need to breast-feed 8 to 12 times every 24 hours until satiety, usually 10 to 15 minutes on each breast, the pediatricians’ group says. This translates to as much as six hours a day, a huge time commitment for new mothers.
“But the real burden is that society makes breast-feeding seem overwhelming, when it is not in and of itself so difficult,” says Dr. Kimberly Lee, a neonatologist who is associate director of the newborn nursery at Beth Israel Deaconess Medical Center.
Another part of the problem is that breast-feeding can get off to a rough start because many new mothers are sent home from the hospital within 48 hours — before their milk supply is firmed established. Then, if they have trouble getting the baby to nurse at home, they may panic and switch to bottle-feeding.
To help with such problems, some hospitals, including Brigham and Women’s and Beth Israel Deaconess, operate telephone hotlines or weekly drop-in groups for nursing mothers.
Some babies simply “won’t latch on” at first, says Judy Gundersen, nursing coordinator for parent and childbirth education and the lactation support service at Brigham and Women’s Hospital. They just lick at the nipple “and mom is so anxious that she lets him lick, not really get latched on.”
In fact, it usually takes “three weeks to get breast-feeding well-established — for babies to become proficient, for the [milk] supply to be established, with `letdown’ and flow of milk brisk,” says Dr. Marianne E. Neifert, a pediatrician at the Columbia Presbyterian/St. Luke’s Medical Center in Denver and co-author of the new breast-feeding guidelines.
Ideally, she adds, breast-feeding should be the baby’s sole nutrition for the first six months and be supplemented with solid food for the next six.
But if you can’t manage it or you are an adoptive mother, she says, don’t “get stuck” in guilt. Move on to an iron-fortified infant formula based on cow or soy milk. Don’t prop the bottle while the baby feeds, she adds. Snuggle the baby as you would if you were nursing.
And you can take some comfort in the fact that infant formulas have improved over time. Soon, in fact, mothers who choose or feel they must use formulas may have an expanded choice.
The US Food and Drug Administration is now reviewing evidence for recommending the addition of DHA, an omega-3 fatty acid to infant formula, says Dr. Elizabeth Yetley, director of the FDA office of special nutritionals.
DHA, which is found in breast milk, has been shown in some studies to boost development of the eye and brain.
But even as formulas get better, lactation specialists say, it’s unlikely any product will truly mimic human milk.
Which means, in essence, that the modern world — especially employers — must adapt to the hunter-gatherer lifestyle.
Perhaps the National Organization for Women puts it best: “When women do not have to hide in the bathroom or in a corner to breast-feed or pump, we will have come a long way toward real respect for the job of being a mother.”