Breastfeeding/Pumping

[diosa78]

I am pregnant with my 2nd and currently working in a busy ER. I plan to breastfeed/pump and return to work when baby is around 8 weeks. I am nervous about not being able to pump (I have only worked about a year in this ER and from other nurses, I have been told that there is not much support to express milk). I would really like to pump until I can get through respiratory season to reduce my baby's chances of getting sick.

I know federal law mandates that I get breaks whenever I need to express milk (which I would like to do every 4 hours and I understand that they don't have to pay me for these breaks which I am ok with). Basically, I would need two 15 minute breaks and I would use my lunch time to pump as well. So, any advice on how I should approach my manager to make sure I get these breaks? The last hospital I worked at was very supportive and I was able to pump about every 4 hours, so I am nervous that I am not going to have the same support. Any advice/tips is appreciated.

[Tait, MSN, RN]

As a soon to be breastfeeding new momma myself I would just be frank about it with your manager. I am not sure how policies factor into this one. I know our hospital just recently created "lactation rooms" for staff mommas, so I am pretty confident I will be able to pump when I need to.

Best of luck and congratulations!

[Elvish, BSN, DNP, RN, NP]

I'd approach him/her sooner rather than later and let them know your plans. Let them know you're willing to be flexible and pump (if you can) when there is downtime. I think most people's objection to it comes from the perception that women use it as an excuse to not work as hard as everyone else, or to go take a break as soon as they see the sky falling.

Does your place have an OB department? If so, call them up and ask if there are any lactation consultants - or, failing that, floor nurses for whom breastfeeding is a professional interest - who might be able to help you out. When my son was a baby and still breastfeeding, I switched jobs to work in OB and the staff and LCs there helped me find the pump room and hooked me up with pump tubing etc. that was compatible with the pumps they had there.

Back to your manager, if you are professional about and let them know your needs, but also let them know you'll be more than willing to help out your coworkers when they need breaks and/or extra help with their patients, you might find a better response. I know some supervisors are more okay with this than others so I'll keep my fingers crossed for you. (I used to work in a not-so-pump-friendly environment so I sympathize with you here.) And congratulations!!

[ktwlpn, LPN]

I found that after I had been back at work for about a month my body seemed to put out alot less milk during my shift and production seemed to double during my off hours.I stopped pumping at work but continued nursing without a problem.Good luck.

[WalterAm]

diosa,

I have helped several friends who are facing challenging work/pump situations-one in the military, and another who is a city bus driver. The book Breastfeeding in Combat Boots offers a ton of advice from an LC who went through the challenges you face while serving in the military. I read the book while I was serving and pregnant, but I was able to get discharged before putting any of Robyn's advice to the test! An excerpt from the book can be found here. The chapter in the link happens to be on planning, which would probably be of use to you right now! There is also an article from the American Academy of Pediatrics (found in the journal of the AAP) that looks at options for breastfeeding mothers returning to work. It may help if you can show your employer that the AAP supports pumping at work. Here is the link. Good luck!

[Meriwhen, ASN, BSN, MSN, RN]

I think the key is that you make sure that your manager knows that you'll still get the work done. I have a tech who is currently pumping. As long as she's getting her work done and coordinates the break with me and the other techs so we always have staff coverage, I have no problem whatsoever with her taking a longer break than usual or even an additional break to pump. Having a sympathetic manager also can't hurt--I breastfeed once so I can relate, and I definitely support what she is doing :)

However, if she spent more time with her pump than actually on the floor with the patients, or if pumping/lactation became her excuse for slacking on the job, then I would have an issue with it. While her child may be her priority (as it should be), patient care has to be my priority and it's my license on the line...neverminding that it's not fair to the other techs to shoulder the majority of her workload.

[linearthinker, DNP, RN]

Good for you! I pumped for at least a year after returning to work with each of my kids, and back then there were no laws requiring my employer to provide me with time or place to pump.

First, buy the best quality pump you can. You probably already know that.

2nd, when making arrangements to return from your mat leave, just tell (do not ask) your supervisor what your pumping needs and schedule will be, and enforce it. I mean, when it is time, walk away. (yes, yes, it goes without saying she is not going to abandon her patients or leave anyone in an unsafe situation, so all of you getting all worked up, calm the heck down right now) You are your own best advocate. Don't be apologetic, be proactive and firm. The law is on your side!

I am so proud of you! Good luck and take care. :)

[NicuGal, MSN, RN]

Maybe you will be the one to change that mentality! We have had kids in our unit whose moms were ER nurses and they would change their shirts and come up and nurse their babies on their breaks and lunches!

Does your hospital offer employee pump rooms? We have 2 rooms on 2 different floors so moms can pump, and we have had them call and ask to use our pump rooms which we gladly let them use...and we have pumps for them so that they don't have to bring their own! You could also call the postpartum floor ahead of time and ask if they have a pump you could use while at work. Although, Medela makes a great one that comes in a travel bag! Call lactation services where you work (if they have it) and they can hook you up!

You may not get out as often as you like, but try to pump at least 2 or 3 times during your shift. Like others said, many find that their supply drops off during work hours but picks up on their hours at home. Make sure you nurse frequently at home and really make sure you stay hydrated at work...lots of water and not caffeine! You could also run and pump while there is a down time...you don't have to be on a strict schedule, it only takes 15 minutes to pump! Also, make sure you bring your baby's picture, it will help your let down, esp if you are having a busy rotten day!