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breastfeeding is best, to the tune of billions

When I first saw the news, I wanted to just, you know, sigh. It's a drum many Portland mamas have been beating for at least a decade, probably several: breastfeeding is not just great for a baby, it's cheap, and not just for a family's budget during those first several months but for society. (And I want to say here that I know some mamas want to, but aren't able to, breastfeed because of work or health reasons or adoption or just some rare bit of fate that comes between a baby and "breastfeeding success," and that I don't want to call out the mamas for whom it doesn't work out -- except to offer my sympathy and support and love.) But, says my friend and fellow finance geek Melly, a "recent study published in Pediatrics found that poor compliance with breastfeeding recommendations costs the U.S. at least $13 billion each year, with nearly all of the cost related to infant morbidity and mortality."

Well. You know if the finance geeks, the AP, the Daily Mail and Business Week and CNN and the rest of them are putting the word "breastfeeding" in headlines and -- it's not just a casual glance at the practice, they're encouraging it -- you know times, they are a-changing. And I appreciate the specificity of the facts here. Another bit from Melly's piece: "In 2006, only 13 states met the quite low 17% target set by the Healthy People objectives for mothers exclusively breastfeeding their infant through six months of age." Wow -- I know Oregon is one that easily met the target, but 17%, and we know why (poor social support, terrible workplace conditions for breastfeeding moms, tiny or non-existent maternity leaves, too many low-income working and single moms, too much -- too effective -- marketing by the formula companies). Mamas in Portland and elsewhere are working on that stuff; a press release even this weekend from the Nursing Mothers Council of Oregon offers support to businesses to give moms a place to pump at work -- see more info from Marion Rice about that, after the 'continued' link. But we can't even get 17% of moms (theoretically, quite a few more than 17% are able to stay home with their children) to breastfeed for six months, even though it's far cheaper?

Here's the part that had headline writers clucking and the news anchors squawking: "The study authors listed direct and indirect costs associated with illness and premature death due to the current poor levels of compliance compared with 90% compliance in 2007 dollars." I'll go ahead and list the ones Melly put in her piece because, they're not shocking to us who've been stressing about how easy it would be to make the beginnings of so many little lives better. Here it is:

  • $4.7 billion and 447 deaths due to sudden infant death syndrome.
  • $2.6 billion due to 249 deaths from necrotizing enterocolitis, a common gastrointestinal syndrome in premature infants.
  • $1.8 billion due to 172 excess deaths from lower respiratory tract infections, such as pneumonia.
  • $908 million due to otitis media (ear infection).
  • $601 million due to atopic dermatitis (eczema).
  • $592 million due to childhood obesity.
Umm, wow, again. And I decided in the end that I shouldn't sigh or roll my eyes or wring my hands one more time and ask, "why? how? what the heck have we done, modern society?" but just be hopeful, because to have finance geeks and news anchors and CNN talking heads well, talking about this is an awesome way to get breastfeeding more accepted. And really, money that we all are spending on ear infections and eczema and obesity and death should get us sitting up and paying attention, and then sitting back down in our favorite cozy chair to breastfeed our babies.

Here's what Marion wrote me about the Nursing Mothers' Council: As you know sometimes moms returning to work don't feel comfortable talking to their employer about their breasts. It's kind of the last thing we want to do, but we do have a responsibility to inform our employer that we will pump upon return to work. NMC can be a bridge between mom and her employer to help ease that transition. Ideally we get the employer to provide our services as an employee benefit.

Nursing Mothers Counsel is a non-profit organization that has just launched a program to help companies support employee breastfeeding as a natural and normal part of the corporate culture. We can work with you to develop a plan for our services that meets your needs while working within your budget. Contact, Marion Rice for more information, 503.708.0707 or marionrice @ me .com.

1. We help to build a supportive environment within your company by developing understanding of the business case for breastfeeding across key stakeholders.

2. We help develop employee policies regarding the use of a break room for employees that can also be used for breast milk expression and guide the company through a process of becoming a breastfeeding friendly employer to help limit exposure to potential complaints.

3. NMC assists companies in identifying space for on-site lactation rooms and developing a budget and plan to outfit the rooms for breast milk expression. We work with corporate representatives to identify space for the pumping station(s) that satisfy the Rest Periods for Expression of Breast Milk law requirements and result in happy employees and babies.

4. NMC is available to assist in ongoing support and education for employees returning to work and pumping through peer counseling and workplace coaching.


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A little of-topic, but I am wondering if anyone can recommend a good breast pump? It's been difficult finding one that is well-reviewed and cost-effective. I'd appreciate any tips if y'all have had good experiences with any one particular brand/model.

I've given my Medela Pump In Style Advanced a workout over the past 8 months since my supply is on the low side and my daughter isn't the biggest fan of nursing. So far it's been up to the task and is showing no sign of stopping. Depending on your needs - and I never expected to have this need - a pump that, like mine, can be completely separate from the bag is really convenient so that you can tote it around the house/work more easily. Good luck.

Subsidizing breast pump rentals would be necessary as well. If you go back to work when the baby is small, pumping several times a day, every day, requires a good quality pump. It's so easy for milk production to drop otherwise and it's a slippery slope once the milk stores run out and you have to start supplementing. It was something I couldn't really afford at the time, but we rented a pump right away and made it 8 months with the first kid and 5 months with the second. If your baby has complications or you have trouble breastfeeding, some insurances might cover the cost.

My employer has been much more supportive than my baby's doctors. We've spent far too much time and energy dealing with doctors trying to get us to use formula.

My employer has a lactina pump which works well. I also sometimes use a medela hand pump which also works well. I have a pumpinstyle but it has never worked that well for me though I know many moms that like theirs.

I wonder how they determine those cost figures? I mean, my son has had a couple of ear infections already and he was exclusively breastfed till 6 months and we are still going strong now at 9 months. Would the money we have spent diagnosing and treating his ear infections somehow not be included in that total since he nurses? Just curious. I love that this topic is in the news.

I just had to mention that I just finished doing my taxes (on-line) while nursing and then came over here and read this post - made me chuckle.

My insurance covered 80% of my breast pump as a durable medical good. I had to get a Medela Pump in Style from a certain vendor, but it worked great. I pumped for a year! Definitely consult with the insurance provided nurse who worked with you while you were pregnant. They have all the answers.

If you don't have insurance, you can get a used pump on Craigslist or at one of the many consignment shows. Just buy new tubes and valve covers and boil the plastic parts.

I was lucky for pumping at work. I have a female boss and we had a little conference room near my part of the building that I used. Just make sure to put up a sign so no one walks in on you...a chair in front of the door helps, too. The worst was when I had to pump in the bathroom, but I understand that the State of Oregon requires companies to provide a place for moms to pump that is not a bathroom. Is that correct?

The Oregon law requires employers who have more than 25 employees to provide a space that isn't a restroom for pumping.

I'm a nursing mom myself and I work with pregnant an newly delivered moms. One of the real barriers to work related breastfeeding is the cost of high quality breastpumps. They are really essential to maintaining a milk supply (and not injuring your breasts...yikes) when away from your baby. These pumps usually cost upwards of $250. For many families, it is really difficult to purchase a good pump. We are lucky to have a WIC program that has rental pumps in Multnomah county, but most communities do not have such a service. It seems to me that health insurance companies really should be paying for or subsidizing these pumps. Some do, but it is by no means universal. This study demonstrates that a breastpump is a health care need. Of course, longer/paid parental leaves would address this too, but that is another post...

I'm pumping nowadays, been back to work for a week. I pumped for almost a year with my first, also. I know that a good pump is expensive, but it is still less than a month of formula for a 6 month old. I like the Medela massaging attachments (as much as I can like a pump accessory). I got my pump used off of Craigslist, I just didn't have the money for a new one, but knew I needed a good one. It's the pump-in-style.

I'm glad we have formula for those who need it. However I am an ardent supporter of breastfeeding for primary food source for as long as possible, before introducing solids. I'm no martyr, and I barely kept up with my son's needs, and I'm kind of surprised with how many women give up so quickly. I also despise pumping. But it's a short time out of my life, for a huge investment for my kids. And, I think about how I feel when my mom tells me that she used certain parenting methods that I find cruel, and I don't want my kids to wonder why I didn't do the best I could for them.

I wonder a bit about those numbers. I kind of support the display of them even though there is probably more to it. My son seemed no more or less ill or a burden to the system than some friend's son who was exclusively formula fed (medical reasons). They practice attachment parenting, and that is about the smartest kid I know, talented, warm, loving, outgoing and creative. I wonder if there are cultural issues associated with formula feeding, or if there are some bonding/connections issues that aren't formed in some bottle feeding families. I know that formula was introduced in developing countries that didn't really need it (as being better than breastmilk) and it would be interesting to see what links there are there.

I think that at a minimum as long as the highest health authorities we have recommend exclusive breastfeeding (6 months) should be the paid amount of paid time off. After all, for most of us that would just be a year out of 50 or so years of working. But I really think a year is more appropriate for each child. It keeps women working, too, and not making difficult decisions such as whether or not to quit. There's scientific evidence nowadays to support that it's healthier developmentally for babies to be with just one primary caretaker up to age 1; not being 1/4 ratio.

For the mama who's looking for a recommendation on a pump: I second what k's mama had to say about the Medela Pump In Style Advanced that you can completely separate from the bag. It costs about $50 more than the ones that stay in their bag/backpack but the extra convenience is worth it. It allows me to carry the pump wherever I go without the extra bulk of the bag that Medela provides. And personally I find the Medela bags unattractive and they have a kind of stinky, vinyl, made in China smell.

I'm a mama who commutes to work by bus so I'm carrying everything I need to for the day with me to work. So that means wallet, keys, phone, toiletry bag, sunglasses, lunch, pump, cooler for expressed milk, book/knitting, and whatever else I might be bringing with me. After a few months of carrying the pump and cooler in a tote bag separate from my purse and finding it awkward, I found an attractive backpack/purse that holds everything.

I also spent the extra money to buy extra kits of pump parts (shields, valves, tubes and AC adapter) so I have one set at work and one set at home for when I pump in the evening and on the weekends. I keep all the parts in a little wash tub that I use to wash my parts out. Again, for me as a mama who rides the bus, I was focused on limiting how much stuff I had to carry and I devised a system that works for me.

I've been back at work for three months and my son is now seven months old. I'm fortunate that my workplace and my coworkers are very supportive and I really had no issues.

I'm temporarily working out of two offices and spend most of my days on a construction site. While I'm on site I have my own office with a door and its own little bathroom so I truly lucked out. I made a "do not disturb" door hanger and my coworkers know what's going on when my door is closed. :-)

When I'm back in the main office, I use our building's pumping room that came about due to the efforts of mamas who came before me. It has all the essentials (fridge, micro, lockers, sink, comfy chairs, lock on door) and is convenient. We've averaged from about four to six mamas using the room. We have a white board schedule that allows everyone to indicate their anticipated schedule, although you're free to use the room as you wish, provided there's space. There's been a couple of times when I pumped with another mama and enjoyed the conversation and info sharing.

One interesting development in our group was a new mama who I believe is Indian. Early on we discovered that when she pumps she locks the door for privacy and I attribute her modesty to a cultural difference. But it made a new challenge for those of us who were comfortable pumping with others in the room. (Once I arrived at the end of my day just in time so that I was able to fetch my milk out of the fridge before she started pumping. Otherwise, I would have missed my bus.)

It makes me wonder what the norm is in other workplaces. Do mamas pump in privacy and lock the door, or do they pump with other mamas in the room?

I pump in privacy and lock the door. I don't think I would be comfortable pumping in front of co-workers. I don't consider myself a modest person (I regularly breastfeed in public, without a cover or anything), but something about being in the work environment makes me want more privacy. Also, I find being hooked up to a pump vaguely humiliating. I've always hated pumping, but I'm going on kid #2, pumping for more than a year with both. At least with #2 I don't have to pump in a bathroom. Now I get the luxury of a computer storage closet :)!

My real challenge with pumping is making time in my workday. It takes me 30 minutes each time. It's hard to pump 2-3 times/day and get my work done, and leave on time to pick the kids up from daycare.

I vote for 1 year paid maternity leave.

I just wish my work had a computer in the room so I could actually get something done while I pump. A medical office exam room, with a short chair and a phone is just boring. I know it is better then a bathroom, but I could actually be productive if I had better access.

This is not completely relevant to the post, but I just wanted to mention that WIC in Multnomah county gives new breast pumps out for free to low-income working mothers. I got one (a very nice Medela) in 2008, and I believe they are still doing this. If you are a part of WIC, you just sign up for the class and receive your pump! I think that is pretty fabulous.

Apart from the fabulous work that Marion is doing, Nursing Mothers Counsel also has grant pumps available to mamas who are WIC eligible (That is somewhere around 40K or less a year for a family of 4), pumps for sale at near cost, and low rates for rental pumps.
If you have any breastfeeding questions or issues, you can call NMCs 24 hour warmline at (503)282-3338 or go to www.nursingmotherscounsel.org

I agree about the medela pumps being nice- after our baby was born we had tons of issues with supply (turns out I have hypoblastic breast tissue...immature milk glands) but the medela pump never gave me a problem while I tried to work things out. My body ultimately failed and my son has formula intolerances so he's been on donor milk, but the pump was excellent!

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