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This came on an US-based email list
Alison Macfarlane
Department of Midwifery
City University
24 Chiswell Street
London EC1Y 4TY
Phone (0) (44) 207 040 5832
Fax (0) (44) 207 040 5866
Email [log in to unmask]
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
On Behalf Of Nancy Krieger
Sent: 01 September 2006 13:21
To: [log in to unmask]
Cc: Nancy Krieger
Subject: [spiritof1848] NY Times: "On the Job, Nursing Mothers Find a
2-Class System"
fyi: on class disparities in options for nursing mothers, with attendant
health implications for the infants ...
September 1, 2006 -- New York Times
On the Job, Nursing Mothers Find a 2-Class System By JODI KANTOR
When a new mother returns to Starbucks' corporate headquarters in
Seattle after maternity leave, she learns what is behind the doors
mysteriously marked "Lactation Room."
Whenever she likes, she can slip away from her desk and behind those
doors, sit in a plush recliner and behind curtains, and leaf through
InStyle magazine as she holds a company-supplied pump to her chest,
depositing her breast milk in bottles to be toted home later.
But if the mothers who staff the chain's counters want to do the same,
they must barricade themselves in small restrooms intended for
customers, counting the minutes left in their breaks.
"Breast milk is supposed to be the best milk, I read it constantly when
I was pregnant," said Brittany Moore, who works at a Starbucks in
Manhattan and feeds her 9-month old daughter formula. "I felt bad, I
want the best for my child," she said. "None of the moms here that I
know actually breast-feed."
Doctors firmly believe that breast milk is something of a magic elixir
for babies, sharply reducing the rate of infection, and quite possibly
reducing the risk of allergies, obesity, and chronic disease later in
life.
But as pressure to breast-feed increases, a two-class system is emerging
for working mothers. For those with autonomy in their jobs - generally,
well-paid professionals - breast-feeding, and the pumping it requires,
is a matter of choice. It is usually an inconvenience, and it may be an
embarrassing comedy of manners, involving leaky bottles tucked into
briefcases and brown paper bags in the office refrigerator. But for
lower-income mothers - including many who work in restaurants,
factories, call centers and the military - pumping at work is close to
impossible, causing many women to decline to breast-feed at all, and
others to quit after a short time.
It is a particularly literal case of how well-being tends to beget
further well-being, and disadvantage tends to create disadvantage -
passed down in a mother's milk, or lack thereof.
"I feel like I had to choose between feeding my baby the best food and
earning a living," said Jennifer Munoz, a former cashier at Resorts
Atlantic City Casino who said she faced obstacles that included
irregular breaks and a refrigerator behind a locked door. She said she
often dumped her milk into the toilet, knowing that if she did not pump
every few hours, her milk supply would soon dwindle.
The casino denies discouraging Ms. Munoz from pumping. "We have policies
and procedures in place to accommodate the needs of all of our
employees," Brian Cahill, a Resorts spokesman, said.
Nearly half of new mothers return to work within the first year of their
child's life. But federal law offers no protection to mothers who
express milk on the job - despite the efforts of Representative Carolyn
B. Maloney, Democrat of New York, who has introduced such legislation.
"I can't understand why this doesn't move," she said. "This is
pro-family, pro-health, pro-economy."
Meanwhile, states are stepping in. Twelve states have passed laws
protecting pumping mothers - Oklahoma's law, the newest, will take
effect in November. But like Oklahoma's, which merely states that an
employer "may provide reasonable break time" and "may make a reasonable
effort" to provide privacy, most are merely symbolic.
Public health authorities, alarmed at the gap between the breast-feeding
haves and have-nots, are now trying to convince businesses that
supporting the practice is a sound investment. "The Business Case for
Breastfeeding," an upcoming campaign by the Department of Health and
Human Services, will emphasize recent findings that breast-feeding
reduces absenteeism and pediatrician bills.
In corporate America, lactation support can be a highly touted benefit,
consisting of free or subsidized breast pumps, access to lactation
consultants, and special rooms with telephones and Internet connections
for employees who want to work as they pump, and CD players and reading
material for those who do not. According to the nonprofit Families and
Work Institute, a third of large corporations have lactation rooms.
Even without these perks, professional women can usually afford a few
months of maternity leave during which to breast-feed. When they return,
they can generally find an office for the two or three 20-minute
sessions per workday typically necessary. Even bathrooms - the pumping
spots of last resort - are more inviting at an accounting firm than in a
fast-food restaurant.
Wealthier women can spend their way out of work-versus-pumping dilemmas,
overnighting milk home from business trips and buying $300 pumps that
extract milk quickly, along with gizmos that allow them, in what seems
like a parody of maternal multitasking, to pump while driving to and
from work.
In contrast, said Dr. Lori Feldman-Winter, an associate professor of
pediatrics at the University of Medicine and Dentistry of New Jersey and
a member of the American Academy of Pediatrics' committee on
breast-feeding, her patients cannot afford a basic $50 breast pump - an
investment, she said, that "could prevent a lifetime of diseases." The
academy urges women to breast-feed exclusively for six months and to
continue until the child turns 1.
Many of her patients learn about breast-feeding through the government
nutrition program Women, Infants, and Children, which distributes
nursing literature to four million mothers, and also provides classes
and lactation consultants.
Because of this and similar efforts, 73 percent of mothers now
breast-feed their newborns, according to the Centers for Disease Control
and Prevention. But after six months, the number falls to 53 percent of
college graduates, and 29 percent of mothers whose formal education
ended with high school. In a study of Oklahoma mothers who declined to
breast-feed, nearly a third named work as the primary reason. Others,
like Ms. Moore of Starbucks, find the early days of breast-feeding
frustrating, and their impending return to work means they have little
incentive to continue.
"Sometimes my co-workers will sneak in two or three smoking breaks"
before she can steal away to pump, said Laura Kruger Rowe, who works at
a Starbucks in Rochester.
The company, known for its generous benefits, has no breast-feeding
policy, but will "work with partners to accommodate their needs on a
case-by-case basis," said Valerie O'Neil, a spokeswoman.
As at Starbucks, the gap between working mothers can play out within a
single organization. At many law firms, lawyers can pump in their
offices, while secretaries use bathroom stalls; in the Army, which also
has no policy on the matter, officers are less likely to encounter
problems than enlisted soldiers, who have less autonomy and a more
complex chain of command.
"They're scared to death to even talk to their employers," Dr. Barbara
L. Philipp, an associate professor of pediatrics at Boston University
School of Medicine, said of the housekeepers and fast-food servers whose
children she treats. They may fear the kind of harassment that Laura
Walker, a former server at a Red Lobster restaurant in Evansville, Ind.,
said she faced.
According to the complaint Ms. Walker filed with the Equal Opportunity
Employment Commission, the restaurant ignored a note she brought from
her nurse explaining her need to pump. The managers cut her hours,
assigned her to the worst tables and ridiculed her - for instance,
jiggling the restaurant's milk containers and joking that they were for
her. Eventually Ms. Walker's milk ducts clogged, landing her in the
hospital with mastitis.
Officials of the restaurant chain said they did assist Ms. Walker.
"We at Red Lobster work with all new mothers to accommodate thein. "That
occurred multiple times in this case," she said, declining to go into
detail because of a confidential settlement Ms. Walker reached with the
company.
Shortly after Marlene Warfield, a dental hygienist in Tacoma, Wash.,
began pumping on the job, she said her boss wore a Halloween costume
consisting of a large silver box - his interpretation of a pump, perhaps
- with a cutout labeled "insert breast here." When he instructed Ms.
Warfield to leave her pump at home, she said, she quit her job- and
consulted the local human rights commission, which found nothing illegal
about the dentist's actions.
In contrast, higher-paid women can often pump without anyone knowing -
or with everyone knowing. Nina Wurster, who works in human resources for
the Advisory Board, a consulting group in Washington, conducts phone
interviews from the lactation room. "I just say, sorry about the
background noise and I keep going," she said. But breast-feeding is now
so accepted in white-collar circles that some women are completely
matter-of-fact about it, pumping right in their open cubicles.
"It's been great," said Melany Richmond, an electrical engineer at
Zilog, a semiconductor company, in Bellevue, Wash. "I put a little sign
up - it says 'Do Not Disturb,' with a little 'Moo' on the bottom."
Pumping breast milk has one benefit that cannot be quantified: it makes
working mothers feel less guilt-ridden about leaving their children.
"There is a lot of satisfaction in knowing I am doing right by him," Ms.
Wurster said of her son, James.
Dr. Philipp recalled a small furor about whether Jane Swift, the former
governor of Massachusetts who gave birth to twins, would breast-feed
after returning to work.
"That's a great thing to do, but she had her own office and could set
her own schedule," Dr. Philipp said. "The one I want to know about is
the lady cleaning her office."
*****************************************************
Nancy Krieger, PhD
Professor, Department of Society, Human Development, and Health Harvard
School of Public Health
677 Huntington Avenue, Kresge 717
Boston, MA 02115 (USA)
office: 617-432-1571
fax: 617-432-3123
email: [log in to unmask]
web: http://www.hsph.harvard.edu/faculty/NancyKrieger.html
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