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Office of Graduate Medical Education provides wearable pumps for residents who breastfeed

The Office of Graduate Medical Education at the University of Kansas School of Medicine has launched an innovative program to support residents who are breastfeeding.

hand holding wearable breast pump

Medical science is clear that breastmilk is the best food for most new babies, and doctors-in-training are educated about the many benefits of breastfeeding: stronger immune systems and lower risk of childhood diseases for the baby, as well as emotional benefits and a reduced risk of some cancers for the mother.

Yet when female medical residents return to work after having their own infants, many struggle to practice for themselves what they have learned to support and promote for most patients. Medical residencies—the stage of education after graduating from medical school when newly minted doctors train in a particular specialty—are famous for their long shifts and intense workloads.

For a resident working in a busy clinic or performing surgical procedures, finding time to pump breastmilk multiple times a day, as well as securing a private, convenient place to do it, can be next to impossible. Often, residents who are lactating wind up abandoning breastfeeding earlier than they'd planned. (The American Academy of Pediatrics recommends that infants be breastfed for at least their first six months of life.)

One year ago, the Office of Graduate Medical Education at the University of Kansas School of Medicine launched an innovative program to support residents who are breastfeeding. The program provides, free of charge, wearable breast pumps for up to one year to medical residents who need them.

These lightweight, wireless pumps fit discreetly inside a bra, enabling a mother to go about routine activities while the pump silently expresses milk. The pumps, powered by chargeable batteries like those in cell phones, can be controlled through a smartphone app. The program also provides mini-fridges to store the milk after pumping.

"This means they can do surgery, they can see patients, they can be in the ER [while they pump]," said Gregory K. Unruh, M.D., senior associate dean of graduate medical education (GME) at the KU School of Medicine. "And they're telling us that the pump relieves a ton of stress."

‘This has changed my life'

Supplying wearable pumps for residents was the brainchild of Andrea McMillin, manager of accreditation and CLER (clinical learning environment review) in the GME office. McMillin is part of the team responsible for making sure that the KU School of Medicine meets all the requirements set by the ACGME, the body responsible for accrediting graduate medical education (residency) programs in the United States.

Women have outnumbered men entering medical school since 2017, and women now comprise more than half of all medical students in the United States. Most medical students and residents are child-bearing age. In July 2018, the ACGME released a new requirement that residency programs must provide easy-to-access space for lactation, with refrigeration to store milk, that is close to where residents provide patient care.

Supporting employees and students who breastfeed is not a new idea at KU. In 2011, the wims program helped establish lactation support spaces throughout the KU Medical Center campus and The University of Kansas Health System.

McMillin, herself a mother who pumped breast milk on campus, is quick to acknowledge the enormous value of those spaces to many. But she also knew that the situation was different for medical residents.

"As somebody who sometimes had to figure out how to pump in different parts of campus, and knowing what residents' lives are like, I knew that that wasn't a workable solution for them," said McMillin. "If they're operating for eight hours, and maybe get a 10-minute break, they're not going to go find a computer, check and see if a room is available, book that room, run to that room, pump, run back, and store all their stuff somewhere. There's just not enough time."

"I've had two weekends when I was on a Saturday 24-hour call ... And there have been plenty of times I was wearing the pump when I was responding to a trauma."

—Amanda Hangge, D.O., fifth-year surgical resident

McMillin started looking at how other organizations support employees who breastfeed. Some have whole suites designed exclusively for lactation, where women can walk in and use one of the individual stations with privacy curtains and a sink. But creating such a facility would be expensive, to say nothing of the issue of finding space on a campus where space is already at a premium.

And then one day McMillin found herself in a casual conversation with a faculty member who'd recently had a baby and told her about using a wearable breast pump.

"She told me, ‘This has changed my life. I don't have to clear 30 minutes off my schedule to pump that I could have given to a patient or plan my pumping around teaching responsibilities, and I have even pumped while I'm giving a lecture,'" McMillin remembers. "With her first two children, she was not able to breastfeed beyond a few weeks or months, but with this kind of pump, she was able to breastfeed a whole year, and she was so proud of that."

McMillin was sold. She proposed the idea of buying pumps for residents to Unruh and Phillip Byrne, Ed.D., then the assistant dean for GME Administration, who gave it the green light. The GME office purchased the first three pumps in December 2019, and McMillin sent an email to residents about the new program. Within an hour of hitting "send," all three pumps had been reserved by female residents.

A workable solution

At $500 a piece, and not covered by insurance, the pumps would be a luxury purchase for residents, who earn modest salaries, but they are a cost-effective solution for the medical center, McMillin noted. Mini-fridges are also available for residents who need secure and private storage for their milk.

Amanda Hangge, D.O., a fifth-year surgical resident, has been using one of the wearable pumps since she returned to work five weeks after the birth of her daughter, Annabell, in August 2020.

For Hangge, the pump enables her to fulfill her responsibilities to her daughter and to her patients. "I have a surgeon's mentality. In general, I wouldn't want to ask to miss part of a case [to pump]. I want to be there for the surgery, and I'm responsible for the patient. But I'm also responsible for my child and I should do what's in the best interest of my child."

Hangge's goal is to breastfeed for one year. She noted it's not an easy task and that every week is an accomplishment, but using the wearable pump at work has made her goal attainable.

"[The pump] allows me to work. I've had two weekends when I was on a Saturday 24-hour call. That's a long time to be away from your child, and you still have to pump," Hangge said. "And there have been plenty of times I was wearing the pump when I was responding to a trauma."

Since buying the first three pumps, the GME office has purchased seven more. All of them are currently in use or reserved. Thirteen women have borrowed the wearable pumps since the program began. McMillin would like to see the program expand to other types of health professionals in training at the medical center.

"When you can feed your own kid from your body, it feels like a superpower. And to have that taken away when you're not ready for it, because the environment isn't conducive to your needs is, is hard," said McMillin. "So to be able to give them this, to have that be something that makes a difference for them, is huge."

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