JAAPA Podcast Episode Summary

Episode Title: Exploring Workplace Barriers Faced by Breastfeeding PAs
Date: April 24, 2024
Host: JAAPA (Kim and Martine)
Guest: Lindsay (PA, Researcher and Author on Breastfeeding PAs)

Episode Overview

This episode of the JAAPA Podcast delves into the unique and often challenging landscape faced by physician assistants (PAs) who breastfeed while working. Featuring guest expert Lindsay—whose recent research explored barriers for breastfeeding PAs—the conversation covers legislative updates, personal experiences, literature gaps, key findings from the newly published study, and actionable recommendations for workplaces and future research. The overall tone is candid, empathetic, and supportive, with the hosts and guest sharing personal stories to underscore the need for continued advocacy and awareness.

Key Discussion Points & Insights

1. Setting the Stage: Legislation & Personal Experience

• Introduction of Federal Protections:

  • The Pump Act (2022) and Fair Labor Standards Act mandate reasonable breaks and provide protected, non-bathroom spaces for lactating employees, extending protection up to one year after a child’s birth (00:06).
  • These laws newly cover many employees, including salary-exempt positions common among PAs.

• Personal Journeys:

  • Lindsay, Kim, and Martine describe the logistical, emotional, and physical challenges of balancing breastfeeding and patient care, often pumping in cars, offices, or non-private spaces (01:11, 02:48).
  • Martine relates: "I remember pumping in the car ... on my way down to work and on my way back ... Because if I didn't do that, forget it" (02:48).

2. Benefits of Breastfeeding (For Baby & Mother)

• According to Lindsay and established guidelines:
  • Infant Benefits: Reduced risk of respiratory infections, otitis media, diarrhea, asthma, obesity, diabetes, childhood leukemia, SIDS, and infant mortality.
  • Maternal Benefits: Lower risk of type 2 diabetes, hypertension, breast, ovarian, and endometrial cancers.
  • "The World Health Organization states that optimal breastfeeding could save the lives of 820,000 children under the age of five" — Lindsay (04:19).
  • Despite these benefits, sustaining breastfeeding while working is notably challenging.

3. Challenges & Barriers for Breastfeeding PAs

• National Trends: Less than a third of US infants are exclusively breastfed at six months (05:02).

• Common Barriers Identified:

  • Lack of protected time and private space to express milk.
  • Absence of supervisor/colleague support.
  • Administrative and workflow constraints; lack of adequate milk storage.
  • Stress and demanding, unsupportive work settings.

• The PA Context:

  • 71% of PAs are women, with a median age of 38—making workplace breastfeeding a particularly salient issue in the profession (06:11).
  • Before Lindsay’s study, existing research focused mainly on physician mothers, with similar reported struggles (06:26).

4. Lindsay’s Study: Survey Methods & Key Findings

• Survey Launch:

  • Distributed via the PA Moms AAPA Special Interest Group Facebook group (over 17,000 members) using convenience sampling (07:43).
  • Survey adapted from previous research on physician mothers.
  • Covers intentions, workplace experiences, support, and decisions to stop breastfeeding (08:26).

• Notable Findings:

  • High initiation: 96.3% began breastfeeding, surpassing national averages.
  • Drop-off: Only 54.8% breastfed to 12 months, compared to 76.8% who intended to.
  • Primary barriers: Lack of time, space, and support.
  • 27.6% of PA moms reported quitting breastfeeding due to workplace demands (09:21).
  • Quote: "Despite our PA education and breastfeeding intent, workplace factors have a sizable effect" — Lindsay (09:21).

5. Specialty, Environment, and the PA Profession

• Specialty Impacts:

  • Anecdotes suggest specialty (hospital medicine vs. outpatient) affects breastfeeding duration, but Lindsay's data did not find a specific statistical link to duration (13:06).
  • "The study didn’t take into account that PAs are able to switch specialties ... Future studies could probably take some of that into account" — Lindsay (13:06).

• Comparisons to Other Health Professionals:

  • PA data closely mirror trends among physician mothers: high initiation, early cessation due to workplace barriers (14:26).

6. Recommendations for Employers & Next Steps

• Supporting Breastfeeding Employees:

  • Sufficient protected break time and access to a private, non-bathroom place to pump.
  • Foster a supportive environment and promote flexible scheduling (14:59).
  • Employees: Know your rights under the Pump Act and state laws.
  • Quote: "Workplaces need to create supportive environments for breastfeeding mothers and flexible schedules so that ... PA moms have adequate time to meet their workplace obligations as well as expressing breast milk" — Lindsay (14:59).

• Advocacy:

  • Open dialogue with employers is crucial; awareness can prompt policy and culture change (18:55).

7. Looking Forward: Research and Legislative Needs

• Future Research Suggestions:

  • Analyze the impact of specialty-switching.
  • Compare inpatient vs. outpatient environments.
  • Study state-specific law effects (e.g., Washington protects up to two years vs. federal one year standard).
  • Repeat research post-Pump Act implementation for up-to-date insights (16:51).

• Quote: "Future studies ... could examine how different state laws affect breastfeeding duration." — Lindsay (16:51)

Memorable Quotes & Moments (with Timestamps)

• Personal Sacrifice:
  • Martine: "During my break, that's all I did ... breastfeeding, doing my lunch break or charting while breastfeeding, where I was seeing patients was also my office." (02:48)
• Workplace Struggles:
  • Lindsay: "I had to pump in patient exam rooms that didn’t have locking doors. Many times I was locked in on, so it definitely lacked privacy." (01:11)
• Practical Solutions:
  • Lindsay: "Employers should provide ... adequate place for expressing breast milk. Workplaces need to create supportive environments." (14:59)
• On Legislation:
  • Lindsay: "The result of this act is that workplace breastfeeding protection is now extended to many employees who were previously not protected." (15:30)
• Aspirational:
  • Martine: "I agree with Kim. I have a daughter as well, so hopefully by the time they grow up and are ready to enter the workforce, things will be way different." (19:11)

Important Segment Timestamps

• 00:06 — Introduction to breastfeeding legislation and guest
• 01:11 — Lindsay’s personal breastfeeding at work experiences
• 02:48 — Martine details her own workplace breastfeeding journey
• 04:19 — Lindsay discusses breastfeeding health benefits
• 05:43 — Workplace barriers and success factors
• 07:43 — How the survey was conducted via PA Moms group
• 09:21 — Key study results: intent vs. real breastfeeding duration
• 13:06 — Discussion on specialty impact and study limitations
• 14:59 — Recommendations for employers to promote breastfeeding
• 16:51 — Suggestions for future research and impact of state/federal laws
• 18:55 — The importance of open communication with employers and knowing one’s rights

Conclusion

The episode’s meaningful, firsthand narratives alongside Lindsay’s novel research underscore the persistent challenges—despite legislative gains—faced by breastfeeding PAs, especially concerning workplace support, environment, and culture. There is clear momentum for improvement, from both an organizational and legislative standpoint, with a call for further research and open advocacy to shape a more supportive future for all working parents.

Resource Note: The hosts also mention the “PAs for Women Empowerment” caucus and its infographics for workplace advocacy and education.