Breastfeeding does not fit within the medical disability model of US law (Eichner, 2008). Therefore, breastfeeding has woefully inadequate protection under federal employment law. At the absolute minimum, physicians require flexibility in patient care schedules and a convenient, private, clean space to accommodate milk expression at appropriate intervals. Ideally, they will receive workplace support or even incentives for making healthy choices for their families.
As an example, the health insurance company CIGNA spends about $80,000 a year on its Working Well Moms program (Riccitiello). CIGNA provides lactation rooms and breast pumps for its women employees and spends approximately $200 on each employee in the program. Preliminary results show that 70% of the CIGNA employees who participate in the program are still breastfeeding at six months and a third are still nursing at one year. By comparison, only 20% of the employees who planned to breastfeed, but did not participate in the program, were still nursing at six months and only 2% kept nursing to one year. Since an employer can save $3 for every $1 invested in breastfeeding support (HHS Blueprint for Action on Breastfeeding, 2000) primarily through decreased employee turnover and absenteeism to care for sick children, CIGNA’s program has proven very cost effective.
Another specific target for physician advocacy and activism is reasonable breastfeeding accommodations for professional examinations. With the help of medical organizations such as the Academy of Breastfeeding Medicine, we need to collectively build on the publicity and momentum of the 2007 Currier case, in which one medical-student mother was granted appropriate breastfeeding accommodations for her USMLE exam.