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Gender, Place and Culture

Vol. 14, No. 5, pp. 551–567, October 2007

Expressing Anxiety? Breast pump usage in American wage


workplaces

MAIA BOSWELL-PENC* & KATE BOYER**


*The University at Albany, USA
**University of Southampton, UK

Abstract This article considers the potential and problems for women seeking to
combine breastfeeding with wage labor outside the home through the use of breast pumps.
After locating the breast pump within cultural, historical and legislative contexts of
shifting views about infant nutrition on the one hand and trends in women’s participation
in the wage work force on the other, we unpack how this technology has re-shaped the
landscape of choices about infant feeding in the United States. Using disciplinary lenses of
science and technology studies, feminist geography and women’s studies, we examine how
the breast pump has reshaped workplace experiences after childbirth. Based on interviews
and survey data with respondents in Albany, New York across a range of class and racial
backgrounds, we submit that while the breast pump does allow some women to combine
breastfeeding and wage work outside the home, the advantages of breast pumps are
constrained both by cultural attitudes about pumping as an activity, the lack of a sufficient
legislative framework, as well as by the way workplaces themselves are designed.

Key Words: Wage workplace; lactating body; breast pumps; infant feeding
decisions; work/life balance

Introduction
A large body of research now demonstrates the importance of infant feeding
choice to individual and public health, with a host of studies showing that many
diseases and conditions can be prevented or limited in severity by prolonged
breastfeeding (Scariati et al., 1997; Goldman, 2000). Yet in spite of recommen-
dations about breastfeeding from the World Health Organization, the American
Academy of Pediatrics (AAP) and the US Surgeon’s General; as well as efforts by
the US Department of Health and Human Services (DHHS) to raise breastfeeding
rates domestically (DHHS, 2002; Merewood & Heinig, 2004),1 breastfeeding

Correspondence: Maia Boswell-Penc, Department of Women’s Studies, The University at


Albany, Albany, NY 12222-341, USA. E-mail: mboswell@nycap.rr.com Kate Boyer, School of
Geography, University of Southampton, Highfield, Southampton, SO17 1BJ, UK. E-mail:
laurakateboyer@hotmail.com

ISSN 0966-369X print/ISSN 1360-0524 online/07/050551-17 q 2007 Taylor & Francis


DOI: 10.1080/09663690701562248
552 M. Boswell-Penc & K. Boyer

initiation and duration rates in the United States remain low. The ‘bottle or breast’
question has long been cast, at least partially, in terms of convenience, mobility,
and the ability to integrate infant feeding with wage labor outside the home. In
this context, generations of US women have chosen infant formula over nursing.
Over the last ten years, however, breast pumps designed for individual use have
begun to hit the marketplace offering a ‘third alternative’: combining the health
benefits of nursing and (at least some of) the convenience and increased mobility
of formula. This article considers the potential of the breast pump to increase
breastfeeding rates by enabling women to combine nursing with wage work in a
greater range of ways.
We approach this subject through our disciplinary backgrounds of feminist
geography, women’s studies and science and technology studies, and locate our
investigation within broader research interests on breast milk contamination and
the intersectionality of racism, classism and sexism. We are both white, middle-
class academics. Maia Boswell is a mother of two small children, currently
breastfeeding one and an avid pump user. Although Kate Boyer has not
experienced the breast pump firsthand, as a woman in her mid-30s she has a
plurality of friends who are currently raising children and so was drawn to the
topic through their experiences. Although feminist geographers have begun to
examine the relationships between technology and women’s empowerment
(Smith, 2003; Gilbert & Masucci, 2004), no analyses to date have considered the
breast pump in these terms.
This investigation builds on concerns in feminist geography with the ways in
which gender relations are produced within the wage workplace (England, 1993;
McDowell, 1997), as well as the ways in which wage work and care work come to
be marked as gendered and linked to certain kinds of spaces (Boyer, 2003Boyer,
2003; Brown, 2004). Although we define women’s unpaid labor in the space of the
home as work and acknowledge that the home itself can serve as a site of wage
labor, this study focuses on pumping in wage workplaces outside the home
because pumping in these spaces poses special challenges that pumping at home
does not. While we recognize that breast pumps can impact upon women’s lives
beyond work, we focus here primarily on the workplace because women across a
range of class-positions face dilemmas in integrating lactation with wage work.
This work also builds on scholarship in feminist science and technology studies
(STS) in terms of the processes through which understandings of technology and
those of gender co-make one another (Webster, 1996; Bray, 1997; Gorenstein, 2000).
In recent years, women in the United States have seen the emergence of a slew of
new technologies which, like the breast pump, have brought much greater
temporal and spatial freedom to their users, such as laptops, cell phones and
ATMs (Wajcman, 2004). While acknowledging technology’s capacity to bring
convenience and even sometimes joy to our lives, we share with scholars in STS a
wariness toward celebratory claims over the capacity for devices to up-end power
asymmetries of racism, classism or sexism on their own (Cowan, 1983; Cockburn,
2004).
The breast pump is significant not only as a means of enabling more women to
combine wage work with nursing, but also as a technology which allows physical
separation between mother and child for whatever reason, and for fathers or
partners to also participate in infant feeding. The breast pump provides a means
of expanding women’s choices regarding infant nutrition in general, with the
potential to make breastfeeding a more viable option for more women
Breast Pump Usage in American Workplaces 553

in particular. Our goal in this article is to examine the new spaces and potentials
that breast pumps open up; and also to examine where and why this technology
falls short.
We draw on primary print and web material relating to breast pump use and
breast pump advertisements as well as secondary academic literature on infant
feeding in order to locate breast pumps within the broader context of infant
feeding choices in the US, and illustrate how choices about infant nutrition are
structured by social location, information networks and the dominance of the
infant formula industry. In turn, we consider the legislative environment
surrounding infant nutrition, and its effectiveness in protecting nursing and
pumping. Finally, we consider the experiences of women seeking to combine
nursing with wage work, drawing on interviews and survey data.2 We argue that
while the breast pump does offer libratory potential, at present that potential is not
being fully realized. We submit that women seeking to combine wage work and
pumping face both logistical and social barriers and that these barriers highlight
the persistent tension in the United States between care work, wage work and the
spaces in which each takes place, as well as a persistent anxiety over women’s
bodily realities in the workplace.

Background
Starting in the early twentieth century, the use of formula became widespread
both domestically and as an export to the global south, being advertised as less
cumbersome than breastfeeding and (erroneously) as nutritionally superior
(Apple, 1987; Apple & Golden, 1997). Together with the rise of agro-chemistry,
bio-engineering and the shift toward more highly processed foods, formula fit
within a modernist approach to health in the second half of the twentieth century
in which more highly engineered products and practices were viewed as superior
to their lower-tech (or non-technical) alternatives (Merchant, 1980; Palmer, 1988).
Infant formula remains big business; amounting to a $3 billion-a-year industry
in the US alone (O’Mara, 2003). It maintains its dominance in the US in part
through aggressive marketing techniques, including the distribution of products
free to new mothers in hospitals. Although the US agreed in 1998 to ratify the
World Health Organization’s ban on the direct marketing of formula to
individuals and health facilities, it has not enforced this ban and continues
to allow the distribution of free product to hospitals, doctors’ offices and directly
to women (World Health Organization, 1981; Hausman, 2003, p. 95).
Scientific evidence now clearly shows breast milk to be nutritionally superior to
formula, even when taking into account environmental toxins breast milk may
contain (Steingraber, 2003; Boswell-Penc, 2006). Research has shown that not just
acute illnesses such as diarrhea, ear infections and respiratory infections, but a
series of chronic diseases and conditions—Sudden Infant Death Syndrome (SIDS),
obesity, diabetes, leukemia, breast cancer, asthma and lowered IQ—are linked to
not receiving breast milk (Mortensen et al., 2002). Breastfeeding—even with a
pump—is much less expensive than formula when considered over time. While
one year’s worth of formula costs around $2,000 (with pre-digested brands
costing up to $5,000), most pumps cost between $30 and $300.
Yet this information has not fully permeated into public consciousness or public
policy. Indeed, the US has one of the lowest rates of breastfeeding initiation and
shortest duration, of any country in the industrialized world.3 While 69.5% of US
554 M. Boswell-Penc & K. Boyer

mothers initiate breastfeeding, only 17% are still exclusively breastfeeding when
their babies reach 6 months and fewer than 5% are still breastfeeding when their
babies reach one year.4 While breastfeeding initiation appears unaffected by a
mother’s employment status, duration rates are influenced by maternal
employment, with only 10% of mothers who work full time breastfeeding their
six-month-olds, compared with almost three times that number of stay-at-home
mothers (Fein & Roe, 1998; Meek, 2001).
Breast pumps emerged out of three cultural trends occurring over the last 30-
odd years. The first of these was the growing recognition of breast milk’s
superiority to formula as noted earlier. This trend began in the 1960s, pioneered by
lactation advocacy groups such as La Leche League (LLL). The second factor was
the increase in the number of women returning to wage work sooner after
childbirth since the mid-1970s in the US due to wage compression and economic
restructuring (Hayghe, 1986; England, 1993). The third factor has been the
resistance of US legislative bodies to ‘family friendly’ and breastfeeding friendly
policies. Such conditions have made extended pregnancy-leave rare, thus making
pumping or formula-use a virtual necessity for women seeking to combine
nursing with wage work (Demleitner, 1992; Hrdy, 1999; Galtry, 2000).
Breast pumps come in a wide range of models, from manual to electric to
battery operated, ‘back-pack’ and ‘briefcase’ models (see Figure 1). Since breast
pumps are competing with formula, their advertisements stress convenience,
portability and the possibility that another person can help with the work of
feeding (once milk has been pumped).5 Pump manufacturers also highlight the
unobtrusiveness of their products, such as the Isis brand ‘back to work’ model of
breast pump, advertised as being especially quiet and discreet. Starting in 2003,
some manufacturers began to offer ‘hands free’ models, one of which has been

Figure 1. Medala double-electric breast pump—briefcase model.


Breast Pump Usage in American Workplaces 555

advertised through an image of a woman on a playground, pushing her child on a


swing, while milk is (presumably) being pumped from her breasts.
While such advertisements can be interpreted simply as a message that
pumping can take place effortlessly amidst one’s day-to-day activities, they can
also be read as evidence of a culture which values and expects multi-tasking
(particularly from women), in which ‘just nursing’ is not enough. They suggest
that this artifact will deliver greater autonomy and spatial freedom—assumed
desirable qualities—while at the same time revealing an undercurrent of anxiety
about other people finding out that one is using this technology.6 The lactating
body has long been a source of anxiety for American women, but the body being
‘pumped’ takes this anxiety up one notch. Feeding a child formula from a bottle is
everywhere unremarkable. While not as common as bottle-feeding, nursing is
nevertheless becoming more common in public and semi-public spaces such as
malls, workplaces (sometimes through legal means).7 By contrast, pumping
remains an activity that is expected to be hidden (even if hidden in plain sight, like
the pumping swing pusher).

Legislative Context
Soon after the AAP released its recommendation that all infants be breastfed
exclusively for the first six months of life, New York Congresswoman Carolyn
B. Maloney introduced legislation supporting breastfeeding for paid workers,
which resulted in the New Mothers’ Breastfeeding Promotion and Protection Bill
(H.R. 3531) in March of 1998. Yet the enactment of such legislation has been slow.
Although as of 2005 36 states have enacted legislation associated with
breastfeeding, federal-level legislation has not yet found widespread support
(Chien, 2005). The legislative environment around pumping is a patchwork which
varies by industry and by state, with only nine states having some form of
legislation in place.
Breastfeeding legislation regarding employment involves two subsections:
provisions that allow for unpaid break time to pump (four states delineate that
these must run concurrent with already established breaks) and provisions that
employers are to make reasonable efforts to provide non-toilet locations for milk
expression (Chien, 2005, p. 6). Yet these provisions do not necessarily guarantee
adequate time for pumping, since they do not factor in time for other necessary
non-work functions such as bathroom breaks and eating meals (Chien, 2005, p. 6).
Indeed, the toothlessness of such legislation is further revealed by the fact that
many of the states that have adopted it have added clauses stating that employers
are not required to provide breaks if such breaks disrupt daily operations (Chien,
2005, p. 6). The vast majority of women workers in the United States do not enjoy
paid pumping breaks, have access to lactation rooms, or enjoy considerations such
as tax breaks for pumping equipment. At the time of publication only one of the
provisions of Representative Maloney’s 1998 Breastfeeding Promotion and
Protection Bill has been enacted into law: a provision allowing states to spend
money on breastfeeding promotion and support through the Women, Infant,
Children (WIC) program.
The situation in the United States differs sharply from the situation in many
other parts of the world. Today over three-quarters of the countries in the world
have adopted the International Labor Organization’s current standards which
include, in addition to maternity leave policies, breastfeeding breaks totaling
556 M. Boswell-Penc & K. Boyer

at least one hour per day.8 In Mozambique, mothers can take two paid half-hour
breaks per day (in addition to normal breaks) for up to six months; in Egypt
women are granted two half-hour breaks for 18 months; and in Japan women are
granted two half-hour breaks which are paid if there is a collective agreement in
that workplace.9 As with legislation around child care provision (England, 1996),
the US also lags behind Europe in legislation designed to enable breastfeeding.
In France, mothers are allowed two one-hour breaks and nursing/pumping
rooms must be provided by employers; and in Norway, where 99% of mothers still
nurse at six weeks and 80% still nurse at one year, women are allowed two hours
daily.10 In Sweden, which had breastfeeding rates comparable to the US until the
government launched a pro-breastfeeding campaign, a woman can take breaks for
pumping or nursing as she wishes. It is noteworthy that Scandinavian success
rates have been related to work policies and that, there, few women express milk,
as extended maternity leave and on-site childcare are much more available than in
the US (Greiner, noted in Hausman, 2003, p. 183). The lack of a supportive
legislative framework constitutes a formidable structural barrier to women in the
US seeking to combine breastfeeding and wage labor.

Methodology
In order to get at the experience of combining pumping with wage work,
we distributed a questionnaire to mothers at three daycare centers in Albany, New
York, catering to parents from a range of socio-economic backgrounds. We also
conducted one-on-one interviews with the mothers in this sample that we were
able to contact, as well as friends, using a snowballing technique to further our
interview pool. In total we received written questionnaires from 17 respondents
out of a total of 64 distributed and conducted 12 interviews between the fall of
2004 and the fall of 2005. We used these sources to begin to understand women’s
experiences in trying to use breast pumps in a range of different wage workplaces.
Albany is a mid-sized city in northeastern United States. Although this region
has undergone significant disinvestment due to deindustrialization, Albany has
retained a fairly steady economic base due to non-mobile institutional employers
in state government as well as several colleges, universities and hospitals. Despite
targeted zones of investment downtown, Albany has significant pockets of inner-
city poverty and fairly stark racial and socio-economic segregation by
neighborhood. While Albany offers a range of daycare centers, we chose our
research sites so as to reflect a range of clienteles. The first site is in a state
office complex located downtown, and caters primarily to managerial staff and
clerical workers, although it is also open to non-state workers if space remains.
The second site is located downtown in a diverse, low-income neighborhood,
which serves as its main clientele. The third site is located at the suburban campus
of the University at Albany and caters to staff, faculty and students, as well as
janitorial and food-service staff. All three sites offer state sponsored subsidies.
Inviting responses from childcare workers at these facilities allowed us to broaden
our interview pool further to include some younger, lower income women,
several of whom are women of color. As Kim England (1998) has observed,
childcare in the US and Canada is highly uneven geographically. By drawing data
from childcare centers in different parts of town catering to neighborhoods across
a range of socioeconomic levels, we hoped to capture some of this diversity.
Breast Pump Usage in American Workplaces 557

While the scope of this study did not allow us to focus on class differences in the
resources available to deal with children’s needs and their implications with
regard to needing to work and views of motherhood, we recognize that these and
other considerations do play a role. It should be noted, for example, that of the two
women in our research pool who identified themselves as upper or upper-middle
class—one a white, 33-year-old medical doctor who had chosen not to practice
and the other a white 42-year-old woman with a masters in business
administration who pursued volunteer work but not paid employment—used
their pumps for mobility enhancement not related to work outside the home.

Analysis
Bottle and mop versus breast pump and briefcase: race, class and infant feeding choice
While the economic factors requiring greater numbers of women to return to the
workplace sooner after childbirth over the last 30 years have affected women (and
men) across race, ethnic and economic lines, the question of how to proceed with
infant nutrition in this context has produced a range of different responses which
tend to vary by race, class and ethnicity. Much research has shown that the
decision to breastfeed, knowledge about the benefits of breast milk and awareness
of breast pumping technologies is shaped by social networks, local knowledge
and the level of formal education.11 The literature suggests, for example, that
white women, women with more formal education, middle-class women and
older women are more likely to nurse than are women who are younger, poorer,
less-educated and/or of color (Wolf, 2003). African-American women in
particular nurse at lower rates than do other women (Blum, 1993, p. 299).12
Infant feeding decisions are in many ways also a function of economic
opportunity, because while pumping is cheaper than formula over the long
haul, formula is cheaper at any single point of purchase. The Boston-based pilot
project ‘Pumps for Peanuts’, which sought to provide subsidies for pumps so that
lower-income families who had babies in a neonatal intensive care unit could
purchase pumps, found that economics played a large role in infant feeding
choices (Phillipp et al., 2000). One lactation consultant noted that ‘for many of
these families the choice they quietly faced was paying for a breast pump or
meeting a basic need such as food, rent, or heat for the rest of their family’ (Philipp
et al., 2000, p. 250). In addition to economics, decisions to breastfeed are also
shaped by attitudes about the body and motherhood.13
To convey the typical relationship between infant feeding choices and socio-
economic advantage, feminist scholar Judith Galtry has advanced the linked
figures of the ‘bottle and the mop’, on the one hand and the ‘breast and the
briefcase’ on the other. This shorthand highlights the fact that women who nurse
tend to occupy higher paying, briefcase-toting jobs if they work outside the home,
while even those that do not work outside the home tend to occupy a
higher economic standing (Galtry, 1997). By extension, the ‘bottle/mop’ and
‘breast/briefcase’ pairings bring another figure into the equation—the figure of the
breast pump; after all, those briefcase-toting mothers, if they are using breast milk,
are most likely also toting a breast pump in their daily commute to and from work.
Our research suggests that income plays a significant role not only in infant
feeding choices, but also in choices about pumps. Several of our interviewees who
used pumps stated that, due to cost, they had not bothered researching different
558 M. Boswell-Penc & K. Boyer

pump models but rather had chosen to simply borrow equipment from friends.
Seven respondents borrowed pumps from friends, while two others purchased
equipment at ‘bargain rates’, one from an estate sale and the other from eBay. Six
respondents noted that if they had had a better pump, they suspect they would
have nursed for a longer period of time. One, a 35-year-old high-school graduate
working in a clerical position as a unit secretary, claimed ‘it seemed like the pump
I used in the hospital worked the best. The ones in the stores didn’t work as well’.
Significantly, this mother stated that she stopped nursing because eventually, after
three months, she ‘wasn’t able to give him enough’. Another, a white, 35-year-old
high-school graduate with some college education working as a teaching assistant
in a local middle school, stated ‘I think if I could have purchased a better pump for
less money and had a private designated nursing room, I would have nursed for
longer’; she also stated, ‘government subsidies would have been nice. I would
have breastfed either way, but if a subsidy allowed me to purchase a better pump,
I may have nursed for longer’. This mother nursed for four months exclusively
and for one month in combination with formula. A 42-year-old Latina immigrant
domestic worker, whose baby was only a few weeks old at the time we
interviewed her, said she had successfully used a Medela double electric pump at
the hospital and was allowed to use it on loan for one week, after which she had
switched to a single manual pump, which she planned to use when she returned
to work (she could not afford an electric pump). We know from verbal follow-up
two months after the initial interview that this mother was not able to sustain
pumping, we surmise, in part, because of the difficulty of operating the pump she
had access to.
Pumping also has to be understood as part of a network of wage and non-wage
work that includes not only nursing women seeking to return to work, but also
whoever looks after her child (or children) while she is there. When women use
breast pumps, sometimes someone else takes on the responsibilities of bottle-
feeding, often in the context of formal or informal waged work. Such relations are
powerfully mediated by class, race, ethnicity and gender: the vast majority
of childcare workers are women, disproportionately women of color,14 many of
whom are themselves mothers of young children. Childcare workers face some of
the lowest wages and lowest benefit levels of all US workers (Whitebook et al.,
1997; Occupational Wages, 2004) and research suggests that institutional barriers
prevent most childcare workers from taking extended maternity leave to establish
breastfeeding. Demands of the work itself, particularly the requirement to
maintain certain ratios of care-givers to children, may also present a barrier to
milk expression in the childcare workplace. For example, a 21-year-old
respondent of color who is a childcare worker noted her experience: ‘because
my daughter is in the infant room and because we don’t have enough teachers,
I can’t leave the room to nurse her’. Consequently, she nursed exclusively for
seven weeks until her return to the wage workplace, then nursed while not at
work and used formula during the day. These types of barriers add up to a class-
based double standard mediating who gets to breastfeed and who does not.
Although the medical community and federal agencies have initiated public
health campaigns to raise awareness about the health benefits of breastfeeding
(Wolf, 2003) and programs such as ‘Pumps for Peanuts’ have sought to subsidize
the cost of breast pumps, some women still seem unaware of health and other
benefits for mothers and children and many women still face barriers, including
lack of access to higher-end pumps that function more efficiently. Hence, although
Breast Pump Usage in American Workplaces 559

the breast pump does have emancipatory potential we also want to signal the
social factors which constrain who is most likely to reap its benefits. Being bound
up with the politics of who does and does not nurse, it is important to note that at
present breast pumps are a classed and racialized technology in that their users
are not representative of all women with young children, but are rather a whiter,
wealthier subset of that group.15

Experiences of breast pumping in the workplace


With the proliferation of information technologies such as e-mail, cell phones,
blackberries and pagers, for many employees wage work is no longer physically
limited to the workplace, and work-related activities have come to occupy an
ever-greater portion of time outside of work (Moss & Townsend, 2000). With so
much work taking place at home, we might ask: should there not be more living
allowed at work? The following section queries whether the breast pump
provides a means of ‘pushing-back’ on the life – work balance—and challenging
traditional gendered public/private divides—by bringing to work an
activity traditionally associated with the private space of the home. Or, despite
its promise, does the breast pump unwittingly create ‘more work for mother’,
as Ruth Schwartz Cowen (1983) argues so many so-called ‘labor saving’
technologies have done? And if it does, how could this burden be lessened?
Though breast pumps can enable lactating women to return to work, breast
pumping at one’s place of employment can be tricky. At the most practical level,
breast pumping at work is far from a guaranteed right in every state, and some
women have been fired for it. For example, the 2003 case of Kathleen Landor-St.
Gelais v. Albany International Corporation heard before the New York Supreme
Court featured a plaintiff who had sought to pump milk at work (in a bathroom
stall) and store it in a communal refrigerator (her suit was dismissed on several
grounds).16 Even the breastfeeding advocacy community, represented by the
organization La Leche League, has been ambivalent about using breast pumps as
a means to return to work. As Hausman (2003) has noted, there is a tendency
within this community to view the breast pump as a technological fix which
discounts the emotional and psychological aspects of nursing, and historically this
community’s stance has been that women with young children should stay at
home and nurse as long as they can (Bobel, 2001).17 Though La Leche League has
revised its position against the breast pump in recognition of the economic
realities which constrain women’s choices about timing their return to work, this
position might be interpreted as only qualified support and plays into narratives
about women with children as ‘not belonging’ in the workplace.18
Even where accommodation for pumping is in place, problems can remain both
at the level of built form and at the level of cultural practice. Most workplaces
‘design out’ nearly all activities other than work itself. For example, worksites in
which one cannot eat or sit down (such as most stores) and in which bathrooms are
too few (such as outside and/or male-dominated worksites) show how workplaces
routinely deny the physical needs of the body. Our interviews offer a clear
illustration of how workplace design is typically engendered and how
breastfeeding women in particular are constructed as ‘out of place’ at work. For
example, one woman, a white, 30-year-old graduate student who identified herself
as middle class, claimed that her decision to stop nursing was based partly on the
fact that she did not have a private space to pump at her university. In her academic
560 M. Boswell-Penc & K. Boyer

department, where ‘space is at a premium’, she was told that she could pump in the
ladies room, where there were no electrical outlets, or in her own office that she
shared with a male student. Facing these barriers, she reported that ‘needless to say,
pumping at school did not last very long’, and that ‘If [she] had a more comfortable
place to pump. . . [she] probably would have nursed for a longer time period’—four
months in her case. Other women complained of similar problems, including the
lack of privacy, having to pump in bathrooms with no outlets, or finding, in the
words of one woman, a white, 33-year-old college graduate with a job in state
offices, who nursed exclusively for four months and in combination with formula
subsequently, that ‘I sometimes need[ed] to work through breaks because we are
busy and have deadlines to meet’, such that she could not find the time to express
milk. These comments highlight ways in which many American workplaces
continue to deny the needs of the lactating body.

Expressing anxiety
Popular literature we consulted for this study suggests that women seeking to
nurse in public often face attitudinal and other barriers. Our research suggests that
the lactating body in the workplace causes anxiety because it forces the
acknowledgement of women’s biological productivity. Anxiety can focus on
breast milk as well as the act of expressing it. As Boswell-Penc (2006) has argued,
breast milk itself can be viewed with suspicion as a potentially contaminated and
contaminating substance—a ‘biohazard’. We can find an example of this in the
scene from the film Fahrenheit 911 in which Michael Moore interviews a woman
who had a bottle of her breast milk confiscated at an airport as a matter of
protecting national security. Having spent several years researching barriers to
breast pump use, Congresswoman Maloney reports that ‘many women have
contacted [her] office, having been fired or discriminated against for expressing
milk during the day,. . . others have had their pay docked for pumping during the
workday, have been harassed’. Our research bears this out, with many of our
interviewees suggesting that they have experienced feelings of anxiety about
pumping, or have received comments conveying anxiety about pumping at work
or storing milk in communal refrigerators. This kind of anxiety echoes a very old
narrative of fear about women’s entrance into the white-collar workplace in the
early twentieth century which produced impressive efforts to physically separate
men and women employees and provide for women’s ‘special needs’ (Boyer,
2003). While on the one hand such efforts were about preventing gender mixing,
they can also be read as an expression of fear about women’s bodies and the
substances they produce. The breast pump calls attention to a bodily function in a
dramatic way and this can cause anxiety. One of our interviewees, the doctor who
had chosen to be a stay-at-home mother, but pumps so that she ‘has freedom and
can go out’, reported that ‘my husband watched me give birth, is around when I
nurse and even sees me pee, but I draw the line at pumping’.
In the US as in the rest of the industrialized West, engaging the body through
technology has become commonplace (Balsamo, 1996). Women rely on technology
to monitor blood-sugar levels, control fertility, learn if they are pregnant. Yet our
evidence suggests little enthusiasm for engaging the body through the technology
of the breast pump. As one interviewee, a childcare worker, put it: ‘I just don’t
enjoy using the pump’. Although this respondent also noted that she had paid
only $50 for her double pump, suggesting that it was low-end and perhaps
Breast Pump Usage in American Workplaces 561

inefficient; no one interviewed for this study described pumping as an enjoyable


experience.
Meanwhile, expressing milk in the workplace presents additional kinds of
issues that pumping at home does not. Several women reported feeling anxious
about drawing attention to the act of pumping at work; a 43-year-old financial
advisor who nursed her first child for only a few weeks stated that pumping
‘made me feel like a cow’, and that she ‘didn’t want to have to deal with bodily
functions at work’. But, it is important to note that she made this comment in
reference to her first child, who was six at the time of this interview. By this time,
she had chosen to nurse her second child for much longer and had used a pump
much more successfully after her return to work, thus suggesting that, at least in
this case, attitudes may be changing. Similarly, the graduate student who used the
Medela single electric pump noted that ‘having to explain to everyone who comes
into the bathroom . . . what the loud noise is wasn’t all that comfortable’. Similarly,
as Dilys Wynn, one nursing mother whose interview was featured in the article
‘Express yourself: How to successfully combine breastfeeding and work’,
explained her experience: ‘I didn’t tell my manager or my co-workers that I was
expressing milk at work . . . It was a male-dominated industry and it would have
been too embarrassing’. To mitigate her embarrassment Wynn pumped in a
medical office at her workplace.19

Time, space and class


Bracketing the anxiety pumping may produce, being able to engage in this activity
in the first place depends on being able to secure the requisite time and space.
Pumping itself takes about 5 – 25 minutes every few hours, and requires a place—
ideally with privacy and a sink—in which one can relax enough so that one’s milk
will let down. And here the onus is on employees (rather than employers) to
procure the requisite space and time. As Wynn put it: ‘It is up to you to work out
where to pump, where to chill and store your milk and how to schedule work
breaks that coincide with let-down times’.20 Most workplaces do not provide
additional breaks or space to accommodate pumping, thus most women need to
accomplish their pumping breaks as they can around the (temporal and spatial)
edges (Allerton, 1997). A 35-year-old, middle-class, white clerical unit secretary in
state government, who switched to formula after three months because ‘we do not
have a designated room or time to pump’, noted that ‘Having a private place (not
the bathroom) to pump would have allowed me to pump longer than I did’—in
her case, three months. A 40-year-old white, middle-class manager at the New
York State Taxation and Finance Department commented ‘if it was easier and
convenient to pump at work I would have continued breastfeeding longer’—in
her case, also three months. A 33-year-old white, middle-class college graduate
with a ‘desk job’, who nursed exclusively for four months and in combination for
four more, stated that ‘If there were other breaks allowed besides the standard
breaks I would probably have pumped more. But to pump at both my breaks and
feed him at lunch leaves me no time for myself’.
These comments suggest how, in many workplaces, pumping can end up
adding more work to one’s workday. Indeed, our interviews suggest that the
decision to switch to formula is sometimes case as an effort to share the labor of
infant feeding. As one respondent in our survey who nursed in combination with
formula for three weeks and then switched exclusively to formula, put it: ‘I did not
562 M. Boswell-Penc & K. Boyer

want to be solely responsible for my child’s sustenance. The father should also
participate’.21
Our interviewees reveal a variety of strategies—some quite creative—to achieve
some modicum of isolation in the absence of a dedicated lactation room. Some
women pumped in their car, some in bathrooms, some women found small,
unused rooms or closets. One interviewee told of a colleague who worked in state
government who wound herself up in a long window curtain whenever she
pumped. A 33-year-old first-grade teacher noted having to pump in a closet and
stated that this ‘was no fun’, that workplace policies ‘made it difficult’. She also
worried, ‘I know this has impacted co-workers who chose never to breastfeed’.
Anxiety about one’s milk being viewed with suspicion or about having one’s
breasts manipulated by a loud machine within earshot of ones’ colleagues, as well
as the desire to avoid adding another layer of spatial and temporal discipline on
top of those already required by one’s job, all serve as disincentives to pumping at
work.
Some savvy employers in highly remunerative sectors of the labor market who
value their employee’s time and want them back at work as quickly as possible
after childbirth do provide accommodation to allow their employees to blend
nursing or pumping with wage work. Progressive companies and those in the
health fields have also been at the forefront of providing pumping rooms, lactation
specialists and paid breaks available to their employees. Three respondents in our
sample reported pumping with ease: a 42-year-old white middle-class educational
administrator with a Master of Science degree, who nursed exclusively for 11
months stated that ‘my workplace was accommodating and understanding and
I was lucky’; while a white middle-class woman of 38 and a 34-year-old
occupational therapist both reported no problems with workplace accommo-
dations. As feminist geographers Mona Domosh and Joni Seager note, companies
in certain very highly remunerative sectors of the economy, such as financial
services, have been at the front of the curve in terms of providing lactation rooms
for their employees (at least for upper-level employees whose time and skills are
at a premium). They note, for example, that J.P. Morgan provides a lactation room
with built-in pumps on their trading floor (Domosh & Seager, 2001). Of course,
most women do not work as stockbrokers for J.P. Morgan. With the exception of
the three respondents noted above, the majority of our respondents reported
problems with workplace accommodation.
And as a corollary to the gusto with which some high-wage employers have
embraced workplace lactation, we suggest that finding time and space to pump is
especially difficult in low-wage jobs. Space costs and women who work in fast
food restaurants, coffee shops or mall stores are very unlikely to have access to the
kind of ‘extra spaces’ such as dedicated lactation rooms, examination rooms or
empty conference rooms that middle class women might use. Thus, whether one
chooses to continue nursing after returning to work is not only a question of
cultural preferences or the cost of a breast pump, but it is also an issue of
workplace design and whether one works for an employer who will make space
for this activity.

Conclusions
While breast pumps allow women to combine work and nursing in new ways,
we are concerned that the benefits of breast pumping are distributed unevenly.
Breast Pump Usage in American Workplaces 563

Our research from Albany suggests that economic insecurity adversely affects
women’s ability to integrate breastfeeding with wage work outside the home.
This problem is amplified by the fact that low-income women are more likely to
have to return to work sooner after bearing children, as compared with more
affluent women. We are concerned that even where breast pumping is allowed it
remains socially and logistically awkward, with both the leg-work of convincing
one’s boss to allow one to pump on the job, as well as pumping itself adding up
to ‘more work for mother’. And we are concerned that by providing a
personalized, technical fix to the question of workplace lactation, breast pumps
may lessen possibilities for receiving paid maternity leave, or remove any
incentive for employers to come up with more—and perhaps better—
alternatives for women trying to combine work and nursing (such as by
providing on-site childcare).
Going into our study we thought that the expansion of government subsidies
for breast pumps together with legislation protecting pumping could make a big
difference for breastfeeding rates in the US. Our interviews do suggest that
legislation forcing employers to offer longer paid maternity leave, lactation
rooms and paid pumping breaks would enable more women to combine
pumping with wage labor, as would increased subsidies for pumps and pump
rental. Relatedly, legislation would need to reach out not only to the high end of
the labor market, but to women working in retail, in service industries, house
cleaning, daycare, offices and restaurants. In order to overcome the continued
belief (as advanced by the formula industry) that breast milk is not all that much
better than formula, the US would also need to sign on to legislation controlling
the direct marketing of breast milk substitutes, as is done elsewhere in the world.
Until policymakers take this action and/or begin to allow advertisements stating
the risks of formula use (Wolf, 2003; Merewood & Heinig, 2004), it may be
difficult to garner the kind of public support necessary to promote nursing and
pumping on a wide scale.
Policy provides an important part of the solution as it has the power to re-frame
responsibility for a problem from the individual to the collective. But at the same
time, our research suggests that these improvements alone are not enough.
In addition to the material changes that are required, we argue that for the breast
pump to truly fulfill its potential as a feminist technology will require semiotic
changes as well. We need to change the politics of banishment which structure
how we are told breast pumping should proceed, and challenge narratives which
encode woman’s biological productivity as shameful. We need to expand the
limits on what kind of bodies belong at work, and allow a broader range of living
to occur there (especially as so much work has followed us home). Finally, rather
than focusing single-mindedly on this way of blending nursing with other
activities, we must be fully engaged with thinking creatively about what might be
the best way. These transformations will require not just legislative change,
but cultural change.

Acknowledgements
The authors would like to thank all the women who participated in this study for
their generosity of time and insights. Given the magnitude of other demands on
the time of mothers with young children, we are grateful to all who responded to
564 M. Boswell-Penc & K. Boyer

our survey and interview questions. We would also like to thank the three
anonymous reviewers and editorial staff of Gender, Place and Culture.

Notes
1. For the AAP see http://www.aap.org/advocacy/releases/feb95breastfeeding.htm (accessed 16
November 2005). For the World Health Organization, see http://www.who.int/inf-pr-2001/
en/note2001-07.html (accessed 1 October 2004). For the Surgeon General, see Spisak & Gross
(1991).
2. For more information about our survey and interview data, please refer to the section on
‘Methodology’.
3. See http://www.house.gov/maloney/issues/womenchildren/breastfeeding/worldwide.htm
(accessed 26 January 2002).
4. For more on rates see Ryan (1997).
5. It is interesting to note that in the US context ‘pumping’ seems to be used, emphasizing the
machinery, whereas in other contexts, ‘expression’ seems preferable, commenting on the relative
speed and efficiency of the process.
6. For a critique on the assumption that greater mobility necessarily leads to greater freedom and
economic security for women see Gilbert (1998).
7. See for example ‘Breast-feeding: a civil right’ (editorial), The New York Times, 20 May 1994, v.143
pp. A14, 26; Rohter (1993).
8. See Congresswoman Maloney’s website at http://www.house.gov/maloney/issues/
womenchildren/breastfeeding/worldwide.htm (accessed 26 January 2002).
9. This is not to argue that women in these countries have more rights overall than women in the US.
10. ‘Breastfeeding on a Worldwide Scale: How the United States Lags Behind its International
Counterparts’. Available at http://www.house.gov/maloney/issues/womenchildren/
breastfeeding/worldwide.htm (accessed 26 January 2002).
11. See Dyck (1996) for more on how social networks shape women’s choices around work and
mothering.
12. For rates by race see the Centers for Disease Control study, see http://breastfeed.com/news.htm
(accessed 25 February 2007).
13. ‘Promoting and Supporting Breastfeeding’. David Meyers, MD from American Family Physician:
A Peer-Reviewed Journal of the American Academy of Family Physicians, http://www.aafp.org/
afp/20010915/editorials.html (accessed 15 September 2001).
14. A Profile of the Working Poor, 2000, Bureau of Labor Statistics, http://www.bls.gov/cps/
cpswp2000.htm (accessed 30 November 2005).
15. For more on breast-feeding as a luxury see Blum (1993, p. 292).
16. State of New York Supreme Court, Appellate Division, Third Judicial Department.
17. Although this position could also be read as an acknowledgement that pumping itself is work.
18. Although Bobel’s research suggests that LLL’s basic stance that nursing at home is preferable to
returning to work, even with a pump (Bobel, 2001, p. 139).
19. http://breastfeed.com/resources/articles/bfeedandwork.htm (accessed 30 November 2005).
20. Ibid.
21. This respondent first wrote ‘the father should also suffer’, but then crossed out the word ‘suffer’,
replacing it with ‘participate’.

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ABSTRACT TRANSLATION

Expresando la angustia: El uso de los sacaleches en los


lugares de trabajo renumerado
Resumen Este artı́culo considera la potencial y los problemas para mujeres
quienes tratar de incorporarse amamantar a través del uso de sacaleches con el
trabajo renumerado afuera del hogar. Después de situar el sacaleches dentro de
sus contextos cultural, histórico, y legislativo, y los cambios en la opinión pública
sobre la nutrición de los infantes, se desempaca cómo ésta tecnologı́a ha
reformado el panorama de opciones sobre la alimentación de infantes en los
Estados Unidos. Utilizando las marcas teóricas de los estudios de ciencia y
tecnologı́a, la geografı́a feminista y los estudios de mujeres, se examina cómo los
sacaleches han cambiado las experiencias en el lugar de trabajo después del parto.
Basado en entrevistas y datos de encuestas realizados con mujeres de diversas
clases y razas en Albany, Nueva York, sostenemos que mientras el sacaleches
Breast Pump Usage in American Workplaces 567

permita que combinen algunas mujeres la lactancia materna con el trabajo


renumerado afuera del hogar, las ventajas del sacaleches están constreñidos por
las actitudes culturales hacia la extracción de leche como una actividad, por la
falta de un marco legislativo, y además por el diseño de lugares del trabajo.

PALABRAS CLAVES : Trabajo renumerado; el cuerpo lactando; los sacaleches;


decisiones sobre la alimentación de infantes; la balanza de la vida y trabajo

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