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Health & wellness

A New Hampshire mother’s fight to breast-feed

Though laws allow mothers to pump milk while at work, actual breast-feeding is not protected

Kate Abra Frederick with son Devon in Conway, N.H.

Fred Field for The Boston Globe

Kate Abra Frederick with son Devon in Conway, N.H.

Fifteen extra minutes.

That’s what Kate Abra Frederick asked her employer for: a half-hour, rather than a 15-minute break, so she could zip over to the day-care center less than a two-minute drive from her office to breast-feed her new baby boy.

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The 42-year-old New Hampshire woman, who was terminated from her job last August for not returning to work after her maternity leave, says she stayed home because her employers would not agree to what she calls a reasonable request to accommodate her desire to breast-feed her child during the workday.

“I felt like a volcano was erupting and heading straight for me and I was locked in,” she said of the drawn-out communications she had with her employer over her breast-feeding rights. Frederick had worked as a child support officer with the New Hampshire Department of Health and Human Services in Conway. “If I went back to work and did what I needed to do for my health and [my son]’s health, I would have been insubordinating.”

Now on unemployment benefits while fighting a legal battle, Frederick’s case, filed with the federal Equal Employment Opportunity Commission, highlights a reality for many working mothers across the country: Despite doctors widely recommending breast-feeding for children’s and mothers’ lifelong health, following through for many women proves frustrating and sometimes impossible.

Lauren Cairns (left) and Melissa Church breast-feed their children at a support group meeting in North Conway, N.H.

FRED FIELD FOR THE BOSTON GLOBE

Lauren Cairns (left) and Melissa Church breast-feed their children at a support group meeting in North Conway, N.H.

The Affordable Care Act and state laws require most employers to accommodate women who wish to breast-feed by allowing them to pump milk during the workday to later bottle-feed their children. But Frederick’s son Devon, like many babies, would not take a bottle at first; to breast-feed him, she would have to physically be with him.

That means she fell into a legal black hole in terms of protection: Employers aren’t required to let their employees breast-feed children during work hours — they just have to make it possible for mothers to pump their milk.

Jake Marcus, a Philadelphia lawyer and national breast-feeding advocate, calls that legal distinction between pumping and feeding “absurd.”

“Just the specter of having children in the workplace scares people,” she said.

Most mothers who wish to breast-feed and not just pump have to find time during the day to run to a day-care center or pick up their child at regular intervals, Marcus said — making the task nearly impossible for women without the privilege of flexible work schedules.

“There are enormous risks from not breast-feeding,” said Dr. Melissa Bartick, chair of the Massachusetts Breastfeeding Coalition. Stopping breast-feeding earlier puts children at risk for many chronic diseases such as diabetes, obesity, and even leukemia, she said.

Breast-feeding can also help reduce the mother’s risks of breast and ovarian cancer, diabetes, high blood pressure, and heart attack, she said.

Bartick has also done research showing long-term cost savings from breast-feeding: her 2010 study in the journal Pediatrics showed overall savings to the health care system of $13 billion a year and 911 preventible deaths, mostly among infants, if 90 percent of American mothers could breast-feed their children exclusively for six months.

Though 77 percent of American infants begin breast-feeding, only 16 percent remain exclusively breast-fed at 6 months — the World Health Organization’s recommendation, according to a 2013 report from the Centers for Disease Control.

But it’s difficult for most Americans to breast-feed exclusively, and the organization Best for Babes, which promotes breast-feeding, reports most women don’t meet their own goals due to a combination of cultural pressures, workplace trouble, and simply the struggle of juggling life and motherhood.

“Breast-feeding still isn’t normal yet in the United States and until it’s accepted as normal, it’s going to be an uphill battle,” Bartick said of workplace protections for breast-feeding mothers.

Frederick needed to breast-feed: She developed gestational diabetes while pregnant, and her lactation consultant, midwife, and nurses all told her that breast-feeding would be best for her and Devon’s health. She also deals with ongoing issues of anxiety and post-traumatic stress disorder, putting her at risk for post-partum depression — which breast-feeding can help stave off by facilitating mother-baby bonding and releasing endorphins.

In her EEOC complaint, Frederick’s communications with her employer are detailed.

The department’s director of human resources, Mark Bussiere, wrote Frederick in one e-mail last August: “DHHS is in compliance with the law” allowing her to “express milk” — a legal phrase which is almost always interpreted to mean pumping rather than feeding, Marcus said.

The specific request denied, he wrote, was Frederick’s appeal to leave her office on an extended break, time she offered to make up by staying later.

Frederick said that during her time at the department, leaving the office grounds was a casual, everyday occurrence among employees, many of whom walked up and down the short stretch of rural road, got coffee, or smoked off the office grounds on breaks.

Bussiere, reached by phone, said he isn’t aware if employees regularly leave the office grounds on breaks, but that supervisors may “speak to them in some manner” if they do.

“We don’t have any security or ability to enforce this, it’s just a matter of practice,” he said.

He then said he could not speak further on the matter because of the pending complaint.

Marcus said the department’s reaction to Frederick’s request is a common one, and likely not illegal.

“The employer can often dictate what the employee does on a break,” she said. “For many women, before you’re pregnant, you can take lunch and no one checks which Blimpie’s you go to, but now they’re leaving for the same amount of time to feed the child . . . and the employer can decide what you do on your breaks.”

A little over a month after the e-mail correspondence, Frederick received a letter dismissing her.

For Marcus, Frederick’s case is unsurprising and fits with what she sees regularly. She told of a woman who worked in a prison being allowed to step outside prison grounds to administer insulin shots for her gestational diabetes yet having to fight to leave the grounds to pump breast milk.

In the end, Marcus thinks the answer for women like Frederick lies in new laws.

“If you follow the common sense train, it leads back to a legislature, and not a court,” she said.

Frederick is still breast-feeding 14-month-old Devon and awaiting her first mediation meeting between the EEOC and her former employer — the department responsible for promoting World Breastfeeding Week across the state.

On a sunny morning, she and members of her breast-feeding support group from the local hospital sat outside in a North Conway park, breast-feeding slings and cloths slung over their shoulders, babies held to their chests, while older children played on a jungle gym nearby.

“It should be normal, all of us sitting out in the park here,” said Heather Towle, the lactation consultant who leads the support group. “Breast-feeding is so normal, but it’s the hardest thing for women to do, after having the actual baby.”

For Frederick, breast-feeding has changed her life. It’s a part of her identity, haunting each failed job interview of the past year.

“When I filed at the EEOC, I did not feel empowered,” she said. “I felt like I was . . . getting up for the first time, after having been beaten to the ground.”

Sanjena Sathian can be reached at sanjena.sathian@globe.com. Follow her on Twitter @sasathian.

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