P3.040: Don't Bite the Hand that Feeds You: Supporting Breastfeeding Physicians in the Pediatric Emergency Department

Background: Six months of exclusive breastfeeding is recommended by most professional organizations, and legal breastfeeding protections have been in place in the United States since 2010. Physician mothers have a higher rate of breastfeeding initiation as well as early cessation than the general public. Of the approximately 3,500 practicing Pediatric Emergency Medicine (PEM) physicians in the United States, almost 70% are female. Pumping while working in the Pediatric Emergency Department (PED) remains challenging, and there is a gap in research regarding PEM physicians and their breastfeeding plans.

Methods: To describe the experience of breastfeeding and pumping in the PED and determine if factors that impact breastfeeding and pumping behaviors in PEM physicians including differ by fellow or attending status. This is a secondary analysis of a cross-sectional survey on caregiving and burnout among PEM providers. A subset who had pumped breastmilk were included for analysis. Data was collected from January 20 to April 1, 2024. Surveys were distributed through the Brown University PEM Listserv, and professional Facebook groups. Descriptive statistics were utilized to report primary outcomes, and Chi squares or Fisher’s Exact tests assessed differences among fellows and attendings.

Results: A total 143 survey participants reported breastfeeding during their career; 112 (78%) were attendings and 31 (22%) were fellows while pumping. Of all participants, 47% had a designated private pumping space in their PED, while 17% reported pumping in a bathroom or closet, and only 33% reported ideal space and resources. Attendings pump less frequently and for less time than fellows (80% vs 58% report pumping less than 30 minutes per shift; p< 0.017), and 21% of all participants report being required to complete work tasks while pumping. Decreased breastmilk supply was reported in 70% of respondents after returning to work, primarily attributed to decreased pumping frequency. Of PEM attendings, 86% report working single coverage, and 77% pump less often when they work these shifts; 21% of attendings vs 3% of fellows report that increased physician staffing would make it easier to pump on shift (p < 0.02). Regarding factors that make it harder to pump, attendings report increased impact compared to fellows by understaffing (28% vs 7%; p< 0.02), and business of the PED (38% vs 16%; p< 0.03), while more fellows report work culture as a factor that makes it harder to pump (23% vs 9%; p< 0.06).

Conclusion: Significant workplace and schedule improvements could bolster physician satisfaction with the experience and longevity of pumping after returning to work.