since i first read of Sophie Currier and her plight to test/lactate, something bugged me about the story. Lithwick raised good questions, but my bugginess runs somewhat askance to her points made.

full disclosure: this is almost impossible to believe, nearly more impossible to achieve-- but i've been lactating for 18 years, almost non-stop. (there are three 3-week intervals between weanings and births accounted for in that span of time.)

i have a lot of children, have breastfed all of them to toddlerhood (my oldest is 27) and tandem nursed a couple of them. (a practice i would not recommend except under... well... exceptional circumstances.)

i was a breastfeeding counselor for 8 years and a breastfeeding advocate/ activist for many more. 15 years ago when a breastfeeding woman got kicked out of the Toledo Art Museum for nursing her baby (seated on a bench, facing a painting, with her back to the other visitors) i was part of a large crowd of women staging a breastfeeding nurse-in at the museum that resulted in the Museum articulating a policy allowing breastfeeding to take place in the exhibits.

activism notwithstanding, it's been years since i mistook my sisterhood in the human race as permission to ask pregnant women if they planned to breastfeed. it's been years since i tried to convince anyone "just to try it. you'll never be sorry."

disclosure time is over. doesn't it seem like i should be so supportive of currier's breasts and her intent to not suffer engorgement/ infection? i'm not. so, what the hell is bugging me about this story?

first thing bugging me: harvard med school doesn't interest itself in statements from the American Academy of Pediatrics. here is the AAP policy statement on breastfeeding, issued in 1997. seems harvard med school has yet to see it: <link>

The AAP concludes its statement on breastfeeding such: Although economic, cultural, and political pressures often confound decisions about infant feeding, the AAP firmly adheres to the position that breastfeeding ensures the best possible health as well as the best developmental and psychosocial outcomes for the infant. Enthusiastic support and involvement of pediatricians in the promotion and practice of breastfeeding is essential to the achievement of optimal infant and child health, growth, and development.

[no wonder so many pediatricians suck at supporting breastfeeding. (it's too pun-able to pass up.) they weren't allowed to pump during the test, making them bitter and unsupportive. ]

but there's more bugging me. sophia currier does seem like an entitlement junkie.

some of us have managed to breastfeed with the outright disapproval of ignorant pediatricians, continual sidelong glances of uncomfortable inlaws, dismissive comments from non-breastfeeding mothers like "i wanted my body back", and strangers asking about a nine month breastfeeding baby "how long will you nurse her?" (best answer, "about five more minutes.) some of us have refused to nurse in filthy ladies rooms, have never purchased those ridiculous nursing capes, have never flashed a tit in public, nor squirt milk on the guy in the airplane seat next to us.

some of us have practiced public nursing in front of friends, mirrors and husbands to make sure "nothing's showing." some of us have followed the AAP's advice that "crying is a late stage indicator" of hunger and have stopped mid-burger- bite to get a mildly fussy baby latched-on discreetly-- before her crying attracted attention from all over the Wendy's dining room.

some of us have pumped while driving, (another practice i don't recommend) have fibbed to phone contacts that the shoosh-shooshing of a breastpump set on Weapons of Mass Destruction is really the sound of a broken steam furnace or that we're on dialysis.

some of us post to the various Frays with hardly ever a capital letter used, as we've almost always got a breastfeeding baby in our laps. one handed typing is the best we're at. capitals are tougher than they're worth.

some of us are breastfeeding veterans with war stories, dammit. we've earned our breastfeeding chops. we helped to return the American mothering landscape into a moderately breastfeeding culture. we did it, not by asking for special treatment, but by simply expecting to be ignored. (except for that nurse-in. then, we were hard to ignore, but overall, ignoring us was the point.)

sophie currier is making momentary gains while evoking potentially enduring resentments. she's calling undue attention to something that should be a non-issue. she'd have done better by just flipping the on-switch of her mini-travel-pump mid-test, and kept on testing.

i'm glad i got that off my chest.

waltz n capsize

having just read the links provided in the "competition/ not black and white" thread and realizing that Currier was, in fact, given the option of pumping while testing at the computer, i'm glad to know my gut serves me well. i'd charged she's calling undue attention to something that should be a non-issue and dammit, if i wasn't right.

sophie currier has an agenda other than fair test-taking for the breastfeeding mother. Currier's cute baby, Lea, has a dummy for a mom. Sophie may be educated, but she isn't wise.

the enduring resentment is mine.

w n c

Just so you know - yours is one of the most intelligent, thoughtful, realistic replies in this forum. Congrats, and I applaud you for your attitude and everything you've accomplished (whereas I really can't congratulate Ms. Currier since she has basically had her hand held her entire life).

your remarks are most kind as is your heavenward thumb. thanks so much.

always an angel, huh? funny how some of the nicest folks around these fray parts have wings.

see you around!

waltz n capsize

i rescind my complaints against Harvard Med School because i read they had tried to accomodate Currier quite fairly.

still, the AAP policy on breastfeeding is very worth reading.

additionally, a mother who feeds her baby primarilly pumped breastmilk is not correctly referred to as breastfeeding. instead the practice is correctly referred to as breastmilk feeding or breastmilk supplementing. as the AAP policy statement suggests, while breastmilk supplementing is superior to formula feeding, it is inferior to breastfeeding.

there are more than separation/bonding issues involved in this distinction. breastmilk delivered directly from the breast to the baby is perfect in its non-homogenization, has the most living antibodies and is the perfect temperature for delivery. additionally, the act of suckling milk from the breast is the ideal workout for baby's developing mouth, tongue and jaw muscles.

any mother who is primarilly pumping breastmilk (which almost certainly would be the case of a mother who is away from her baby 60 or more hours a week) would most correctly be referred to as breastmilk bottle feeding while breastfeeding supplementing.

too much verbage for a Slate headline, but more correct.

finally, very pretty picture of the breastfeeding baby on the front page of Slate,but my qualm is this: only at-home breastfeeding should look like that. potential breastfeeding mothers and their partners may find all that supposed breast exposure a profound detriment to breastfeeding. too bad they don't know that public nursing, done right, is almost invisible and doesn't draw much attention at all-- that's why they haven't noticed it.

w n c

One more clarification - this really has nothing to do with Harvard. She's been gone from there for 1.5 years (and many med schools confer the MD degree w/o a passing score on the Step 2). So Harvard was uninvolved in this, with the exception of writing the National Medical Licensing Board a letter encouraging them to make concessions for her.

This is a nationwide licensing exam that every med school graduate takes to prove basic competence. She can take it anytime throughout the year (already took it in May and failed) as it is literally offered almost any day of the year. So she is basically asking for a concession in a test that affects thousands and thousands of doctors every year.

So these are the written boards, not the oral boards (which are far more difficult)? A 9-hour multiple choice exam?

thanks for the clarification on the testing board.

w n c

"some of us are breastfeeding veterans with war stories, dammit. we've earned our breastfeeding chops. "

I think it's awesome that you've done all the things you done (with the possible exception of pumping while driving). I only have one child, he's almost three and still nursing, and we've certainly done our share of nursing in awkward situations. I missed portions of classes to pump during law school. Etc etc. And there are things I don't like about Sophie's story either.

But, I question the attitude that because some people have had to "earn their chops," everyone else should go through those same struggles over and over. Isn't the goal of creating a breastfeeding culture to allow more people to breastfeed, not just people like us, for lack of a better expression? Personally, I would find it extremely difficult to pump and take an exam at the same time, and I don't think that's a good solution. Nor would I feel comfortable pumping in front of some stranger in a test room - I simply never found pumping discreetly to be possible, unlike breastfeeding. So just because I'm not "tough enough" means I should have to choose between taking the exam or breastfeeding?

Sophie may be a bit of a whiner, who knows? But personally I think the goal should be to make being a breastfeeding mother easier instead of harder, not making every breastfeeding mother show her grit and determination in order to be good enough.

I think the goal should be to make being a breastfeeding mother easier instead of harder, not making every breastfeeding mother show her grit and determination in order to be good enough.

hi baglewoman,

i agree with you. see how currier has turned the tables. she's redefined the fight when there needn't be any discussion.

sophie currier was offered many concessions to a more agreeable testing environment. (please read the links provided in the competition/ black-white thread.) she finally won better than that.

but sophie currier has potentially made it harder for every woman to pump at work/ school and possibly harder even to breastfeed in public situations because she's been demanding. because she appears to be a whiner. because she reeks of entitlment theory. because she's evoked unnecessary resentment. much of these threads and other blogs attest to the resentments.

every nursing mother shouldn't be forced to take up arms-- to fight for her right to lactate. but wisdom, prudence-- those go a loooong way promoting such an important cause. currier failed on these. she didn't do nursing mothers and babies(and surely not potential/ future nursing mothers and babies) any favors.

the wisest thing a breastfeeding woman can do is expect to be ignored.

waltz n capsize

I have read the links, and I don't think pumping while trying to take a high stakes exam is a reasonable accomodation. I recently took the bar exam, and there's no way in heck I think taking the exam while pumping is equivalent to taking the exam while not pumping. Sure, it's possible - apparently a lot of women have done it. But I don't see why they should have to, or why it should be some red badge of courage to do so and make it through. I don't agree that expecting to be ignored is the best we can expect - it works in some situations, but not in all, I just see no reason to force a choice between continuing to breastfeed and being able to focus on an exam that is essential to your career - extra break time to pump just does not strike me as that big of a deal.

bagelwoman, i respect the achievements you've made while continuing to provide the best nutrition for your baby.

but considering all the concessions already offered to Currier for her ADD and pumping needs; an extra day to test, private testing room et al, i conclude that:

1. either Currier is far too high need and special case to be training in an appropriate field or

2. seeking further entitlement and attention, she's stormed a hill that will have negative backlash for many lactating women. or

3. both.

w n c

I completely agree it's unfortunate that this is on top of the other special arrangements in terms of it being a test case, because it makes it all too easy to assume that she's just working the system

So if that were not the case, if she were otherwise a normal testaker who had gone to court to seek break time to pump, would you think that was reasonable? I guess I'm just not clear how much of your reaction is that she as an individual is an entitlement junkie who is making us all look bad, versus that any woman asking for extra time to pump would us all look bad by asking for the accomodation.

Enjoying having this discussion with you, by the way, it's been a lot of food for thought!

why is there this general attitude that women who give birth are some golden category of sanctified human being deserving of unwavering accommodations? What does that say about those women who would rather dedicate themselves to a career?

this is a good question. if i were presenting a case for my own needs, i would need to pump every 3 hours for 15 minutes from the hours between 8 am and 2 pm. after that, i could stretch time for pumping to every 4 hours. that's one hour fifteen minutes of pumping throughout an 8 hour day. (i've been pumping 6 times a day for our special needs 15 month old baby since she's been born. in the early months, i pumped as much as 8 times a day. it was harrowing.)

but if i were allowed to complete any computer tasks while i pumped (as i often do, and as currier's test is administered on a computer terminal) i'd need no extra time to pump.

i understand my personal needs are not necessarilly difinitive. as a breastfeeding counselor, i have offered the conventional advice for "how often to pump at work?": if possible, the woman should pump according to her baby's nutritional needs. for instance, if the baby's caregiver indicates Baby sleeps a lot in the morning, but is hungry at 11 am and again at 12:30, the mother might try to match her pumping times to that as much as possible.

many babies' hunger, though, adjusts to the mother's work schedule. baby will take a bottle or two with the caregiver, but really want to nurse a LOT when its mother comes home. many working mothers find their babies get most of their nutrition nursing throughout the evening and night (or non-employment hours) because that's when mother is most available to baby.

if currier simply needed accomodations to aid her pumping, she already had that. if currier, in fact, needs, more than the generous concessions, she may be poorly suited for her career choice at this time. (as would i be. i'd make a piss-poor doctor at any time of my life. there's no personal idictment in my suggesting she's not suited for the research field to which she aspires.)

if currier doesn't really need the extra breaks to pump, and has made her case on principle or on entitlement, she's been very unwise. she hasn't done much to inspire the working/ academic public toward more sensitivity to the lactating woman. she also hasn't done much to make herself appear like a good employment choice. pro-breastfeeding as i am, i'd think thrice before hiring her.

thanks for the thoughtful exchange, bagel.

w n c

The accomodations NBME offered were not generous - she could pump in a video-monitered glass walled examination room during the test (since I don't like pumping in front of my mother I would find that completely unacceptable) or she could pump during her 45minute breaktime. Your post highlights the unique and very individual needs of a woman and her infant in terms of feeding/pumping and how these needs evolve with time.

The bottom line is that they did not accomodate her request for additional adequate time.

In my opinion Sophie is entitled -- entitled to breast feed in a way that meets the physiologic needs of her body and her infant. That does not make her a whiner who has ruined it for the rest of us. She is doing what any mama does -- going to bat for her baby and willing to take it as far as she needs to so that no other female medical student will have to endure such discrimination (and negative blogging, including your Dan Q. reference) if she needs accomodations to pump.

I'm surprised that with your understanding of breastfeeeding you are not more supportive of another woman's desire to adequately pump to maintain her milk supply. She asked for break time, not extra exam time. I'm surprised you aren't on Sophie's side of this.

On a separate note, what an awesome committment to pumping you've made. That's a lot of work.