To describe implementation of a lactation policy in a large academic neurology department, with focus on needs assessment, rationale for change, and practical interventions.

The WHO and AAP strongly recommend breastfeeding when able and desired. Studies of physician mothers identify work-related factors that hinder breastfeeding: lack of time, space, and supportive culture. The authors aimed to investigate and address such barriers in the workplace.

In 2022, the authors anonymously surveyed clinical and research faculty in their department. 66% of respondents who previously or currently breastfed reported discomfort when discussing lactation accommodations with supervisors. Qualitative data described concerns about financial disincentives of pumping, inadequate lactation facilities, and subsequent stress and isolation. Literature demonstrating the organizational value of investment in corporate lactation policies was compiled. Data from the survey and literature were presented to departmental leadership.

The impact was twofold: Leaders were convinced of the gravity of the problem and the value of prompt intervention. The authors proposed and implemented the following policy: (1) To protect time for pumping and mitigate impacts on compensation, for one year postpartum the wRVU (work relative value unit) target was decreased by 15% and/or research salary was supported up to 15%. (2) Division chiefs and expecting faculty were given written guidance for discussing schedule adjustments. (3) List of lactation rooms and logistical info was posted in the department’s cloud. (4) Lactation policy was discussed at multiple faculty meetings. Outcome: Upon initiation, there was widespread positive feedback. Department leadership felt the financial impact of the policy was justified. Surveys of breastfeeding faculty were deferred due to risk of de-anonymization.

The literature supports the value of workplace lactation policies. Academic medicine departments can tailor such policies to address concerns around financial equity and wellbeing. Anonymous surveys may be key to demonstrating need and determining impactful solutions.