This past weekend was the first time going to the field since my daughter was born in February.  Army regulations prevent units from having new moms go on overnight trips until your little one is over four months old. So as of June 13, I was on the list to head out to the field.  This weekends training schedule was packed, including bussing across the state and being the Officer in Charge (OIC) on the weapons qualification range.

Even without being a new mom, even for the second time, being the OIC of a range is an important responsibility that takes a lot of planning, coordination, management, and execution.  There are a lot of moving parts that go into making the range a success and accomplishing the mission.  But I also had another mission: pumping and saving enough milk for my baby girl.

I looked to one of my favorite resources on the subject: Breastfeeding in Combat Boots.  Robyn Roche Paul is the go-to resource when it comes to knowing about the tips and tricks for successfully breastfeeding in the military.  She has been a breastfeeding advocate since she herself became a mother while serving in the Navy, and has been an International Board Certified Lactation Consultant (IBCLC) since 2006.

My husband was able to find a plug in cooler at a garage sale a couple of months ago, and I originally planned on taking it with to store my milk in.  But after a test run last weekend, we discovered that it just wasn’t staying cold enough and it wasn’t going to the best choice for the logistics of taking it from our sleeping area to the range and back again. So then I started looking into taking some dry ice in a small picnic cooler.  I found a distributor nearby and they were really informative about how to use it – but they advised that I would need to check with the bus company that would be transporting us to verify that they would allow it on the bus.  Since the buses are contracted, I would need to talk to the actual bus driver that I would have on the day of and that just wasn’t information that I was able to track down.

So, my section NCOIC helped me to verify that they cooks for the unit would have ice on hand throughout the training exercise.  She chuckled a bit about it, but her daughters are actually my age and breastfeeding mothers themselves.  The morning of departure, I packed up a bag of ice from my own freezer and tucked it into my cooler. I also made sure I had a couple of special things in my pump bag to make sure that I would have smooth sailing all weekend.

1. Freemie  – These collection cups for my breast pump were a HUGE game changer.  I’m able to use them with my Medela pump as well as with their own model as well!  They tuck right into my bra so that I can pump discretely whenever, and wherever I can.  I just put them in place, and then I just pull my tan t-shirt back down and pull my ACU blouse back together so that you can hardly tell I’m pumping. The noise of my pump humming next to me is the only thing that gave me away a couple of times! I even pumped in the control tower of the range!  They are absolutely worth the investment.
2. Battery Pack – Medela has a battery pack that is compatible with their Pump in Style pump and this was amazing for pumping on the bus to and from our training.  It was a four hour bus ride each way, and it’s not always possible to pump right before boarding based on what is going on.  But with the battery pack I could pump anywhere that I needed to.
3. Power Adapter – I also made sure to tuck a power adapter into my bag just in case I needed to pump while in a vehicle I would be able to with ease.  I didn’t use it this weekend, but it has come in handy before and I definitely recommend every pumping mom have one in her bag!
4. Pacifier Wipes – There are some fancy wipes you can get for your pump parts for quick cleaning on the go. But when I checked out the ingredients compared to the equally fancy but much cheaper pacifier wipes available, they were very similar.  So when the best I can do is a quick wipe down this is what I use.  You don’t want your milk sitting in your pump parts out in the heat in the field, it’ll cause bacteria to grow.
5. The Basics – These are things I always have on hand including my breastmilk storage bags, permanent marker, and extra tubing.

I am very fortunate to be in a unit with many people who are supportive of me and other mothers in the unit that are on this pumping journey.  I was able to pump on the bus on the way to our training base, in the barracks, at the range, and on the way back as well.  There were some hiccups of course, but these have to be taken with a little grace and press on to not only accomplish my mission to nourish my daughter but also to accomplish the unit mission.

I missed a pumping session due to a required certification course with Range Control, and it made me anxious at the time and impatient to get to a place that was at least semi-private to pump.  I didn’t feel comfortable pumping in the van on the way back to the barracks because it was a packed full 12 passenger van but I just had to tell myself that I was already late pumping anyways and the extra ten minutes it would take to get there wasn’t going to make a huge difference.  When I got there, I was able to sit down and have a moment of quiet and pump.

The morning of the range, I woke up to pump and the milk started backing up into the tubing!! AHH!  It made me panic for a split second, but then I got my wits about me and disconnected the tubing before the milk reached the pump.  After calming down from my oh-my-gosh-my-pump-almost-just-got-milk-in-it moment.. I just took my pump cups and the tubing to the latrine, washed everything and started again.  And it was fine!

The Non Commissioned Officer in Charge (NCOIC) on the range with me was really supportive.  He had zero issues with my pumping in the tower, saying something to the effect of “Of course, it’s just natural!” After hearing so many stories of other Soldiers having unsupportive environments, it was a sigh of relief to just be able to do what I needed to do and take care of business.

Other tips:

• At breakfast and dinner each day I replaced the ice for my cooler and it worked out really well. But we were eating in a DFAC which made it a lot easier.  But our food service section told me that even if they had been cooking out of the MKT they could have helped me with ice.  Don’t be afraid of simply asking for what you need.  You might be surprised how supportive people can be with just a simple request!
• I ended up moving my pump from the normal pump bag into my assault pack so that it was easier to take with wherever I needed to go.  It helps decreasing the I’m-carrying-a-breastpump-everywhere feeling too.  Just another Soldier carrying around a normal assault pack.
• I used a pillow over the pump in the barracks after lights out and before wakeup to keep it from making too much noise and waking up the other Soldiers.
• I wore tank tops under my tan t-shirt to make sure that when I was getting my pump stuff set to go I wasn’t showing my stomach. That might not bother other people but I like to stay as covered up as possible especially at work, and it is also a good-will gesture to put others at ease who might be around when you need to pump.
• Stay flexible.  You might not always be able to pump in ideal conditions.  You might end up pumping in places you’d never expect, with people around.

The Army doesn’t have a regulation to protect the rights of breastfeeding mothers like the other services, so you have to be pro-active.  Instead of focusing on what the Army doesn’t spell out in writing, we can focus on the flexibility that we can have with it.  I’ve found a lot of success with being honest about what I need to accomplish my goals and frankly, not making it sound like a big deal.  I don’t ask permission to pump; I let people know that I need to go take care of something and I’ll be with them in about 15-20 minutes. If I have a meeting scheduled at the time that I normally pump, then I pump earlier or wait until after if I know for sure that it’ll be a short one.  The more natural we make it seem, the less it will phase others and the more pumping can be normalized.

Today marks the beginning of World Breastfeeding Week 2014!  The theme this year is “A Winning Goal for Life!” Every year thousands of mothers, lactation consultants, birth workers and more come together to celebrate the beautiful and natural act of breastfeeding, and to emphasize the importance of increasing and sustaining the protection, promotion and support of breastfeeding.

According to the World Health Organization (WHO), breastfeeding not only provides the best nutritional support for your child but it also enhances maternal bonding, stimulates psycho-social development, improves physical growth, reduces susceptibility to common childhood illness, improves immune system function, and also has long term benefits including increased performance and productivity and reduced risk of some non-communicable diseases.

The WHO recommends exclusive breastfeeding for at least six months, followed by continued breastfeeding while offering complementary foods for up to two years or beyond.  These goals may seem very doable for most women, but for working mothers and especially those in the military, it is very challenging.  In order to exclusively breastfeed for six months the WHO and UNICEF recommend several things:

• Initiation of breastfeeding within the first hour of life;
• Exclusive breastfeeding – that is, the infant only receives breastmilk without any additional food or drink, not even water;
• Breastfeeding on demand – that is, as often as the child wants, day and night;
• No use of bottles, teats or pacifiers.

Three of these recommendations present significant challenges for working mothers.

Exclusive breastfeeding – no formula – is the first.  Many working mothers, after returning to work from the extremely limited maternity leave find themselves in a rather awkward position of having to explain to their supervisor why it is important that she be permitted to use her breast pump every 2-3 hours for 20 minutes.  In the case of the military, the Air Force, Navy, Marines, and Coast Guard do have regulations in place to ensure that mothers are given these opportunities. However the Army does not.  So many mothers in the Army, when faced with resistance or are flat out told that they will not be permitted to pump due to “mission requirements,”  either give up pumping at work completely, or they pump as often as they can.  Usually once after physical fitness training (PT) in the morning, once at lunch, and then if they manage to get a break at some other time they do it then as well.  The result of these spontaneous pumping sessions is inevitably a reduction in milk supply, resulting in the use of formula to supplement.

The second challenge, nursing on demand, is closely tied to the first challenge.  In that, working mothers aren’t with their child throughout the day and therefore cannot do so.  If unable to pump at the same times that the child is eating, a decrease in supply occurs resulting in supplementation with formula.

Third, of course, is no use of bottles or pacifiers.  This is just not possible to do as a working mom.  The child has to use one or they wouldn’t be able to eat after the end of the maternity leave.

I was very fortunate in my breastfeeding journey with my son.  When I returned from my maternity leave, I also happened to be the Commander of my Army Company. I had my own office to provide privacy for pumping sessions, which I simply closed my door and ignored the knocks for 15 minutes.  When the new commander arrived, and I became the XO again,  we shared an office and it was a bit more challenging.  I decided to use the break room twice a day by putting a sign on the door to not be disturbed.  I also pumped in my car quite often.  Over my year of pumping I also pumped in several different types of vehicles (an LMTV, a HUMMWV, a TMP van) as well as the corner of a crowded training room while using a cover.  All not ideal places, but I kept myself covered and discrete as possible.

A great contributor to my success is also all about attitude.  The Army does not have a regulation to “approve” breastfeeding.  That also means that it doesn’t have a regulation that disapproves it either!  So when faced with opposition, I felt empowered to work with them to find a resolution that would enable me to continue to provide for my family – and my child – the very best that I could.

I may not have been able to pump every single time that I needed to, there were several times that hours had passed since a pumping session and I was stuck in a meeting that I couldn’t leave, but I always did when I could.  When my son was 10 months old we moved across the country to a schoolhouse environment and it became even more difficult. I didn’t want to be seen as having preferential treatment for pumping (also a common fear among breast feeding mothers in the military) so I would only pump after PT and at lunch.  As my supply decreased we did end up day weaning at one year. But a year of breastfeeding in the military is a huge milestone!  I’m proud of what we accomplished, even if it isn’t the two years that the WHO recommends.  If we could have gone longer, maybe we would have.

So this week, as you see working mothers passing by with newborns, infants, and even toddlers give them a little word of encouragement in their journey.  Because this is a tough road that we are on, and positive words mean a lot.  Encouraging breastfeeding is simply the right thing to do.

I would also like to thank the Lactation Consultants who helped us on our journey.  During the first eight weeks of my sons life, we had a really hard time with breastfeeding.  We were battling with thrush, latch issues, oversupply, reflux, and fast letdown.  Without the help of Dorothy, my lactation consultant “angel”, we probably wouldn’t have made it even past my six weeks of leave.

And another shout out to Robyn and her amazing book Breastfeeding in Combat Boots who gave tons of information on how to make it all happen while serving!  I was able to meet Robyntwo years ago when she came to speak at Madigan Army Medical Center, and she was very encouraging and positive.  She gave a wonderful presentation to the medical providers on why it is so important to encourage breastfeeding and how low the numbers are in the military compared to the civilian world.

An article released by the Navy Times today details plans regarding a bill introduced by Sen Claire McCaskill, D-Mo.,  that would require Tricare to cover breast pumps for Active Duty members as well as military dependents.  The Affordable Care Act, introduced in 2013 to improve healthcare nation wide currently requires insurance companies to cover the full cost of renting or buying pumps as well as lactation counseling and support.  However, as the single source for healthcare to military personnel, Tricare is exempt from this and most of the requirements of the ACA.  At this time, Tricare will only cover the cost of a pump for mothers of premature or at risk newborns.

As an active duty member, it was vital for me to have a quality pump to ensure that I could provide the nutrition needed to my son.  Without a pump, we would have spent hundreds of dollars on formula during his first year. This issue is near and dear to my heart, as many Soldiers do not have the funds to secure a pump and therefore rely upon the formula provided by programs like WIC.  By ensuring that medical equipment provisions through Tricare are on par with civilian counterparts, we will be able to ensure that our Soldiers are getting and giving the best care during the crucial first years of their children’s lives.

Senator McCaskill’s bill, S1994, is already drawing praise from the National Military Family Association, an advocacy group representing military dependents, retirees and families. “Ensuring that military health care benefits are on par with civilian coverage is one of our top priorities,” NMFA officials said.

Please contact your Senator, and let them know that you would like them to support S1994 and help military families obtain the same benefits that their civilian counterparts are already enjoying.