Implementing a Clinic Schedule with Protected Lactation Break Time Helps Neurology Residents Achieve Lactation Goals.

Introduction: Lactating physicians face considerable challenges in achieving lactation goals due to inflexible schedules and a lack of break time. While federal mandates have outlined the necessity of lactation breaks, the frequency and duration of breaks are unspecified. The objective of this study was to fill this gap by designing and implementing an outpatient neurology resident clinic schedule with protected lactation breaks, ensuring support and quality of trainees' educational experience. Methods: This quality improvement study began with developing a prototype schedule with input from lactating physicians, a lactation consultant, and neurology residency program leadership. Neurology residents and fellows with prior lactation experience were surveyed to determine if the proposed schedule would have fit their individual needs. The clinic schedule with protected lactation break time was then implemented, and lactating neurology residents were surveyed regarding their experience. Results: Eleven previously lactating neurology residents and fellows who were surveyed about the proposed schedule agreed that the prototype schedule would suffice for their personal lactation needs. The clinic schedule was implemented for 5 neurology residents returning from maternity leave in 2022 to 2023, and 4 residents completed a survey of their experience. There was unanimous agreement that protected lactation breaks helped residents achieve their lactation goals and strongly benefited work/life balance and overall well-being. Despite this intervention, 75% of respondents stopped breastfeeding earlier than intended, and 100% of respondents experienced complications perceived to be related to inadequate pumping, such as diminished milk supply. Ongoing barriers to achieving breastfeeding goals included work interrupting lactation breaks, lack of lactation rooms, and lack of computer workstations in lactation rooms. Conclusions: Inclusion of protected lactation breaks in outpatient clinic schedules helped neurology residents achieve their lactation goals as well as promoted work/life balance and overall well-being. However, more work is needed to address other barriers to achieving lactation goals.