Breast-feeding Mom's War Over Pumping

June 29, 2007 — -- Sophie Currier of Brookline, Mass., is one of those talented, overachieving women we all love to hate. She spent eight years at Harvard working on a combined M.D.-Ph.D. degree, receiving exemplary grades even though she struggles with dyslexia and attention deficit hyperactivity disorder. Oh, and during that time, she also had two children. The youngest, Lea, is just 8 weeks old.

But before Currier launches her medical career, she must pass a daylong exam run by the National Board of Medical Examiners. And that's proving to be a bit of a problem for this nursing mother.

Currier breast-feeds her daughter every few hours -- around the clock. And if she can't be with her daughter, Currier uses a breast pump to keep up her milk supply. But the nine-hour exam includes only a total of 45 minutes break time throughout the day. So Currier requested some extra time to accommodate her nursing needs. The board said no.

Medical experts agree that if a nursing mother doesn't express her milk -- even for a day -- her supply could begin to dry up, her breasts will engorge and she could develop a painful infection called mastitis.

"I think it's infuriating and amazing and I'm appalled," said Currier. "All the literature says there are health benefits to nursing. I'm just asking for a little extra break time so I can pump my milk. The thing is, if I had a broken arm they would make accommodations for me, but not for breast-feeding. It's ridiculous."

Catherine Farmer, of the National Board of Medical Examiners, responded in a faxed statement: "We do provide a wide variety of accommodations to test-takers with documented disabilities under the Americans With Disabilities Act."

But maintaining a milk supply for a hungry baby isn't a disability under the ADA.

Currier said the NBME hasn't responded to her repeated requests to discuss the issue. But the board did tell her it's had very few -- if any -- requests to accommodate nursing mothers, despite administering the exam more than 125,000 times in 2006.

"Something like 55 percent of all medical students are women, so I don't believe this has never come up before; this isn't just about me," said Currier.

Audrey McCandless agrees. McCandless is a fourth-year medical student at Ohio State. She is 6 ½ months pregnant and will have to take a daylong clinical skills test after her baby is born. McCandless was stunned to hear she might be facing a no-pump policy herself in a few months.

"You know, most of the problem that comes with breast-feeding in public is ignorance," McCandless told ABC News. "But that doesn't seem to be the case here. They're supposed to be medical professionals. They should be encouraging, not putting up barriers."

The American Medical Association's policy states: "Our AMA encourages all medical schools and graduate medical education programs to support all residents, medical students and faculty who provide breast milk for their infants, including appropriate time and facilities to express and store milk during the working day."

But, it seems, the testing centers aren't governed by this policy.

In commenting on Currier's situation, Catherine Farmer of the NBME wrote: "Given the high stakes involved, those of public safety, the fairness and validity of the exam are extremely important."

"Is she going to have the answers written on the side of the breast pump? I don't think so," said Dr. Ruth Lawrence, who has spent the past 15 years educating the medical profession about breast-feeding through the Academy of Breast Feeding Medicine, an organization she helped create. "If she can't pump it, that could put her milk supply at risk and definitely make things very uncomfortable for her. They say nursing is not on the ADA list. Well, a lot of things aren't on the ADA list."

Lawrence also wonders who is ultimately responsible for the policies at the National Board of Medical Examiners. "I don't know if this is a doctor making decisions or more of a bureaucrat." The NBME is listed as a nonprofit organization. The approximately 80 people on the board aren't listed on the organization's Web site, and a spokesperson declined to provide names of the members.

Currier's plight has not only got medical professionals talking, it's generating opinionated posts on Internet message boards.

On MomMD, female med students have been sharing their pumping horror stories -- failed batteries, pumping in supply closets and delayed tests causing pumping panic. KL writes: "By the end of my Step CS (medical exam) I was almost in tears." She advises to "Test your pump equipment early -- and have several back-up plans (I did not have a car-charger for my pump!)."

Rock_See, however, thinks this is much ado about nothing. "It was uncomfortable, but I did it and it didn't kill me."

On Boston.com, the message board about Currier's plight has logged more than 3,000 page views -- no other issue even comes close to that many views. One comment reads: "Get over yourself. Breast-feeding doesn't entitle you to special treatment." And another woman writes: "I think professional women who whine about things like this give the rest of us a bad name."

Currier is now in a time crunch because she has to take the exam before she begins her residency at Massachusetts General Hospital in November. And she has already failed the exam once. The NBME is accommodating her dyslexia by giving her two days to finish the test instead of one. But for a nursing mother, that's just double the trouble.

For her part, Lea spends her days like most infants -- eating and sleeping -- blissfully unaware of the controversy swirling around her.