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Canada's Kim Gaucher attends a training session during the Tokyo 2020 Olympic Games at the Saitama Super Arena in Saitama on July 24. The International Olympic Committee's rule that no family could travel to Tokyo due to COVID-19 restrictions left Ms. Gaucher with having to choose between her sport and her baby. The IOC later allowed breastfeeding moms to bring their children to Tokyo.THOMAS COEX/AFP

Andrea Daly is a Toronto-trained cardiologist and mother of two young kids. She is completing a fellowship in critical care at Stanford University.

The electric breast pump was first invented in 1991. Yet 30 years later, mothers who breastfeed still struggle to find time and space to express breast milk at work. A recent uproar forced the International Olympic Committee to reverse a ban on women athletes bringing their nursing babies to Japan, which offered a high-profile example of the plight of breastfeeding moms who work.

Kim Gaucher was one of the mom-athletes affected by the IOC’s ridiculous baby ban. A 20-year veteran of the Canadian women’s basketball team, Ms. Gaucher returned to peak physical condition just months after giving birth to be ready for Tokyo, her third Olympic Games. Then the IOC informed her that she would not be allowed to bring her baby because of COVID-19 restrictions on family travelling with athletes, which essentially forced her to choose between her sport and her baby.

This choice between career and family is not unique to athletes. A 2016 American study found that a mere 40 per cent of mothers with babies had access to pumping spaces at work, and the proportion dropped considerably for Black and Hispanic women.

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In 2019, when I was in my second year of cardiology training, I did not even know what a breast pump was until well into my first pregnancy. Our baby registry was filled will cute bath-time items and swaddling blankets, but I quickly became aware of how important my pump would be. I had had the luxury of a mild oversupply and was able to build a freezer “stash” prior to returning to work. On returning to work at three months postpartum, my husband would feed our baby pumped breast milk throughout the days and nights I was at the hospital, and I would pump enough to replace that amount.

Maintaining supply requires pumping time, and finding the time and space to pump requires the support of employers. Pumping is less efficient than direct feeding and takes about 30 minutes, not including the time needed to gather supplies, find space and clean up afterwards. I felt fortunate when my division purchased a small fridge for my call room. When I moved to California to train in the intensive care unit, after the birth of my second child in 2020, I was at first excited to see a lactation room – but it was essentially a closet, lacking computers, phones or fridges. For an ICU doctor to be separated from their patients’ data, even for the 30 minutes it takes to pump, is unfeasible. Because I had good success with a wearable motorized pump, I just sat with the rest of my team and chimed in when someone would ask: “What is that noise?”

Women may need anywhere from two to five pump sessions daily, which can be a challenging time commitment in any work setting. This often leads to skipped pump sessions, which spirals into lower supply and the subsequent need for even more pump sessions to re-establish good supply. Missed sessions lead to clogged ducts and mastitis, an infection requiring antibiotics.

Wearable pumps fit in a bra and collect milk into the cups themselves, and they may have a small external motor the size of a hockey puck that clips onto a belt. But these pumps cost hundreds of dollars, they may not work for all women and they can make the logistics of pumping more challenging in the absence of a secure place to store them between sessions.

It doesn’t have to be this way. Pumping women need a private space to connect and disconnect from their pumps, an adjacent lockbox for the pump, a sink to clean the pump if desired, and a fridge to store milk. Pumping women would like their employers to understand the logistics of pumping and be supportive of this medical decision. I had moral support from colleagues and friends, but I primarily gained knowledge and resolve from a Facebook group for breastfeeding physicians, affectionately known as the Milkas, which has helped countless women navigate both big (how to establish supply with a preemie, for example) and small (forgot my pump charger) breastfeeding woes.

Thanks to overwhelming outcry, the IOC carved out an exemption for nursing babies at the Olympics and Ms. Gaucher brought her daughter to Tokyo. The ability to be both a breastfeeding mother and a working woman is not a case of trying to do it all; it is a fundamental right, not only for Olympians, but for all mothers and babies.

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