VCU news

By Brian McNeill

For their capstone project in the master’s degree in adult learning program at the School of Education at Virginia Commonwealth University, a team of six students explored the question of whether working mothers at VCU Health were being properly protected, supported and empowered to express breast milk while at work.

The students interviewed dozens of VCU Health employees, researched federal and state law, gathered data, identified lactation guidelines at other workplaces, and ultimately drafted a set of recommendations — the first of which was to encourage VCU Health to adopt a lactation support policy.

On June 1 — thanks in large part to the project — VCU Health implemented a Team Member Lactation Support Policy that provides guidelines and resources for its employees on expressing breast milk in the workplace during working hours.

“The work on this project has been so energizing,” said Kirsten Olsen, one of the students who worked on the project. “The whole process of learning how to work as an integrated team was truly a gift. Researching together what should be a priority in the work, disagreeing on what should be a priority and learning how to reshape those conflicts into moments of discovery and forward movement is a skill that cannot be learned alone. I am forever grateful to all the members of the capstone team.”

In addition to Olsen, the team included Anna Clark, Brett Currie, Tasia Thompson, Sheila Regan and Beth Marcus.

While working on their project, titled “Are Working Mothers at VCU Health Properly and Effectively Protected, Promoted, Supported, Educated, and Empowered in Their Lactation Efforts?” the students were linked up with Valerie Coleman, head of lactation services for VCU Health, who served as their sponsor.

“Their work provided a solid rationale for the need for such a policy to protect women from discrimination when requesting a clean, safe space, and the time, to maintain their milk supply by pumping,” Coleman said. “Their research showed that many women were not able to reach their breastfeeding goals by lack of support and resources when returning to work. As of June 1, 2021, there are laws in place, both state and federal, mandating compliance and our policies should align with the evidence and the law.”

VCU Health’s new policy, Coleman said, will promote, protect and support breastfeeding.

“Science overwhelmingly indicates human milk is nutritionally the best for human infants,” Coleman said. “One goal is to protect the gut flora, the super genome of the gut, the microbiome. Artificial milk substitutes or milk from another species (cows) sensitizes the gut before it is ready to easily digest substances other than human milk. Infants who do not get human milk are at an increased risk for ear infection, eczema, diarrhea and vomiting, hospitalization for respiratory tract diseases within the first year, asthma, allergies, obesity diabetes, leukemia and SIDS (sudden infant death syndrome). Women who do not breastfeed are at increased risk for breast and ovarian cancer, metabolic syndrome, postpartum depression, osteoporosis, osteoarthritis, diabetes and high blood pressure and heart disease.”

Breastfeeding is the single most effective intervention to improve chronic and acute health outcomes, she said, and it has a significant impact on the health trajectory of women’s and children’s lives.

The capstone project, Coleman said, ignited a process that led to VCU Health’s implementation of the new policy.

“The students laid the groundwork in identifying in our own backyard obstacles women had to deal with and the lack of awareness of many people in supervisory roles of the compliance issues,” she said. “They toured the pump room spaces provided on the medical campus and interviewed women to gather primary data. They were innovative and energized.”

The new policy outlines several responsibilities on the part of the health system and its employees to provide a supportive environment that enables lactating team members to express milk.

It provides guidelines on giving team members reasonable breaks to express milk, as well as a clean, private place to express milk that is not a restroom and that is located near the team member’s work area. It also has guidelines to allow members to store expressed milk in workplace refrigerators or in personal coolers.

The policy also requires team members who wish to express milk during work hours to keep managers informed of their needs so they can work collaboratively to coordinate reasonable accommodations. And it explains that team members are expected to do their part in helping to keep lactation rooms clean.

Olsen, a Pregnancy and Parenting Partnership program manager in the Department of Obstetrics and Gynecology in the VCU School of Medicine, came up with the idea for the capstone project to focus on VCU Health and lactation support.

The idea came out of another research project Olsen had conducted around the psychographic effects of the marketing of infant feeding. As part of the initial research, Olsen interviewed pregnant women who work at VCU Health, many of whom expressed anxiety about being supported in their lactation needs when returning to work. Olsen suggested further researching lactation support at VCU Health. She presented the topic to the capstone group, and they voted to pursue the project under the supervision of Robin Hurst, Ed.D., an associate professor in the School of Education.

“The students had a choice of assignments, and chose this to investigate. It was a remarkable effort on their part, and they concluded their study in one semester,” Hurst said. “They were very focused and determined during the semester to discover what VCU Health offered their lactating employees.”

The students’ project, Hurst added, is a great example of the “action learning” process that has been a cornerstone of adult learning graduate students at VCU for four decades.

“The action learning process revolves around asking questions, and not just any questions but tough, and often fresh, questions to uncover problems,” Hurst said. “The students work with informants, as well as among themselves to analyze the problem and responses, and provide suggestions and recommendations on how to address the problem.”

In Olsen’s case, the work didn’t stop after the capstone project was turned in. In spring 2020, Olsen and Coleman gave a presentation to a VCU Health Human Resources work group that outlined the need for a policy. Shortly thereafter, COVID-19 shut down everything. But the HR group began meeting later in the summer, and Olsen worked with them.

They met weekly, working with and getting approval from various divisions at VCU Health, including facilities, legal, risk management and leadership. HR also developed learning modules to train VCU Health team members on the new policy.

“It was announced that it was going live and it is now policy at VCU Health,” Olsen said. “As of June 1, we have a lactation policy and learning exchange modules.”

In the weeks since then, Olsen said, other schools at VCU have reached out to express interest in adopting a similar policy.

“If you do take the time to kind of create something like this and do all the work that has to go into it, then it’s replicable,” she said. “Somebody else can just be like, ‘Oh, sweet. You have a policy and it’s already been vetted by risk management? Perfect. We’ll just put it into place.’ It can just be replicated across the system.”