Lactation

Scope

This policy applies to Indiana University School of Medicine (IUSM) Graduate Medical Education (GME) residents.

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Policy Statement

In promoting a family-friendly work environment, IUSM GME recognizes the importance and benefits of breastfeeding for both parents and their infants. Each program, in partnership with the Sponsoring Institution and participating sites, must ensure healthy and safe learning and working environments that promote resident well-being and provide for clean and private lactation facilities. This includes providing protected time at regular intervals for pumping on all types of rotations and space for lactation that has refrigeration capabilities with proximity appropriate for safe patient care.

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Reason for Policy

This policy outlines the supportive environment provided by IUSM GME, IUSM, and hospital affiliates which enables a breastfeeding GME trainee to engage in the lactation process in the appropriate workplace setting in compliance with Indiana law (IC 5-10-6-2 and IC 22-2-14), federal regulations including the Fair Labor Standards Act and Pregnant Workers Fairness Act, and the ACGME.

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Procedures

The responsibility of the program, in partnership with the Sponsoring Institution, to address the needs of the lactating trainee must include:

• Create a program specific lactation policy. See Program Lactation Policy Template for a template.
• Provide information about medical coverage related to breast pumps (see Medical Benefits Related to Breast Pumps).
• Provide information about available spaces for lactation at IUSM and hospital affiliates (see Resource 1: Lactation Resources in the GME Resource Library).
• Provide information regarding options for protected time for lactating parents, working collaboratively with residents and supervising faculty to have a proactive plan in place to ensure residents who are lactating have protected time at regular intervals for pumping on all types of rotations, including inpatient, ambulatory, research, etc.
• Provide considerations for who can cover any direct patient care responsibilities during a trainee absence. To whatever extent possible, programs should proactively determine how direct patient care responsibilities (e.g., clinic slots, responding to an admission pager or urgent consult, etc.) could be covered during the pumping time.
  • Trainees should not have to “make up” time spent pumping unless there is a concern for meeting ACGME requirements. Programs should explore options for accommodations that would not significantly differentially impact the educational experience over the course of a year of lactation.
  • As possible, efforts should be made to avoid shifting significant additional work (e.g., additional clinic sessions, higher patient volumes, etc.) to other trainees or faculty.
• Provide information about accommodations during test taking (e.g., In-Service Exams, Board Exams, etc.).
• Provide lactation accommodations for each trainee until the trainee’s child is one year old. After that time, additional accommodations should be discussed on a case-by-case basis.
• Trainees with questions or concerns should first contact program leadership and, if necessary, the Office of Graduate Medical Education. For more information on raising concerns, see the IUSM GME policy on Teacher/Learner Conduct and Unprofessional Behavior.

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Definitions

ACGME is the Accreditation Council for Graduate Medical Education.

A resident is an IUSM resident or fellow, or a non-IUSM resident of fellow electively rotating through IUSM who provides clinical care as part of a GME program.

Lactation process is the ongoing process of milk production by the breasts. Human milk is produced on a constant basis, which means it needs to be expressed while the parent is separated from their infant.

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Implementation

The Designated Institutional Official (DIO) for Graduate Medical Education is responsible for implementation of this policy.

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Oversight

Policy Authority for this document resides with the Graduate Medical Education Committee. The DIO and the Graduate Medical Education Committee are responsible for oversight. The policy will be reviewed every three years or more often if deemed necessary.

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History

1. Policy approved by GMEC 15 January 2025.

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