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Old 09-26-2007, 02:00 PM   #1
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We're due for a breast feeding discussion

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BOSTON --A Harvard student must be allowed extra break time during her nine-hour medical licensing exam so she can pump breast milk to feed her 4-month-old daughter, a Massachusetts appeals court judge ruled Wednesday.

Sophie Currier, 33, sued after the National Board of Medical Examiners turned down her request to take more than the standard 45 minutes in breaks during the exam. She said she risks medical complications, including engorgement and inflammation, if she does not nurse her daughter, Lea, or pump breast milk every two to three hours.

A Superior Court judge last week rejected Currier's request to order the board to give her an additional 60 minutes of break time. Appeals Court Judge Gary Katzmann overturned that ruling, finding that Currier needs the extra break time to put her on "equal footing" with the men and non-lactating women who take the exam.

The board had cited the need to be consistent in the amount of break time given and said other nursing mothers who have taken the exam have found 45 minutes in breaks sufficient.

But Katzmann said that amount of break time was "insufficient" for Currier to nurse her baby, properly express breast milk, eat, drink and use the restroom over the course of the nine-hour exam.

Without extra break time, Currier would have to choose between pumping breast milk and ignoring her bodily functions or foregoing pumping and causing herself significant pain, the judge said.

"Under either avenue, (Currier) is placed at significant disadvantage in comparison to her peers," Katzmann wrote in his 26-page ruling.

Calls to Currier, her lawyer and an attorney for the board were not immediately returned.

Currier, of Brookline, has finished a joint M.D.-Ph.D. program at Harvard University while having two babies in the past two years. She has been offered a residency in clinical pathology at Massachusetts General Hospital beginning in November, but cannot accept it unless she passes the test. Her goal is a career in medical research.

Currier took the exam in April when she was 8 1/2 months pregnant, but failed by a few points. She had planned to take the test again earlier this week, but put it off after Norfolk Superior Court Judge Patrick Brady ruled against her last week.

Currier, who also has a 22-month-old son, already has received special accommodations under the Americans with Disabilities Act for dyslexia and attention deficit hyperactivity disorder, including permission to take the test over two days instead of one.
I understand the need for extra time, which she's been given. The NBME has already compromised with her, but it seems like she is just being unreasonable. I've never been a nursing mother, but it seems a little far fetched that if she doesn't breast feed every 2 or 3 hours that she'll be in pain. If that's true, then she must never sleep for longer amounts of time than that. If she had just passed the exam the first time, then there would have been no issue.
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Old 09-26-2007, 02:12 PM   #2
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They used the word "engorgement". Cool!


Seriously, if she'd only passed the bloody test the first time, this would've never happened.
Also, when she goes to sleep at night, maybe she wakes up every 2 or 3 hours and pumps her breasts. Or maybe her husband does it for her.
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Old 09-26-2007, 03:47 PM   #3
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I guess it depends whether your attitude towards her situation is more characterized by "Put up or shut up--lots of nursing moms do, and it's just a one-time test" or "No one should be forced by their school or employer to accept significant physical discomfort as the price of nursing while studying or working, period."

As far as whether her characterization of her needs is unreasonable, that's hard to say, because every mother's experience is different. For many women, waiting 4-1/2 hours for a break long enough to pump milk falls into the 'somewhat unpleasant, but doable' category. Others would be in quite a bit of pain by that point. If the woman has a history of mastitis, and has typically been nursing her baby every 2-3 hours, then she definitely shouldn't wait that long, whether the pain is bad or not. Just because she normally nurses every 2-3 hours during the day doesn't necessarily mean she does so at night--if the baby is routinely sleeping through most of the night, but still wants to nurse frequently during the day, then the mother's lactation cycle will adapt to that, though that doesn't happen instantaneously or at will. Similarly, with pumping, different women release milk at different rates. For some, 15 minutes with a standard hospital-grade electric pump is perfectly adequate; for others, it takes 30. (There are a lot of working nursing mothers whose "lunch break" consists of hurrying to the handicapped stall in the nearest public restroom, sitting on the toilet, and pumping with one hand while eating a sandwich with the other so as to make it back to their workstation in time.)

My guess is that anyone who's managed to simultaneously do med school and earn a PhD while giving birth to and parenting two children is not the lazy whiner type. But again, every woman's body is different and who's to say previous nursing moms who took the test didn't successfully handle comparable levels of discomfort and time stress without major issues. It just depends on whether you think their experiences, or her and her doctor's estimation of her own particular needs, should be the yardstick.
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Old 09-26-2007, 04:07 PM   #4
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I was thinking of the news story where the mothers had a nurse in protest at an Applebee's after one woman was asked to cover her breast- and therefore the baby's head- with a towel. She said it was cruel to the baby. I disagree. Nursing mothers in public are not ok IMO and if they are, might as well let every girl and woman expose their breasts in the mall. I know a lot of people who nurse and they squeeze the milk into bottles for when they have to be in public. I don't want to sound rude but it's gross. I don't want to be in a resturant and see some woman's boob getting sucked, which is essentially what it is. How is a kid sitting in that resturant seeing a naked boob like this okay and not in a Playboy? It's still there, and doesn't belong in public view, sorry. Bring a bottle or cover with a towel in the name of decency.
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Old 09-26-2007, 04:14 PM   #5
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Quote:
Originally posted by Butterscotch
I was thinking of the news story where the mothers had a nurse in protest at an Applebee's after one woman was asked to cover her breast- and therefore the baby's head- with a towel. She said it was cruel to the baby. I disagree. Nursing mothers in public are not ok .
So nursing mothers should be forced to stay in while the child is still at the breast feeding stage? Wow, how very 1950's of you.

Just given some of the things you said in your post, you know very little about breast feeding.

Please tell me the original reason for breasts. Playboy or feeding? Don't answer that, it will just make your logic look ridiculous.
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Old 09-26-2007, 04:32 PM   #6
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Quote:
Originally posted by BonoVoxSupastar


So nursing mothers should be forced to stay in while the child is still at the breast feeding stage? Wow, how very 1950's of you.

Just given some of the things you said in your post, you know very little about breast feeding.

Please tell me the original reason for breasts. Playboy or feeding? Don't answer that, it will just make your logic look ridiculous.
You look ridiculous because you obviously ignored the rest of my post which said

I know a lot of people who nurse and they squeeze the milk into bottles for when they have to be in public.

and nothing looks more ridiculous than a bare boob hanging out in public. There is no problem as long as they cover it up, if they refuse to use the breast pump and temporary bottles as my friends and coworkers do.

I wonder if most men even realize there is such a thing as a breast pump and bottles of breast milk saved and used in public. It's a very popular practice. Also working mothers use this practice so their babies can have their breast milk while at the sitter's. There are other things a woman can do.
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Old 09-26-2007, 04:38 PM   #7
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A "woman's boob getting sucked" is a natural human function, there's nothing sexual or "dirty" about it. It's a breast and it's breastfeeding. We have had that discussion here several times, a search could bring up a few threads. Some women pump milk for convenience, and maybe some are uncomfortable breastfeeding in public. But that is their choice, just like it is the choice of others to do it. I have never seen a woman do it in public while baring her entire breast, most women are extremely discreet about it.

I believe this woman does have mastitis, it was on a tv news story I saw about this case.
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Old 09-26-2007, 04:45 PM   #8
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Breastfeeding in public has absolutely zero to do with the case at hand--let's leave that for other threads, please.
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Old 09-26-2007, 05:07 PM   #9
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Quote:
Originally posted by Butterscotch


You look ridiculous because you obviously ignored the rest of my post which said

I know a lot of people who nurse and they squeeze the milk into bottles for when they have to be in public.

Well that was the comment that made me think you didn't know much about breast feeding, for breast pumps are the norm these days, and not just "sqeezing it into bottles." But I'm glad you know something about it. You still don't seem to understand the original purpose of breasts and the issues dealing with this paticular case.
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Old 09-26-2007, 05:35 PM   #10
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Quote:
Originally posted by yolland
My guess is that anyone who's managed to simultaneously do med school and earn a PhD while giving birth to and parenting two children is not the lazy whiner type. But again, every woman's body is different and who's to say previous nursing moms who took the test didn't successfully handle comparable levels of discomfort and time stress without major issues. It just depends on whether you think their experiences, or her and her doctor's estimation of her own particular needs, should be the yardstick.
I respect what she's managed to accomplish, but it seems like she is not willing to give an inch here. Mutliple concessions have been made to her such as the extended breaks and taking the test over two days, but for whatever reason this isn't good enough. I think that most people would've been satisfied with the concessions. So it's not a case of the NBME not caring about her case or being ironclad in their policies.

Another thing, what's wrong with waiting until you can go a little longer without breast feeding to take the test? It may be apples and oranges here, but if someone has a "medical condition" that interferes with taking the test - case of Mono, flu, whatever condition, then they don't take the test at that time. You don't go asking for all these concessions.

Granted, I have no idea what her medical condition, but this case just doesn't sit well with me. I fully admit I'm judging her here, but she has a history of milking her conditions for everything it's worth. She had students read her textbooks to her at MIT, getting the extra days, etc. It baffles me how she already has a residency at Harvard lined up since she's already failed this test once - a test to demonstrate minimum competentcy. I'd also like to know why, with having such bad ADHD, she's going in pathology - it's one of the most tedious specialties out there.

If she takes this test in the next couple of weeks and got all the time she needed, it would be some poetic justice if she failed it again because she spent too much time on this case rather than studying.
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Old 09-26-2007, 06:22 PM   #11
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Quote:
Originally posted by randhail


I respect what she's managed to accomplish, but it seems like she is not willing to give an inch here. Mutliple concessions have been made to her such as the extended breaks and taking the test over two days, but for whatever reason this isn't good enough. I think that most people would've been satisfied with the concessions. So it's not a case of the NBME not caring about her case or being ironclad in their policies.
So what would you suggest?


Quote:
Originally posted by randhail

Another thing, what's wrong with waiting until you can go a little longer without breast feeding to take the test? It may be apples and oranges here, but if someone has a "medical condition" that interferes with taking the test - case of Mono, flu, whatever condition, then they don't take the test at that time. You don't go asking for all these concessions.
Yeah, it is apples and oranges. Breastfeeding isn't contageous...
Quote:
Originally posted by randhail

Granted, I have no idea what her medical condition, but this case just doesn't sit well with me. I fully admit I'm judging her here, but she has a history of milking her conditions for everything it's worth. She had students read her textbooks to her at MIT, getting the extra days, etc. It baffles me how she already has a residency at Harvard lined up since she's already failed this test once - a test to demonstrate minimum competentcy. I'd also like to know why, with having such bad ADHD, she's going in pathology - it's one of the most tedious specialties out there.

If she takes this test in the next couple of weeks and got all the time she needed, it would be some poetic justice if she failed it again because she spent too much time on this case rather than studying.
What's her history of milking her conditions? I didn't see anything about people having to read to her, etc... Normally people with ADHD can't take their meds while pregnant or breastfeeding.
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Old 09-26-2007, 06:32 PM   #12
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It's hard to tell, having never breastfed, but 45 minutes sounds reasonable to me to finish doing that and eat. These are stressful exam times. My friends who sat the Bar ate their sandwiches in 15 minutes. It's not a day where you'll do anything in a leisurely way. So I don't really understand why she'd need 60 minutes, honestly. I've never breastfed, but I've seen plenty of women who have, and it didn't take that long. And honestly if she needs to finish eating in 10 minutes and that's quick, well, yeah suck it up, in a sense. I just don't really see that as a reason to litigate to the appellate level - what a waste of our judiciary, honestly.

Maybe somebody here who has breastfed can comment on the timing of it (is it doable in 45 minutes with a quick lunch), because I really have no way to evaluate.
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Old 09-26-2007, 06:58 PM   #13
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Quote:
Originally posted by BonoVoxSupastar

So what would you suggest?

What's her history of milking her conditions? I didn't see anything about people having to read to her, etc... Normally people with ADHD can't take their meds while pregnant or breastfeeding.
Honestly, I feel like the NBME has done enough. So either she take what they gave them or wait until she can go longer periods without breast feeding. It's not like she needs to take this today because residency doesn't start until July 1.

Quote:
Sophie Currier made it through MIT -- brilliantly -- in part because the school paid other students to read books to her and share their class notes.

By the time she was in graduate school, MIT provided computers that scanned books and read them aloud to Currier; she was also allowed extra time on exams.


[url]http://www.boston.com/yourlife/health/diseases/articles/2006/06/26/hyperactive_adults_need_help_too/?page=3[url]
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Old 09-26-2007, 07:48 PM   #14
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Thanks for the clarification...

To be honest I really can't say anything more, she seems to have a lot going against her and seems to be doing it all at one time... Maybe she doesn't need to recognise the limits she has here...
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Old 09-26-2007, 07:54 PM   #15
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Quote:
Originally posted by Butterscotch
I was thinking of the news story where the mothers had a nurse in protest at an Applebee's after one woman was asked to cover her breast- and therefore the baby's head- with a towel. She said it was cruel to the baby. I disagree. Nursing mothers in public are not ok IMO and if they are, might as well let every girl and woman expose their breasts in the mall. I know a lot of people who nurse and they squeeze the milk into bottles for when they have to be in public. I don't want to sound rude but it's gross. I don't want to be in a resturant and see some woman's boob getting sucked, which is essentially what it is. How is a kid sitting in that resturant seeing a naked boob like this okay and not in a Playboy? It's still there, and doesn't belong in public view, sorry. Bring a bottle or cover with a towel in the name of decency.
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