Nursing Mothers Offered Additional Break Time During Testing

Natasha Sriraman, MD

Breastfeeding is good for infants and mothers. Countless studies in the U.S. and throughout the world support this. According to breastfeeding data from the Centers for Disease Control and Prevention, 75 percent of mothers in the U.S. initiate breastfeeding.

Advocating for children through the protection, promotion, and support of breastfeeding is a high priority for the AAP. Educating pediatricians to understand their role in encouraging and supporting breastfeeding is also essential.

It stands to reason, therefore, that pediatric organizations should support pediatricians who are, themselves, breastfeeding. The American Board of Pediatrics (ABP) reports in its annual workforce data book that nearly 71 percent of first-time takers of the initial certifying exam are women. In fact, more females than males are entering most pediatric subspecialties.

So how does the ABP support women physicians who are breastfeeding, as they prepare and take their required board exams? 


Gail McGuinness, MD, ABP Executive Vice President

The ABP allows courtesy accommodations for breastfeeding mothers during examinations at secure testing centers. The key is for the exam candidate to let the ABP know her needs when she applies to take an exam – long before the actual day of the exam.

The exam for general pediatric certification takes seven hours, and other exams, for subspecialties and maintenance of certification, take at least four hours to complete. We want these nursing mothers to be comfortable during the exam, so we allow them to take additional break time (30 extra minutes) to express milk.

We also offer a “personal item exception” to allow nursing mothers to bring aids (such as a breast pump), medication or other items into an examination room. Breast pumps may be stored in a personal locker, or stored at the testing center administrative desk.

We require that requests be made in writing at least eight weeks prior to the testing day so we can work out details with the testing center.

Breast Feeding Form | Personal Item Exception Form

The sooner the ABP staff knows a mother needs special accommodations, the better able we are to communicate this need to the secure testing center. Some testing centers have no dedicated space for breastfeeding mothers, while some centers are better suited for breastfeeding mothers than others. Occasionally, testing center staff have been able to repurpose space to accommodate breastfeeding mothers, or a candidate may be directed to a different testing center that can better serve her needs. Most major cities have multiple testing centers. When we know the needs in advance, we will work directly with the testing center staff to find the best arrangement for the testing candidate.

We know how important these accommodations are to mothers and infants and we are happy to work with our pediatrician mothers to help make arrangements for their breastfeeding needs.


About the AuthorsNatasha Sriraman, MD, MPH, FAAP, FABM

Natasha Sriraman, MD, MPH, FAAP, FABM is an Associate Professor of Pediatrics at Children’s Hospital of The King’s Daughters in Norfolk, Va. She previously served as Education Chair for the Section on Breastfeeding of the American Academy of Pediatrics (AAP) and as a board member and co-chapter breastfeeding coordinator for the Virginia AAP Chapter. For her work, she has received special recognition from the AAP for breastfeeding advocacy. She also was a board member and is active with Postpartum Support Virginia, working with the VA-AAP. She was a member of the strategic team that wrote the ABP’s MOC/QI breastfeeding on-line module. She is a board member and verification chair for the Academy of Breastfeeding Medicine and serves on the Board of For Kids, an organization in Coastal Virginia that breaks the cycle of homelessness and poverty for families and children.



ABP Executive VP Gail McGuinness, MD

Gail McGuinness, MD, is Executive Vice President of the American Board of Pediatrics (ABP). She is responsible for initial certification in both general pediatrics and its subspecialties. She provides oversight for the development of training standards, the tracking and evaluation of residents and fellows, and the credentialing for and administration of examinations. A member of the Board of Directors of both the ABP and the American Board of Medical Specialties, she is board certified and maintaining certification in general pediatrics and also is certified in neonatal perinatal medicine.