Working Women and Breastfeeding

It has been recognized that breastfeeding constitutes the best source of infant nourishment, functioning as nutrition as well as the "living fluid" imbued with a complex blend of enzymes, hormones, and antibodies, unique to the mother and her infant. Baby formula is unable to replicate the above essential substances. As breastfeeding is recognized as the superior mode of feeding infants, it must be protected, promoted and supported even among working mothers, after they return to their jobs. The WHO (World Health Organization) recommendation is that babies ought to be given nothing but breast milk until six months of age, with some amount of breastfeeding to be continued, at least till they reach two years of age (Deirdre Desmond & Sarah Meaney, 2016).

Breastfeeding at the Workplace

Breastfeeding rates in a majority of industrialized nations are generally below the desired levels. For instance, the 2002 U.S. estimate is that roughly seven in ten American mothers breastfed their babies in the hospital, but less than half this share (i.e., only 33%) were still feeding breast milk to their babies at six months (Abbott Laboratories, 2003). The British breastfeeding rate was 76% among just-born babies, with over 33% of mothers stopping breastfeeding by the time the baby was six weeks old. Workplace barriers may aggravate the issue and be a major contributor to a large number of working mothers' decision to prematurely quit breastfeeding. Public health drives focused at encouraging breastfeeding among working mothers call for breastfeeding support by employers, highlighting two major potential advantages to them. Firstly, absenteeism will reduce among breastfeeding moms, as breastfed infants' immune systems are stronger and they fall ill less often. Secondly, employee retention will improve among organizations supporting breastfeeding at the workplace. A key challenge, however, is the work setting's potential endogeneity, particularly that of facilities for breastfeeding. Women with high breastfeeding propensity may opt for jobs at workplaces that provide the facility to work and simultaneously breastfeed. If the above statement were true, our predictions of breastfeeding facilities' effect on returning to work as well as on breastfeeding would be upward-biased (Emilia Del Bono & Chiara Pronzato, 2012).

Job-holding among mothers, particularly full-time jobs, negatively affects breastfeeding duration. (However, breastfeeding initiation seems to be less deleteriously impacted by employment.) 35.5% of women with babies aged 0-12 months hold full-time jobs outside of home, while 16.1% hold part-time outside jobs. Meanwhile, 40% of women with babies aged 12-24 months hold full-time jobs outside of home, and 17% hold part-time outside jobs. Hence, improving mothers' breastfeeding ability, or that of expressing and storing milk, at workplaces, has the potential to improve breastfeeding rates in the nation. An analysis of females highly susceptible to premature quitting of breastfeeding revealed that mothers who planned on recommencing work full-time a month prior to really doing so were 1.34 times more likely to terminate breastfeeding than mothers who, in the very same period, didn't think of returning to their jobs. The odds rise to 2.18 times in the month of return to one's job, and drop to 1.32 times during the very first month of recommencing work. But during the second month, the likelihood of quitting breastfeeding doesn't vary significantly from that of non-working breastfeeding moms during the very same month. Hence, if workplace conditions promoted initiation and continuation of breastfeeding among mothers until the first two months of rejoining the organization, there is a greater likelihood of them extending their breastfeeding duration until the child turns one, at least (Lindsey Murtagh & Anthony D. Moulton, 2011).

Efforts to promote workplace breastfeeding are of three types: voluntary initiatives by the organization, governmental requirements and support, and support provided by private organizations/groups (including nonprofits). According to evidence, organizations can enjoy net economic advantages if they allow their female employees to combine breastfeeding and work. The "Business Case for Breastfeeding" initiative of the DHHS (Department of Health and Human Services) claims that, besides increasing experienced personnel's retention, breastfeeding decreases healthcare spending, boosts employee morale, improves organizational image, lowers absenteeism rates, and enhances productivity (Lindsey Murtagh & Anthony D. Moulton, 2011).

Challenges from Community

The key community-level breastfeeding obstacles may be classified under two broad heads.

Literature extensively documents male displeasure with breastfeeding being done in public. Some research works clearly reveal males' greater likelihood to disapprove, as compared to females (Avery, A. B. & Magnus, J. H., 2011). One important discovery that emerged after a focus group study performed in three major American cities was that African as well as Caucasian males and females expressed disapproval of public breastfeeding, with some males even accepting the incongruities between breast exposures in public within cultural contexts as opposed to exposure during breastfeeding.

Several researches with expecting mothers reveal that they expect being faced with challenges when it comes to breastfeeding their babies in public. One research work involved a number of females discussing modest and discreet breastfeeding when in public, and the widespread disapproval of blatant breastfeeding within public settings (G. Mackean & W. Spragins, 2012).

Workplace Support Laws

Three kinds of reactions have been witnessed among governments across the globe, with respect to the potential clash between breastfeeding and paid maternal employment. First, at least since the year 1919, workplace conditions have been regulated for offering maternity protection (e.g., mandating organizational provision of maternity leave). Secondly, laws fighting discrimination have imposed responsibilities on organizations to make arrangements for breastfeeding and lactation at the workplace. Lastly, governments have promoted the best breastfeeding support practices (including providing relevant education and support to interested organizations) (Julie Smith, et al., 2013).

1. The latest ILO (International Labor Organization) convention on maternity protection (C183) includes minimum workplace standards for paid maternity time-offs and lactation breaks.

2. Since somewhere during the mid-nineties, the public health policy of Australia has openly supported sustained and exclusive breastfeeding up to 6 months of age, a policy that has, of late, been reinforced by the nation's health ministers' ratification of the Australian National Breastfeeding Strategy.

3. Another Australian policy instrument that has effectively offered a certain measure of protection and support to breastfeeding working moms is its anti-discrimination legislation, in place since early in the '80s. Australian courts have largely considered breastfeeding a gender- or pregnancy- linked condition and, hence, has covered it broadly by provisions pertaining to discrimination in this regard.

Research and Expert Suggestions

Breastfeeding-friendly workplace policies of granting breast pumping breaks to female employees will go a long way towards increasing continued breastfeeding after mothers of infants return to work. Particularly, superiors' and coworkers' encouragement to working mothers to utilize these breaks has a significant impact on continued breastfeeding following recommencement of jobs. Furthermore, dedicated lactation rooms increase working mothers' readiness to continue breastfeeding. Therefore, management support and attitudes have an influence on working mothers' perceptions of breastfeeding support at the workplace. In breastfeeding-friendly organizations, comfortable, private lactation rooms constitute a crucial element (Su-Ying Tsai, 2013).

A study specific to breastfeeding moms who are nursing professionals revealed that they undergo intense emotional upheaval. While they are aware of the significance of breastfeeding as they belong to the health sector, they cannot effectively perform this task on account of their busy work schedules. The study highlighted nurse moms' recommendations and stressed their negative experiences in this regard. Positive as well as negative experiences are encountered, in general, and this is mediated by the health behaviors of mothers. Full-time working and breastfeeding moms find the experience rewarding, on the whole, and challenging as well (Naeem Zafar Sh. & Irma Bustamante-Gavino M, 2008).

Other Employees' Attitude

Over 50% of mothers having kids aged below 3 years are a part of the American workforce. Their postpartum return to jobs is usually coincident with breastfeeding cessation, indicating that mothers who work outside of their homes come across workplace-linked barriers to continuing breastfeeding. Hence, clearly, it is vital to accommodate lactation at workplaces. One of the goals of the nation's 'Healthy People 2010' initiative is to ensure half the nation's infants are breastfed until they reach six months, at least, and a fourth are breastfed till they turn one. Such accommodation may vary from sufficient milk-expressing breaks and designated lactation rooms to allow for pumping/nursing, to creches for facilitating breastfeeding and lactation service coverage within personnel health plans. A fear of harsh negative response from one's workforce is another obstacle to organizations' readiness to accommodate workplace breastfeeding (Kathryn Suyes, Sheryl W. Abrahams, & Miriam H. Labbok, 2008).

Conclusion

Promotion of breastfeeding represents a key public health intervention area, owing to low exclusive breastfeeding rates among the mothers of few-weeks-old babies. Breastfeeding intent forms the most crucial factor determining breastfeeding, especially exclusive breastfeeding. All the same, only a few women who wish to breastfeed can actually achieve their desired breastfeeding duration. Obstacles to breastfeeding reported by working mothers include age, maternal work, existing emotional support (particularly spousal support), planned pregnancy, maternal education and race. Tackling barriers using maternal education can help improve exclusive breastfeeding rates across the globe. According to the U.S. Breastfeeding Committee, exclusive breastfeeding-related fears and misperceptions hold mothers back from considering it. The Committee advised creating greater awareness of and attention to exclusive breastfeeding's significance, for promoting it. Lastly, researchers have proven that better-educated females will more likely exclusively-breastfeed their babies for longer periods as compared to less-educated ones (Uche H. Nnebe-Agumadu, Elizabeth F. Racine, Sarah B. Laditka, & Maren J. Coffman, 2016).

References

Abbott Laboratories (2003). "Mothers Survey," Ross Products Division: Abbott Laboratories

Avery, A. B., & Magnus, J. H. (2011). Expectant fathers' and mothers' perceptions of breastfeeding and formula feeding: a focus group study in three U.S. cities. Journal of Human Lactation, 147-154.

Deirdre Desmond, & Sarah Meaney. (2016). A qualitative study investigating the barriers to returning to work for breastfeeding mothers in Ireland. International Breastfeeding Journal, 11-16.

Emilia Del Bono, & Chiara Pronzato. (2012). Does breastfeeding support at work help mothers and employers at the same time? Institute for Social and Economic Research.

G. Mackean, & W. Spragins. (2012). The Challenges of Breastfeeding in a Complex World.

Julie Smith, Ellen Mcintyre, Lyn Craig, Sara Javanparast, Lyndall Strazdins, & Kate Mortensen. (2013). Workplace support, breastfeeding and health. Australian Institute of Family Studies, 58-73.

Kathryn Suyes, Sheryl W. Abrahams, & Miriam H. Labbok. (2008). Breastfeeding in the workplace: Other employees' attitudes towards services for lactating mothers. International Breastfeeding Journal, 3-25.

Lindsey Murtagh, & Anthony D. Moulton. (2011). Working Mothers, Breastfeeding, and the Law. American Journal of Public Health, 217-223.

Naeem Zafar Sh., & Irma Bustamante-Gavino M. (2008). Breastfeeding and working full time. International Journal of Caring Sciences, 132-139.

Su-Ying Tsai. (2013). Impact of a Breastfeeding-Friendly Workplace on an Employed Mother's Intention to Continue Breastfeeding After Returning to Work. Breastfeed Medical, 210-216.

Uche H. Nnebe-Agumadu, Elizabeth F. Racine, Sarah B. Laditka, & Maren J. Coffman. (2016). Associations between perceived value of exclusive breastfeeding among pregnant women in the United States and exclusive breastfeeding to three and six months postpartum: a prospective study and exclusive breastfeeding to three and six months postpartum: a. International Breastfeeding Journal.