Archive | JHL article

Working and Breastfeeding: Can we do both?

With the known benefits of breastfeeding for the infant, mother, and employer, it is discouraging that most mothers who initiate breastfeeding quit before their infants’ first birthday. Among children born in 2008, only 44% were breastfed at 6 months and 24% at 12 months, even though 75% were breastfed after birth. Work-related issues can be a major reason why women fail to start breastfeeding after the birth of their child, or stop breastfeeding before the child has received the full benefits.  With more than 50% of mothers of infants participating in the work force, we need to find ways to balance employment and breastfeeding.

Our recent study found that women who were working full-time (≥35hrs/week) were less likely to initiate breastfeeding or to continue breastfeeding beyond 6 months, compared to women who were not working. The breastfeeding experience of women who worked part time was similar to that of women who were not working. We also found that mothers in professional occupations (architecture, engineering, legal, health care practitioner, etc) were more likely to initiate breastfeeding when compared to women in administrative occupations or other occupations (namely farming, fishing, and forestry; construction and extraction; installation, maintenance, and repair; production; transportation and material moving; and military-specific occupations), even after taking into account several factors known to be associated with breastfeeding, including the amount of maternity leave time taken.

The findings from our study, and others, suggest that part-time work offers an effective strategy for successfully combining breastfeeding and employment. There has been some success with corporate lactation support programs in helping working women breastfeed longer.  However, pumping alone at work may be inadequate to maintain milk flow because direct breastfeeding stimulates the breasts more effectively than do the best electric or manual pumps. Among women who breastfed and worked, women who directly breastfed their infant during the workday persisted in breastfeeding longer than other breastfeeding women who returned to work.

We recommend that employers, in addition to providing comprehensive, high-quality lactation support programs, explore strategies that allow lactating mothers have direct access to their babies. Such strategies, as promoted in the Surgeon General’s Call to Action to Support Breastfeeding, include having the mother keep the baby with her while she works, allowing the mother to go to the baby to breastfeed during the workday, telecommuting, offering flexible work schedules, maintaining part-time work schedules, and using on-site or nearby child care centers.  Because no single strategy will fit all employment settings, creativity is needed, especially for mothers who are not working in professional occupations. A woman’s decision to breastfeed, though personal, requires action from multiple players, if she is to succeed. Let’s act NOW!

Chinelo Ogbuanu, MD, MPH, PhD

Senior Maternal and Child Health Epidemiologist

Maternal and Child Health Program

Georgia Department of Public Health

chogbuanu@dhr.state.ga.us

 More information about our work is available in:

“Balancing Work and Family: Effect of Employment Characteristics on Breastfeeding”

J Hum Lact, August 2011; vol. 27, 3: pp. 225-238.

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The Breastfeeding Team

Fathers influence mothers’ breastfeeding decisions and experiences! Fathers’ perceptions of their roles as members of the breastfeeding family are probably important components of that influence. Previous studies asking men directly about their breastfeeding-related roles have predominantly focused on the “dark side” of the father’s experience – particularly their limited ability to nurture and bond with their babies. Our study more fully explored fathers’ experiences by interviewing twenty-one involved fathers of breastfeeding babies about fathering a breastfed baby and about their role in the breastfeeding family.

Fathers identified their unique roles as team members ensuring that their babies received the benefits of breastfeeding. When asked “What is it like to be the father of a breastfeeding baby?” fathers generally focused on the pleasure of knowing that their baby was obtaining the benefits of breastfeeding and their role in supporting the breastfeeding mother. They frequently used the term “we”, suggesting their roles as integral members of the breastfeeding team and characterized themselves as the supporting cast member to the mother’s starring role. One father summed up his role as “…a support person…almost like a checking line as opposed to scoring line. She’s doing the big good stuff and I’m just supporting her to get that done.”

A primary fathering role was supporting breastfeeding by learning about breastfeeding both with the mother and independently. Some fathers became the mother’s memory when she could not take in all the advice she was being given and others used their knowledge of breastfeeding resources to encourage mothers seek out professional breastfeeding support when needed. As well, many fathers supported breastfeeding by sharing housework and childcare and some provided assistance “in the breastfeeding moment” by facilitating mothers’ comfort during breastfeeding or assisting with the use of breastfeeding equipment.  Perhaps most importantly, fathers supported the breastfeeding mother by valuing her and by trusting, respecting, and supporting her personal choices.

Fathers insisted that being the father of a breastfeeding baby was not unique in general, but they often identified their own special ways of nurturing and fostering positive father-infant relationships as they “waited their turn” to bond with their babies through feeding. Some fathers chose to be involved while the mother was breastfeeding so that they could bond while the infant “is still in the feeding zone.” Others developed rituals for spending time with baby or found their own masculine way of nurturing, such as holding their infant with their strong arms and talking to the infant in their deeper voice. These supportive and nurturing behaviors were not seen as compensating for the “dark side” of breastfeeding, but as important contributions in their own right.

Many fathers want to be involved in the lives of their breastfeeding children. Health care providers should be encouraged to acknowledge fathers as members of the breastfeeding team and engage fathers in learning about breastfeeding and the many possible forms of breastfeeding support. Each father should be encouraged to communicate with his partner about her goals and desires for breastfeeding and regularly negotiate the type and amount of involvement both parents want the father to have. We suggest that fathers should be presented with the range of possible supportive behaviors and empowered to explore and determine their own unique roles as an integral part of the feeding process in which, although they may be the “supporting actor” and the mother the “star”, both roles are essential and worthy of acclaim.

Lynn Rempel, RN, PhD

Associate Professor, Chair,

Department of Nursing

Brock University

lrempel@brocku.ca

Rempel LA, Rempel, JK. The Breastfeeding Team: The Role of Seo Services Involved Fathers in the Breastfeeding Family J Hum Lact. 2011:27;115-121.

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