Breastfeeding rates and duration are impacted by many factors. One of the main challenges women experience when aiming to meet their breastfeeding duration or exclusivity goals is the return to work process.
Some studies report rates of breastfeeding with respect to returning to work, while others have focused on women’s experiences during this transition. In this blog we will explore the research surrounding the topic.
What factors impact breastfeeding and returning to work?
A recent systematic review and meta-analysis on the subject focused on breastfeeding prevalence and duration reported by studies that collected data from mothers who were returning to work.
The meta-analysis results showed significant differences in breastfeeding prevalence after returning to work between different parts of the world. Middle eastern countries generally had lower rates of breastfeeding after returning to work while Oceania (data from Australia) had the highest. The UK, Europe and US landed in the middle. Despite these general patterns between continents, there was significant variation between individual countries, with rates of breastfeeding after returning to work ranging from 2% (in India) to 61% (in Thailand). The review noted that more research on the subject is needed as data was not available for many countries.
In a study completed in Scotland, certain employment factors showed associations with breastfeeding outcomes. Not surprisingly, longer maternity leave is associated with increased duration of breastfeeding. This was also a significant finding from a study completed in Taiwan. Full-time employment was associated with shorter breastfeeding durations, the association was smaller when employment was part-time and non-significant for self-employment, showing how flexibility positively impacts the situation.
Another review that explored the determinants of breastfeeding rates after returning to work in Europe found multiple impacting factors. Some supported what is outlined above, with self-employment and flexible (non-manual) roles being more protective of breastfeeding. And other factors encompassing the workplace environment and working conditions such as having lactation rooms, co-workers support and breastfeeding workplace policies were supportive of breastfeeding after returning to work.
What are the reported experiences of breastfeeding women when returning to work?
Current research is taking place at the University of Reading, in the UK. Their work is ongoing and their focus is on the experiences of breastfeeding mothers in the workplace as well as the perspectives of HR and line managers. Preliminary reports show women find the combination of returning to work and breastfeeding difficult, creating isolation and anxiety for some. They have reported physical issues such as drops in milk supply, mastitis and fatigue. The HR perspective has shed an additional insight to the issue, with only 23% of those interviewed reported having a breastfeeding policy in place.
A study conducted in Iran found experiences between women to be slightly mixed, but primarily challenging. Many reported feelings of guilt about leaving their babies and returning to work. Another common theme was having an unsupportive working environment. Some recalled instances of short break times, insufficient for a successful feeding session. Others reported feeling judgement and hostility from their colleagues around taking breaks to pump leading them to endure painful engorgement and negative impacts on their milk supply to avoid negative responses.
All participants in this study reported a need for improved policies around breastfeeding in the workplace. Some have requested reduced hours or more flexibility, but were met with resistance from employers because policies did not allow this. Others mentioned the national government policies that encouraged breastfeeding, but highlighted how these policies do not consider implementation in work places to enable continued breastfeeding for working mothers.
Another study completed in Australia in 2019 carried out a survey involving over 3000 participants. Women who had returned to work while breastfeeding in the previous 3 years were included. They reported differences among the group in terms of having confidence in maintaining breast milk supply as well as in meeting personal breastfeeding goals.
Factors that supported confidence in supply and meeting of breastfeeding goals included having a suitable place to express, having a set return to work plan, having a supportive workplace, returning to work after their exclusive breastfeeding period and finally having confidence to speak out about their rights.
Confidence to advocate for their rights was a reported theme in this study, and proved to be positively related to the rate of achieving breastfeeding goals. The authors of this study have noted that education and raising awareness of women’s rights to breastfeed or express at work can be beneficial in improving women’s experiences of breastfeeding and returning to work.
References
Brugaillères, P., Deguen, S., Lioret, S., Haidar, S., Delamaire, C., Counil, E., & Vandentorren, S. (2024). Maternal employment characteristics as a structural social determinant of breastfeeding after return to work in the European Region: a scoping review. International Breastfeeding Journal, 19(1), 38. https://doi.org/10.1186/s13006-024-00643-y
Burns, E., Elcombe, E., Pierce, H., Hugman, S., & Gannon, S. (2023). Breastfeeding after return to work: An Australian national workplace survey. Maternal & Child Nutrition, 19(3), e13516. https://doi.org/https://doi.org/10.1111/mcn.13516
Chuang, C.-H., Chang, P.-J., Chen, Y.-C., Hsieh, W.-S., Hurng, B.-S., Lin, S.-J., & Chen, P.-C. (2010). Maternal return to work and breastfeeding: A population-based cohort study. International Journal of Nursing Studies, 47(4), 461-474. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2009.09.003
Dutheil, F., Méchin, G., Vorilhon, P., Benson, A. C., Bottet, A., Clinchamps, M.,…Navel, V. (2021). Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(16), 8631.
Skafida, V. (2012). Juggling work and motherhood: the impact of employment and maternity leave on breastfeeding duration: a survival analysis on Growing Up in Scotland data. Matern Child Health J, 16(2), 519-527. https://doi.org/10.1007/s10995-011-0743-7
Valizadeh, S., Hosseinzadeh, M., Mohammadi, E., Hassankhani, H., M. Fooladi, M., & Schmied, V. (2017). Addressing barriers to health: Experiences of breastfeeding mothers after returning to work. Nursing & Health Sciences, 19(1), 105-111. https://doi.org/https://doi.org/10.1111/nhs.12324
