A mother deciding whether to breastfeed and for how long faces many questions. Does she understand its benefits and challenges? Will she come back to a conducive, supportive work environment?
The American Academy of Pediatrics recommends breastfeeding for 12 months, yet the United States does not require any paid leave for new parents. The Family and Medical Leave Act provides qualified employees with three months of leave, but it is unpaid.
With that as the backdrop, researcher-educator Diane Spatz wanted to find out more about what happens when a woman plans to continue breastfeeding and pumping at work.
Spatz, a perinatal nursing and nutrition professor in the School of Nursing and lactation program director at the Children’s Hospital of Philadelphia (CHOP), paired up with Elizabeth Froh, clinical supervisor of CHOP’s lactation team and Human Milk Management Center, to design a two-part study. The first looked at quantitative data about breastfeeding rates. The second, published recently in the Journal of Human Lactation, focused on the personal experiences of 545 female CHOP employees who took and returned from maternity leave.
“This study shows even if you put into place really excellent support, access to hospital-grade breast pumps, numerous pump rooms, and have a strong policy—even with all that, some women can still find it challenging [to keep breastfeeding],” Spatz says.
For the study, the researchers asked open-ended questions about pumping at work and breastfeeding duration. Then they performed a content analysis to generate themes from the qualitative data. Many participants reported feeling supported in their efforts. Others, however, had more difficult experiences due in part to the fact that co-workers often don’t understand the time commitment required for breast pumping, which can take 20 to 40 minutes, depending on the mom, quality of the pump, time to clean the parts, and travel time to a lactation room.
“That is something women report universally once they go back to work,” Spatz says. “It’s a hard thing to be a mom and go back to work and pump. It takes time. Even when you have lots of resources and a strong policy, it still comes down to time.”
The data also demonstrated “internal barriers,” individualized experiences that might have nothing to do with work setting. Examples include fatigue from breastfeeding twins or internal pressure related to the competing needs of doing work versus taking the time to express milk while working.
Though this research took place in a single hospital, Spatz said she feels the general idea could be applied to other settings once more examination is completed.
“Pumping if you work in a hospital is different than in an office building, where your work time might be more flexible but there might not be enough resources,” she says. “What about people who work in settings like factories? We know that can be much more challenging.”
In the future, Spatz would like to conduct in-person focus groups to hone in on some of the nuances of women’s experiences that are difficult to obtain through the current study’s survey methods.