Pediatricians Advocating Breastfeeding - Let's Start with Supporting our Fellow Pediatricians First_2019.pdf

Physician mothers have some of the highest rates ofbreastfeeding initiation; however, their rates of continuationof breastfeeding to 12 months of age dropsubstantially from 97% to 34%.1 Major barriers include difficultyfinding time and a place to express their milk while atwork, competing demands from work and family, as well asperceived lack of employer support.1,2 Less than one-third ofphysician mothers are able to reach their personal breastfeedinggoal, with more than one-half stating that they would havebreastfed longer if their “job had been more supportive.”3Insufficient opportunities to express milk can not only leadto a physician mother not meeting her own lactation goals,but also to blocked ducts, mastitis, decreased milk supply,feelings of inadequacy, stress, and burnout.4 Several factorsare specific to early cessation of lactation in physician mothers,including the shame and stigma around breastfeeding4 andtaking breaks from patient care, teaching, and even researchto express milk during working hours.2 This is especially aproblem for fields where physician mothers are involved withoperating room and procedural duties.5 Furthermore, physiciansoften work in teams and taking a break may affectother team members, or the work cannot continue withoutthe physician (eg, operating rooms or procedural spaces).Unfortunately, anecdotes of physician mothers beingsuboptimally supported in lactation in the workplace are notuncommon, even in pediatrics. Although many behaviorsaround expressing milk in the workplace are “tolerated” byemployers, these behaviors are not explicitly protected asrights of the employee by many institutions. The AffordableCare Act6 mandates that employers provide lactating motherswith “reasonable break time and a private space to expressbreast milk,” however, these accommodations are minimaland many employers, including hospital systems, have notextended their policies or cultures to increase support fortheir lactating employees.