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

Physician mothers have some of the highest rates of
breastfeeding initiation; however, their rates of continuation
of breastfeeding to 12 months of age drop
substantially from 97% to 34%.1 Major barriers include difficulty
finding time and a place to express their milk while at
work, competing demands from work and family, as well as
perceived lack of employer support.1,2 Less than one-third of
physician mothers are able to reach their personal breastfeeding
goal, with more than one-half stating that they would have
breastfed longer if their “job had been more supportive.”3
Insufficient opportunities to express milk can not only lead
to 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 factors
are specific to early cessation of lactation in physician mothers,
including the shame and stigma around breastfeeding4 and
taking breaks from patient care, teaching, and even research
to express milk during working hours.2 This is especially a
problem for fields where physician mothers are involved with
operating room and procedural duties.5 Furthermore, physicians
often work in teams and taking a break may affect
other team members, or the work cannot continue without
the physician (eg, operating rooms or procedural spaces).
Unfortunately, anecdotes of physician mothers being
suboptimally supported in lactation in the workplace are not
uncommon, even in pediatrics. Although many behaviors
around expressing milk in the workplace are “tolerated” by
employers, these behaviors are not explicitly protected as
rights of the employee by many institutions. The Affordable
Care Act6 mandates that employers provide lactating mothers
with “reasonable break time and a private space to express
breast milk,” however, these accommodations are minimal
and many employers, including hospital systems, have not
extended their policies or cultures to increase support for
their lactating employees.