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

<div>Physician mothers have some of the highest rates of</div><div>breastfeeding initiation; however, their rates of continuation</div><div>of breastfeeding to 12 months of age drop</div><div>substantially from 97% to 34%.1 Major barriers include difficulty</div><div>finding time and a place to express their milk while at</div><div>work, competing demands from work and family, as well as</div><div>perceived lack of employer support.1,2 Less than one-third of</div><div>physician mothers are able to reach their personal breastfeeding</div><div>goal, with more than one-half stating that they would have</div><div>breastfed longer if their “job had been more supportive.”3</div><div>Insufficient opportunities to express milk can not only lead</div><div>to a physician mother not meeting her own lactation goals,</div><div>but also to blocked ducts, mastitis, decreased milk supply,</div><div>feelings of inadequacy, stress, and burnout.4 Several factors</div><div>are specific to early cessation of lactation in physician mothers,</div><div>including the shame and stigma around breastfeeding4 and</div><div>taking breaks from patient care, teaching, and even research</div><div>to express milk during working hours.2 This is especially a</div><div>problem for fields where physician mothers are involved with</div><div>operating room and procedural duties.5 Furthermore, physicians</div><div>often work in teams and taking a break may affect</div><div>other team members, or the work cannot continue without</div><div>the physician (eg, operating rooms or procedural spaces).</div><div>Unfortunately, anecdotes of physician mothers being</div><div>suboptimally supported in lactation in the workplace are not</div><div>uncommon, even in pediatrics. Although many behaviors</div><div>around expressing milk in the workplace are “tolerated” by</div><div>employers, these behaviors are not explicitly protected as</div><div>rights of the employee by many institutions. The Affordable</div><div>Care Act6 mandates that employers provide lactating mothers</div><div>with “reasonable break time and a private space to express</div><div>breast milk,” however, these accommodations are minimal</div><div>and many employers, including hospital systems, have not</div><div>extended their policies or cultures to increase support for</div><div>their lactating employees.</div>