March 19, 2018 / 7:28 PM / 4 months ago

Even doctors struggle to continue breastfeeding

(Reuters Health) - Although doctors may be more likely than other mothers to breastfeed for at least a year, less than one-third of female physicians are able to continue nursing as long as they want, a U.S. study suggests.

Overall, about 42 percent of female physicians who are mothers breastfeed for at least a year, compared with about 27 percent of mothers nationwide, researchers report in JAMA Internal Medicine.

Still, nearly half of doctors who are mothers said they stopped breastfeeding sooner than they would have if their jobs had been more accommodating, and only 28 percent said they kept going until they achieved their personal goal for the duration of breastfeeding.

“We showed that longer maternity leave, accommodating schedules for pumping and dedicated private space for pumping is associated with longer breastfeeding,” said lead study author Dr. Nelya Melnitchouk of Harvard Medical School and Brigham and Women’s Hospital in Boston.

“As physicians, we are taught to lead by example, and we can start with more accommodating work places to support breastfeeding,” Melnitchouk said by email.

Other mothers may also have a better shot at breastfeeding when their doctors are able to set this example, Melnitchouk added.

“Physicians’ breastfeeding behavior has been shown to correlate with physician breastfeeding advocacy for the patients and increases patients breastfeeding status,” Melnitchouk said.

Pediatricians recommend that mothers exclusively breastfeed infants until they’re at least six months old because it can reduce babies’ risk of ear and respiratory infections, sudden infant death syndrome, allergies, obesity and diabetes. For mothers, breastfeeding for at least one year has been linked to a lower risk of depression, obesity, and certain cancers.

Results from the current study are drawn from anonymous online surveys completed by 2,363 members of a social media group for female physicians with kids. Women who were currently breastfeeding were excluded.

Almost everyone in the study – 94 percent – had breastfed for at least a while.

Mothers were more likely to continue for at least one year when they were older, with more years practicing medicine and additional children.

Most women who used breast pumps to express milk said they did this in their own office, while about 19 percent used lactation rooms, 13 percent used on-call rooms, 14 percent used their car, and 21 percent used empty patient rooms.

The most common barriers to continued breastfeeding were inadequate time to pump during the workday and an inflexible schedule, followed by the lack of space.

The study wasn’t a controlled experiment designed to prove whether or how specific workplace policies or aspects of the job might directly impact the initiation or duration of breastfeeding.

Still, the barriers women face are well established and include a lack of time, stigma, discrimination, and a perception that women don’t have a strong work ethic when they engage in maternal responsibilities, said Patricia Davidson, dean of the Johns Hopkins School of Nursing in Baltimore.

“The most important finding of this study is that these educated women, with options, face substantial barriers,” Davidson, who wasn’t involved in the study, said by email. “In a dialogue of money, sex and power - it is frightening to think of the experience of (other) women (who are) uneducated, powerless and with limited options for income.”

“Incorporating breastfeeding, particularly pumping at work, requires dedication, commitment but most importantly support of colleagues and an enabling and supportive culture,” Davidson said. “Many health professionals rarely have time for a bathroom break – so this requires not just commitment from a woman but also from her colleagues and administration.”

SOURCE: bit.ly/2poWvGg JAMA Internal Medicine, online March 19, 2018.

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