Virtual Medical Centre

Breastfeeding and the Workplace

• Introduction
• Prevalence of breastfeeding amongst Australian women
• Impact of work and childcare on women's breastfeeding decisions
• Why encourage breastfeeding in the workplace?
• Laws relating to breastfeeding in the workplace
• Creating breastfeeding-friendly workplaces
  • Developing a workplace breastfeeding policy

Introduction

Combining work and breastfeeding can create considerable pressures for working women with newborn babies. As a result, working mothers are less likely to breastfeed their babies than non-working mothers.

Each year an estimated 118,000 Australian women return to paid work within 6 months of delivering a child, that is, at the time when it is recommended that they breastfeed their infant exclusively (feed them breastmilk and nothing else) to provide them with optimal nutrition. For these women, breastfeeding at work is necessary if they are to breastfeed regularly enough to maintain a supply of breastmilk sufficient to enable exclusive breastfeeding and workplace support is necessary to allow them to breastfeed at work. However, some workplaces are not "breastfeeding friendly", that is, there are barriers which prevent women from breastfeeding in these workplaces.

Prevalence of breastfeeding amongst Australian women

Over 90% of Australian women initiate breastfeeding after childbirth, 56% continue breastfeeding until their child reaches 6 months of age and 30% are still breastfeeding 12 months after childbirth. However, amongst those who continue breastfeeding until 6 months of age, only 20% continue breastfeeding exclusively (use breastmilk as the sole source of infant nutrition and do not feed infants with complementary foods).

Impact of work and childcare on women's breastfeeding decisions

While evidence suggests that returning to work is not the key reason women cease breastfeeding, working mothers are less likely to breastfeed than those who do not work. For example, one study found that women working fulltime three months after childbirth had breastfed their infants for a shorter period of time (8.6 weeks less) than women who were not working three months after childbirth. Another reported that women who returned to work within 12 weeks of childbirth were twice as likely not to breastfeed their infants, while women who went back to work within six weeks of childbirth were four times less likely to breastfeed, compared to non-working women. This indicates that women face considerable challenges in providing breastfeeding and maintaining paid employment.

Higher breastfeeding rates amongst women with flexible working conditions (e.g. self employment, flexible hours) and those working <15 hours per week, indicate that workplace flexibility is an important factor influencing a working woman's decision to breastfeed. Breastfeeding rates are higher amongst infants who receive parental care only, compared to those who receive non-parental care. This indicates that childcare facilities (compared to parental care) may not provide adequate opportunities for women to feed their infants with breastmilk.

Why encourage breastfeeding in the workplace?

Encouraging new mothers to breastfeed is important as breastmilk is the optimum source of nutrition for infants. Breastmilk is a living tissue which contains all the nutrients needed by infants. Breastmilk cannot be reproduced artificially. Its nutritional composition changes naturally as breastmilk production progresses (the infant ages) and according to a diurnal rhythm (a daily rhythm, for example the nutritional content of breastmilk may be different in the morning compared to at night). In the first few days after childbirth women secrete a substance known as colostrum, which contains higher concentrations of vitamins A and B and protein and lower concentration of fat compared to mature breastmilk. Lactating women commence secreting mature breastmilk 7-14 days after childbirth.

Breastmilk production is stimulated by infant suckling, as the suckling action of an infant stimulates the release hormones called prolactin and oxytocin. These hormones are produced by the pituitary gland and regulate the production and secretion of breastmilk respectively. When an infant suckles, oxytocin stimulates the secretion of breastmilk and signals the pituitary gland to secrete prolactin, which in turn stimulates the production of more breastmilk.

The amount of breastmilk a woman produces is therefore directly proportional to the extent to which her infant suckles or she expresses breastmilk (the rate at which milk is emptied from the breast). Frequent suckling and on-demand feeding patterns are associated with maintenance of adequate levels of breastmilk to enable exclusive feeding. In order to produce sufficient breastmilk for exclusive infant feeding, a woman must breastfeed regularly throughout the day. Taking long breaks from breastfeeding (e.g. an eight hour break in which the mother is away from the infant for fulltime work commitments) disrupts breastmilk production and exclusive breastfeeding is not possible under these circumstances. Working women therefore need to breastfeed their babies or express their milk while they are at work, in order to maintain adequate breastmilk production for optimal infant feeding.

Laws relating to breastfeeding in the workplace

The rights of women to breastfeed without discrimination and the rights of infants to receive optimum nutrition from breastmilk, are internationally recognised by bodies such as the World Health Organisation and the United Nation Children's Fund (UNICEF).

Under Australian laws, employers are obliged to seriously consider any request from an employee for family-friendly working arrangements (including time for breastfeeding). In addition, employers have an obligation to provide work flexibility to enable parents to maintain a healthy balance between work and life, wherever the nature of the work makes it reasonable to do so.

More information on Work and Parenting.

Despite laws requiring employers to reasonably consider flexible arrangements for working parents, Australian women are not legally guaranteed the right to take breaks from work to breastfeed or to breastfeed in public places (including workplaces). As such, female employees who wish to breastfeed at work must negotiate individually with their employees for the right to do so. In addition, many women do not currently have access to maternity leave immediately after childbirth, the time when breastfeeding patterns are established. However, the introduction of a government funded universal parenting leave benefit in Australia from 1 January 2011 is expected to increase women's access to paid maternity leave.

Creating breastfeeding-friendly workplaces

A breastfeeding friendly workplace is one in which women:

• have access to a suitable facility in which they can breastfeed their infant or express their breastmilk;
• are provided breaks from work in order to breastfeed or express milk; and
• can discuss their breastfeeding needs with their employer.

The Australian Breastfeeding Association now manages an accreditation program for breastfeeding-friendly workplaces. The program offers consultancy services to assist employers in identifying barriers to breastfeeding in the workplace and accreditation to those employers who successfully remove these barriers and create breastfeeding-friendly workplaces.

Developing a workplace breastfeeding policy

Providing any of the following arrangements or facilities could make the workplace more breastfeeding friendly:

• Lactation breaks: to enable breastfeeding women time off work in order to breastfeed. Lactation breaks should occur in addition to, not instead of, normal meal and tea breaks. Two 30 minute breaks per 8 hour working day should be provided, although there is no legal requirement that employees receive pay for lactation breaks;
• Breastfeeding and expressing facilities: which can be used by breastfeeding employees. The facilities should be clean, comfortable and private and include hand washing and milk storage facilities;
• Offering flexible working arrangements: including job sharing, extended unpaid maternity leave and part time work which may more easily enable women to return to work and breastfeed simultaneously; and
• Workplace support: to ensure that breastfeeding employees feel comfortable to breastfeed in the workplace and do not suffer discrimination or harassment as a result of doing so.

Companies that wish to develop breastfeeding-friendly policies might begin by:

• Conducting a safety audit to determine the extent to which it is safe to breastfeed in the workplace;
• Examining the informal practices which occur in the workplace and how they influence a woman's ability to breastfeed;
• Ensuring women who have given birth or are planning to have access to flexible work arrangements, such as part time work or job sharing;
• Ensuring the workplace is free of harassment and discrimination against women who choose to breastfeed, for example by addressing women's right to breastfeed in the workplace as a specific component of workplace training; and
• Examining measures other companies have taken to make their workplaces more breastfeeding friendly.