Breastfeeding support for hospital employees increasing, except child care

Issue: January 2019

Jennifer M. Nelson

ORLANDO — Although hospitals in the United States provided more breastfeeding support to their employees between 2007 and 2015, less than 2% of respondents offered all seven breastfeeding supports included in a CDC survey of the hospitals, according to a presentation at the AAP National Conference & Exhibition.

Perspective from Joan Younger Meek, MD

“Hospital supports for breastfeeding have been increasing, except for on-site child care, so hospitals may want to consider reviewing those supports that they provide to their employees to ensure that they are providing employees the ability to be able to maintain breastfeeding, if they choose,” Jennifer M. Nelson, MD, MPH, FAAP, a medical epidemiologist at the CDC, told Infectious Diseases in Children.

Nelson and colleagues examined results of the CDC’s Maternity Practices in Infant Nutrition and Care Survey, which is a census of all hospitals and birth centers in the U.S. that assesses infant feeding-related maternity care practices and policies. She reported that the survey, conducted every 2 years between 2007 and 2015, had a response rate of greater than 80%.

The researchers measured the proportion of hospitals offering seven breastfeeding supports to employees included in the survey. Nelson and colleagues reported that the proportion of hospitals providing six of the supports increased between 2007 and 2015. These included a designated room to express milk (70.7% to 89.8%), permission to use work breaks to express milk (95.9% to 98.9%), providing electric breast pump (80% to 85%), availability of lactation consultants (68.3% to 77%), breastfeeding support groups (17.7% to 29%) and paid maternity leave (33.5% to 37.6%). On-site child care provision declined, from 14.5% to 11.7% during the time. The researchers wrote that despite more hospitals offering an increased number of supports, only 1.9% of those surveyed offered all seven breastfeeding supports in 2015.

Nelson also discussed a cooperative agreement between the CDC and AAP to improve breastfeeding-related education and training for physicians.

“Two of the things we are looking at doing is writing a model policy to support breastfeeding among medical students, residents and fellows, and to develop an action plan to help foster support in the medical community for breastfeeding physicians,” she said. – by Bruce Thiel

Reference:

Nelson J, et al. Trends in hospital provision of breastfeeding supports to their employees, United States, 2007-2015. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.

Disclosure: Nelson reports no relevant financial disclosures.

Perspective

Joan Younger Meek, MD

The CDC hospital survey data indicate that the support for breastfeeding in the hospital setting has increased between 2007 and 2015. More than 80% of women initiate breastfeeding in the U.S., and most women of reproductive age are in the workforce. In the survey, less than 40% of the hospital systems offered paid maternity leave of any duration.

Because the AAP recommends exclusive breastfeeding for the first 6 months (and continuation of breastfeeding throughout at least the first year of life), this means that many breastfeeding women will be employed outside of the home during the first year of their baby’s life. Those women either need support for direct breastfeeding in the workplace, often impractical in the hospital setting, or policies in place for break time and a non-restroom private place to express and store milk in the workplace, as required by the Affordable Care Act for hourly wage earners.

There are many women employed in the hospital system as health care providers, nurses or other ancillary health care workers, and support staff. These women need support when they return to work. In addition, the attitudes about breastfeeding by women working in the hospital setting may be influenced either positively or negatively by the support, or lack thereof, that they receive from the hospital administration, managers, and coworkers.

When women employed in the hospital are successful at meeting their own breastfeeding goals, they may be more likely to create an atmosphere of support and encouragement for their coworkers, as well as for the patients delivering in the maternity hospitals in which they work. Surveys have shown that many physicians-in-training do not believe that they receive adequate breastfeeding support, and this can create negative impressions about breastfeeding.

The cooperative agreement between the CDC and the AAP aims to improve education for physicians about breastfeeding and enhance the skills of physicians in clinical management of breastfeeding mothers and children. It will also develop and disseminate policies that support medical students and residents when they are breastfeeding parents themselves.

Joan Younger Meek, MD

Professor of clinical sciences,

Florida State University College of Medicine

Immediate past chair, AAP Section on Breastfeeding

Disclosures: Meek reports no relevant financial disclosures.

American Academy of Pediatrics National Conference and Exhibition

Breastfeeding support for hospital employees increasing, except child care

Perspective