|
 We
are deeply grieved...
BPNI informs its readers with great regret of the sad and untimely passing
away of Dr. Kamal Islam, State Representative UNICEF, Calcutta in an air
crash in Nepal on 5th September,
1999. He was aged 51 years. Dr. Islam is survived by his son.
Dr. Islam was always very helpful to the cause of promotion and protection
of breastfeeding and provided to BPNI his able guidance, wise counsel, and
solid support. He was a tower of strength for our Information and
Communication Project. In his passing away, we have lost not just a
friend, philosopher and guide, but a man who was truly committed to the
health and well-being of the mother and the child.
The entire BPNI
fraternity joins in conveying its heartfelt condolences to the bereaved
family and in praying for the
peace of the departed soul. |
The Working Mother and
Breastfeeding
Working
outside the home is often cited as a reason for the decline in breastfeeding
rates around the world because breastfeeding and working are seen as mutually
exclusive activities. A high percentage of mothers return to work during their
infant’s first year of life. Work environments often derive from a model
centered on a male workforce, with little consideration for women’s particular
needs both as workers and parents. Also, inadequate attention is given to
enhancing the compatibility of breastfeeding and work. Labour and government
laws to accommodate nursing mothers, including maternity leave and benefits,
nursing breaks and reasonable childcare facilities have not yet been enforced
fully in most countries.
In India, maternity leave is variable, nursing
breaks are unofficial and childcare facilities at the work place remain
inadequate. In addition, the mothers are not fully aware of their legal rights
regarding maternity leave and breastfeeding period. Throughout pregnancy and
postnatal period, the breastfeeding mother needs support for her activities,
which continue to be viewed by many as unusual or different from the
bottle-feeding norm. When social support is lacking, the frequency of formula
supplementation increases significantly, and breastfeeding duration declines.
Mothers who wish to continue breastfeeding after
returning to work have relatively few and simple needs, yet most stop
breastfeeding and switch their babies to formula even before going back to work,
or soon after returning. Others elect to extend their maternity leave or resign
their positions to stay at home, because of a perceived incompatibility between
continued breastfeeding and their employment situation. Many male corporate
executives are uncomfortable in discussing breastfeeding with female employees
and may express negative attitudes regarding the appropriateness of the activity
in the work setting.
Many executives have simply not considered fully the
corporate impacts resulting from the health benefits to infants who are fed
breastmilk. The mothers of healthier babies are likely to be more productive at
work and be absent from work on fewer days to stay at home to care for a child
who is sick. A reduction in absenteeism among employed mothers can represent a
cost saving to the employer.
In order to maintain an
adequate supply of breast milk, the employed mother needs to use a breast pump
two or three times during the shift. Many obstacles such as inflexible work
schedules, non-empathetic supervisors and absence of privacy often keep mothers
from effectively draining breast milk while at work. To help these mothers,
these barriers should be identified and strategies should be evolved to
eliminate these (see Table give below).
Table: Barriers to breastfeeding for working
women and potential strategies
|
Barrier |
Short-Term Strategies |
Long-Term Strategies |
|
Lack of child care facilities at or near the
workplace. |
(a) Provide information to mothers about
child care facilities near the worksite.
(b) Establish a child care information and
referral system. |
Establish governmental policies to enable the
majority of employers to subsidize child care. |
|
Conditions of work environment |
(a) Provide nursing breaks for working
mothers.
(b) Provide place for mothers to express
breastmilk and to refrigerate breastmilk. |
Provide flexible working hours, job-sharing
programs, and part-time options at the worksite. |
|
Employer policies:
(a) Inadequate maternity leave programs.
(b) Loss of employment. |
(a) Encourage legislation for disability
insurance in states where maternity leave benefits do not exist. |
Establish a national maternity policy with
job-protected leave, full or partial wage replacement, and health insurance. |
|
Societal attitudes towards breastfeeding. |
Develop public education programmes. |
Develop educational programmes for school-age
children. |
|
Mother's lack of understanding and knowledge
about breastfeeding. |
Establish worksite pre-natal education
programs on infant feeding and decision making, including information about
employer policies and breastfeeding support measures. This can be included
in existing health information/health promotion programs. |
Integrate material about working and
breastfeeding in all programmes provided by all classes of employers in
public and private sectors. |
|
Lack of understanding
and knowledge of health professionals about breastfeeding. |
Develop
professional education programmes for health professionals, especially
nurses. |
Integrate material on breastfeeding into
curricula in professional training programs at the undergraduate and post
graduate levels. |
Many studies have been conducted to study women’s
experiences of combining breastfeeding and employment. The findings suggest that
nursing breaks,friendly workplace environment and space for expressing
breastmilk and for babies could help more women to experience the benefits and
rewards of continuing to breastfeed after returning to employment. Provision of
a reasonable accommodation at the work place and time to express breast milk
during the work shift resulted in a higher proportion of mothers nursing for a
longer period of time. The overwhelming majority of women who combined
breastfeeding and employment felt that it was worth the trouble, that they would
recommend it to others, and that they have done something special for their
infants that no one else could do. To solve some of the common problems of
employed breastfeeding mothers, research based recommendations can be offered.
|
Research Findings
Successful
employed breastfeeding mothers . . .
(1) Were most
anxious about the baby and breastfeeding in the first week of employment.
(2) Waited until
the baby was four months or older before returning to work.
(3) Used part
time/flexible working hours when they first returned to work
(4) Expressed
milk during their absence
(a) especially
in the first month
(b) to remain
physically comfortable
(c) to reduce
the likelihood of leaking
(d) to collect
milk for use later
(5) Obtained
less milk at the end of the work week than at the beginning
(6) Complained
most often about exhaustion
(7) Viewed
breastfeeding as the key to continued "correction" with the baby despite
separations |
Recommendations
Successful
employed breastfeeding mothers .
. .
(1) Try to
return to work on a Thursday or Friday in order to be able to look forward
to a weekend that is only a day or two away
(2) Stay home as
long as possible
(3) Return to
work on less than a full-time schedule in the beginning
(4) Learn how to
express breast milk
(5) Increase
fluids near the end of the work week; to avoid fullness on Mondays, restrict
fluids slightly
(6) Use
breastfeeding as a "break" from home chores
(7) Remember
that only the mother can enjoy the special closeness that breastfeeding
represents |
REFERENCES
-
Berg A, Brems S. A case
for promoting breastfeeding in projects to limit fertility. In: Van Esteric P.
Women, Work and Breastfeeding. Cornell International Nutrition Monograph
Series 1992; 23:85.
-
Haider R, Begum S.
Working women, maternity entitlements, and breastfeeding: A report From
Bangladesh. J Hum Lact 1995; 11(4): 273-277.
-
Van Esteric P, Greiner T.
Breastfeeding and women’s work: constraints and opportunities. Stud Fam Plann
1981; 12:184-197.
-
Cohen R, Mrtek MB. The
impact of two corporate lactation programs on the incidence and duration of
breastfeeding by employed mothers. Am J Health Prom 1994;8(6): 436-441.
-
Katcher AL, Lanese MG.
Breastfeeding by employed mothers: a reasonable accommodation in the work
place. Pediatrics 1995; 75(4): 644-647.
Dr. J.P. Dadhich
|
Innocenti Declaration
The
Innocenti Declaration on
the Protection, Promotion and Support of Breastfeeding,
signed by 32 governments, 10 UN agencies in 1990 states that for optimal
breastfeeding
all women should be
enabled to practise exclusive breastfeeding and all infants should be fed
exclusively on breastmilk from birth to four to six months of age.
Thereafter, children should continue to be breastfed, while receiving
appropriate and adequate complementary foods, for up to two years of age
or beyond.
As part of its operational
targets, this declaration calls on all governments by 1995 to:
-
Enact imaginative
legistation protecting the breastfeeding rights of working women and
establish means for its enforcement; and
-
Ensure the
implementation of the International Code of Marketing of Breastmilk
Substitutes so that the marketing of such substitutes is not targeted at
employed women.
The Technical Meeting of
June 1990 prior to the Innocenti Declaration also recommends:
-
The establishment of a
task force "Women, Work and Breastfeeding" within National Breastfeeding
Committees, and
-
The integration of
issues relevant to employed women in all breastfeeding promotion
programmes.
|
|
Creating mother-friendly workplaces
Time
1) Provide at
least four months paid maternity leave (with an ideal of six months) that
begins after the baby is born. Offer other options such as longer leave with
partial pay.
2) Offer
flexible work hours to breastfeeding women such as part-time schedules,
longer lunch breaks, and job sharing.
3) Provide
breastfeeding breaks of at least an hour a day.
Space/Proximity
1) Support
infant and child-care at or near the workplace, and provide transportation
for mothers to join their babies. For rural worksites and seasonal work, use
mobile child-care units.
2) Provide
comfortable, private facilities for expressing and storing breastmilk.
3) Keep the
work environment clean and safe from hazardous wastes and chemicals.
Support
1) Inform
women workers and unions about maternity benefits and facilities and provide
information to support women's health.
2) Ensure that
mothers have full job security.
3) Encourage
co-workers and management to have a positive attitude toward breastfeeding
in public.
4) Encourage a network of supportive women in unions or workers' groups who can
help women to combine breastfeeding and work.
1) Provide at least four
months
The
Innocenti Declaration on
the Protection, Promotion and Support of Breastfeeding,
signed by 32 governments, 10 UN agencies in 1990 states that for optimal
breastfeeding
all women should be
enabled to practise exclusive breastfeeding and all infants should be fed
exclusively on breastmilk from birth to four to six months of age.
Thereafter, children should continue to be breastfed, while receiving
appropriate and adequate complementary foods, for up to two years of age
or beyond.
As part of its operational
targets, this declaration calls on all governments by 1995 to:
-
Enact imaginative
legistation protecting the breastfeeding rights of working women and
establish means for its enforcement; and
-
Ensure the
implementation of the International Code of Marketing of Breastmilk
Substitutes so that the marketing of such substitutes is not targeted at
employed women.
The Technical Meeting of
June 1990 prior to the Innocenti Declaration also recommends:
-
The establishment of a
task force "Women, Work and Breastfeeding" within National Breastfeeding
Committees, and
-
The integration of
issues relevant to employed women in all breastfeeding promotion
programmes.
|
World
Breastfeeding Week (1-7, August 1999)
Theme:
Education for life
Position
Statement on HIV and Infant Feeding
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