Make breastfeeding work at work

Breastfeeding is one of the most natural and protective acts mothers can perform to nurture and bond with their babies. High quality international research has shown that breastfeeding can promote healthy brain development, increase intelligence scores, protect against child infections and death. It also reduces the risk for obesity and chronic diseases in later life, like diabetes, in both low-income and high-income countries. Other studies have shown that breastfeeding also prevents malocclusion (when your upper and lower teeth do not align when you close your mouth).

For nursing women, breastfeeding offers protection against breast cancer, ovarian cancer, type 2 diabetes and heart disease. It also improves birth spacing (allowing a specific amount of time between pregnancies). Given the well-documented public health benefits of breastfeeding, support for breastfeeding can lead to improved mother and child health, reduced healthcare expenditures, gains in work productivity, and enhanced national development. 

Providing accessible, high-quality and equitable support for all women who want to breastfeed is, therefore, a sound social investment. This could ensure great gains in child health and development with long-lasting benefits.  

In South Africa only 32% of infants under the age six months are exclusively breastfed. This is contrary to the recommendation from global health authorities that babies should be exclusively breastfed from birth to six months and thereafter other nutritious foods should be introduced into the child’s diet, while breastfeeding ought to continue for two years and beyond. 

The success of breastfeeding is, however, not the sole responsibility of mothers but involves many different stakeholders. Mothers need support from their partners, families, communities, healthcare facilities, government and workplaces. With Women’s Month in full swing, it is important that we talk about breastfeeding in the workplace. Globally, mothers have identified work as one of the main barriers to exclusive and continued breastfeeding. It is a leading reason for not breastfeeding, or for ceasing to breastfeed early.

Working mothers often find it challenging to combine and continue breastfeeding with full-time employment, especially if workplaces are not supportive of breastfeeding or expressing breastmilk. A study has shown that workplace support for breastfeeding in South Africa is limited and inadequate. The challenges mothers experience at work include the lack of time to breastfeed or express, especially if employers insist that tea and lunch breaks should be used for expressing. 

In South Africa, the provision of time to breastfeed and/or express breastmilk is recommended according to Section 87(1) (b) of the Basic Conditions of Employment Act No. 75 of 1997, Code of Good Practice on the protection of employees during pregnancy and after the birth of a child. It states in subsection 5.13 that “arrangements should be made for employees who are breastfeeding to have breaks of 30 minutes twice a day for breastfeeding or expressing milk each working day for the first six months of the child’s life”. Unfortunately, there is a lack of awareness of the breastfeeding time recommendation among workplaces and employees. 

Furthermore, a lack of space for breastfeeding is another challenge, with mothers often having to use a bathroom to express breastmilk. Other challenges include unsupportive employers, supervisors and staff, a lack of communication about breastfeeding and mothers’ needs and a fear to communicate with supervisors. Additionally, mothers often experience conflict between work demands and their infant’s breastfeeding needs which cause emotional stress. If women are not supported, they often introduce commercial milk formula feeding when returning to work or start mix feeding. 

Women should not have to choose between breastfeeding their children and their work. The support a woman receives in terms of workplace arrangements is therefore critical to enable her to continue breastfeeding and to overcome these barriers. The provision of supportive workplace practices for breastfeeding has shown to enhance working mothers’ ability to continue breastfeeding along with employment. 

Breastfeeding supportive practices at work can include: 

• Developing policies to support breastfeeding mothers in the workplace; 
• Providing pregnant women time to attend antenatal clinics or be present at antenatal visits;
• Education of all staff, managers and co-workers about the benefits of breastfeeding and and the recommended breastfeeding time;              
• Interpersonal communication before and after maternity leave to discuss the mother’s needs; 
• Educational material or access to professional breastfeeding support;     
• Providing a private area (not a bathroom) for women to breastfeed or express milk; 
• Allowing time and flexibility to express breastmilk at work; 
• Providing working mothers with options when returning to work, such as working part-time, job sharing or extending maternity leave; and
• Providing onsite or nearby childcare facilities at work.

These are important practices that should be implemented to ensure that women are enabled to breastfeed for as long as they want and to provide them with a supportive work environment. 

In addition, there is a pressing need to create advocacy regarding the benefits of breastfeeding support in the workplace for employers, employees and society as a whole, as well as the breastfeeding rights of women in the workplace. Every effort must be made to ensure that women have access to breastfeeding support at work and in all other environments. This is a wise and achievable investment in our communities and the country’s future health and development.  

Professor Lisanne du Plessis is an associate professor and Dr Lynette Daniels a senior lecturer in the Division of Human Nutrition, Department of Global Health in the Faculty of Medicine and Health Sciences at Stellenbosch University.