Barriers to Breastfeeding in Female Physicians.

BACKGROUND Breast milk is considered the normative nutrition for human infants, and exclusive breastfeeding for the first 6 months of life is recommended by several national and global societies. Female physicians are a high-risk group for early unintended weaning. We aimed to assess and compare the most common barriers to successful breastfeeding perceived by female physicians in various stages of training and practice. MATERIALS AND METHODS Female faculty physicians and trainees (medical students, resident physicians, and fellows) affiliated with a large medical university in 2016 were surveyed via an anonymous web-based survey distributed through institutional e-mail lists. The three-item survey assessed role, breastfeeding experience, and perceived barriers to successful breastfeeding. Comparisons between groups were performed using Wilcoxon rank-sum tests or Fisher's exact tests. RESULTS The survey was distributed to 1,301 women with 223 responses included in analysis. The majority (57%) of respondents had never breastfed; of those, 87% reported plans to breastfeed in the future. Ninety-seven percent of women with breastfeeding experience reported at least one perceived barrier to successful breastfeeding. Trainees identified more barriers compared with faculty physicians (median count 5 versus 3, p = 0.014). No individual barrier reached statistical significance when comparing between faculty and trainees. The most frequently identified barriers to breastfeeding were lack of time and appropriate place to pump breast milk, unpredictable schedule, short maternity leave, and long working hours. CONCLUSIONS Physicians and medical students who breastfeed face occupation-related barriers that could lead to early unintended weaning. Trainees and faculty report similar barriers. Institutional support may help improve some barriers to successful breastfeeding in female physicians.

[1]  T. Strout,et al.  Congratulations, You’re Pregnant! Now About Your Shifts . . . : The State of Maternity Leave Attitudes and Culture in EM , 2017, The western journal of emergency medicine.

[2]  Arnold G. Reinhold,et al.  Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs , 2017, Maternal & child nutrition.

[3]  J. Schold,et al.  Determinants of breastfeeding initiation and cessation among employed mothers: a prospective cohort study , 2016, BMC Pregnancy and Childbirth.

[4]  D. Spatz,et al.  National Survey of Convention Centers’ Lactation Facilities , 2016, Journal of human lactation : official journal of International Lactation Consultant Association.

[5]  W. Longo,et al.  Pregnancy and Parenthood among Surgery Residents: Results of the First Nationwide Survey of General Surgery Residency Program Directors. , 2016, Journal of the American College of Surgeons.

[6]  J. Weiss,et al.  What Provisions Do Orthopaedic Programs Make for Maternity, Paternity, and Adoption Leave? , 2016, Clinical orthopaedics and related research.

[7]  S. Hawkins,et al.  Breastfeeding and the Affordable Care Act. , 2015, Pediatric clinics of North America.

[8]  D. Christakis,et al.  Relationship of maternal perceptions of workplace breastfeeding support and job satisfaction. , 2015, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[9]  Avika Dixit,et al.  “Frustrated,” “Depressed,” and “Devastated” Pediatric Trainees , 2015, Journal of human lactation : official journal of International Lactation Consultant Association.

[10]  M. Haight,et al.  Airports in the United States: are they really breastfeeding friendly? , 2014, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[11]  D. Drachman,et al.  Breastfeeding in obstetrics residency: exploring maternal and colleague resident perspectives. , 2013, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[12]  Emily A Mallin,et al.  Dr. MILK: support program for physician mothers. , 2013, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[13]  D. Levine,et al.  Personal breastfeeding behavior of physician mothers is associated with their clinical breastfeeding advocacy. , 2013, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[14]  Section On Breastfeeding,et al.  Breastfeeding and the Use of Human Milk , 2005, Pediatrics.

[15]  R. Kravitz,et al.  Annual work hours across physician specialties. , 2011, Archives of internal medicine.

[16]  R. Altman,et al.  Breastfeeding education and support services offered to pediatric residents in the US. , 2011, Academic pediatrics.

[17]  D. Levine,et al.  Breastfeeding intentions of female physicians. , 2010, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[18]  B. Milcarek,et al.  Residency Curriculum Improves Breastfeeding Care , 2010, Pediatrics.

[19]  Arnold G. Reinhold,et al.  The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis , 2010, Pediatrics.

[20]  D. Levine,et al.  Physician mothers: an unlikely high risk group-call for action. , 2010, Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.

[21]  E. Garshick,et al.  Satisfaction of women urologists with maternity leave and childbirth timing. , 2010, The Journal of urology.