Physician Mothers: How do we fare with breastfeeding?
A recent study published in the Breastfeeding Medicine by Sattari et al looked at breastfeeding intentions of female physicians. They looked at breastfeeding behavior of these women at 3, 6, and 12 months. Not surprisingly, of the 50 women surveyed, 100% of these physicians had intentions of long-term breastfeeding. However, as the results showed, the rates of exclusivity/any breastfeeding declined as the women were followed. Although the sample size was small, it brings to light many of the issues women physicians face when going back to work.
Physicians know the benefits of breastfeeding, and it’s interesting to see that most plan on breastfeeding. The authors point out that not only does breastfeeding benefit the mother and her baby, but our personal stories can usually help a patient. In my case, breastfeeding didn’t come easy. My personal struggles to provide breastmilk for my 3 children have helped me counsel mothers in my pediatric practice. But ironically, even though I work in a field that should obviously support breastfeeding, this wasn’t my experience. I struggled with finding the time and space to express milk—and yes, I did pump in a bathroom stall!! Ironically, it was after my 3rd child, when I was working in a Pediatric emergency room, that I was given the most support: nurses told me in the middle of my shift to go pump, with my director even offered me a hospital-grade pump!!
This study highlights that specialty and stage of career can and do affect breastfeeding longevity. Attendings are generally in the best position to alter their schedule to accommodate pumping breaks, as opposed to residents. During residency and fellowship, I had many friends who chose to breastfeed only for the 6 weeks of their maternity leave, or found, after returning to work, that the long hours and stress of call nights severely diminished their supply. A primary care specialty is more likely to be favourable, compared with a surgical specialty where women struggle to find time to pump during the day. The authors point out that the logistics of timing of surgeries and proximity of lactation rooms make it difficult for women in surgical subspecialties to express milk. I’ve seen this among my friends as well—regardless of stage of career. One friend mentioned that due to the timing of the cases and fear of missing an interesting case, she would have to choose between eating or pumping since there wasn’t enough time to do both.
Although the study didn’t address this, I suspect that many women in surgical specialties still have to deal with the fact that they may still be in a male-dominated specialty, and bringing up the topic of time and space for expressing breastmilk would not be well-received.
As the RRC has instituted a decline in resident work hours, this may work favorably for women doctors who choose to continue to breastfeed. However, every woman, every specialty, and every institution is different. What works for one may not work for another. But I have to ask: with the passage of the new health reform bill and the increasing popularity of the Business Case for Breastfeeding, can these programs catalyze change within our medical specialties?
There is a light on the horizon. As a breastfeeding community, our efforts to educate and advocate have put the terms breastfeeding, expressing breastmilk, and workplace in the forefront. 10, 5, or even 3 years ago, we wouldn’t even be having this discussion. My hope is that with this increasing attention, women in the medical field will feel that they have more options to continue nursing after returning to work—regardless of specialty, work hours, or stage of career.
I ask my medical colleagues: what were your experiences, and what changes can make to support our own?
Natasha K. Sriraman is a general pediatrician and a professor of Pediatrics at Children’s Hospital of The King’s Daughters/Eastern Virginia Medical School in Norfolk, VA.
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