breastfeeding mothers employed outside the home are the same as those of breastfeeding mothers in the general population. However, the overall rate of breastfeeding is lower among employed mothers and the duration is shorter.

Mothers employed outside the home face special problems when breastfeeding their infants. A survey of employed breastfeeding mothers by Auerbach and Guss (1984) shows that excessive fatigue, the logistics of pumping and storing milk, the excessive time spent traveling to and from the baby during the workday, and concern about having an adequate milk supply were common problems in this group. These problems were compounded by lack of time to complete work duties and to eat properly.

These findings are not surprising in light of a survey of policies and practices to support breastfeeding mothers in the workplace (Moore and Jansa, 1987). The survey sought responses from 100 of the most profitable Fortune 500 companies and an additional 12 companies that were known to have breastfeeding support programs. All the Fortune 500 companies responding had maternal leave policies and guaranteed a return to an equivalent job. However, only about 33% offered flex-time or part-time work, only 14% allowed breastfeeding at work, and fewer than 5% allowed job sharing or provided day care. Most of the 12 companies known to support breastfeeding allowed flex time, part-time schedules, and job sharing. However, fewer than half provided a place for mothers to breastfeed, and none provided day care or permitted mothers breaks for breastfeeding.

In another study, Barber-Madden and colleagues (1987) reviewed published research as well as policy statements of professional groups such as the American Academy of Pediatrics (AAP, 1982) and identified six types of barriers to breastfeeding for employed mothers. They include (1) lack of child care at or near the workplace, (2) work environments that do not provide a place for pumping and storing milk, (3) restrictive employer policies that fail to provide adequate maternity leave and job security, (4) social attitudes of employers and coworkers toward breastfeeding that result in disapproval and harassment, (5) inadequate maternal knowledge about breastfeeding, and (6) lack of knowledge concerning breastfeeding on the part of health professionals, especially those in occupational health. These authors suggest both short- and long-term strategies for dealing with such barriers that would require economic commitments by employers or governments as well as the development of educational materials on breastfeeding targeted specifically at the problems of employed mothers.

Adolescent Mothers

The few small studies conducted on pregnant adolescents or adolescent mothers indicate that these adolescents may not differ substantially from older mothers in their selection of infant-feeding methods. In a survey of pregnant inner-city adolescents aged 12 to 19 years, investigators found that those



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