Returning to work

What should I know about returning to work?

Returning to work creates challenges for breastfeeding mothers. The timing of the return to work may depend on the availability of paid leave. Returning to work within six months has been shown to increase the risk of depression and early weaning. Some mothers have health problems for months after delivery. Before returning to work, mothers need to establish a plan for maintaining their milk supply and providing milk for their baby. Laws about a woman’s right to breastfeed at work vary and employers may not accommodate breastfeeding needs or guarantee a workplace free of discrimination or harassment.

A) Maternity leave

1) The duration of paid maternity leave

The duration of paid or unpaid maternity leave varies greatly around the world (OECD 2017; Strang 2017). For example, Canada provides eighteen months of paid leave, while at the other extreme a few countries, including the U.S., have no national policy guaranteeing paid leave to employed women who give birth (Froh 2018).

2) The benefits 

Mothers who are able to take paid maternity leave are (Jou 2017; Van Neil 2020):

  • Less likely to return to hospital.
  • Better able to manage stress.
  • Have better mental health.
  • More likely to exercise.
  • Less likely to have babies who had to return to hospital.
  • Less likely to experience partner violence.

Paternal leave has been shown to result in fathers taking time off work to care for their family (Huerta 2014).

3) Increased breastfeeding

Mothers with a paid maternity leave are more likely to breastfeed (Monteiro 2019; Navarro-Rosenblatt 2018). Every additional month of paid leave appears to increase the likelihood of breastfeeding (Chai 2018; Hamad 2018). When paid maternity leave is extended from 6 to 12 months after delivery (Nandi 2018):

  • Mothers are more likely to take longer leaves.
  • Babies are less likely to be sick or die.
  • The impact of a mother’s temporary absence from the workforce on the economy is minimal.

B) Benefits for continuing to breastfeed after returning to work

1) Benefits for mother and baby

Breastfeeding after returning to work has many health benefits for the baby both before and after one year of age and for the mother. It also smooths the transition to this next stage in their lives by supporting the bond between the two of them (Franco-Antonio 2021). 

2) Benefits for the family

Breastfeeding reduces the risk of illness in children, so it helps reduce stress on families.

Children of working parents are often in daycare or other settings where they are in contact with other children and as a result, they tend to get sick a lot more often (Mattar 2019; Franco-Antonio 2021). 

This means a parent may have to take time off work to look after their child and possibly take the child to a health-care provider or care for the child in hospital. A parent may not be able to return to work for a while because the child won’t be allowed to attend daycare until healthy.

Continuing to breastfeed is also generally cheaper than using infant formula.

C) Health challenges when returning to work

Returning to work can create challenges for breastfeeding and for mothers.

Returning before the baby is six months old has been shown to increase the risk of depression and early weaning (Andres 2016; Dagher 2014; Fernández-Cañadas 2017; Kornfeind 2018; Villar 2018).

If you do decide to return, make sure you are physically able to do so. Some mothers have health problems for many months after delivery, including (Brown 2000):

  • Back pain
  • Difficulty holding urine (incontinence)
  • Bowel problems
  • Sexual difficulties
  • Depression

D) Workplace accomodation

Returning to work can interfere with breastfeeding (Hamner 2021). Support at work varies greatly among workplaces, types of employment, and countries, and can affect breastfeeding rates (Spitzmueller 2018). Having a supportive workplace lowers the risk of early weaning (Kim 2018; Navarro-Rosenblatt 2018; Scott 2019; Wallenborn 2019). One study found less supportive workplaces in the service, production, and transportation industries (Snyder 2018).

1) The right to breastfeed

Before you return to work, learn about your rights. The amount of accommodation an employer must make for breastfeeding women varies among countries and areas within countries (Gonzalez-Nahm 2019). Mothers can get more information on this from:

2) Talking to an employer

Mothers should consider discussing their breastfeeding plan with their employer before returning to work (Marinelli 2013; OWH 2017). Mothers need to know if their workplace can accommodate their breastfeeding needs and that they will be able to express or breastfeed at work and be free of discrimination or harassment (McCardel 2020).

If employers are reluctant to accommodate breastfeeding, a mother can inform them that:

  • Breastfeeding will allow her to be a better employee with less absenteeism and less stress (Gabriel 2019; Gartner 2005; Jantzer 2018)
  • The company’s support for breastfeeding will enhance its “family-friendly” image and reduce its costs for health care and absenteeism.

Health-care providers can also be useful resources. They may be able to provide a letter saying a mother needs to express at work for medical reasons. The following is a form letter for use by a physician.

Physician letter for employer accommodation for breast pumping

E) How to continue breastfeeding after returning to work

If mothers want to breastfeed once they return to work, they need to plan how to maintain their milk supply and provide milk for their baby. 

If mothers choose to breastfeed during the workday, they may be able to have the baby brought to them or they may be able to leave the workplace and go to the baby.

If breastfeeding is not an option, the best alternative is to express regularly and for every missed feed.

The number of times mothers breastfeed or express each day will depend on their breastfeeding patterns at home and on the age of the baby. Ideally, the schedule of breastfeeding or expressing at work will match the schedule used at home. This ensures that mothers don’t go too long between sessions and increase their risk of short-and long-term problems.

Expressing or breastfeeding may require small changes to the mother's schedule. Some mothers take a shorter lunch break and two longer coffee breaks, which gives them time to breastfeed or express three times a day.

Mothers may consider doing a trial run before returning to regular work. 

References

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