Maternal Well-Being, Infant Feeding and Return to Paid Work by Sarah Jewell

Infant feeding decisions are a very personal choice. Work by Professor Amy Brown has shown a detrimental impact of not meeting their breastfeeding goals on mother’s well-being, known as breastfeeding grief. One potential barrier to breastfeeding for as long as the mother (and child) wants in the way they would like is return to work. A work colleague and I went on maternity leave at a similar time back in 2020, and noticed in the online breastfeeding support groups we were members of a lot of questions relating return to work. Common questions included “Do I have to stop breastfeeding?”, “ How will it work?” “What happens if I cannot get my child to take a bottle?”, “How do I broach the subject with my line manager?”. There is a lot of anxiety and stress around continuing to breastfeeding upon return to work. We realised there was a lack of awareness and understanding of the topic with the focus tending to be on the practical than the emotional element. As academics do, we decided to find out more by conducting our own research! We were very lucky to get funding for our ‘Maternal Well-Being, Infant and Return to Work Decisions’ project from the Nuffield Foundation.

In this blog we use the terms women, mothers and breastfeeding for brevity, as these are the terms the majority identify with but acknowledge that some individuals may identify with and prefer other terms.

What is the legal requirement for employers?

The UK Health and Safety Executive (HSE) state pregnant and breastfeeding employees are entitled to more frequent breaks (but it does not state these need to be paid) and employers must provide these employees somewhere suitable to rest. This area should be hygienic and private so employees can express milk should they wish to, with a fridge to store expressed milk. The fact the HSE use ‘should’ when mentioning facilities implies these are recommendations rather than legal requirements. The HSE also states that the toilet is not a suitable place for women to breastfeed/express milk. Somewhat concerning, our project’s mother’s survey suggests that of those who had expressed milk at work, 27% had done so in the toilets, with 4 respondents saying they had breastfed their child in the toilet. Only 19% (9%) stated they had expressed milk (breastfed their child) in a private dedicated breastfeeding room.

Employers are required to consider risks to breastfeeding employees and their children as part of individual health and safety risk assessments. Only 24% of our survey sample who had returned to work and were still breastfeeding had an individual risk assessment.

The ACAS guidance referenced by the HSE tends to be very focused on the practical element with only a brief mention of employee wellbeing related to health issues such as mastitis.

Understanding how to support breastfeeding employees and their well-being at work

Returning to work is an emotional time and for some decisions relating to infant feeding can add to the stress and worry. 26% of respondent to our survey felt some conflict between their infant feeding and return to work decisions. For those women in our survey who returned to work and had to make changes to the way their child was fed, whilst some adjusted well, for some there was a range of mixed and negative emotions: sadness, disappointment, worry, anxiety, conflict, guilt. There is a need to make sure women feel supported in their choices around infant feeding and return to work. However, the topic of breastfeeding and the workplace is a topic that is not often spoken about and there is a lot more to supporting women than providing ‘somewhere to express breast milk’….

Early findings from our mother’s survey suggests that few firms have a transparent breastfeeding policy with 78% of our employed sample stating that employer either did not have breastfeeding policy or they were not aware of it. Women in our survey were asked what support they would have liked. Many commented on wanting more/better facilities. Other common themes related to flexible work/working from home, phased return to work, and mentor/buddy systems, and simply a recognition that return to work and having a small child is an emotional and tiring time.

Our project really wants to get to the heart of issues and provide recommendations for good workplace policy in order to improve the working lives of women and their well-being. We are just about to start analysing our mother’s survey and on the back of this are conducting some more in- depth interviews, before moving onto the employer perspective. Watch this space!

About the author

Sarah Jewell is a Professor of Economics at the University of Reading. Her current research interests lies in the area of women's health and the workplace. She is currently leading a Nuffield Foundation funded project on 'Maternal Well-Being, Infant Feeding and Return to Paid work'.

You can find out more about the project on the project webpage and follow updates on the project Facebook Page. You can follow her on Twitter.