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Am Fam Physician. 2003;68(11):2109

On page 2199 of this issue, you'll find an article titled “Returning to Work While Breastfeeding,” by Frances Biagioli, M.D., Oregon Health & Science University of Medicine, Portland. Dr. Biagioli provides a review of breastfeeding that will help family physicians provide support to new mothers. A patient information handout accompanies the article and will serve as a useful guide for breastfeeding mothers. The American Academy of Family Physicians and other health organizations recommend that infants be breastfed for the first six months of life and then fed breast milk supplemented by solids for at least the next six months. The Healthy People 2010 goals include achieving a breastfeeding rate of 75 percent in the early postpartum period, 50 percent in the first six months, and 25 percent at one year of age; corresponding breastfeeding rates are currently 68 percent, 31 percent, and 17 percent.

Dr. Biagioli notes that 60.7 percent of women work outside the home and make up 46.5 percent of the work force. The percentage of infants who are breastfed is lowest in infants whose mothers work full-time, compared with infants whose mothers work part-time or who are not employed. It's apparent that there is a need to provide better support for breastfeeding mothers, but especially for those who plan to return to work.

An accompanying editorial on page 2129,“Breastfeeding and Returning to Work in the Physician's Office,” by David Meyers, M.D., Georgetown University Medical Center, Washington, D.C., describes the challenges of breastfeeding among employees in clinical health settings. Physicians and other health professionals returning to work have the added difficulty of trying to schedule pumping breaks between patient visits. Dr. Meyers provides practical advice for family physician offices that offer an example for the entire business community.

I'm happy to report that, as an employer, the AAFP stands behind its clinical recommendation in support of breastfeeding by making provisions for its own mothers on staff who want to continue breastfeeding after their return to work. The AAFP allows flexible work schedules to accommodate the needs of breastfeeding mothers and has lactation rooms. However, even in a health organization, it wasn't always this way. A few years ago, when a number of employees in the publications division happened to become pregnant at the same time, including myself, there were no lactation rooms in the organization's headquarters. Employees in the division negotiated to use a small resource center as a lactation room. In the tradition of office humor, someone posted a note on the door dubbing this room “Pumping Station No. 9,” and we had some other jokes while everyone adjusted to the idea. I'm not sure how I did it now, but I managed a schedule of breast pumping along with issue deadlines and succeeded at the one-year goal, thanks to the encouragement of coworkers and support from the organization. Our experiences helped pave the way toward the inclusion of lactation rooms in the building design when the AAFP moved to new headquarters. My hope is that the example of the organization and examples from groups such as Dr. Meyer's will provide encouragement to all health professionals and mothers.

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