Abstract
BackgroundReturn to employment is a major barrier to breastfeeding continuation, globally and in the Southern African context. The Lancet Breastfeeding Series revealed an explicit need for research exploring breastfeeding as a workplace issue in low- and middle-income countries. A dearth of research on workplace breastfeeding in South Africa calls for attention to this topic. This study sought to explore breastfeeding at work experiences from the perspective of employed mothers and senior managers in a provincial government setting in South Africa.MethodsThe study adopted an exploratory qualitative design with multi-perspective semi-structured interviews. Snowball sampling was employed to recruit twelve participants, senior managers (n = 4) and employed mothers (n = 8), from two provincial government departments in Cape Town, South Africa. Interviews were conducted between April and August 2018 to capture participants’ experiences with breastfeeding in the workplace. Thematic analysis was used to analyse data.ResultsFour key themes that described experiences of workplace breastfeeding emerged which further traversed three critical maternity periods: pregnancy, maternity leave, and return to work. The prevalent themes were: 1) Knowledge about the legislation and breastfeeding support benefits. Most participants only knew about the legislated four months maternity leave and time off for prenatal visits but lacked knowledge about comprehensive maternity benefits; 2) Perceptions and experiences of breastfeeding in the workplace. Breastfeeding was perceived to be a mother’s responsibility and a private issue. As a result, most participants stopped breastfeeding prior to or immediately upon return to work after maternity leave; 3) Barriers to breastfeeding continuation, such as the absence of a conversation about infant feeding plans between managers and mothers; and 4) Recommendations to improve breastfeeding support at work from an individual, organisational and national level.ConclusionsOur study contributions emphasise that breastfeeding support from managers should begin prior to the mother taking maternity leave, and that in addition to providing supportive facilities (such as private space and breastmilk storage), immediate supervisor support may be critical in fostering breastfeeding-friendly workplaces for mothers. Management implications for advancing workplace breastfeeding support in the public sector are presented.
Highlights
Return to employment is a major barrier to breastfeeding continuation, globally and in the Southern African context
The aim of this study is to explore experiences of workplace breastfeeding among employees and managers in a provincial government setting in South Africa, to gain an understanding of the local specificities that shape this phenomenon
Our findings suggest that if managers and mothers have a conversation about entitled breastfeeding breaks and workplace support prior to the mother’s maternity leave, it is likely that fewer mothers will perceive return to work as a reason to stop breastfeeding
Summary
Return to employment is a major barrier to breastfeeding continuation, globally and in the Southern African context. Return to employment is a major reason breastfeeding is compromised both globally [6,7,8,9] and in the Southern African context [10, 11]. Not surprising, breastfeeding at work is a complex work-family issue because in order to maintain the World Health Organisation’s (WHO) recommendation to breastfeed exclusively for the first six months of the infant’s life [12], most mothers must engage in this responsibility in the time and space of paid work. Employed mothers tend to stop breastfeeding in preparation to return to workplaces that are not conducive to maternal needs [13, 14] and breastfeeding mothers often fall short of the ideal worker ideology around which organisations are built. Workplace breastfeeding support could make positive organisational contributions by decreasing absenteeism, job dissatisfaction, staff turnover and improve staff retention [16,17,18]
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