Abstract
BackgroundThere are unique challenges to parenting in residency and there is limited data to guide policy regarding lactation facilities and support for female physicians-in-training. We aimed to assess issues surrounding breast-feeding during graduate medical training for current residents or recent graduates from United States (US) residency programs.MethodsA national cross-sectional survey was sent to current and recently graduated (2017 and later) female residents in June 2020. This questionnaire was administered using the Qualtrics Survey tool and was open to each participating woman’s organization for 4 weeks. Summary statistics were used to describe characteristics of all respondents and free-text responses were reviewed to identify common themes regarding avenues for improvement.ResultsThree hundred twelve women responded to the survey, representing a 15.6% response rate. The median duration of providing breastmilk was 9 months (IQR 6–12). 21% of residents reported access to usable lactation rooms within their training hospital, in which 12% reported a computer was present. 60% of lactating residents reported not having a place to store breast milk. 73% reported residency limited their ability to lactate, and 37% stopped prior to their desired goal. 40% reported their faculty and/or co-residents made them feel guilty for their decision to breastfeed, and 56% reported their difficulties with breastfeeding during residency impacted their mental health.ConclusionResidents who become mothers during training face significant obstacles to meeting their breastfeeding/pumping needs and goals. With these barriers defined, informed policy change can be instituted to improve the lactation experience for physicians-in-training.
Highlights
There are unique challenges to parenting in residency and there is limited data to guide policy regarding lactation facilities and support for female physicians-in-training
The median total time of breastfeeding and pumping was 9 months (IQR 6–12 months), with 74% of respondents continuing after 6 months, and 13% continuing past 12 months
One woman mentioned “maternity leave policies are atrocious in the United States (US) especially in surgical programs and need to be reformed at the ABMS [American Board of Medical Specialties] and Accreditation Council for Graduate Medical Education (ACGME) levels”. In this national survey study of current residents and recent graduates, we found that women who become mothers during residency training face many obstacles to meeting their breastfeeding and pumping goals upon returning to clinical duty
Summary
There are unique challenges to parenting in residency and there is limited data to guide policy regarding lactation facilities and support for female physicians-in-training. The American Academy of Pediatrics (AAP) recommends breastmilk as the exclusive form of nutrition for the first 6 months of an infant’s life, followed by continued breastmilk for 1 year or longer, while the World Health Organization (WHO) recommends breastfeeding for 2 years or beyond [7, 8] For most women, this requires ~ 4–10 feedings and/or pumping sessions per day and pumping typically takes 15 to 30 min, depending on the individual. In a report of faculty/attendings across medical specialties, the lack of lactation facilities and time available for breast pumping after returning to work was the most frequently cited negative experience following childbirth [6]. Informative, these studies have been small, singlespecialty and had varying inclusion of both residents and faculty members
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