Making Breastfeeding Work – Dr Nur Hidayati

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I am a proud breastfeeding mom. I fully believe breastfeeding is best for baby and best for mother. But being a working mom places a huge challenge to continue breastfeeding our babies.

Our Ministry of Health (MOH), supports breastfeeding and actively promotes it from even before the baby’s birth. As part of our Baby Friendly Hospitals Initiative, mothers have been given information and resources even during pregnancy on how to make breastfeeding work for them.

But to many working moms – even trying to attain breastfeeding up to 6 months is a huge obstacle. Many decide to stop breastfeeding once they return to the work place. This is especially if the mother lacks support at both home and the workplace as well as from our community.

When I talk to other full time working breastfeeding moms, I hear the same thing all the time. Bosses who do not let them have pumping breaks. Mothers not allowed to store their expressed breast milk (EBM) in the office fridge or pantry. No provision for a private area for mothers to pump causing mothers to either resort to express their milk in secluded store rooms, ‘surau’ or even toilets. Some mothers were even labelled as being lazy for taking frequent pumping breaks or accused of not focusing on work.

In fact this rang true for many juniour doctors who just became mothers. Despite being a health care provider who is aware the importance of breastfeeding, working and breastfeeding in a hospital opened up my eyes that even hospitals as a workplace can be hostile to breastfeeding mothers. A colleague once suffered breast engorgement for hours just because she was stuck seeing cases non stop in the outpatient clinic. There are juniour doctors who went for a pumping session in the middle of ward rounds or on calls who were criticized for avoiding work.

My fellow colleagues and I experienced all this first hand and it breaks my heart to hear interns working with me telling me that they had to stop breastfeeding as they cannot juggle pumping at work with the chaotic pace and heavy hospital workload. Some even ended up choosing to quit being doctors in order to focus on their children. I knew so many talented female doctors who did not opt for postgraduate training for critical medical fields like Internal Medicine, Obstetrics & Gynaecology, Surgery etc because of the same reason.

Even at home, mothers who choose to continue breastfeeding may continue to face challenges. Mostly from family members and spouses who may not be knowledgeable about breastfeeding. New mothers may receive wrong information about breastfeeding from well meaning relatives. In fact, some stay at home mothers can even end up stopping breastfeeding because of this.

If we want more mothers to choose and continue breastfeeding, we as a community need to support them on their journey. Make breastfeeding welcomed at the workplace by introducing breastfeeding mother-friendly policies. Remove the stigma that choosing to breastfeed means that female worker is unproductive. Normalise nursing in public. Create awareness and spread correct breastfeeding information to new mothers.

People ask me how I managed to breastfeed my child up to 2 years. My answer – because I have good support from my colleagues and family members. It was a challenging journey that I did not do alone.

Tips on how to make breastfeeding work for you at the workplace

1. Plan ahead – Tell your employer even before you deliver your baby that you plan to breastfeed your child. Talk to them and find out what is the company policy regarding expressing breast milk at work. If your company does not provide designated space for expressing breast milk and storing EBM, you probably need to make arrangements to allow you to do so. Find out where you can store your EBM and where you can express your breast milk in privacy earlier.
2. If you’ll be pumping in your office, you can make a ‘do not disturb’ sign in front of your door. If you work in a cubicle which lacks privacy, you can either ask for a private space that allow you to express your milk in private or continue pumping at your desk. I have met mothers who have pumped in their cubicles discreetly using nursing covers while continue doing their work. In fact, I know a stewardess who pumped her milk while working on board of airplanes!
3. Let your workmates know your plan. They may wonder why you’re disappearing a few times a day, so fill them in on your baby-feeding plans and get them enrolled in your informal support group. Explain and assure your colleagues that your decision to continue breastfeeding would not affect your job productivity.
4. Use time wisely. You can still continue doing light work like catching up on your work emails while you pump. As a postgraduate doctor, I used my pumping sessions as my study sessions – time for me to read up on new journals, writing study notes or doing past year exam questions.
5. Eat healthy and drink a lot of water. Many mothers who came back to the work place noticed their milk production dropped. I recommend mothers to keep themselves hydrated by drinking lots of water and choosing a healthy diet. Avoid caffeine and alcohol.
6. Keep your expectations real. Not everyone pumps out 5-6 oz of EBM the first day back at work. Stress can affect your breast milk production so think positively. Being able to keep nursing your child when you return to work is a huge achievement on your part. Don’t hold yourself to an unrealistically high standard for milk production. It’s not easy, but you will get better with every nursing or pumping.
7. Create support groups – I used to have a Whatsapp group consisted of fellow colleagues who were currently breastfeeding, pregnant or previously breastfed their children. We support each other by giving tips and encouragement by sharing experiences. I am sure in your workplace – you will have other women who have gone through the same journey as you are going through. If you have no one, you can look for fellow breastfeeding mamas online on web forums and social media groups. Remember – you are not alone.

Whether they decide to fully breastfeed, do mixed feeding with formula or only nurse during confinement – all mothers deserve to be supported through out their breastfeeding journey. Having longer maternity / nursing leave, nursing friendly policies and provisions at the workplace would definitely encourage Malaysian mothers to successfully breastfeed their children longer. Hopefully – we can achieve this soon with everybody’s support and spreading more awareness in the community.

Info and resources for breastfeeding support.

• http://www.breastfeedinggateway.org – your source for reliable and up-to-date breastfeeding information
• http://kellymom.com – evidence – based information source for breastfeeding moms

This article is dedicated to all breastfeeding doctors and nurses… moms.

Dr Nur Hidayati is an internal medicine registrar currently working in a hospital in Kuala Lumpur.

[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.] 

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