Breastfeeding, a smart choise for working women.

Submission to the E-Consultation on Hunger, Food and Nutrition Security

Submitted by: Eminence and Bangladesh Civil Society Network for Promoting Nutrition(BCSNPN)

3/6, Asad Avenue, Mohammadpur, Dhaka, Bangladesh. email:,

Introduction: Mothers are the fastest-growing segment of current global workforce.In the past 20 years, thepercentage of new mothers in the workforce has increased which makes women more challenging when they become pregnant.In most cases, those mothers are not able to return works due to lack of support in work place or lack of care giver who can take care of their baby during her absence that make it challenging to continue her jobs and results is discontinuation of job in this stage. Those continue their job phase lots of challenges to continue breastfeeding to their child and started bottle feeding. It is welldocumented that one of the primary reasons for early breastfeeding cessation is theMother’s return to work.[i][ii][iii][iv]

Breastfeeding is a low-tech, low-cost health promotion behavior that has received increasing support from public healthauthorities worldwide over the past 50 years. It has become increasingly clear that breastfeeding is the best option forinfant and young child feeding, and that not breastfeeding exposes mother and child to higher risks of ill health in both theshort and long term.

Inappropriate Infant and Young Child Feeding practices is one of the major cause of child malnutrition. Initiation of breastfeeding within one hour, exclusive breastfeeding for first six months and continued breastfeeding for 20 to 23 months have been identified as major indicators for achieving Millenium Development Goal 4, reducing child mortality one third by 2015.

Barriers to optimal infant and young child feeding contribute to 1.4million preventable deathsannually in children under five, the majority of whom are dying already during the first month of life.Initiating breastfeeding within the first hour of birth can reduce neonatal mortality by 20%, butshockingly, more than half the world’s newborns are not breastfeed within an hour of birth. Exclusivebreastfeeding for six months and continued breastfeeding for 12months may prevent under fivechild deaths by 13%, complementary feeding may contribute to reduce 6%child deaths (Lancet2003). Globally only around 37% of infants under six months are exclusively breastfed(Lancet2003). A 16-country study found that adequate maternity leave policies might increase breastfeedingsufficiently to prevent one to two neonatal deaths per 2,000 live births.[v]

Human milk and infant formula are not equivalent and are not equally suitable options for infantfeeding.Research[vi][vii] has found that for every$1 spent on breastfeeding support, companies save $3. This is because in companies which supportbreastfeeding women return to work earlier,fewer health-care dollars are spent, fewer sick days are taken, employees report greater job satisfaction, companies report reduced staff turnover.

Health insurance studies have documented that infants who are exclusively breastfed for threemonths or longer have overall health care costs that are $300-$400 less per year than infants whoare bottlefed.[viii] Evidencereported in a two-year study of 343 employees an annual savings of $240,000 in healthcare expenses.[ix] Breastfeeding also Lower Absenteeism & Turnover RatesOne-day absences to care for sick children occur more than twice as often for mothers of formulafeedinginfants.[x]A study of multiple companies with lactation support programs found an average retention rateof 94%.[xi]

Given this atmosphere of unacknowledged demand, there is an urgent need to educate employerson the value and feasibility of worksite breastfeeding support programs for business profitability. So a worksitebreastfeeding support initiative can easily build upon the increased awareness of the importanceof breastfeeding, utilizing a combination of outreach and education strategies to reach both employers and empoyees.Breastfeeding support in workplace improve retention, mitigates lost productivity/absenteeism, earlier return from maternity leave, higher employee loyalty and create a family friendly business.

Challenges and opportunities:

The challenge in terms of breastfeeding protection is the adoption and themonitoring of an adequate policy of maternity entitlements that facilitate six months of exclusivebreastfeeding for women employed in all sectors, with urgent attention to the non-formal sector. Lack of support in Workplace, family members, poor Implementation of the International Code of Marketing of Breastmilk Substitutes makes mother more difficult to continue breastfeeding.

The Innocenti Declarations (1999, 2005) and WHO Global Strategy for IYCF (2002) call for provision of imaginative legislation to protect the breastfeeding rights of working women and further monitoring of its application consistent with ILO Maternity Protection Convention No 183, 2000 (MPC No. 183) and Recommendation 191. MPC No. 183 specifies that women workers should receive:

  • Health protection, job protection and non-discrimination for pregnant and breastfeeding workers
  • At least 14 weeks of paid maternity leave
  • One or more paid breastfeeding breaks daily or daily reduction of hours of work to breastfeed

Furthermore, Recommendation 191 encourages facilities for breastfeeding to be set up at or near the workplace.

Many country’s make good progress in tracking maternity protection and could manage six months maternity leave with payment, however, long ways needs to go to achive this.

Directions for the future:

  • Aware employers with this maternity protection law and encourage for incorpoarting into their existing policy.
  • Prenatal education classes for the pregnnat women in the work place
  • Orientation of employes with the advantages of breastfeeding
  • Establish baby creche in all work places.
  • Improve knowledge amongst both employers and employees regarding importance of proper breastfeeding and complemnetary feeding practices.
  • Establish a work site environment that favors mothers recently given birth breatsfeed exclusively enabling them to transition back into the workplace while optimizing the benefits their infants receive from being breastfed.
  • Advocate employes to make an reasonable time and private accommodations for employees to express milk atthe workplace whom are not taken their baby in the work site.
  • Ensure Co-workers support in the work place.
  • Proper implementation of International Code of Marketing of Breastmilk Substitute.
  • Provision of worksite based lactation management.

[i]Taveras, E.M., Capr, A.M., Braverman, P.A. Jensvold, N.G., Escobar, G.J. and Lieu, T.Z. 2003. Clinician support

and psychosocial risk factors associated with breastfeeding discontinuation. Pediatrics 112(1): 108-115.

[ii]Ryan, A., Wenjun, Z. and Acosta, A. 2002. Breastfeeding continues to increase into the new millennium.

Pediatrics 110(6): 1103-1109.

[iii]Fein, S.B. and Roe, B. 1998. The effect of work status on initiation and duration of breastfeeding. Am J Pub

Health 88(7): 1042-1046.

[iv]Visness, C.M. and Kennedy, K. I. 1997. Maternal employment and breastfeeding: Findings from the 1988

National Maternal and Infant Health Survey. Am J Pub Health 87: 945-950.

[v]Ruhm C. Parental leave and child health. Journal of Health Economics. 2000;19(6):931-960.

[vi]Cohen, R. et al. Comparison of maternal absenteeism and infant illness rates among breast-feeding and formulafeedingwomen in two corporations. Am J Health Promo 1995; 10(2):148-53.

[vii]Cohen, R. and Mrtek, M. The impact of two corporate lactation programs on the incidence and duration of breastfeedingby employed mothers. Am J Health Promo 1994; 8(6):436-41.

[viii]U.S. Department of Labor Women’s Bureau. Employment status of women and men in 2008. Available at:

. Accessed May 15, 2009.

[ix]Dickson V, Hawkes C, Slusser W, Lange L, Cohen R, Slusser W. (2000). The positive impact of a corporate lactation program

on breastfeeding initiation and duration rates: help for the working mother. Unpublished manuscript. Presented at the

Annual Seminar for Physicians on Breastfeeding, Co-Sponsored by the American Academy of Pediatrics, American College of

Obstetricians and Gynecologists, and La Leche League International. Chicago, IL: July 21, 2000.

[x]Cohen R, Mrtek MB, Mrtek RG. (1995). Comparison of maternal absenteeism and infant illness rates among breastfeeding and

formula-feeding women in two corporations. American J of Health Promotion, 10(2):148-153.

[xi]Ortiz J, McGilligan K, Kelly P. (2004). Duration of breast milk expression among working mothers enrolled in an employersponsored

lactation program. Pediatric Nursing, 30(2):111-119.