Breastfeeding and work: Let's make it work

Even after complementary foods have been introduced, breastfeeding remains a critical source of nutrients for the young infant and child. It provides high-quality nutrients and protective factors for positive health effects throughout the life-span, including improved physical, psychological, motor, mental and psychosocial growth and development, much needed for increased performance and productivity. Breastfeeding children also reduces their risk of contracting certain non-communicable diseases. 

In the World Health Organisation’s Southeast Asia region, less than half of infants (an estimated 49 per cent) are exclusively breastfed. Unfortunately but not surprisingly, the new-born mortality rate is still high and the region has failed to achieve the Millennium Development Goal of reducing child mortality by two-thirds by this year. 

The WHO has been actively promoting breastfeeding as a key initiative to reduce child mortality. Recent global initiatives like the UN Secretary-General’s Strategy for Women’s and Children’s Health, the “Promise Renewed – Call to Action for Child Survival” campaign, and “Every Newborn Action Plan” all emphasise the importance of breastfeeding. The “Essential Newborn Care Interventions” package includes breastfeeding as a key WHO-promoted initiative, while the Global Strategy for Infant and Young Child Feeding underscores the essential interventions needed to protect, promote and support breastfeeding. 

In 1990, the WHO’s Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding set targets and highlighted mobilisation of support for breastfeeding and recognition of the right of the infant to nutritious food enshrined in the Convention on the Rights of the Child. Decades later, we are still a long way from achieving those targets. We clearly need to do more. 

This year’s Breastfeeding Week carries the slogan “Breastfeeding and work – let’s make it work!” It is time to focus more on enabling mothers to breastfeed their babies at work. Approximately 50 per cent of mothers with children less than one year of age are in the labour force. Returning to work is frequently cited by women as a primary reason for discontinuing breastfeeding. Doing work of any type, including physical labour, does not lead to any change in quantity or nutritional quality of breast milk. Though mothers may want to breastfeed, conditions in the workplace may not be conducive. A woman’s ability to breastfeed is markedly reduced if breaks are not available, quality childcare at or near her workplace is inaccessible or unaffordable, and facilities for pumping or storing milk unavailable. 

Laws and policies must be enacted to ensure workplaces are mother-friendly workplaces, and to build social awareness of working women’s rights to breastfeed. Countries that guarantee breastfeeding breaks until an infant is at least 6 months old show significantly higher rates of exclusive breastfeeding, especially where the share of females in the labour force is higher. 

Further, such policies and mechanisms should be extended to cover the many women in Southeast Asia who work in the informal sector, including the self-employed, seasonal or contract workers and unpaid domestic and care workers. Even if legislation cannot be effectively enforced in the informal economy, examples elsewhere in the world show it can help set norms and guidelines for all employers. 

Most countries in Southeast Asia have banned the promotion of formula milk and bottle-feeding and set out requirements for labelling and information on infant feeding. But implementation of this legislation is lax and needs to be strengthened.

Some countries have also launched policies that guarantee paid maternity leave and promote a more enabling environment at the workplace for breastfeeding. However, the benefits of such measures elude the many working women, especially in those in the informal sector, who still lack the power to negotiate for breastfeeding rights. 

We call upon all stakeholders – healthcare providers, employers, labour and trade organisations, civil society, international organisations and governments – to join in supporting the right of mothers to breastfeed at work and ensure the best possible health for all children. 

 

Dr Poonam Khetrapal Singh is World Health Organisation regional director for Southeast Asia. This week is World Breastfeeding Week.