Barriers to Breastfeeding for US Physicians Who Are Mothers

Melnitchouk, Nelya; Scully, Rebecca E.; Davids, Jennifer S.

doi:10.1001/jamainternmed.2018.0320

Cited by 61 publications

(70 citation statements)

References 6 publications

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“…However, in a 2018 JAMA research letter, less than one‐third of physicians report adequacy of breastfeeding according to their personal goal. Physicians experience several common barriers to breastfeeding, including lack of break time, lack of appropriate places to express breast milk, unpredictable clinical schedules, short maternity leaves, and long working hours . Trainees and faculty members have similar barriers, although being a trainee was associated with a larger number of reported barriers .…”

Section: Discussionmentioning

confidence: 99%

The Birth of a Return to work Policy for New Resident Parents in Emergency Medicine

Gordon

Sebok‐Syer

Dohn

et al. 2019

Academic Emergency Medicine

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Objective: With the rising number of female physicians, there will be more children than ever born in residency, and the current system is inadequate to handle this increase in new resident parents. Residency is stressful and rigorous in isolation, let alone when pregnant or with a new child. Policies that ease these stressful transitions are generally either insufficient or do not exist. Therefore, we created a comprehensive return-to-work policy for resident parents and piloted its implementation. Our policy aims to: 1) establish a clear, shared understanding of the regulatory and training requirements as they pertain to parental leave; 2) facilitate a smooth transition for new parents returning to work; and 3) summarize the local and institutional resources available for both males and females during residency training.Method: In Fall 2017, a task force was convened to draft a return-to-work policy for new resident parents. The task force included nine key stakeholders (i.e., residents, faculty, and administration) at our institution and was made up of three graduate medical education (GME) program directors, a vice chair of education, a designated institutional official (DIO), a chief resident, and three members of our academic department's faculty affairs committee. The task force was selected because of individual expertise in gender equity issues, mentorship of resident parents, GME, and departmental administration.Results: After development, the policy was piloted from November 2017 to June 2018. Our pilot implementation period included seven new resident parents. All of these residents received schedules that met the return-to-work scheduling terms of our return-to-work policy including no overnight shifts, no sick call, and no more than three shifts in a row. Of equal importance, throughout our pilot, the emergency department schedules at all of our clinical sites remained fully staffed and our sick call pool was unaffected. Conclusion:Our return-to-work policy for new resident parents provides a comprehensive guide to training requirements and family leave policies, an overview of available resources, and a scheduling framework that makes for a smooth transition back to clinical duties.

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Section: Discussionmentioning

confidence: 99%

The Birth of a Return to work Policy for New Resident Parents in Emergency Medicine

Gordon

Sebok‐Syer

Dohn

et al. 2019

Academic Emergency Medicine

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“…There was considerable heterogeneity in the study populations, survey instruments used and outcomes reported. Most studies included only residents (n=22; 43.1%) 18-40 but 10 included a combination of faculty statuses (19.6%) [41][42][43][44][45][46][47][48][49][50][51] (table 2). Most studies combined participants from different practice disciplines (n=28; 54.9%), 20 -22 27 32 35 36 39 41 42 44 45 50 -66 while the remaining studies reported on participants from a single discipline.…”

Section: Characteristics Of Articles Surveys and Interviewsmentioning

confidence: 99%

Experiences of breast feeding at work for physicians, residents and medical students: a scoping review

et al. 2020

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ObjectiveTo review and summarise the available literature regarding breastfeeding experiences of medical students, residents and physicians.Eligibility criteriaArticles of any design, including non-peer reviewed data that examine the experiences of breast feeding of medical students, residents and staff physicians.Information sourcesOvid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid EMBASE, Scopus and Web of Science.Risk of biasAll peer-reviewed studies underwent risk-of-bias assessment using relevant tools, depending on the study design.Included studiesWe included 71 citations; 51 surveys, 3 narrative descriptions, 9 editorials or letters to the editor, and 3 reviews.Synthesis of resultsIncluded articles were heterogeneous with respect to their study design, target population and outcomes reported. Most articles had a high risk of bias. Only five articles reported the impact of an intervention.Description of effectDespite heterogeneity, the majority of articles described important barriers to breast feeding for physicians, residents and medical students. These barriers were similar across studies, and included inadequate and inaccessible space, time constraints and inflexible scheduling, and lack of colleague support. The consequences of these barriers included low milk supply and early discontinuation of breast feeding.Strengths and limitations of evidenceDue to the observed heterogeneity of articles identified in this review, we are unable to assess trends in barriers or duration of breastfeeding over time.InterpretationInterventions to overcome systemic and cultural barriers to breast feeding are needed to meet legal obligations of workplaces for physicians and trainees. These interventions should be formally evaluated using implementation science or quality improvement methods.

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“…The most frequently cited challenges included inadequate time, schedule inflexibility, and insufficient space. 30 At the point of returning to work, the formerly pregnant surgeon is getting even less sleep than previously, managing the emotions and concerns involved with leaving a new baby at home, and has caloric requirements higher than during pregnancy (500 vs. 300 extra kCal/day). Feeding a newborn generally occurs every 3 hours during the day, and therefore pumping breast milk should occur at roughly the same frequency to avoid diminishing supply.…”

Section: Breastfeedingmentioning

confidence: 99%

The Pregnant Surgeon

Harnsberger

Davids

2019

Clin Colon Rectal Surg

Self Cite

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The proportion of women entering medicine and surgery is increasing steadily. As more women surgeons have children during residency and practice, it is essential that we adopt a team approach to the pregnant surgeon, as a pregnancy undoubtedly impacts the team and not just the individual. Coauthored by a practicing surgeon mother of 2 (J. D.) and a postgraduate year 8 colorectal surgery fellow mother of 2 who is currently pregnant (C. H.), we aim to review the data while providing some practical advice for pregnant surgeons and those considering pregnancy, as well as their valued colleagues, mentors, and administrators. Physical challenges are discussed by trimester, as are the risks facing the pregnant surgeon, the logistics of transitioning in and out of maternity leave, and postpartum considerations.

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Barriers to Breastfeeding for US Physicians Who Are Mothers

Cited by 61 publications

References 6 publications

The Birth of a Return to work Policy for New Resident Parents in Emergency Medicine

The Birth of a Return to work Policy for New Resident Parents in Emergency Medicine

Experiences of breast feeding at work for physicians, residents and medical students: a scoping review

The Pregnant Surgeon

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