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

Abstract

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.

How midwives and nurses experience implementing ten steps to successful breastfeeding: a qualitative case study in an Indonesian maternity care facility

“…183) [ 48 ]. Research demonstrates that barriers to health staff breastfeeding at work include structural barriers, such as lack of space and time or flexibility to accommodate pumping, lack of maternity leave, and lactation policy to guide health staff who returned to work [ 49 – 51 ]. Sufficient paid parental leave is necessary to enable parents to continue breastfeeding and not force them to choose between their paid work and parenthood [ 46 ].…”

Experiences and Impacts of Harassment and Discrimination Among Women in Cardiac Medicine and Surgery: A Single-Center Qualitative Study

“…Medical leaders can advocate for systems-level changes to support pregnancy and parenthood in cardiology, including call-schedule flexibility, identifying lactation spaces, and advocating for onsite childcare. 20 , 23 In addition, medical leaders must act in the moment to address maternal discrimination, including casual remarks that denigrate the work ethic or potential of mothers, or refer to parenthood as an inconvenience.…”

“…However, the ubiquity of sex-and gender-based harassment and discrimination in other academic medicine departments and universities suggests that these results are applicable to many settings. 4,11,14,[16][17][18][19][20][21][22][23][24] Although the number of participants in this study may be small relative to the sample sizes typically seen in quantitative studies, qualitative data provide greater detail on experiences, impacts, and perceptions; for these reasons, sample-size considerations do not apply well to qualitative studies. 26 These qualitative data provide insight intto how experiences of harassment and discrimination were perceived by women in cardiac sciences, building upon numerical data and demonstrating the impacts, coping strategies, and contributors in ways that better link to potential interventions.…”

Delivering Better Solutions for Women Physicians Who Experience Pregnancy, Childbirth, and Childrearing

“…6 Similarly, the institutional culture and support for lactation accommodations were found to be lacking for women physicians, trainees, and students in a recent scoping review. 7 These structural and cultural barriers to flexibility in training that continue into practice, as well as the broad lack of support for women physicians who choose to have children, can lead to significant career dissatisfaction, burnout, and potentially to physicians leaving medicine. Furthermore, women often bear the financial costs of pregnancy and maternity leave, whether it is the loss of income from time away from practice and/or having to extend training, which means deferring the higher income that comes with being in practice.…”