Experiences of workplace breastfeeding in a provincial government setting: a qualitative exploratory study among managers and mothers in South Africa

Abstract

Background Return to employment is a major barrier to breastfeeding continuation, globally and in the Southern African context. The Lancet Breastfeeding Series revealed an explicit need for research exploring breastfeeding as a workplace issue in low- and middle-income countries. A dearth of research on workplace breastfeeding in South Africa calls for attention to this topic. This study sought to explore breastfeeding at work experiences from the perspective of employed mothers and senior managers in a provincial government setting in South Africa. Methods The study adopted an exploratory qualitative design with multi-perspective semi-structured interviews. Snowball sampling was employed to recruit twelve participants, senior managers (n = 4) and employed mothers (n = 8), from two provincial government departments in Cape Town, South Africa. Interviews were conducted between April and August 2018 to capture participants’ experiences with breastfeeding in the workplace. Thematic analysis was used to analyse data. Results Four key themes that described experiences of workplace breastfeeding emerged which further traversed three critical maternity periods: pregnancy, maternity leave, and return to work. The prevalent themes were: 1) Knowledge about the legislation and breastfeeding support benefits. Most participants only knew about the legislated four months maternity leave and time off for prenatal visits but lacked knowledge about comprehensive maternity benefits; 2) Perceptions and experiences of breastfeeding in the workplace. Breastfeeding was perceived to be a mother’s responsibility and a private issue. As a result, most participants stopped breastfeeding prior to or immediately upon return to work after maternity leave; 3) Barriers to breastfeeding continuation, such as the absence of a conversation about infant feeding plans between managers and mothers; and 4) Recommendations to improve breastfeeding support at work from an individual, organisational and national level. Conclusions Our study contributions emphasise that breastfeeding support from managers should begin prior to the mother taking maternity leave, and that in addition to providing supportive facilities (such as private space and breastmilk storage), immediate supervisor support may be critical in fostering breastfeeding-friendly workplaces for mothers. Management implications for advancing workplace breastfeeding support in the public sector are presented.

Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review

“…In Kenya, Ethiopia, and South Africa, studies reported that the lack of a specific location to express or store breastmilk at workplaces was a barrier to EBF [ 64 , 84 ]. In Tanzania and South Africa, mothers were denied breastfeeding breaks during working hours, which affected EBF [ 65 , 81 , 94 , 95 ]. Other studies reported that mothers felt stressed while working, as they did not find time to eat or worked for long hours, which affected their ability to breastfeed [ 66 , 80 , 84 ].…”

A influência do retorno ao trabalho no aleitamento materno de trabalhadoras da enfermagem

“…Este aspecto está em consonância com a literatura, que aponta o apoio no local de trabalho como aspecto crucial e positivo na duração da amamentação 15 . O ato do chefe encorajar verbalmente esse desejo vem demonstrando ser contributivo, gera o comprometimento, melhora a produtividade e diminui o absenteísmo e a insatisfação com o trabalho [14][15][16][17] , se tornando ainda mais relevante durante o período inicial após o retorno ao trabalho, considerado como momento crítico para a continuidade para amamentação 18 .…”

“…Uma sala de amamentação adequada, privada, com insumos para a ordenha das mamas é crucial e, além de contribuir significativamente para a continuidade da amamentação, possui baixo custo de implementação e manutenção para a organização 17,18 , o que novamente reforça a importância da construção desses ambientes de lactação, conforme destacado pelas participantes da presente pesquisa.…”

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“…This is legislated in the labor laws of some countries, for instance the South African employment act legislates for breastfeeding/milk expression breaks for lactating mothers 26 . However, a major challenge is that many employers and employees are not aware of these policies or their rights 27 . In addition, although these suggested policies are very good, the lack of proper implementation, monitoring and tracking prevent success.…”