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Mothers who delay returning to work beyond 13 weeks are more likely to breastfeed for a longer duration

June 10, 2011

The sooner a mother goes back to work after having a baby, the less likely she is to breastfeed, according to an Arnold School of Public Health study published in the June issue of the journal Pediatrics.

Dr. Chinelo Ogbuanu, a 2010 PhD graduate of the University of South Carolina's Arnold School of Public Health, along with Arnold School faculty researchers, looked at both the initiation and duration of breastfeeding by new mothers.

"Results suggest that women who are out of work or on leave beyond the 13-week period are more likely to both initiate breastfeeding and to breastfeed longer," said Dr. Saundra Glover, associate dean for health disparities and social justice in the Arnold School and Dr. Ogbuanu's lead co-author on the publication. "Based on our findings, if women delay their return to work, then the prevalence of breastfeeding in the U.S. may increase."

As part of the research into the relationship between breastfeeding and work, Ogbuanu and her co-authors looked at information from 6,150 women who worked before giving birth. While Glover said the findings didn't surprise her, she said the research points to the need to consider longer, paid maternity leaves – something the U.S. Surgeon General also has supported.

"Many women, particularly women of color and lower socioeconomic status, cannot afford to be out of work on long, unpaid leave. Women are making a decision based on money rather than the health of their babies," said Glover, a professor in the department of health services policy and management. "The United States is the only developed country in the world without paid maternity leave. And when you look at infant mortality, we have the highest infant mortality rate of all developed countries."

Three of four mothers in the United States start out breastfeeding their babies, according to the Centers for Disease Control and Prevention's 2010 Breastfeeding Report Card. However, at the end of six months, breastfeeding rates fall to 43 percent and only 13 percent of babies are exclusively breastfed. The American Academy of Pediatrics recommends that breastfeeding continue for at least 12 months, and thereafter for as long as the mother and baby desire. Mothers stay out of work an average of 12.4 weeks after giving birth. The federal Family Medical Leave Act (FMLA) protects a woman's job from being ceded to another employee for 12 weeks.

"Children who are breastfed are healthier. If the mother stays home longer she is more likely to breastfeed," Glover said. "Then, when she goes back to work and the children go to daycare, they are less likely to get sick or pick up childhood illnesses. One of the greatest benefits of breastfeeding is for the immediate health and survival of the infant."

Ogbuanu is now the senior maternal child health epidemiologist with the Maternal and Child Health Program in the Georgia Department of Community Health. Other Arnold School faculty members involved with the study were Drs. James Hussey, Jihong Liu, and Janice Probst.

Among the study's highlights:

• Women who returned to work at 13 weeks or later were more likely to predominantly breastfeed longer than three months, compared to those who returned within six weeks. They were also 21 percent more likely to breastfeed — with or without supplemental formula — beyond three months.
• Women who had not yet returned to work by the nine-month interview were 13 percent more likely to initiate breast-feeding compared with those who returned to work within the first six weeks. They also were 70 percent more likely to predominantly breastfeed beyond three months.