A young family physician newly ret...

A young family physician newly returned to practice after taking a two-month maternity leave. She was grateful to her sum of two units male senior partners for allowing her to be at abiding-place with her first child. Although being away from her infant was difficult, she was excited about seeing her patients again. Well aware of the many benefits of breastfeeding, she was prepared to expres her milk while at work and to continue nursing at night. She knew that she was fortunate to have her acknowledge office where she could store her electric cross-question and close the door when she urgencyed privacy.

Things did not go on as smoothly as planned. It took a fair amount of negotiating to arrange morning and afternoon breaks in the physician's schedule. Neither of her partners had eternally taken paternity leave, let alone required "pumping breaks." She also felt pressur to maintain her productivity. At first, patients were frequently scheduled during the two 15-minute slot in her schedule that were intended for pumping. plane on good days, it was challenging to procure her office door closed, assemble the cross-examine think about her baby, and relax enough to achieve a proper milk "let-down" within 15 minutes.

After several weeks, however, the office settl into a verse With some strategic scheduling, the physician was able to expand her breaks to 20 minutes. The sallys about mistaking her breast milk for coffee creamer ceased, and her partners began asking her for advice about breastfeeding management. This physician was able to withhold breastfeeding for 13 months.

Breastfeeding after returning to work has significant health and emotional benefits for mothers and their infants. However, no matter what a woman's profession is, working outside the hearthstone poses significant challenges to breastfeeding. In this issue of American Family Physician, Biagioli (1) provides a thorough overview of the issues surrounding a nursing mother's revert to work and the ways in which her family physician can support her in this challenging transition.

Family physicians should consider to what extent we can support our colleagues, as well as our patients, as they continue breastfeeding after a answer to work. Extended maternity leave, part-time work, and on-site child care all contribute to the solution, on the contrary these options are unlikely to be available to, or appropriate for, all working women

Individualized local solutions, oftentimes involving flexible scheduling, are necessary. in the greatest degree importantly, we need to display our colleagues that we embrace breastfeeding as being best for mothers and children, and that we are willing to make the changes necessary to render certain that it succeeds.

Family physicians' offices can appoint an example for the entire business community about to what extent to make breastfeeding work. encourages phlebotomists, and clerical workers face many of the same challenges to breastfeeding as physicians, without having a private office space. Lactation swings benefit office staff as well as patients. to what degree much easier it will be to write a note to our patient's employer when we ourselves have instituted the changes that we are advocating.

We also can become advocates for breastfeeding-friendly work policies in our hospitals. As large employer hospitals quickly will reap the benefits of improved morale, increased employee retention, and decreased days missed from work to care for sick children. The Aetna insurance company reported that it saved more than $1400 and three sick days by breastfeeding employee in the first year of its employee breastfeeding support program. (2)

And hindrance us not forget residents. Family medicine residents report as well-as; not only-but also; not only-but; not alone-but high interest and strong commitment to breastfeeding, as well as high breastfeeding initiation rates in those who have given birth. (3) However, these residents also have relatively high rates of weaning one time they return to work. (3) level within an 80-hour work week, there can be time to expres breast milk if residents have support.

While we are in succession the way to achieving our Healthy clan 2010 goal of having 75 percent of American women single out to initiate breastfeeding in the immediate postpartum period, we are making les progres toward meeting our more limited goal of having 50 percent of mothers breastfeeding at six month (4) As a society, we must do away with the barriers to breastfeeding after women revert to work. As family physicians, we can take out these barriers in our offices to benefit our patients, our staffs, and ourselves.

REFERENCES

(1) Biagioli F Returning to work while breastfeeding. Am Fam Physician 2003;68:2199-22062213-15

(2) Ball TM Bennett DM The economic impact of breastfeeding. Pediatr Clin North Am 2001;48: 253-62

(3) Gjerdingen DK Chaloner KM Vanderscoff JA. Family practice residents' maternity leave experiences and benefits. Fam M 1995;27:512-8

(4) Ryan AS, Wenjun Z Acosta A. Breastfeeding continues to increase into the just discovered millennium. Pediatrics 2002;110:1103-9.

David Meyer MD is a family physician with Unity Health Care, Washington, DC and an assistant professor in the Department of Family Medicine at Georgetown University Medical Center also in Washington, DC He generally serves as the American Academy of Family Physician's delegate to the United States Breastfeeding Committee.