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SheMD Journal Club: Barriers to Breastfeeding for US Physicians Who Are Mothers

Updated: Feb 25


Here at sheMD, we believe in the importance of practicing Evidence-Based Medicine. We believe the same principles apply to discussing Gender and Medical Education. Therefore, we are bringing you an entire Journal Club series! Our series focuses on foundational and new literature within the gender and medicine space.


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https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2674255


Why is this article important?

  • This article focuses on factors that impact breastfeeding. It’s important to learn what impedes and what is conducive to breastfeeding so that the work-place can be modified to help physicians who are mothers reach their own personal breast feeding goals.




Article Summary

What they looked at:

  • The study used Social media recruitment via (Physician Moms Group) and sent an anonymous online survey on impact of pregnancy and maternity leave


How they measured things:

  • Of the 14,518 members of the Physician Moms Group at the time of the study, 2,363 mothers (16.3%) completed the survey. Women who were currently breastfeeding were excluded. Univariate analysis was performed using χ2 and Fisher exact tests. A multivariable model was also created to determine predictors of sustained lactation to at least 12 months postpartum and to personal goal. A 2-sided P < .05 was used to determine statistical significance. The survey was approved and the need for patient informed consent was waived by the institutional review board of Brigham and Women’s Hospital.


What were their outcomes:

  • 41.7% of physicians who are mothers who initiate breastfeeding sustain breastfeeding for at least 1 year. Although this finding exceeds the national rate of 27%,3 fewer than one-third of the respondents reported being able to sustain breastfeeding to their personal goal and ½ reported that they would have breastfed for longer




Why do we care about this article?

  • Fewer than ⅓ of the respondents reported being able to breastfeed. Nearly half of respondents reported that they would have breastfed for longer if their job had been more accommodating.

  • Some barriers to establishing a pumping routine included:

  • Inadequate time 85.4%

  • Schedule inflexibility 37%

  • Insufficient space 23.3 % (some used call rooms, lactation rooms, their car, empty patient rooms)

  • Respondents who reported longer maternity leave, dedicated space to pump, and accommodating schedules were more likely to report lactation to at least 12 months postpartum and to personal goal


Take Home Point

  • Modifiable, work-related factors— accommodating schedules to allow for pumping, providing longer maternity leave, and establishing a dedicated private space—may improve the ability of physicians who are mothers to continue lactation after they return to work. These factors should be taken into consideration when designing a workplace that is conducive to breastfeeding.


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