Breastfeeding support for Australian hospital employees: a qualitative study

Background: Returning to paid work from maternity leave is a known barrier to achieving breastfeeding duration goals. The Australian hospital workforce operates under mandated state and local policy directives, which stipulate breastfeeding is to be promoted, protected, and supported. While breastfeeding employees’ experiences have been examined across multiple workplace sectors, little is known about how Australian hospital employees manage. It has been reported internationally that hospital employees have a high risk of any breastfeeding cessation on return to work. This study aimed to explore the lived experiences of hospital employees returning to work while breastfeeding at one hospital in Sydney, Australia. Methods: Data collection occurred from March to May 2021. All hospital employees who had returned to work maintaining breastfeeding over the previous four years were invited to participate however employees who volunteered were from nursing, medical, allied health, and administration staff positions. A qualitative interview design enabled collection of in-depth data, focused on hospital employees’ lived experiences of returning to work breastfeeding at this hospital site. Audio-recorded interviews were transcribed verbatim, coded in NVivo, and analysed into themes and subthemes using the seven-step Interpretive Phenomenological Analysis (IPA) process. Results: Thematic analysis of thirteen interview transcripts generated five themes: ‘Continuing to breastfeed was a big concern’, ‘The reality of pumping at work’, ‘Navigating co-worker negativity’, ‘Worry and guilt about work and milk’, and ‘Sometimes it was less challenging’. Themes presented rich, detailed accounts of both contextual and structural challenges faced by breastfeeding employees from this large Australian metropolitan hospital. Conclusion: Despite state and local health department policy that stipulates breastfeeding is to be ‘promoted, protected, and supported’, this study highlights the many barriers faced by hospital employees wanting to meet the health service’s own breastfeeding recommendations. These findings raise issues of gender equity in the health workplace and highlight the need for decent working conditions that actively support breastfeeding continuation after return to work in hospital environments. More broadly, findings point to the responsibility of hospitals to model best practice in supporting breastfeeding employees, aligning with public health recommendations and the rights of employees to combine paid work and breastfeeding.