R. Ortiz Worthington is currently assistant professor, Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Illinois. At the time of writing, she was clinical instructor and a fellow, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh Medical Center and Veterans Affairs Pittsburgh Healthcare, Pittsburgh, Pennsylvania.
D.R. Adams is a resident, Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, Illinois.
Acad Med. 2023 Jan 1;98(1):21-28. doi: 10.1097/ACM.0000000000004898. Epub 2022 Dec 22.
The benefits of breastmilk and lactation are well established for both infants and women. National organizations recommend exclusively breastfeeding for the first 6 months of life and continued breastfeeding for the first 1-2 years of life. For physicians, childbearing years often coincide with key periods of training and their early career. Physician mothers have high rates of initiating breastfeeding but low success in maintaining breastfeeding. Breastfeeding discontinuation among physicians is a well-described, multifactorial issue that has persisted for decades. Reasons for discontinuation include inadequate access to pumping rooms, insufficient workplace and coworker support, and constrained schedules. Pumping is viewed as a burden to teammates and superiors, and physicians are often required to make up time spent pumping. Vague or absent policies to support breastfeeding by accreditation organizations and institutions create workplace conflict and impose additional stress on breastfeeding physicians, who devote significant time, energy, and mental reserves navigating clinical responsibilities, workplace relationships, and licensing requirements to pump. The authors propose several recommendations to improve the environment, support, and resources for breastfeeding physicians with a focus on what individuals, institutions, and professional organizations can do. Creating lactation policies that allow breastfeeding physicians equitable participation in the workplace is a matter of reproductive justice. Improving the collective awareness and support for breastfeeding trainees and physicians is a critical step in recruiting, retaining, and supporting women in medicine.
母乳喂养和哺乳对婴儿和妇女都有好处。国家组织建议在生命的前 6 个月内进行纯母乳喂养,并在前 1-2 年内继续母乳喂养。对于医生来说,生育年龄通常与培训的关键时期和他们的早期职业生涯相吻合。医生母亲母乳喂养的初始率很高,但维持母乳喂养的成功率却很低。医生中断母乳喂养是一个描述详尽、多因素的问题,已经持续了几十年。中断的原因包括缺乏挤奶室、工作场所和同事支持不足、以及日程紧张。挤奶被视为对队友和上级的负担,医生经常需要弥补挤奶时间。认证组织和机构在支持母乳喂养方面的政策模糊或不存在,这会造成工作场所的冲突,并给正在母乳喂养的医生带来额外的压力,他们需要投入大量的时间、精力和心理储备来应对临床责任、工作场所关系和执照要求来挤奶。作者提出了一些建议,以改善母乳喂养医生的环境、支持和资源,重点关注个人、机构和专业组织可以做些什么。制定允许母乳喂养医生公平参与工作场所的哺乳政策,是生殖公正的一个问题。提高对母乳喂养学员和医生的集体认识和支持,是招募、留住和支持医学领域女性的关键一步。