Not sure how I missed this, but the news outlets were recently abuzz about a study that correlated going back to work earlier with a lower likelihood of breastfeeding.
I was hoping that this study would divulge something interesting; maybe some tibit nursing women could use to their advantage in scoring longer maternity leaves (and non-nursing women could just lie and say they were nursing to reap the same rewards – considering your employer has no right to ask what you’re doing with your boobs, I think it’s well within your rights to indulge in lies of omission. Or at the very least, you shouldn’t go to hell for doing it. Actually, you’re going to hell for formula feeding, anyway, so I doubt that a little white lie will add fuel to the eternal hellfire…).
Instead, this is what the study apparently showed, according to MSNBC:
Mothers in the study who went back to work within six weeks were less likely than other women to start breastfeeding – and when they did start, they were less likely to continue.
By comparison, moms who stayed home for at least nine months, or even 13 weeks, were more likely to predominantly breastfeed their babies for three months or more.
My first question was (obviously), “did they include pumping and bottle feeding as ‘breastfeeding’?” Because if not, erm, yes, women who went back to work sooner would have lower rates than those who took longer leave. It’s hard to nurse when you’re in the middle of a meeting, or waiting tables, or what have you.
And I had more questions. How was breastfeeding defined? What confounding factors were controlled for? Because those able to take nine months probably differ from those who went back prior to 6 weeks, for many reasons… job security, socioeconomic status, education level, seniority, etc. According to MSNBC, “In the current study, the authors used statistical tools to try to eliminate the influence of factors that could affect a woman’s ability to nurse, such as her age, ethnicity, income, and the child’s birth weight, for instance.” Okay, so I suppose income level might give some vital insight… but certainly not everything.
I read through the entire study (appearing in a May 2011 issue of Pediatrics) and it turns out that they didn’t address type of employment at all. They did adjust for income and education level, as well as a myriad of other typically-included factors for infant feeding studies. Interestingly, once they did adjust for these, the majority of their findings proved insignificant:
In unadjusted analysis… any maternity leave was positively associated with breastfeeding. The odds of initiating breastfeeding were higher among women who took 13 weeks…and 7 to 12 weeks…of total maternity leave, compared with women who took 1 to 6 weeks. After adjusting for maternal characteristics and all control variables, however, these relationships were no longer significant….
Women who had (7 or more) weeks of paid maternity leave had greater odds of
initiating breastfeeding than women who had 0 weeks of paid maternity leave…In analyses adjusting for maternal and for maternal plus child and community characteristics, this relationship was no longer significant...
And so forth. There was one association which did hold up, though, and rather dramatically:
There was no variation in the duration of any or predominant breastfeeding according to total or paid maternity leave length; nevertheless, the highest proportion of mothers continuing to breastfeed beyond 6 months was among women who had not yet returned to work by the 9-month interview (46.7%) and the lowest proportion was among women returning within 7 to 12 weeks (30.1%)
Okay, so, fair enough. And I was actually happy about this finding. Trust me, I think it would be incredible if we were offered paid maternity leave for 9 months. In-flipping-credible. I then read on to see what the authors were recommending, based on their findings:
…(T)o the extent that the maternity leave length is positively associated with time of return to work, as observed in our posthoc bivariable analysis of maternity leave length and time of return to work, leave policies (unpaid/paid maternity leave) should be instituted at all governmental and organizational levels…
Okay, awesome. That’s great! I’m with you all the way, guys.
….to enable women to take sufficient time off work after delivery to properly nurture their infants...Studies in Canada and the United States support the notion that an increase in maternity leave length mandates in the United States would likely result in a greater proportion of women staying at home longer after delivery.
Properly nurture their infants?? And excuse me for harping on semantics, but “would likely result in a greater proportion of women staying at home longer after delivery” sounds awfully prescriptive to my ears. I would have felt a lot more comfy if that had read “would likely result in a great proportion of women being able to stay at home as long as desired after delivery.”
I bet you’re sitting there shaking your head, thinking, “Come off it, FFF. You’re reading way too much into this. Stop blogging this nonsense and get on your elliptical as you were planning tonight. Your ass could use it.” At least that’s what I was saying to myself. Until I started reading some quotes from the study authors in various news outlets:
One factor they couldn’t control for, said Ogbuanu, was the mother’s intention to breastfeed, and it’s possible that women who knew they wanted to breastfeed “would find avenues to stay home longer.” (MSNBC)
“Many women have to return within six weeks of giving birth,” said Dr. Deborah Campbell, director of neonatology at Montefiore Medical Center in New York City…”Even with high rates of breast-feeding initiation, when women have to go back to work, they often choose to combo-feed with bottle and breast, and the bottle undermines breast-feeding.” (HealthDay)
However, the authors did not find any relationship between breastfeeding and total allowed maternity leave, paid or unpaid. The findings focus instead on the amount of time women took off before returning to work. Some women, for example, who have 12 weeks of maternity leave might not take all of it right after the baby is born. Some of them might return to work sooner, explained Ogbuanu. Others might have had to use some of their leave time before giving birth, if they needed to be on bed rest, for instance…In general, Ogbuanu and her colleagues believe, if new mothers delay their return to work, then duration of breastfeeding among mothers in the U.S. may lengthen… (MSNBC)
There seems to be an underlying message (or maybe not so underlying) that women should be prioritizing breastfeeding over anything else. And I’m not just talking the old work-versus-stay-at-home nonsense, here. The problem is, as the researchers themselves state in the study, the correlation they found is not between length of maternity leave and breastfeeding – it’s between the time a woman goes back to work and breastfeeding.
Yeah, some women may return to work sooner – because they find that their sanity depends on it. I have quite a few friends who feel strongly that they are better moms because they work, and that is their right to decide. Maybe you get 4 months, but you know that taking the full four months will just make you stir crazy, or kill your chances of becoming partner… how would you feel about a policy that forces you to take a specific amount of time off so that you can nurture your baby in a way that someone else believes is appropriate?
Frankly, I think it would be awesome to have a leave policy where you could “bank” your time – say, only take 4 weeks off after birth, but then be able to work reduced hours, or do 4-day work weeks. Or even take additional “banked” time off a few months later, when your baby started the really fun stuff, like smiling, babbling, crawling…that’s when motherhood actually gets fun, for many of us.
Don’t get me wrong – this was a good study, an honest study… and I want to give the researchers props for that. But I also think it may have been a useless study, and a tad paternalistic. What about a study that examines breastfeeding rates from those couples who get ample paternity leaves, as well? My best friend’s husband got 6 weeks off. PAID. I bet if more women had that luxury, a lot more would be successful at breastfeeding.
But hey. Let’s just put it all on women’s shoulders (er, chests). Why fix what isn’t broken?