Women who delay returning to work breast-feed longer

By Matt McMillen

The longer a working mother stays at home with her newborn, the more likely she is to breast-feed and continue doing so for the recommended six months, according to a new study in the journal Pediatrics.

Women who waited at least 13 weeks after giving birth to resume working were far more likely than those who returned within six weeks to start breast-feeding, favor nursing over other foods after three months, and breast-feed at all after the baby's six-month birthday, the study found.

"Our major conclusion is that if the new mother is able to delay the time of returning to work, the prevalence of initiation and the duration of breast-feeding will increase," says Chinelo Ogbuanu, M.D., the lead author of the study and a senior epidemiologist at the Georgia Department of Community Health, in Atlanta.

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The American Academy of Pediatrics, which publishes Pediatrics, recommends that mothers exclusively breast-feed their babies for the first six months of life, and that breast-feeding should continue-along with other foods-for at least another six months. However, only 10 to 20 percent of women follow those guidelines.

That low percentage worries public health experts, as breast-feeding has been linked to lower infant mortality rates and a lower risk of serious infection, asthma, and allergies. Some evidence also suggests that babies who breast-feed are less likely to become obese or develop diabetes when they get older.

The baby isn't the only one who benefits. Breast-feeding mothers are more likely to return to their pre-pregnancy weight than mothers who rely on bottles, and they even appear to have lower rates of breast cancer and other diseases later in life.

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Last but not least, breast-feeding provides many less-tangible benefits to mother and child alike. "It helps them bond in a very powerful way," says pediatrician Lee Beers, M.D., of Children's National Medical Center, in Washington, D.C., who was not involved in the study. "Mother Nature knows what she is doing."

Ogbuanu and her colleagues looked at a nationally representative group of 6,150 women who are participating in a long-term child-development study run by the National Center for Education Statistics. Each woman gave birth to a single child in 2001 and worked in the year before giving birth.

Roughly 70 percent of the women breast-fed their newborn. In general, the researchers found, the longer the mothers delayed returning to work, the more likely they were to breast-feed, and for a greater period of time.

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Compared to women who resumed working within six weeks, for instance, women who hadn't yet returned to work when their babies were 9 months old were 13 percent more likely to breast-feed, 70 percent more likely to mostly breast-feed after three months, and 25 percent more likely to breast-feed after six months-even after demographic differences such as income, education, marital status, and race were taken into account.

Most women do not have the opportunity to stay at home for such a long time, however. The federal Family Medical Leave Act stipulates 12 weeks of unpaid maternity leave to most women with steady jobs, but the law does not cover many part-time workers and those who work for smaller employers.

"Some mothers may not want to bother to try [breast-feeding] if they have to go back to work soon after giving birth," says Ogbuanu, who supports longer-and paid-maternity leave to encourage breast-feeding.

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Beers breast-fed her two children for a year. She stayed home with them for the first three to four months, after which she pumped breast milk at work, where, she says, she was lucky to have a very supportive workplace.

Employers also benefit from supporting nursing mothers, she adds. Mothers who can nurse at work are less likely to take time off to tend to sick babies, and they're more likely to return to work sooner after giving birth. "It's important as a society to make the environment comfortable for women who want to nurse," Beers says.