Breastfeeding has compelling benefits for both babies and mothers—which is why the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend exclusive breastfeeding for the first six months and breastfeeding for a year or longer. In the United States, four out of five mothers start out breastfeeding, but by three months only 44 percent report exclusive breastfeeding. At six months, the rate plummets to 22 percent. There are many reasons a mother might stop breastfeeding: a milk supply that doesn’t match a baby’s demand, a medical consideration, wanting physical independence. But perhaps one of the biggest barriers to breastfeeding is work.

Working and weaning

Mothers are the fastest-growing segment of the workforce. More than half of mothers with infants are employed and of these moms, 73% work full-time. Working is no longer the exception for new mothers; it’s the new normal.

For working mothers, breastfeeding usually means pumping—several times a day—to maintain milk supply. Yet too many workplaces fail to provide the logistical and cultural support mothers need. That helps explain why working full-time at three months postpartum is associated with a significantly shorter breastfeeding duration.

What’s a working mother to do? The Centers for Disease Control’s (CDC) guidelines for supporting breastfeeding employees suggests working part-time, telecommuting, or having on-site childcare so mothers can breastfeed during the work day. But for most working mothers—particularly those in lower paying jobs with little flexibility—these options are rarely available. Without a federal paid family leave policy, many new mothers in the United States can’t afford to stay home with their babies for more than a couple of weeks. In fact, according to one study, one in four mothers returns to work within two weeks of giving birth.

Breastfeeding is often framed as a personal choice—and it is. But it’s also what sociologists Katherine M. Johnson and Colleen Salpini call a “constrained choice”—one that’s affected by a variety of structural factors. Given the challenges facing working mothers, it’s no wonder 60% of mothers say they do not breastfeed for as long as they intended to.

What do working, breastfeeding mothers need?

To empower mothers to meet their breastfeeding goals, as well as the recommendations, we need structural changes that recognize the realities of motherhood and provide the support working moms need:

Time to pump breast milk.

Workplace breastfeeding rights vary from state to state, but at the federal level, the Fair Labor Standards Act (FLSA) requires employers to provide reasonable break time to pump. While the length of a pumping session differs from mom to mom, research suggests that 30 minutes is fairly standard. Mothers who are away from their babies generally need to pump every three to four hours, which may not seem like a big deal if you’re in a private office and can multitask. But consider the nurse making her rounds in an intensive care unit. The factory worker on quality control. The convenience store clerk who works nights. These employees need coverage to take the pumping breaks necessary to maintain their milk supply. What’s more, since employers don’t have to pay for pumping time, many working moms may not be able to afford to take it.

A space to pump breast milk.

The FLSA also requires employers to provide breastfeeding employees with a private lactation space that is not a bathroom. This mandate is better than nothing, but leaves much room for improvement. Many workplaces cobble together temporary solutions: storage closets, conference rooms, or borrowed offices. Such makeshift spaces feel subpar and convey the tacit message to all employees that breastfeeding is neither welcomed nor supported. A truly accommodating lactation space requires thoughtful consideration: if it’s 20 floors away from the person who needs it, or shared by a fleet of other women, it may not make pumping easier.

A supportive workplace culture.

Traditional workspaces were designed for the needs of workers, most of whom have historically been able-bodied men. As the workforce changes, our workplaces must change too. This means looking at the physical space of a workplace to assess how it meets (or doesn’t) the needs of breastfeeding employees. It also means examining organizational policies and social atmosphere. A breastfeeding-positive workplace has a clear lactation policy in place (see San Francisco’s Lactation in the Workplace Ordinance) and ensures that all employees—not just those breastfeeding—understand and support the logistics of pumping at work. New research shows how important co-worker support can be in mother’s decision to continuing breastfeeding after returning to work.

A society committed to normalizing breastfeeding.

Cultural change takes time. But American society has a long history of evolving to become more inclusive and more equitable. Conceivably, workplace support of breastfeeding will trickle down to individuals and help shift our cultural norms to the point at which breastfeeding in public will no longer be news, but accepted as a positive and nourishing human behavior.

The benefits of breastfeeding are clear. So is the reality that many mothers, particularly those working outside of the home, don’t have the support they need to meet their breastfeeding goals. We need progressive policies for paid family leave and flexible work schedules. We need workspaces truly designed for the physiological needs of all employees. And we need to better understand the challenges working mothers face—and work together on solutions that truly make breastfeeding more optimistic and accessible.

Originally published at