Breastfeeding experiences of active duty military women

Military Medicine, May 2003 by Stevens, Kevin V, Janke, Jill

MILITARY MEDICINE, 168, 5:380, 2003

In the last 2 decades there has been an increase in both women in the workforce and women who breastfeed. All women in the workforce may experience a variety of issues when trying to combine breastfeeding and employment. Active duty women may experience issues similar to civilian working mothers, as well as issues specific to military service. The purpose of this qualitative study was to explore the breastfeeding experiences of active duty military women. An interactive interview process was used with a purposive sample obtained from the breastfeeding population of a Midwestern Air Force base. Overall, the nine women included in this study will provide health care professionals with knowledge to address more effectively the needs of the active duty breastfeeding mother.

Introduction

Breast milk has long been termed the perfect infant food, and due to its superiority over formula, it is considered the optimal feeding method for meeting the nutritional needs of infants.1,2 Epidemiological research shows that human milk provides numerous short- and long-term advantages to the infant and mother.1 Current Healthy People3 goals state that by 2010, 75% of women will initiate breastfeeding, 50% will continue to breastfeed through the first 6 months, and 25% will still be breastfeeding at 1 year of age. To meet these goals it is imperative that barriers to breastfeeding be minimized.

Employment, especially outside the home, can have a negative effect on breastfeeding and its duration. A 1995 Ross Laboratories4 mothers' survey found that only 14% of mothers who were employed full-time were still breastfeeding at 6 months compared with 25% of mothers who were not working outside the home.

Working mothers perceive many barriers to combining breastfeeding and working. Some of these barriers include conditions of the work environment, such as no place to pump or store milk, employer policies, and socio-political conflicts related to the separation of work and home.5,6 Whereas working mothers in the military may encounter issues similar to their nonmilitary counterparts, they may also encounter issues unique to the military.

The purpose of this study was to explore the experiences of mothers in military service who are breastfeeding, as they described them. The following research question illustrated this purpose: what were the experiences of active duty military mothers who were breastfeeding?

Review of the Literature: Combining Breastfeeding and Employment

Maternal employment has been identified as a significant factor with regard to a diminished duration of breastfeeding,2,7 and it has been suggested that the anticipated duration has a significant influence on lactation success because it reflects maternal confidence and motivation.8 Ryan and Martinez9 state that mothers who were not working outside of the home were more likely to nurse their infants for a longer period of time than those who were employed full-time. Full-time employment shortened the duration of breastfeeding with more than 80% of mothers employed full-time discontinuing breastfeeding by the time their infants were 6 months of age.6

Several perceived or actual barriers to breastfeeding and working have been reported. Finding time and privacy at work to express their breast milk was problematic for many women.10,11 Other concerns were fatigue, worry about milk supply, leaving the infant, breast engorgement, and getting the infant to accept the bottle.6,10,12 According to Chezem and colleagues,2 an unsupportive work environment, either in policy, physical structure, or both, was another factor in early attrition. Policies with regards to the use of employee's break time is a major obstacle, along with inflexible work schedules, nonempathetic supervisors, absence of a suitable place to express breast milk, and a general lack of support.11

Despite the fact that there are over 190,410 women in the U.S. military,13 most of whom are of childbearing age, there was no literature available on the breastfeeding experiences specific to active duty mothers in the military. They may experience some or all of the problems identified by their civilian counterparts, but may also have other issues specific to service in the military.

Materials and Methods

Design

The purpose of this study was to explore the breastfeeding experiences of military women. The design was qualitative, using the unstructured interactive interview method to collect data. The initial question began with "Tell me about your breastfeeding experiences as an active duty military mother."

Participants

Participants were chosen based on the following inclusion criteria: (1) participants were on active duty at the time at which they gave birth and time of the interview; (2) they had breastfed for at least 3 months while on active duty; and (3) they had breastfed within 6 months at the time of the interview. The number of participants was determined when theoretical saturation of the data was reached.