Hillary Myers' goal to breastfeed for a year after her first child was born in 2011 hit a roadblock when she returned to work. Like many other mothers, she assumed it was because of her body.
Shortly after Myers returned to work, she was forced to start supplementing with formula. Even though she was still pumping, her work schedule didn't allow her to block off enough time. That, combined with a lack of awareness and support, left her unable to keep up.
"Breast milk is supply and demand. Anytime there's a decrease in the amount of stimulation that mom's getting, there's going to be a decrease in supply," said Rebecca Uselton, a registered nurse and certified lactation consultant at Parkridge East Hospital. "You only have to pump for about 15 minutes at a time, so it's not like they need to carve out a huge chunk of time to do it, but it does have to be pretty consistent."
Although breast milk is free and the healthiest food for babies, there are many barriers that prevent even the most well-intentioned mothers from breastfeeding, Uselton said. While she thinks apprehension and self doubt are the biggest barriers, culture and environment also play a major role.
"Society doesn't really make it easy for moms to breastfeed," she said. "A lot of people still frown on breastfeeding in public, and a lot of employers don't want to hire somebody that's going to have to go pump every three hours. There's definitely a huge societal change that needs to take place.
Breast milk is easier for infants to digest and provides important enzymes and antibodies that boost immunity, meaning those babies are less likely to have infections and be admitted to the hospital than babies who are fed formula. Breastfeeding also provides important health benefits to the mom, such as a quicker return to pre-pregnancy weight, and the uterus contracts back to its normal size faster.
Uselton said moms frequently say they breastfed their baby until they went back to work, but then they just couldn't keep it going.
"A lot of times they tell me, 'Well, I'll have to go sit in my car and do it, or I'm going to have to do it in the bathroom,'" she said. "Being relaxed and feeling comfortable is really important when it comes to producing milk, and that's just not very conducive to feeling relaxed."
Breastfeeding can be physically, mentally and emotionally difficult whether mothers are working or not, but work can exacerbate those challenges.
Research from Unum, a supplemental workplace insurance provider, found 47% of new moms in the U.S. cite breastfeeding as one of the biggest challenges of returning to work after birth, and only 17% of new U.S. parents said their employer offered lactation rooms.
Nursing mothers are covered under the federal Break Time for Nursing Mothers law if they are also covered by Section 7 of the Fair Labor Standards Act. The federal law establishes the federal minimum hourly wage and requires employers to pay overtime to those working more than 40 hours in a week.
Myers had the same goal to breastfeed for a year when she gave birth to her second daughter a little over a year ago.
"In some ways it was even more important, because I felt like I had not succeed with my first daughter," Myers said. However, this time was "a lot different."
Unlike before, her new employer - Unum - offered a schedule that allowed her to easily block off time. They also provided a dedicated, comfortable room with a lock on the door and helpful supplies.
Myers said that difference in resources and support made her realize it wasn't her body, but her employer, that held her back initially.
"It wasn't that people were outwardly rude, it could be that they just didn't understand that there was a gap," she said. "I think that a lot of people who have not been breastfeeding working moms, they just don't know."
The American Medical Association, American Academy of Pediatrics, and World Health Organization recommend that women feed their babies only breast milk until the six-month mark, when they begin supplementing with food, and then are encouraged to continue breastfeeding until after their baby's first birthday.
Working mothers can rent or buy a breast pump to help express their milk. Manual pumps typically cost about $50 and electrical pumps can cost $200 or more.
Still, less than 35% of babies in Tennessee were exclusively breastfed, meaning not supplemented with formula, for three months, according to the Centers for Disease Control and Prevention. Nationally, about 47% of babies are breastfed this amount of time.
"Overcoming these barriers is going to take a mindset change by society, I think. It's going to be a long process accomplished by one woman at a time," Uselton said. "I tell my moms all the time, 'If you breastfeed your baby for one day, that's still better than never doing it at all."
Contact staff writer Elizabeth Fite at firstname.lastname@example.org or 423-757-6673.