PS23 How well does the NHS Support Employees Who wish to Breastfeed on return to Work?

Abstract

BackgroundIn line with EU and UK law, NHS organisations have policies to support employees who wish to continue breastfeeding on return to work, which has numerous health benefits. The NHS employs many women of reproductive age, but anecdotally some face significant barriers in continuing breastfeeding. The objectives of the study were to describe awareness of relevant policies, describe breastfeeding behaviours and experience of staff in relation to these, and identify any areas for improvement. Fife NHS Board provides full hospital and primary care services in southeast Scotland and employs 8,000 staff. Methods A questionnaire survey with quantitative and qualitative elements was sent from the Department of Human Resources to eligible employees of NHS Fife who had been on maternity leave between 2007-09.This was adapted from previous surveys with input from experts and was piloted in two stages. Those with serious complications e.g. stillbirth were excluded. Full ethical review was not required. Results 651 women were eligible, with 87 questionnaires undelivered, and 342/564 (61%) returned. Respondents were comparable to female employees of NHS Fife.; 203/329 (62%) reported awareness of the breastfeeding and return to work policy. 26/342 (8%) reported being offered information on support breastfeeding on return to work. 63/270 (23%) who breastfed at all continued on their return and this was more common with increasing age, but not related to setting eg ward, community. 18/270 (7%) would have breastfed longer if their employer had been more supportive, and 43/270 (16%) cited returning to work as a reason they stopped.; 102/254 (40.2%) felt not very or not at all confident to approach their employer regarding support. Women who were aware of the policies were significantly more likely to feel confident than women who were not, (p<0.001). 4 respondents used a suitable area to express milk and 3 made use of a designated fridge for storage.Key themes described were that it was perceived that managers and other workers grudged the extra time for expressing milk or breastfeeding, and lack of facilities. Conclusion Experience of staff was highly variable suggesting the policy was not implemented consistently. Suggested areas for improvement include: clearer information regarding policies with specific information on support for continued breastfeeding, line managers initiating discussion regarding the possibility of breastfeeding on return to work, and ensuring that women who do continue are not stigmatised by colleagues.While these results may not be fully generalisable, it is likely that there are similar issues for NHS employees more widely.