In a recently released issue of Pediatrics, Dr. Andrew Delle Donne and colleagues examine the impact of increased maternity leave on breastfeeding duration and exclusivity among active duty mothers at the Brooke Army Medical Center (10.1542/peds.2018-3795). I learned from this article that in 2016 the Department of Defense lengthened maternity leave for active duty mothers from 6 to 12 weeks, specifically to support breastfeeding initiation and duration. The goals of this “directive-type memorandum 16-002” were to increase breastfeeding success, with the broader goals of improving job satisfaction and military retention. Dr. Delle Donne et al performed a single center retrospective cohort study by comparing rates of breastfeeding throughout the first year of life among infants born to active duty military mothers before (2014) and after the directive (2016) at Brooke Army Medical Center, which has over 1,500 deliveries per year.
We as civilians can learn a lot from this study, as well as from the bold approach of the Secretary of Defense’s directive. The authors point out the several benefits and challenges that active duty military mothers experience as related to breastfeeding – on one hand they have no-cost medical care and ready access to lactation services, and on the other hand, there is no option for part-time employment and all experience “military specific hardships.” That said, the results of this study demonstrate quite unequivocally an increase in breastfeeding duration and exclusivity through 9 months from before to after the directive, and despite many caveats, this increase appears largely due to the directive. The text explains clearly for you how data were abstracted, and Table 3 gives you a great summary snapshot.
What next? This well done study suggests to me that when an employer embraces the challenge of supporting breastfeeding, success is possible. Any company, from huge tech firms to nationwide fast food chains to smaller employers have the ability right within their grasp to create a maternity leave policy that makes a meaningful difference. Certainly more data is welcome, and prospective and comparative studies should be completed. But recall that we live in the only industrialized country in the world that lacks paid parental leave, so rather than waiting for Congress and the President to act, individual employers can be the change-makers. I encourage you to visit the Office on Women’s Health website, “The Business Case for Breastfeeding” to learn more. And read this great article, which is truly inspiring!