Supporting breastfeeding at work in a public sector setting: A qualitative exploratory study among managers and employed mothers

Abstract Background: Return to employment is a major barrier to breastfeeding continuation, globally and in the Southern African context. The Lancet breastfeeding series revealed an explicit need for research exploring breastfeeding as a workplace issue in low- and middle-income countries. A dearth of research on workplace breastfeeding in South Africa, and limited awareness about legislation to protect breastfeeding employees, calls for attention to this topic. Methods: This qualitative study explored experiences of workplace breastfeeding amongst employed mothers and senior managers in two provincial government departments in South Africa. Twelve in-depth interviews were conducted with senior managers ( n = 4) and employed mothers ( n = 8). Results: Thematic analysis of the data revealed findings important to understanding mothers’ decisions about breastfeeding at work, across three critical maternity periods: 1) During pregnancy: poor knowledge about comprehensive maternity benefits and an absence of a conversation on infant feeding plans with managers meant mothers were disempowered to make informed choices about breastfeeding at work; 2) During maternity leave: stress from anticipated work-family conflict and logistical considerations influenced mothers’ decisions to wean infants; and 3) Upon return to work: mothers experienced a lack of workplace infrastructural support for breastfeeding. Conclusion: Our study contributions emphasise that breastfeeding support from managers should begin prior to the mother taking maternity leave. Immediate supervisors were found to be an important but overlooked agent to enforce legislation and provide breastfeeding support. Implications for management for advancing support for breastfeeding at work in the public sector are presented.