Mothers' Pride                                                                                                                    27/1/2003     South China Morning Post

Going back to work after having a baby is an emotional tug for many women, and for those who wish to continue breast-feeding, support is not always available in the workplace, writes Jane Parry.

 

Four times a day, Eunice Ting locks herself in a cubicle of her office toilet and using a hand pump, expresses breast milk for her baby boy Christopher. Although she works in a swish Central office of a financial services company, there is nowhere else suitable for her to express milk, but she is undeterred. “It takes a big effort to pump milk, but Christopher was premature, born at 36 weeks, so I wanted to give him breast milk to make him stronger,” she says.

 

The benefits of breast milk have been well documented. However, in Hong Kong, with its short period of mandatory maternity leave and pressure-cooker work environment, it is not easy to continue breast-feeding on return to the workplace. According to Department of Health statistics, in 2001 about 60 per cent of mothers at least attempted to breast-feed, but the number that continued fell dramatically by the time most working mothers returned to their jobs. Only 29 per cent of mothers were still nursing their babies after two months.

 

“One of the top reasons for women to give up breast-feeding is that they are going back to work,” comments Dr. Khin Phyu Phyu, senior medical and health officer at the Department of Health's Sai Wan Ho Maternal and Child Health (MCH) Centre. “However, if a mother continues to breast-feed, the baby's health will be good, which in turn keeps the mother happy and enables her to be more productive at work,” she adds.

 

Certainly, continuing breast-feeding is a big commitment. Mothers need to allow extra time in the morning to nurse the baby and express breast milk. They need to find a private place in their workplace to pump milk two or three times a day, perhaps with an electrical outlet in order to use an electric pump, and they also need to store the milk in a cool, safe place. Depending on their position in the company, they may need to seek permission from their boss or human resources manager to take the extra time needed during the working day.

 

However, mothers who succeed in juggling both tasks speak of the pleasure, reassurance and bonding opportunities that breast-feeding brings.

 

“When I was pregnant, I decided that I would only breast-feed for six weeks until returning to work, but then I just fell in love with it,” recalls Elizabeth Armstrong of her experience with daughter Lillian, now five.

 

“I expressed milk basically in any room I could find that was available at the time. It was physically draining but emotionally rewarding and what kept me going was that I was sustaining my baby's life and comforting and nourishing her the best way I could.”

 

Now pregnant with her second baby and working in corporate communications with a major bank in Hong Kong, Armstrong is looking for somewhere she can pump milk in her new workplace. “If you're committed to it you can find your own solution,” she says.

 

Exclusive breast-feeding for the first six months of life and continued breast-feeding for the whole of the first year and beyond carries major health benefits. “Breast-fed babies are less likely to have gastroenteritis, diarrhoea, infections of the middle ear, lower respiratory tract and urinary tract, and meningitis,” explains Dr. Patricia Ip Lai-sheung, Chief of Service at the Department of Paediatrics and Adolescent Medicine, United Christian Hospital.

 

Research indicates that health benefits may last a lifetime, including increased IQ and lower incidence of diabetes and colon cancer. There are also health pay-offs for the mother.

 

“Psychologically for mothers breast-feeding gives that closeness that may be lacking if a woman is working, compared to women who are looking after their children all day long. The health benefits come when women breast-feed over an extended period and include reduced rates of pre-menopausal breast cancer and osteoporosis,” says Ip.

 

How long women breast-feed is determined by a range of factors, including family and social support, accurate information about establishment and management of breast-feeding, and access to help when things go awry. All the Department of Health’s 50 MCH clinics, which among them see more than 90 per cent of Hong Kong’s newborns, now heavily promote breast-feeding and offer support to working breast-feeding mothers through antenatal and post-natal education, mother-to-mother support groups and a telephone hotline.

 

“Family support is very important but the learning process has to be guided by someone who knows how to do it, and the MCH clinics can provide that. Once breast-feeding is going well, women have the motivation to continue,” says Khin. In the private sector, there are lactation consultants and midwives who can act as troubleshooters and there are also mother-to-mother support organizations and hotlines in both Cantonese and English.

 

Taiwan and China have enshrined in law a mother’s right to express milk during working hours, but Hong Kong working mothers must rely on the willingness of their employers to accommodate them on an ad-hoc basis.

 

Alice Wong returned to work in a small travel agency when her baby Justin was only a month old. She had been breast-feeding him from the start and was determined not to allow office hours to get in the way of continuing, but it was the positive attitude of her boss and colleagues that made it possible. “If my boss hadn't been supportive I would have had to give up breast-feeding,” she says.

 

Employers that are explicitly supportive of breast-feeding are few and far between. Within the civil service, Hong Kong's largest employer, only the Department of Health has a formal policy supporting its staff should they decide to breast-feed. There are also some enlightened private sector employers, such as Merrill Lynch Asia Pacific, which has a parenting room complete with easy chair, fridge, lockable door and power point.

 

“We set up the room because for our employees in an open-plan office it isn't convenient to breast-feed or express milk. Some staff also have their domestic helpers bring the baby to the office and they can also feed them in the parenting room,” says Elaine Chan, Merrill Lynch's director and head of human resources, Asia Pacific region.

 

“In the longer term, if we have motivated employees they will be more productive and there could be a staff-retention benefit too. The parenting room shows our employees that we respect individual circumstances,” she adds.

 

Getting more employers to do the same is an uphill struggle, but the Baby Friendly Hospital Initiative Hong Kong Association has launched a campaign to get more employers to become mother and baby-friendly workplaces.

 

“To qualify, employers must have a nursing policy in writing, provide a clean, private room or corner and the necessary flexibility in the woman's work schedule,” explains Dr. Constancia Wu, the Association's honorary spokeswoman. “A company's corporate image is enhanced if it takes care of its female staff.”

 

For Wong, pumping milk and lugging bottles home for 18 months is still yielding benefits. “Now my son is at kindergarten and, whereas his classmates' mothers are frequently taking their children to see the doctor, Justin had only one day sick out of 100 days at school,” she says. “Also, despite my mother's fears that he would be too clingy if I continued to breast-feed, he's a very happy and independent little boy.”

 

Tips to help keep babies on the breast

- Try to extend your post-natal maternity leave as long as possible, or at least until after the baby is six weeks old, by which time breast-feeding is usually well-established.

- Seek professional advice from a lactation consultant or experienced midwife before returning to work. She can help you devise a plan of action that will work for you, give you information on how to avoid common breast-feeding problems and help you choose the right kind of breast pump.

- Two weeks before returning to work, get used to using a pump and stockpile milk in the freezer in breast-milk storage bags or bottles.

- Take your cue from your baby- some take to bottles, others refuse completely or feed little in the day-time, compensating in the evening and night. Remember, no baby will willfully starve itself.

- If your baby has never been fed by bottle, it is best to practise once or twice a day with expressed breast milk before you return to work.

- Expect that during your first week back at work your milk supply will drop. Do not be alarmed – it will soon return to normal.

- Consider other possibilities if there is nowhere for you to pump at work, such as pumping before leaving for work and immediately on returning home, and having the baby brought to your workplace at lunchtime for a feed.

- Remember that the short-term effort of pumping and continuing to breast-feed will pay off with long-term health benefits for you and your baby.