Objective. To determine how employment as a resident physician (resident) affects breastfeeding practices and experiences.
Design. Cross-sectional questionnaire survey.
Setting. US resident physicians in the second half of their postgraduate year three (PGY3).
Participants. 1500 questionnaires were mailed at random to female 1990 graduates of American medical schools. After eliminating unusable surveys, an adjusted response rate of 45% produced 450 surveys; 60 delivered a child during residency.
Measurement/Main Results. Forty-eight (80%) of 60 residents who delivered initiated breastfeeding, and continued for the duration of their maternity leave (mean, 7 weeks). With a return to residency half (24) of those who had initiated breastfeeding discontinued breastfeeding. The breastfeeding rate dropped to 15% (9/60) at 6 months. Residency work schedule was the most common reason (80%) for discontinuing breastfeeding. Of the 24 residents who continued breastfeeding while working, 83% pumped breast milk during their work shifts; 79% felt there was insufficient time during work, and 42% reported no appropriate place at work to express milk. Only 54% who continued felt supported by their attending physicians for their efforts to breastfeed; 67% felt colleagues were supportive.
Conclusions. The breastfeeding initiation rate for resident mothers was in compliance with the Healthy People 2000 guidelines, but the rate at infant age 6 months fell well below the goal of 50%. Modifiable factors in residents' work sites include both physical and emotional accommodations to encourage resident mothers to breastfeed.