Physician Satisfaction With Lactation Resources Following an Intervention to Improve Lactation Accommodations
Authors: Mourad Michelle , Prasad Priya , Wick Caroline , Sliwka Diane 
Published: August 2023

Importance

Physicians who attempt to continue breastfeeding after returning from childbearing leave identify numerous obstacles at work, which may affect job satisfaction, retention, and the diversity of the physician workforce.

Objective

To study the association between improved lactation accommodation support and physician satisfaction.

Design, Setting, and Participants

This cohort study compared the physician experience before and after a July 2020 intervention to improve physician lactation accommodation support at a large, urban, academic health system. The satisfaction of physicians returning from childbearing leave between July 1, 2018, and June 30, 2020 (preintervention), was compared with that of physicians returning from leave between July 1, 2020, and November 30, 2021 (postintervention). Initial data analysis was performed on February 22, 2022, with additional tests for interaction performed on May 18, 2023.

Intervention

The intervention included creating functional lactation spaces, redesigning communication regarding lactation resources, establishing physician-specific lactation policies, and developing a program to reimburse faculty for time spent expressing breastmilk in the ambulatory setting.

Main Outcomes and Measures

The main outcomes were (1) space improvements, use, and costs of the lactation accommodation program and (2) an ad hoc survey of physicians’ reported experience with lactation accommodation support before and after the intervention. Survey data were collected using a 5-point Likert scale to assess physician perceptions of institutional support. Responses collected during the preintervention period were compared with those collected during the postintervention period using unpaired t tests.

Results

In this study, 70 clinical faculty (mean [SD] age, 34.4 [2.9] years) took childbearing leave in the preintervention period compared with 52 (mean [SD] age, 34.8 [2.7] years) in the postintervention period. Fifty-eight physicians (83%) completed the preintervention survey and 48 completed the postintervention survey. When comparing the pre- and postintervention periods, faculty reported improvements in finding time in their clinical schedule to devote to pumping (mean [SD] response, 2.5 [1.3] vs 3.6 [1.5]; P &amp;lt; .001), initiatives to address the impact of lactation time on productivity (mean [SD] response, 2.0 [1.0] vs 3.0 [1.5]; P = .001), and a culture supportive of lactation (mean [SD] response, 2.8 [1.4] vs 3.4 [1.3]; P = .047). Forty childbearing faculty took advantage of lactation time reimbursement and were reimbursed a total of $242 744.37. Faculty whose return to work overlapped with the entire year of the study received financial support for lactation for a mean (SD) of 8.9 (0.2) months, with an average reimbursement of $9125.78.

Conclusions and Relevance

The findings of this cohort study suggest that a multifaceted intervention to combat common challenges in lactation support in academic medical centers yielded improvements in faculty perceptions of institutional support for pumping breastmilk, addressing the impact of lactation time on productivity, and providing a culture supportive of lactation. These findings support the adoption of interventions to improve physician lactation accommodations.