Breastfeeding while employed outside of the home during the first postpartum year, a grounded theory : willfully struggling to maintain daily balance

The purpose of this study was to examine influences on the maternal process of maintaining lactation while employed outside of home during the first postpartum year as perceived by the mother. The American Academy of Pediatrics specifies human breast milk as the best source of nutrition during the first 12 months of life (Gartner, et. al., 2005). The United States Department of Labor reports (USBLS, 2009) that 56.4% of American women who have children less than 1 year of age, are employed. Employment is often cited as related to early weaning (Johnston & Esposito, 2007; McInnes & Chambers, 2008; Nichols & Roux, 2004; Rojjanasrirat & Sousa, 2010; Stewart-Glenn, 2008; Ryan, Zhou, & Arsenberg, 2006). This research was undertaken to address a significant gap in the empirical literature regarding mothers’ self-description of the process of maintaining lactation upon return to the workplace. Eleven breastfeeding mothers shared personal perspectives of the process that they face in their everyday work lives in semi-structured interviews. This qualitative study led to the development of a grounded theory of this process, which was labeled, ‘Willfully Struggling to Maintain Daily Balance’. Findings captured personal perceptions of critical elements related to this process that may serve to inform the development of effective nursing interventions or policy in support of breastfeeding and employed mothers. The study found that the breastfeeding and employed mothers began the process with a sense of willful self-determination to combine lactation with employment, the influence of role models, and basic breastfeeding knowledge. Mothers struggled with intervening variables that either bolstered or undermined their efforts during the process, such as adequate sleep and/or breast milk supply, and elements of support or non-support. Mothers developed individual strategies for use in maintaining a daily balance between their `breastfeeding and employment efforts and for addressing any intervening variables. The employed and breastfeeding mothers ultimately found ‘a way to make it work’ and/or ‘made their peace with’ resultant outcomes. The research addressed the question of what influences the maternal process of breastfeeding while employed outside of the home during the first postpartum year in a sample of central Texas women.