Working mothers' struggle: Lack of support in the workplace hampers breastfeeding

As government tries to promote breastfeeding by banning advertising for formula milk, practical problems faced by working mothers trying to breastfeed their babies go unresolved.

Having to steal time in between work to lactate in a storage room at her workplace, Ms Idy Tam, who gave birth to a baby girl two and a half years ago, was left with no choice but to drop breastfeeding a month after her maternity leave ended.

"I couldn't pump milk regularly as I might have lunch meetings or other stuff to do," said Ms Tam, an accountant at a big company whose name she declined to disclose.

"There wasn't a nursery room for me to pump milk, so I had to do it in the storage room."

Ms Tam's plea to her company for a better place to lactate ended up in limbo – she was told that there was not enough space and the storage room was her only choice.

"My company doesn't provide any support in terms of policy and facilities, which makes it really inconvenient for us," she said.

Most Hong Kong mothers fail to exclusively breastfeed their babies until the sixth month following labour, the duration recommended by the World Health Organisation (WHO) for better infant development.

According to the Department of Health, the city's exclusive breastfeeding rate for infants between four to six months old is currently 19%, which has edged up from 14.8% in 2011.

The rate is among the lowest compared to other developed economies. Six-month exclusive breastfeeding rate in the US was 47.2% in 2009 while that of South Korea was 49.3%, findings from the Centre for Disease Control and Prevention of the US and the United Nations Children's Fund (UNICEF) show.

The government sought to tap into a ban on formula advertising to boost breastfeeding in 2011, targeting advertisements for formula aimed at children aged six months to three. The proposal was slammed by the city's formula industry, which had voluntarily halted advertising for infant formula, meaning formula products designed for babies under 6 months old.

Ms Sharon Tsui, policy researcher at the committee of the Hong Kong Breastfeeding Mothers' Association, argues that the crux of the city's low breastfeeding rate lies in practical problems working mothers face in the workplace and calls the industry's ban a "fruitless effort" in swaying a preference to breastfeeding.

"Actually nobody knows about the ban as … infant formula products for babies at six to 12 months old are still being advertised."

Ms Tsui said briefer-than-necessary maternity leave and lack of lactation breaks on working days were two major factors crippling breastfeeding, apart from the near absence of lactation facilities for mothers at workplaces.

A survey conducted by the Hong Kong Polytechnic University on new mothers last year found that half of its 508 participants identified work as the principal barrier to breastfeeding and only 0.4% deemed exposure to baby formula advertisements as relevant.

More than half of the respondents considered prolonged maternity leave as helpful in boosting the breastfeeding rate, the survey showed.

Ms Tsui said many new mothers in Hong Kong found the current 10-week maternity leave too short, of which two to four weeks were prenatal.

"The first month after labour is very important for mothers' bodies to form a routine of breast milk production," she said. "Sometimes, everything is still in chaos … but maternity leave ends and mothers have to go back to work. This really makes them frustrated."

Breastfeeding rate in Hong Kong was found to plummet between the second and third months after labour, roughly when maternity leave ends, according to a study published in the British academic journal Biomed Central (BMC) Pregnancy and Childbirth.

The lack of lactation break had further deterred mothers from breastfeeding as they had to lactate every three to four hours in order to keep producing milk, explained Ms Tsui.

"For working moms, they have to use breast pumps. It takes at least half an hour each time. The bosses may think they are sleazing."

The International Labour Organisation recommends a 14-week paid maternity leave and one to two paid breastfeeding breaks each working day.

Ms Tsui said to her knowledge few enterprises in Hong Kong had breastfeeding supporting policy such as paid lactation breaks for new mothers who had resumed work. Relevant statistics are unavailable.

The WHO prohibits "advertising or other form of promotion to the general public" for infant formula in its International Code of Marketing of Breast-milk Substitutes published in 1981. Few governments currently observe the code through legislation.

Infant formula advertising was once banned in the Philippines in 2006 and has been illegal in the UK since 1995.

While many Hong Kong mothers stranded by feasibility concerns are forced to sacrifice breastfeeding to work, some persist.

Ms Sharon Lau Yuk-ping, an office lady working in Sheung Wan, still breastfeeds her now 13-month-old girl.

This is despite the fact that she has to make time to do it in the bathroom while at work.

"Luckily the toilet at the company is quite clean," she said.

"I intend to give up at no time," said Ms Lau. "My baby enjoys being held in my arms and she loves breast milk. This is the strongest motivation for me to keep on breastfeeding."

Reported by Shirley Chan

Edited by Vanessa Piao

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Photographs courtesy of Hong Kong Breastfeeding Mothers' Association.