42 • PERINATOLOGY Vol 24 • No. 1 • May–Aug 2023 Review Article Mangla M, et al. Improving Breastfeeding Rates in Working Mothers such as Nepal, such sociocultural practices lead to seclusion of the woman for a few days after labor and delivery, translating to the care of the baby predominantly being done by care providers other than the mother; this also hinders breastfeeding. It is also observed that women who are employed predominantly in the food and agriculture industry prefer to hide that they are lactating and would not want to breastfeed. Most of these sociocultural practices are passed on through generations. Educating the masses regarding postpartum care and infant feeding practices can play an important role in promoting breastfeeding. Postpartum home visits by health professionals for enforcing healthy breastfeeding practices can be a good and effective solution. Type of employment The nature of employment is also a significant barrier to successful breastfeeding. Women employed in jobs such as waste picking, street vending, and domestic work often find it inconvenient and unsafe to carry their babies along to work. Among women employed in chemical industries and mines, there is a risk of the babies being exposed to harmful chemicals and fumes, and among women employed in the health care sector, there is a risk of exposing the baby to infectious diseases—these concerns hamper successful EBF. Some professions, especially in the health care sector, such as doctors, nurses, and operation theater staff, involve in emergency duties; so, even if a childcare facility such as a crèche is provided on site, mothers cannot breastfeed due to time constraints.7 The COVID-19 pandemic had significantly affected breastfeeding rates among women in certain professions such as health care, police, and similar other occupations in which women had to deal directly with patients affected with COVID-19. Keeping in mind the highly infectious nature of this infection, women would prefer not to breastfeed to prevent their babies from getting exposed. Knowledge regarding the fact that infection is not transmitted from the mother to the baby through breast milk and that even COVID-19–positive mothers can safely breastfeed their babies needs to be spread in society and the masses.8 Legal issues Although the policy and lawmakers do talk about women empowerment and protecting children’s rights, the Convention on the Rights of the Child and Convention on the Elimination of All Forms of Discrimination Against Women (1979) fails to protect the fundamental right of breastfeeding. Only a few states in India have a legislation in place to protect the rights of lactating mothers (Table). There is still no provision to strengthen the infrastructure for providing a hygienic and safe space for breastfeeding in public, which also ensures privacy. The laws governing the construction of public buildings in India, such as the National Building Code of India (2016) and The Kolkata Municipal Corporation Building Rules (2009), have legislations to ensure fire safety, stipulations regarding building materials used, and rules for structural designs. The Act has detailed provisions regarding the special requirements of the elderly population and people with disabilities, such as ramps with railings, lifts, and even special toilets. Unfortunately, the basic requirements of mothers and infants, such as lactation and nursing rooms, have been ignored in this Act. The Maternity Benefit (Amendment) Act of 2017 has made several provisions for lactating working mothers in the form of increasing paid maternity leave, provision of a crèche at the workplace or within a radius of 500 meters for the children of employees, nursing breaks, and even an option to work from home where feasible. Although this Act is a welcome step toward promoting women and child rights, certain conditions, especially at the workplace, have not been addressed in this Act. After this Act came into force, 1,100,000 to 1,800,000 women lost their jobs, as the burden of wage payment lies solely on the employer.9 The employers considered that employing women would be an added economic burden for their establishment and stressedout the male workforce. The law should also stress on
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