Allowing mothers to bring babies to work may sound like a straightforward way to support breastfeeding. New research from UC Santa Barbara anthropologist Kathrine Starkweather suggests it may not be enough.
“You can’t just say, give moms more flexibility in their work, but make them go back to work,” Starkweather said. Her research suggests that even when mothers can keep their babies nearby, work itself can make exclusive breastfeeding difficult.
Starkweather, an assistant professor of anthropology, has spent more than a decade studying the Shodagor, a traditionally boat-dwelling, semi-nomadic ethnic minority community in rural Bangladesh.
Her latest work looks at how women’s livelihoods and postpartum return to work affect breastfeeding and childcare.
Some Shodagor women fish alongside their husbands, taking children onto the boats with them from infancy. Others work as traders, traveling through rural villages selling household goods while their children stay home with fathers, grandmothers or other relatives.
For Starkweather, those very different working arrangements offered a way to test a common idea in global health: If mothers can keep babies with them while they work, will they breastfeed exclusively for longer?
The fishing mothers did have their children with them throughout the day. But they also returned to work soon after giving birth and introduced other foods relatively early.
Starkweather saw some of the reasons firsthand during fieldwork in 2014. She and a research assistant were interviewing a fishing mother from a boat alongside the family’s.
As the woman answered questions, she kept moving — checking on her young son, breastfeeding him for a few seconds, sorting the fish her husband pulled from the river, and tending dinner at the other end of the boat.
“You have all these other demands that you’re trying to contend with at the same time that you also need to breastfeed your baby,” Starkweather said. Having a baby nearby, in other words, does not mean a mother can stop working every time the baby needs to eat.
That has consequences for public health efforts that encourage employers to accommodate mothers and babies at work.
Starkweather’s findings suggest that although workplace flexibility can help support long-term breastfeeding, it cannot substitute for time away from work, especially in the first six months postpartum.
The issue is especially important in communities where families may not have access to high-quality formula, enough water or clean water to prepare it safely.
Exclusive breastfeeding for about the first six months remains the recommendation best supported by evidence for short- and long-term maternal and child health, Starkweather said.
“That makes paid parental leave central to the conversation,” Starkweather said. “Paid leave everywhere in the world is not only good humanitarian policy, but really critical for supporting maternal and child health.”
Her research also gave her reason to question a message she had heard often as a mother herself: that once a baby is given formula or other foods, breastfeeding will inevitably taper off.
That was not what she saw among Shodagor families. Fishing mothers may introduce complementary foods early and still breastfeed their children for more than two years on average.
“It doesn’t have to be this downward spiral,” Starkweather said.
The point, she said, is not that exclusive breastfeeding is unimportant. It is that feeding practices do not always follow the all-or-nothing trajectory mothers are often warned about.
And when it comes to supporting breastfeeding, simply putting mother and baby in the same place may be only part of the equation. Mothers also need time.