Purdue Nursing faculty member and lactation expert explores solutions for improving breastfeeding outcomes for working parents

Written By: Rebecca Hoffa, rhoffa@purdue.edu

Breastfeeding is an influential factor on public health, providing dynamic nutrition and immune protection for infants and physiologic benefits for mothers. The American Academy of Pediatrics and the World Health Organization recommend infants be exclusively breastfed for the first six months of their lives, with breastfeeding continuing alongside complementary foods until 2 years of age or as long as the parent and child desire.

However, national statistics show a stark contrast to those recommendations. Only 24.9% of babies are exclusively breastfed at six months and only 55.8% are receiving any breastmilk at all in the same time frame, based on 2022 data from the Centers for Disease Control and Prevention.

Lauren Ema, who is a clinical assistant professor and recent Doctor of Nursing Practice (DNP) graduate in the Purdue University School of Nursing, practices as a primary care pediatric nurse practitioner and lactation consultant at the Center for Healthy Living. Ema is looking into the barriers that cause parents to stop breastfeeding early — particularly when it comes to lifestyle and work obstacles.

“One of the pervasive issues is how a parent’s return to work impacts that infant feeding relationship,” Ema said.

Lauren Ema(Photo provided)

Coming from a clinical nursing background, Ema has a long history of helping patients live healthier lives. Several years into her career when she transitioned to neonatal intensive care and became a parent for the first time, her perspective toward the challenges of breastfeeding became more focused.

“When I returned to work (after giving birth), I realized the way my brain worked and the way I perceived parents interacting with their babies had totally changed,” Ema said. “One of the things that struck my attention was how much behind-the-scenes work goes into being able to nurture and feed a baby. I was aware of that before, but it just had a whole different meaning when I became a parent myself.”

As part of her DNP coursework in the College of Health and Human Sciences, Ema conducted a review of the literature surrounding working parents’ challenges with breastfeeding. She found many of the articles looked at parents who returned to work before 12 weeks postpartum and after 12 weeks postpartum and saw a correlation between parents returning to work and stopping breastfeeding.

“Pretty consistently, studies do show that early return to work tends to be associated with stopping breastfeeding sooner than recommended,” Ema said, noting this is often more challenging for parents in need of income or parents in professions that are less flexible in nature or have urgent tasks.

Beyond diving into the literature surrounding working parents, Ema also conducted a survey evaluating Purdue graduate students’ perceptions and experiences of lactation support on campus. She noted graduate students often face unique challenges compared to the workforce, as these students often lack the protections like FMLA that many occupations have and are often working on research projects with time-sensitive funding where their duties cannot be easily reallocated.

“A PhD student once came up to me and said, ‘I came back to work on my research project within a week and a half of having my baby because there was no choice,’” Ema said. “This points to a gap where graduate students perhaps experience some unique pressures to continue to show up, but it might be at the expense of their own health, or it might negatively impact their feeding relationship with their baby.”

For Ema, this is a problem that needs to change, and she’s working to make a difference both in the classroom and in her clinical work.

“One of the things I’ve been reflecting on is: How do we thread the needle between having a productive workforce while remembering what we’re working for?” Ema said. “The world is made up of families of all ages, sizes and backgrounds, but we are struggling to find that sweet spot between having as productive of a workforce as possible while having that workforce made up of people who are parts of families. There’s so much that can influence raising a healthy family, and work is part of it, but it shouldn’t be a constant barrier to health.”

Ema noted her DNP coursework provided a great starting point for finding ways to make those changes, focusing on system-level approaches to improve health care and patient outcomes.

“Purdue’s DNP program has several courses that help the student analyze how things work, not only on a machine level but also on a human-to-human level and organizational level,” Ema said. “It changes the way I view problem-solving with patients because I see both the person-to-person things that can be addressed, but I also think about how we can make things run better from a system perspective.”

Ultimately, Ema explained that breastfeeding is a different process for everyone, and the more work that can be done to improve practical support measures for families, the more the statistics will begin to shift toward successful continued breastfeeding.

“I’ve found anecdotally from talking to families that if you give them a safe space to share anything about what it’s like feeding their baby, no matter how they’re doing it, there’s always a story about a challenge they’ve encountered or something where their expectations versus reality were different,” Ema said. “Sometimes it’s traumatic. Sometimes it’s a positive story. It’s just a very interesting field of work, and I think something that we — families, societies, the nation — can better respond to, as feeding a baby is fundamental to basic human functioning.”