Only a quarter of babies in North America are exclusively breastfed for the first six months of life – rates that are far lower than anywhere else in the world.

The global rate for exclusive breastfeeding is almost 50 percent and significantly the maternity leave benefits in the US lag behind many other countries, meaning that women have only a few short weeks of maternity pay or more often have to take unpaid leave.

Paid maternity leave is guaranteed in 178 countries worldwide, the United States not being one of them.

The American College of Obstetricians and Gynaecologists (ACOG) recommends women take at least six weeks off work following childbirth but the United States is the only high-income country to not offer paid maternity leave on a federal level — it’s left to the individual states to figure out. The only states with an active policy are California, Rhode Island, and New Jersey.

40 percent of women don’t qualify for the Family Medical Leave Act (FMLA) which grants 12 weeks of protected job leave, unpaid, at the federal level.

Only 12 percent of women in the private sector have access to any sort of paid maternity leave.

25 percent of women are forced to return to work within two weeks of giving birth to support their families.

Dr Rebecca Jackson, Professor of Obstetrics and Gynaecology at the University of California, San Francisco, said breastfeeding is one of the biggest challenges for women who return to work early – especially low-wage workers.

“If you’re driving a bus, how do you stop that bus to pump milk?” she asked.

One woman was advised to take at least six weeks off work to recover from an emergency C-section surgery and bond with her newborn child. But with no paid maternity leave and bills due, the 26-year-old had no choice but to immediately start looking for a job.

Within two weeks, she was working 45-hour weeks as a waitress doing nightshifts. She was earning $4.35 an hour carrying heavy trays and walking several miles a day – pumping breastmilk in the restaurant toilet when she could, and living in fear of her C-section scar reopening.

She said she didn’t dare tell her new employer how recently she had given birth for fear of being considered a liability. While her manager was supportive of her pumping breastmilk, there was nowhere suitable to do it. “So, I had to take my breast pump into the bathroom and hope that no one came in and saw me pumping,” she explained highlighting the problems faced by many working women in the US.

South Asian countries have the highest exclusive breastfeeding rates at 61 per cent followed by East and Southern Africa with the second highest birth rate at 55 per cent, according to UNICEF’s Fatmata Fatima Sesay.

 She said: “Almost one in three infants in the Middle East and North Africa are exclusively breastfed and only 26% in North America are exclusively breastfed, so we really need to close disparities and gaps.  

“We have seen that 21 countries have increased their exclusive breastfeeding by at least 10%. Countries as diverse as Cote d’Ivoire, Marshall Islands, the Philippines, Somalia and Vietnam have achieved large increases in breastfeeding rates, showing that progress is possible when breastfeeding is promoted, protected and supported.”

The WHO and UNICEF advocate for babies to be breastfed within an hour of birth, exclusive breastfeeding – nothing but breastmilk – for the first six months of their lives, with breastfeeding continuing until the age of two.

However, many women struggle to reach these targets because their working conditions do not allow this.

Dr Victor Aguayo, UNICEF’s global director of nutrition and child development, called on all stakeholders to provide three important measures to encourage breastfeeding, which is fa better for a baby’s health and development than formula milk. 

“The first one is to ensure a supportive breastfeeding environment for all working women. This includes access to lactation breaks and facilities that enable women to breastfeed their babies once they return to the workplace,” said Aguayo.

“The second one is to provide sufficient paid leave to all working parents to meet the feeding needs of their young children. This includes paid maternity leave for a minimum of 18 to 24 weeks or more after birth,” he added.

“And the third one is increased investments in breastfeeding support including national policies and programmes that regulate and promote public and private sector support to breastfeeding women in the workplace.”

The International Labour Organization’s (ILO) senior Gender Specialist, Emanuela Pozzan, noted that 649 million women lack adequate maternity protection.

“We see that paternity leave laws are on the rise,” she added. “We have 115 countries that provide paternity leave – 33 more countries compared to 2011. So, the trend is positive, and yet 1.26 billion men live in countries that do not provide paternity leave.”

While 68 countries have parental leave, this was only paid in 46 countries.

“The ILO’s Convention 183 on maternity protection says women workers should be provided with the right to one or more daily nursing breaks or a daily reduction of working hours, which should be counted as working time and remunerated accordingly,” she added. 

“In 138 countries there is the provision of statutory rights to time and income security for breastfeeding. Eighty  countries grant two daily nursing breaks, and 199 countries offer the right to daily nursing breaks for six months.”

Only one in 10 potential parents have access to free and affordable childcare services. And in fact, 21 out of 178 countries grant universal childcare services in the laws for children aged zero to two years.

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