Supporting of Breastfeeding Trainees: What Would Best Practice Look Like?
Picture this, it’s a hot June day, with temperatures exceeding 30 degrees. I’ve recently returned to foundation training, following a year of maternity leave. I’m sitting in the hospital’s sole ‘breast feeding’ room, a 1m x 2m box shared by patients and staff alike. Sweat clings to me and this box feels suffocating. I cringe, putting my milk-soaked bra back on. I’d been overfull. I hadn’t brought a spare. I begin to feel woozy, sick and my vision blurs, I’m forced to sit back down. A few months ago, I would have welcomed this oxytocin surge, basking in it and holding my son close. Today, away from him and in the heat, it just makes me sad, sleepy and syncopal. The hot weather is always challenging but, with the physiological effects of breastfeeding, I feel it even more acutely.
I know I need to prioritise expressing for mine and my son’s health but, I feel guilty about the added pressure on my colleagues. I’ve found myself explaining my situation, practical needs and entitlements to colleagues, managers and administrators. Most want to be supportive, but their lack of experience makes it challenging. Not much is offered beyond advice to “Take your breaks, you’re entitled to them”. But expressing isn’t a break. Metabolically and practically, it’s more like being asked to fit a 10 km run into every working day.
Speaking to colleagues, I realise I’m not alone. ‘My supervisor implied that I should just stop like she did’ says one. Another found the routine brutal and her ‘milk just dried up’. These experiences aren’t unusual. As breastfeeding rates increase, they reflect the reality for a growing proportion of the NHS workforce 1. UK legislation clearly outlines employee rights however, a 2022 survey of doctors found that for most women these were not met. 2. Many experienced a lack of time and role adjustments, with 90% holding bleeps and over half being physically interrupted whilst expressing. 3. Unfortunately, NHS corporate guidance is distinctly lacking. The agenda for change has no specific recommendations for reasonable adjustments and many trusts have no formal breast-feeding policy. When work disrupts the physiology of lactation, the health of doctors and their infants are put at risk. Balancing motherhood, breastfeeding and training in a system with little flexibility puts mothers at risk of being left behind their male colleagues.
1) Policy + Adjustments
Each trust should have a dedicated employee breastfeeding support policy and risk assessment tool. The assessment should involve a review of shift length, patterns and staffing levels. How the trainee’s needs for nutrition, hydration and rest will be impacted by breastfeeding at work, must also be examined. Considerations should also be given to the impact of special circumstances, for example weather changes or unusual operational pressures. This assessment should guide the production of a personalised support plan, detailing the practical steps that the department will tale to ensure the safety of the trainee and the service. No trainee should feel that feeding their child is a burden on colleagues. If expressing creates unsustainable pressure on a team, that reflects a staffing problem rather than an individual one. This pre-established plan is one way to address this.
2) Senior Education:
Supervisors, line managers and those involved in employee administration (medical staffing, rotas team etc) should receive maternity and breast-feeding education. Training should centre around the legal rights of employees and trust policy. The goal of this is to ensure that access to support and adjustments is applied as standard and not solely reliant on the trainee’s knowledge and strength of self-advocacy.
3) Educational Planning:
Educational opportunities and portfolio assessments are often conducted opportunistically on shift and are therefore time sensitive. The need for regular and regimented breaks for breastfeeding employees can disrupt their ability to access these. Educational and Clinical supervisors should meet with trainees to review their development needs. A PDP should be developed, detailing steps that the department, trainee and supervisor will take to mitigate this inequality.
4) Estates Planning:
Women have a legal right to a clean, private space to express milk and access to fridge storage, whilst at work. Trusts should ensure that these facilities are available and that staff are made aware of their existence. Facilities should be inspected and reviewed regularly, to ensure that they are in a good state of repair and plentiful enough to meet demand. Expansion or restructuring projects should involve breastfeeding spaces being considered basic facilities, in the same way that toilets are.
5) Culture Shift:
Finally, we all have a vital role to play in transforming the culture surrounding breastfeeding in the NHS. Being flexible and mindful of colleagues needs; considering others breaks in work allocation; discussing breast feeding non-judgementally and simply holding space for breast feeding employees can contribute to this change. Upholding other trainees’ rights and promoting their wellbeing is crucial to building a workforce that is happy, healthy and built for longevity. Breastfeeding is a short season in a doctor’s career but, its impact can echo for much longer. When trainees are supported, it bolsters their confidence that they can be both excellent doctors and present parents. Currently, many are left feeling that one role must come at the expense of the other. The NHS can and should do better.
References 1. Office for Health Improvement & Disparities, 4 June 2026, Infant Feeding Survey 2024: full report, https://www.gov.uk/government/statistics/infant-feeding-survey-in-england-2024/infant-feeding-survey-2024-full-report, [Accessed 16/06/2026] 2. Hearfield H, Collier J, Paize F., 20 June 2022, Breast Feeding Experiences of NHS Staff Returning to Work From Maternity Leave: A National Study. BJPsych Open. 2022;8(S1):S53-S54
Zara Burnage
F2, Yorkshire and Humber Foundation School
August 2026
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The views expressed in this article are those of the author’s, and do not necessarily reflect the official stance of the UKFPO.