Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis.

BACKGROUND: The benefits of breastfeeding are widely known; however, continuation after returning to work (RTW) is not. We aimed to conduct a systematic review and meta-analysis to assess the prevalence of breastfeeding after RTW. The secondary objectives were to compare the economic statuses between continents. METHOD: PubMed, Cochrane Library, Base, and Embase were searched until 1 September 2020, and two independent reviewers selected the studies and collated the data. To be included, articles needed to describe our primary outcome, i.e., prevalence of breastfeeding after RTW. RESULTS: We included 14 studies, analyzing 42,820 women. The overall prevalence of breastfeeding after RTW was 25% (95% CI, 21% to 29%), with an important heterogeneity (I2 = 98.6%)-prevalence ranging from 2% to 61%. Stratification by continents and by GDP per capita also showed huge heterogeneity. The Middle East had the weakest total prevalence with 10% (6% to 14%), and Oceania the strongest with 35% (21% to 50%). Despite the prevalence of breastfeeding in general increasing with GDP per capita (US$50,000 42%), the prevalence of non-exclusive breastfeeding follows more of a U-curve with the lowest and highest GDP per capita having the highest percentages of breastfeeding (US$50,000: 50%, versus <28% for all other categories). CONCLUSION: Breastfeeding after RTW is widely heterogeneous across the world. Despite economic status playing a role in breastfeeding after RTW, cultural aspects seem influential. The lack of data regarding breastfeeding after RTW in most countries demonstrates the strong need of data to inform effective preventive strategies.

French women's representations and experiences of the post-treatment management of breast cancer and their perception of the general practitioner's role in follow-up care: A qualitative study.

BACKGROUND: In France, the Cancer Plan II 2009-2013 was launched to improve post-cancer management and promote greater involvement of general practitioners (GPs) in follow-up care. OBJECTIVES: We investigated how women experienced the post-treatment management of breast cancer and perceived the role of the GP in follow-up care. DESIGN: We conducted a qualitative study based on semi-structured interviews with women with breast cancer in remission. The interviews were transcribed and analysed in accordance with the principles of thematic analysis. SETTING AND PARTICIPANTS: We interviewed 21 patients aged between 30 and 86. Eighteen breast cancer survivors were recruited from GP practices and five from a patients' association. RESULTS: Four themes emerged from the thematic analysis: that breast cancer is a life-changing event; how patients managed the effects of treatment; how patients viewed the future; and patients' expectations of their GP. DISCUSSION AND CONCLUSION: French survivors of breast cancer perceived the physical changes caused by their illness to impact their womanhood, leading to difficulties with sexual relations, a diminished sense of self and fears for the future. They felt abandoned at the end of treatment and desired support. They appreciated the ease of contacting their GP but considered follow-up care outside their remit. They agreed to be followed up by their GP, provided that they co-operated closely with a cancer specialist. This is in accordance with the French Cancer Plan II 2009-2013, which recommends greater involvement of GPs in a monitoring protocol shared with cancer specialists.