Family supportive supervision in context: supporting breastfeeding at work among teachers in South Africa

ABSTRACT

Family supportive supervisor behaviours (FSSB) has received growing attention as an effective set of behaviours to facilitate the integration of work and family responsibilities. However, the FSSB construct remains limited in its sensitivity to context and our understanding of FSSB remains embedded in experiences from high-income global North countries and in white collar and private organisational settings. This paper presents a context-sensitive interpretation of FSSB for breastfeeding at work among public school teachers in South Africa–a middle-income global South country. Thematic analysis of in-depth interview data from teachers who are mothers, and principals as supervisors, underscored intersecting layers of contextual complexities that advance understanding of FSSB for supporting breastfeeding at work. Patriarchal culture and pervasive gender-based violence in South Africa compromises mothers’ access to FSSB, while historical socio-spatial inequalities endemic in the public education sector limits the viability of all dimensions of FSSB to improve breastfeeding at work. The study findings have implications for the application of FSSB in diverse geographical, socio-cultural, and economic contexts.

KEYWORDS:

• Breastfeeding at work
• Family supportive supervisor behaviours
• Low and middle-income country context
• Public education sector
• Blended work and family
• Global South

Introduction

Working mothers’ challenges of breastfeeding at work are a concern of growing importance as feminisation of the labour force intensifies globally (Al-Attas & Shaw, 2020; Grandey et al., 2020; Johnson & Salpini, 2017). The World Health Organization (WHO) recommends exclusive breastfeeding (giving breastmilk only) for the first six months of an infant’s life, and thereafter breastmilk with complementary foods for up to two years of age or beyond (World Health Organization, 2021). In supporting WHO’s recommendations, several nation states have adopted maternity protection legislation (Heymann et al., 2013). Additionally, organisations are gradually implementing breastfeeding at work support programmes (Dinour & Szaro, 2017) as studies show that workplace support for breastfeeding reduces absenteeism and staff turnover, and increases job satisfaction and productivity (Cohen et al., 1995; Waite & Christakis, 2015). Yet breastfeeding rates among working mothers remain low.

Breastfeeding at work remains a taboo in most workplaces as it departs from the stereotypical ‘ideal worker’ norm (Acker, 1990). Mothers contend with challenges such as inflexible work schedules and unequal access to physical space in their attempts to blend breastfeeding and employment (Gabriel et al., 2020; Johnson & Salpini, 2017). In low and middle-income countries (LMICs), these challenges are exacerbated due to limited state and organisational resources, and economic contexts where the mother’s income is of necessity. These mothers tend to cease breastfeeding earlier than the recommended duration to return to paid work (Rollins et al., 2016; Stumbitz & Jaga, 2020). What then could support mothers who wish to engage in breastfeeding and employment in this context to do so?

Researchers suggest that first line supervisors who offer informal support, may be effective change agents in facilitating mothers’ successful management of breastfeeding and employment because of their proximity to understanding their workers’ daily work-family demands (Burns & Triandafilidis, 2019; Chow et al., 2011). This informal support is especially beneficial to mothers in contexts of low formal support (Mabaso et al., 2020). Family supportive supervisor behaviours (FSSB) is a specific form of informal support that supervisors demonstrate to assist employees with their integration of work and family responsibilities (Hammer et al., 2009). It has been associated with improved employee and organisational outcomes such as reduced work-family conflict and turnover intention, and increased job satisfaction and performance (Odle-Dusseau et al., 2016). FSSB research however has mostly been quantitative and conducted in the United States (US) (for exceptions, see Bosch et al., 2018; Las Heras et al., 2015) where family forms and sociocultural and economic contexts are dissimilar to those in countries especially in the global South. Work-family assumptions rooted in the experiences of white, middle-class, dual earner couples and nuclear families in high-income global North societies may limit the application of FSSB in LMIC contexts (Las Heras et al., 2015; Ollier-Malaterre et al., 2013). Crain and Stevens (2018) added that our understanding of FSSB remains limited in its sensitivity to context and lacking in insights on behavioural processes at play in their manifestation at work. They recommended more qualitative research to understand FSSB in distinct contexts and settings for broadening the construct and its uptake in the workplace.

Breastfeeding at work in South Africa

South Africa’s exclusive breastfeeding rates are amongst the lowest in the world. Nationwide estimates ranged from 8% (Doherty et al., 2012; Victora et al., 2016) to 32% (South African Demographic & Health Survey, 2017), with mothers’ return to work reported as a major reason for breastfeeding cessation (Siziba et al., 2015). To promote breastfeeding at work, the South African national government legislated four months partly subsidised maternity leave and two 30 minutes workplace breastfeeding breaks for the first six months of the child’s life (Government Gazette, 2018). However, breastfeeding breaks remain underutilised nationwide (Martin-Wiesner, 2018). Among provincial government employees in South Africa, Mabaso et al. (2020) attributed their underutilisation of breastfeeding breaks to the persistence of masculine workplace norms and a lack of awareness of the legislation by mothers and supervisors. FSSB may therefore foster utilisation of maternity protection benefits and compensate for the limited formal support for breastfeeding at work.

This study aims to broaden our understanding of FSSB in the context of breastfeeding at work in a public education setting in South Africa and contributes to knowledge in the following ways. First, it extends understanding of FSSB beyond its value for traditional non-work demands that affect employees in general (such as taking time to attend to a family emergency) by focusing on a gendered, stigmatised blended work-family issue of breastfeeding at work (Gabriel et al., 2020; Grandey et al., 2020). Next, we widen the applicability of FSSB to diverse settings by studying breastfeeding at work among a specific group of working mothers, namely teachers in the public education setting. To gain a nuanced understanding of the unique salience of FSSB dimensions for breastfeeding at work among teachers, we employ a multi-perspective approach incorporating both teachers’ needs for breastfeeding support at work and principals’ needs to provide the support as their immediate supervisors. A multi-perspective approach contributes to the development of specific supervisory behaviours that foster inclusive workplaces for mothers who want to breastfeed at work (Witters-Green, 2003). Finally, while the need to advance supervisor support for breastfeeding at work is by no means a problem confined to LMICs in the global South, we extend FSSB theorising by challenging its Northern universalism that has dominated the conceptualisation of the construct by emphasising local contextual complexities. South Africa’s legacy of apartheid and colonialism continues to shape socio-economic and cultural conditions such that it has distinct influences on breastfeeding at work (Stumbitz & Jaga, 2020).

We organise the paper by beginning with a brief background into the public education sector in South Africa. We then theorise FSSB in relation to the specific blended work-family phenomenon of breastfeeding at work. Next, we detail the method employed and present the key themes derived from the analysis of the data. The paper concludes with a discussion of the findings and implications for management and social policy.

Apartheid and colonial influences on the South African public education sector

In apartheid South Africa, the Bantu Education Act of 1953 (Mujal-León, 1988) created two distinct schooling systems based on race. A superior well-resourced system was created for white learners only, resulting in ‘white schools’ and an inferior system exclusively for black learners, ‘black schools’ (Taole & Wolhuter, 2019). ‘White schools’ were in affluent neighbourhoods, allocated high-quality infrastructure such as sanitation and recreational facilities, and qualified teachers, to maintain white supremacy. ‘Black schools’ received limited resources to develop an unskilled, subjugated labour force (Amnesty International, 2020). In post-apartheid South Africa, to redress past inequalities, the democratic government adopted an equitable funding plan where public schools were stratified into five quintiles ranging from poorest schools (quintile 1) to most affluent schools (quintile 5). Schools in quintile one to three are allocated higher government subsidy to offset poverty levels from their neighbouring communities and quintile four to five schools receive less subsidy and rely more on school fees and fundraising (White & Van Dyk, 2019). Despite the redress imperative, South Africa’s persistent economic inequality that disproportionately affects the black majority undermines these efforts. Consequently, the education sector remains unequal as evident in quintile one to three schools which are often under-resourced. For example, quintile one to three schools may lack recreational infrastructure such as playgrounds, laboratories and libraries, and face increased risk of vandalising due to high poverty and crime in their neighbouring communities, compared to schools in quintiles four and five (Thobejane, 2013).

Theorising FSSB in relation to breastfeeding at work

Hammer et al. (2009) validated four dimensions of FSSB namely; emotional support, instrumental support, creative work-family management, and role modelling. Researchers have explained the relationship between FSSB and positive organisational outcomes by drawing on Job Demands–Resources Theory (JD-R) (Demerouti et al., 2001) and Conservation of Resources Theory (COR) (Hobfoll, 1989). The time, energy, and effort it takes to breastfeed or express breastmilk at work are examples of job demands that when combined with work-related demands drain employee resources and subsequently result in strain. Consistent with JD-R theory, emotional support, that is, supervisors showing interest and inquiring about mothers’ difficulties juggling work and breastfeeding, and voicing concern when mothers articulate strain, should reduce mothers’ feelings of guilt, anxiety, and stress associated with work time pressure from breastfeeding demands (Burns & Triandafilidis, 2019; Froh & Spatz, 2016). Using COR theory, instrumental support and creative work-family management could preserve mothers’ time and energy which they may use to breastfeed at work, thus preventing organisational resource losses (Hobfoll et al., 2018). For example, instrumental support involves supervisors informing mothers about breastfeeding at work policies and availing private space to breastfeed. Furthermore, creative work-family management entails supervisors proactively making changes in the workday schedule to allow mothers to take time out to express or breastfeed. Instrumental and creative-work family support could create a favourable emotional and physical environment for women confronted with physical discomfort (i.e. engorged breasts) which negatively affects their self-esteem and job performance (resource loss), thereby helping mothers better manage breastfeeding and employment (Waite & Christakis, 2015). Lastly, role modelling is grounded in Social Learning theory (Bandura, 1977). Supervisors who demonstrate in-depth understanding of the complexity of breastfeeding at work through personal experience either themselves, with their partner or a close personal contact, are likely to encourage mothers to utilise breastfeeding breaks (Basuil et al., 2016). Consequently, when mothers experience FSSB, they may feel more comfortable engaging in breastfeeding at work.

Method

Research approach, sampling and procedure

An exploratory qualitative approach was adopted to elicit context-sensitive insights into how teachers and principals understood and experienced breastfeeding support at work in public schools (Cassell, 2009). Multi-perspective semi-structured interviews were conducted to seek triangulation with a sample diverse in gender, job level, race, and school quintile (Kendall et al., 2009). As public education is located within the realm of provincial government, it was purposely selected as a model employer, as provincial government offers four months fully paid maternity leave. Furthermore, public education has experienced rapid feminisation in democratic South Africa, at 20–25% more than other public sectors (Taole & Wolhuter, 2019). This sector provides distinct insights because it has a highly controlled work programme guided by scheduled class times and breaks, with intense job demands and almost no schedule flexibility.

Prior to data collection, ethical clearance was sought from the University of Cape Town’s Commerce Faculty Ethics in Research Committee in August 2019 [REC 2019/008/068] and renewed in February 2021 [REF: 2021/02/002] due to COVID-19 pandemic restrictions on data collection in 2020. Approval was also obtained from the Department of Education in the participating province to conduct research within schools. For principals to participate, they had to have supervised a pregnant teacher who returned to the same school after their maternity leave. For teachers to participate, they had to have been pregnant or had a baby and breastfed within two years prior to the interview date. Informed consent was sought from each participant prior to data collection and all interviews were recorded with each participant’s permission. Participants were encouraged to share only that which they were comfortable sharing and could withdraw participation at any point without consequence. Participant confidentiality was assured by not using any names in the reporting of the study findings.

Multiple strategies were employed to recruit participants. First, public-school principals (n = 110) within the province’s main metropolitan region were invited by e-mail to participate. Following a poor response (3%), snowball sampling via word of mouth, social media and personal networks was employed together with purposive sampling to diversify the sample (Creswell & Creswell, 2018). In total, 27 semi-structured interviews from 14 principals (seven female and seven males) and 13 teachers across 18 different schools were conducted (see Table 1 for participant demographics).

Table 1. Demographic characteristics of study participants.

	Age	Gender	Racial group	Marital status	No. years in organization	Child’s age time of study (months)/no. of children
Teacher 1	32	Female	Black	Living with partner	5 years	6 months
Teacher 2	33	Female	Coloured^a	Married	10	27 months (8 months pregnant)
Teacher 3	33	Female	White	Married	4	7 months
Teacher 4	32	Female	Black	Single	3	11 months
Teacher 5	32	Female	Coloured	Married	11	13 months
Teacher 6	34	Female	White	Married	4	10 months
Teacher 7	41	Female	Coloured	Married	23	12 months
Teacher 8	35	Female	Black	Single	3	8 months
Teacher 9	29	Female	Black	Married	1	1 Month
Teacher 10	32	Female	Black	Single	3	11 months
Teacher 11	41	Female	Black	Married	5	14 months
Teacher 12	30	Female	Coloured	Married	3	16 Months
Teacher 13	30	Female	Indian	Married	6	23 months
						No. of children for principals
Principal 1	63	Female	White	Married	23	1
Principal 2	59	Female	White	Married	12	3
Principal 3	57	Male	Coloured	Widowed	19	5
Principal 4	50	Female	Black	Living with partner	5	1
Principal 5	47	Female	Black	Married	12	5
Principal 6	50	Female	Black	Married	4	1
Principal 7	52	Male	Black	Married	4	3
Principal 8	48	Male	Coloured	Single	5	3
Principal 9	57	Female	Black	Married	5	1
Principal 10	60	Male	Black	Married	26	6
Principal 11	56	Female	Indian	Married	6	1
Principal 12	51	Male	Coloured	Married	10	3
Principal 13	58	Male	Indian	Married	38	0
Principal 14	57	Male	Indian	Married	3	3

^a A South African racial category that refers to individuals ‘loosely bound together for historical reasons such as slavery, creolisation and a combination of oppressive and selective preferential treatment under apartheid’ often oversimplified as ‘mixed race’ (Erasmus, 2017, p. 112).

Data collection began in February 2020 with semi-structured face-to-face interviews at the participants’ schools, but with the onset of the COVID-19 pandemic, six interviews were conducted remotely using the virtual Microsoft Teams platform or telephonically. The pandemic also threatened the sampling process as public schools stopped operating or operated intermittently. Consequently, reaching participants through school contact details was restrained and data collection became increasingly challenging during the pandemic as teachers and principals were under severe stress from the uncertainty about teaching in the lockdown (Hamman, 2021).

Interviews were conducted in English and isiXhosa based on each participant’s preference and lasted between 35 and 120 minutes. An example of a question asked to the teachers was, ‘Can you tell me about your experience with breastfeeding and working after maternity leave?’. Principals were asked, ‘In what way(s) did you provide support for breastfeeding at work to a teacher who returned from maternity leave?’. To strengthen data quality and rigour, prolonged engagement with participants and observations of the schools’ facilities were employed. Investigator triangulation through routine discussion of data between the authors to deter bias and refine interview questions was conducted (Lincoln & Guba, 1985; Tai & Ajjawi, 2016). Data collection ceased in May 2021 upon reaching data saturation.

Data analysis

Data analysis was informed by a southern theoretical lens that draws on a range of perspectives which questions universalisms in social knowledge production (e.g. Collyer et al., 2019; Comaroff & Comaroff, 2012). This lens allowed for the emphasis of local contextual issues, such as the influence of colonialism and apartheid, and their effects on material lived realities in a Southern context, to produce plural ways of understanding work-family phenomena (Jaga, 2020). Template analysis (King, 2004), a method of thematically organising and analysing qualitative data in social science research, was employed to analyse the data. This approach was deemed appropriate to examine a phenomenon from multiple perspectives in a given context (King & Brooks, 2018). The first author who is fluent in English and IsiXhosa transcribed verbatim the first four interviews to become familiar with the data and identify preliminary themes. The remaining interviews were transcribed verbatim and translated by a professional transcription company. Transcription accuracy was checked (MacLean et al., 2004) and interview transcripts were imported into NVIVO 12 Pro (Jackson & Bazeley, 2019). The first author conducted the initial coding, thereafter, discussed codes, preliminary themes, and main themes with the other authors regularly, until consensus was achieved. First, each transcript was read and reread, and the initial template was developed from the first four interviews of teachers and principals. Three initial themes emerged in response to the research questions: (1) General perceptions and experiences of breastfeeding at work, (2) Breastfeeding supportive behaviours and (3) Factors influencing supervisor support for breastfeeding. Multiple higher-order (e.g. factors influencing supervisor support for breastfeeding) and lower-order (e.g. socio-economic factors, management style and personal characteristics) codes were created (clustering) from the remaining interviews. Broad themes (e.g. practical changes and challenges to breastfeeding at work support) and sub-themes (e.g. infrastructural inequalities, job-specific conflict, and supportive changes made by supervisors) were later formed (King, 2004; King & Brooks, 2018). A thorough in-depth analysis of the initial template was conducted yielding themes that centred context-sensitive FSSB to advance breastfeeding at work support within the educational setting in South Africa. Data interpretations were based on the final framework developed.

Findings

In what follows, we elucidate the key themes that emerged from the data: the pervasiveness of masculine definitions of workplace behaviour compromises teachers’ access to FSSB for breastfeeding at work, persisting resource disparities from historic socio-spatial and resource inequalities limits the viability of all dimensions of FSSB to enhance breastfeeding at work, and practical changes and challenges to support breastfeeding at work.

The pervasiveness of masculine definitions of workplace behaviour affecting the availability of FSSB

Most teachers believed that their schools were family-orientated as their principals supported them to attend to general family responsibilities outside of work. However, they felt that breastfeeding as a specific need was incompatible with their teaching, and had to be done outside of work time. A male principal voiced his aversion to any adaptations at the school to accommodate a teacher breastfeeding at work, thereby reinforcing masculine workplace cultures and the expectation for women’s lactating bodies to be scheduled outside of the workday, so as not to interfere with work demands:

There is no need for a person to be fiddling with breasts at school. You can express at home before you leave for work. If you have to wake up early and be heading to work around 6am or so, wake up around 4am or 5am and express. (Principal 10 – male – quintile 1 school)

Teachers felt that their job was not built for lactating bodies as teaching required them to be with learners at all times. The lack of facilities (i.e. private rooms for expressing and storage of breastmilk) reinforced their perceptions of a workplace that was not conducive to maternal needs. Teaching schedules seemed inflexible to allow for breastfeeding breaks, even when these breaks were nationally legislated:

… we only have one 30 minutes break for everyone. I really don’t know [how breastfeeding can be done at work] … here we have to get back to class after the 30-minute break. Let’s say you do get the 30 minutes to express then what do you do with the expressed milk? (Teacher 10 – quintile 1 school)

Teachers who could afford unpaid leave utilised the option for extended unpaid maternity leave of an additional two to three months to care for their infants. Most teachers however stopped breastfeeding during maternity leave in preparation for return to employment, as blending work and breastfeeding seemed impossible in an organisational climate that did not consider gender equality concerns about women’s maternity needs. Some principals were so oblivious to breastfeeding at work that one male supervisor alluded to the absurdity of such a possibility in a workplace, implying that a workplace was built on a specific set of appropriate behaviours in which employee bodies would not be lactating:

There are no mothers who would be showing their breasts even in parliament, pumping their breasts. You understand right? I mean they [legislation on breastfeeding at work] must be realistic even in parliament. Look at Khusela Diko, she is young, right? The spokesperson of President Ramaphosa, she is young, she’s at that stage of becoming a new mother but during work time she will not take out her breast to express but has to do that at home. (Principal 10 – male – quintile 1 school)

Underlying power dynamics between teachers and male principals

Most teachers shared that trust and a sense of safety were central to breastfeeding support. They felt that discussing issues related to breastfeeding placed them in a vulnerable position and that they would only feel comfortable speaking to supervisors who had demonstrated a familiarity with maternal needs. They indicated a sense of discomfort about receiving emotional support from male–as opposed to female–principals, because women’s breasts have become sexualised in society:

The discomfort, I think comes from just thinking that okay, he’s a guy and now as I said that, when you are taking out your breasts in public it feels like you are exposing yourself or you are putting yourself under the spotlight where you are in an uncomfortable position, so talking about breastfeeding and or about your breasts to a male figure or a male, just does not come as easy, I don’t know where I can say it comes from but it doesn’t come as naturally … as it is to [speak about breastfeeding] to a female [principal]. (Teacher 9 – quintile 5 school)

To underscore this discomfort another teacher wondered aloud,

How do you talk about things like that to a male manager? Like ‘I need to express because my boobs are feeling hard and feeling full?’. So how do I do that, you know, like you’re in a meeting now and I need to go. They won’t understand man! (Teacher 7 – quintile 4 school)

Somewhat unexpected, the pervasiveness of gender-based violence (GBV) in South Africa emerged as one of the barriers to seeking support for breastfeeding at work from male supervisors:

I think also with rapes, sexual harassment, statutory rape, those type of things, I think we [women] were made to always be aware or cautious in an environment where there’s men. (Teacher 9 – quintile 5 school)

Here the teacher explained that because of the sexualisation of breasts, women would rather refrain from talking about breastfeeding needs with men to avoid drawing attention to their breasts and potentially being harassed. Interestingly, male principals were unaware of teachers’ discomfort with discussing breastfeeding with them. Some principals felt that breastfeeding was a natural practice. After becoming aware of the legislated breaks and understanding the health benefits of breastfeeding to the baby, these principals perceived breastfeeding as a family responsibility which they were willing to support if a need was raised by mothers. By exception, a few male principals recognised the entrenched patriarchal context in South Africa and the scourge of GBV, and articulated an understanding of mothers’ reservations to speak to their male supervisors:

Sometimes it’s not nice for a male to speak to a female … a lot of the things are to do with culture too, right? Women sometimes feel more comfortable to speak to women. Sometimes males might be seen in a particular way due to experiences of women maybe in environments that they might have found themselves, either abused or something of that sort. (Principal 14 – male – quintile 5 school)

Acknowledging that teachers may be more comfortable receiving emotional support from other women, some principals suggested that teachers who felt uncomfortable engaging with male principals about their breastfeeding needs could speak to women in other supervisory positions at the school:

When it comes to the personal issues, like lady-issues [breastfeeding], I’ve got a female deputy principal that normally goes and chats with them. If they feel comfortable speaking with her, they go to speak with her. (Principal 8 – male – quintile 3 school)

However, principals and those in senior positions at public schools in the province, as with most organisations in South Africa, are still occupied predominantly by men. A female principal voiced the need for greater representation of women in management to create an inclusive environment for mothers:

… part of why there needs to be good gender representation in management is so that there is always someone to go to, that you don’t stop breastfeeding your baby because you are too embarrassed or too shy, or whatever, to come to talk to a male principal or a male head of department [HOD]. There’s got to be somebody that you should/would feel comfortable to discuss this [with]. (Principal 1 – female – quintile 5 school)

Persisting resource disparities within schools from an unjust past

Spatial inequalities, from a history of apartheid and colonialism, appear to influence the type and level of support for breastfeeding at work that principals could provide teachers. Principals from schools located in historically disadvantaged neighbourhoods (quintile one to three schools) articulated hindrances in the provision of instrumental support and creative work-family management. For example, some quintile one to three schools did not have spare classrooms or even a staff room to be used as a private breastfeeding space. They suggested that if teachers needed to breastfeed at work they would have to use their classrooms during break times:

We work in a rural [peri-urban] school where learners take a break and play outside and leave the teacher alone in their classroom. You find that there is maybe just one or two offices, where one belongs to the HOD, and they are always in their office, and another to the principal … So, the teacher can use her classroom to express during the 30 minutes breaks when learners go out. (Principal 5 – female – quintile 1 school)

A teacher shared similar sentiments referring to a school that had recently been built yet could not accommodate breastfeeding needs:

The school that we are at is a new school here in School 8. We do not have private spaces, a private space where one could express. Everything is done in the classroom, we do not even have a staff room or anything like that … due to the kind of environment we are working under, I cannot [think about breastfeeding at work] but if there was a private place to do that and a storage place for the milk for the duration of the day then in that instance, I would not have a problem [to breastfeed at work] … (Teacher 8 – quintile 1 school)

Principals from quintile one to three schools further stated that their schools were understaffed and could not afford assistant staff to facilitate creative work-family management strategies such as using a substitute teacher or student intern when a teacher leaves the classroom to express breastmilk. In contrast, principals from historically ‘white schools’ (quintile four to five) were better resourced. Quintile four to five schools were likely to have extra rooms that teachers could utilise if they needed to express or breastfeed. These schools also had access to additional support staff because principals from these schools could raise funds within their affluent parent body:

We get less money [from government], we have to supplement by either raising money and raising our fees … with that we have employed more people in the system … we employed teacher aids, so that’s about one per teacher except in Grade three because we have two per grade … the teacher aids are multifaceted, they serve on many things [like looking after learners when the teacher leaves the classroom]. (Principal 4 – male – quintile 5 school)

Another principal from a quintile five school described the availability of spare rooms that could be used for breastfeeding if teachers desired to breastfeed at work:

There are kind of little hiding holes around the school [where teachers can go and breastfeed in private], maybe not in every school but certainly in our school. (Principal 1 – female – quintile 5 school)

Practical changes and challenges to support breastfeeding at work

Both teachers and principals made several context-sensitive suggestions to advance support for breastfeeding across their varied range of resources. More specifically the principals felt that discussions with teachers about the kinds of support they needed to blend breastfeeding with employment were critical to ensure that appropriate support was provided:

… so a conversation needs to be had, we need to know about the daily experiences of the people [teachers], what are their concerns, what do they feel comfortable with. We might prepare everything for them and then decide they are going to do it [breastfeed] at home … it differs from individual to individual, right? We can make everything available, but it might just be a white elephant … (Principal 14 – male – quintile 5 school)

Similarly, some teachers stated that breastfeeding experiences were diverse, and some teachers may choose not to breastfeed upon return to employment. In these instances, a supervisor’s proactive approach to breastfeeding support could be perceived invasive, especially within a socio-cultural context of patriarchy and pervasive GBV:

Another thing is that the supervisor cannot just walk to you because you are pregnant and ask you how you will breastfeed the baby, because they don’t even know if you will breastfeed or not. So, its best the mother approaches the supervisor … I think that the pregnant person should be the one going to the supervisor with their plan of action, and then the supervisor can work with that plan and figure which time is best. (Teacher 4 – quintile 1 school)

However, while some principals accepted that teachers could proactively seek support when they needed it, others felt responsible for initiating support. These principals argued that some teachers may feel uncomfortable to proactively state their breastfeeding needs, possibly due to cultural beliefs of deference and patriarchy, or fears of appearing less professional at work. One principal suggested:

[we would] have an open and courageous conversation … so I would have a meeting with all soon-to-be mommies and just talk about it [breastfeeding] generally. Let’s take away those stereotypes about breastfeeding and so forth and let’s talk and when they know where I stand when it comes to promoting breastfeeding, they will be comfortable. But I’ve got to show them first that I accept it, that I am for it, and I am promoting it and I have no qualms about you breastfeeding. (Principal 13 – male – quintile 3 school)

To offer instrumental support and creative work-family management, principals suggested several strategies. These included that because teachers only needed to breastfeed for one or two times per day for a few months, their timetable could be adjusted to meet temporal breastfeeding needs. Additionally, teachers who lived close to schools could go home to breastfeed or have their child brought to school at feeding times. A further suggestion was that sick bays, where available, could be used to express breastmilk:

… the law says they must teach for so many hours in a week, for 27 and a half hours per week, the law says they must do extracurricular, core curricular activities and so forth, but internally we can have an arrangement … you just got to tweak the time table and let others understand why you are doing that so that they can help their colleague and when that period [them breastfeeding] is over, you come back to normality … we work as a family. (Principal 13 – male – quintile 3 school)

However, these strategies would be more feasible in well-resourced schools (i.e. with physical space and support staff) than in under-resourced schools.

Discussion

The aim of this study was to explore FSSB for supporting breastfeeding at work within a public education sector in South Africa, an LMIC in the global South. Our use of multi-perspective interviews from teachers and principals surfaced diverse lived realities and local complexities that influenced the nature of FSSB that teachers could access to manage the demands of blending breastfeeding with employment. Specifically, our study showed that the FSSB dimensions of instrumental support and creative work-family management were sometimes beyond the supervisor’s control because of persisting spatial, educational, and economic inequalities from histories of apartheid and colonialism (Taole & Wolhuter, 2019). Principals in quintile four and five schools in affluent communities could provide support in the form of private rooms for breastfeeding, amending teaching schedules, and/or providing substitute teachers to oversee learners in order to facilitate breastfeeding and employment. However, among principals in quintile one to three schools, even when they wanted to provide such creative strategies and instrumental support, they could not, as these schools remained under resourced even 27 years post democracy. Thus, the rhetoric of a supervisor with choice and control does not adequately consider the socio-economic and historical legacies of racial segregation and inequality in a context such as South Africa (Von Holdt, 2010).

A counter-intuitive finding was discovered when analysing the nature of the emotional support dimension of FSSB for breastfeeding at work. Previous studies suggested that proactive breastfeeding support from supervisors was important, as mothers interpreted passivity from supervisors as a lack of interest in their breastfeeding at work needs (Turner & Norwood, 2014). Turner and Norwood (2014) asserted that mothers would rather stop breastfeeding during maternity leave, due to a lack of emotional support, than proactively seek such support from their supervisors. Proactivity from supervisors especially during pregnancy shifts the responsibility to destigmatise breastfeeding at work, from mothers who are often vulnerable and lack confidence to challenge the masculine hegemony (Grandey et al., 2020; Mabaso et al., 2020) to the supervisor. In doing so it creates an inviting climate for mothers to convey their breastfeeding needs. However, in this study, some teachers articulated that despite trusting supervisors with their general work-family needs, they felt that proactive emotional support from supervisors about breastfeeding at work, especially from male principals, was an invasion of their privacy. In a country that has one of the highest levels of GBV in the world (United Nations, 2021), with an average of 116 police recorded rapes each day between 2019 and 2020 (Africa Check, 2020), many teachers lacked trust in the intentions of male principals if they were to offer emotional support for breastfeeding. As a result, teachers were more comfortable receiving emotional support from female supervisors. Again, these findings are complicated by South Africa’s history as black African women are more likely to be vulnerable in terms of being poor, less educated, and single, and accordingly more likely to be victims of GBV (IR Insider, 2021). Our findings showed that in patriarchal societies, socio-cultural contextual factors may limit emotional support that teachers may access especially in workplaces dominated by male supervisors.

Our findings suggest the importance of contextualising FSSB within particular histories, politics, economies, and geographies – creating plural meanings of the FSSB dimensions for diverse lived realities – so that the nature of support is appropriate for advancing support for breastfeeding at work. Assuming Northern universalism of work-family constructs by failing to be sensitive to context (Chung et al., 2022; Jaga, 2020), in this instance by not acknowledging the influence of patriarchy, GBV, and the inequalities in schooling resources based on past racial segregations, threatens the relevance of FSSB particularly in LMIC and global South contexts. This is not to say that such contextual challenges affecting FSSB for advancing breastfeeding at work support are confined to the global South, but the South’s long-term encounters with these challenges can be a source of knowledge as social justice inequalities are rising in global North societies (Comaroff & Comaroff, 2012) and have been accelerated and exacerbated by the COVID-19 pandemic. Our insights on embedding FSSB within complex layers of context extend FSSB theorising. Socio-cultural and economic contextual factors can serve as important antecedents of FSSB or moderating mechanisms in FSSB relationships, such as the relationship between FSSB and mothers’ self-efficacy to breastfeed at work – a strong predictor of breastfeeding duration (Avery et al., 2009).

Practical implications

The study findings have several implications for public school management and social policy. Gender-sensitive initiatives and training should be provided to principals to address sexist stereotypes about breastfeeding. These initiatives should raise awareness about legislation on breastfeeding at work and equip supervisors with skills to approach and discuss gendered subjects to create a more gender equal and inclusive work climate particularly for marginalised teachers’ breastfeeding needs. In a patriarchal society marked with high GBV and related social ills like rape, training must address the negative effects of patriarchy on interactions between teachers and principals. Training should also demonstrate how patriarchal tendencies manifest within the education sector and its detrimental effect on organisational productivity and gender equality (Adisa et al., 2019). A written breastfeeding at work policy should be developed, incorporating multiple stakeholder perspectives, especially those of marginalised mothers, and formally relayed to all employees to illustrate commitment to breastfeeding needs in particular, and a more inclusive workplace culture in general (Chung et al., 2022). Measures to evaluate implementation of the policy by school principals must be established to advance gender mainstreaming in the monitoring of gender equality initiatives in the workplace. Purposive recruitment of more women to principal level should contribute to sensitisation of the education sector to breastfeeding needs given that women dominate the sector yet are a minority at principal level (Davids & Waghid, 2020).

Our study findings emphasised persisting resource inequalities between previously disadvantaged schools (quintile one to three) and affluent schools (quintile four and five). Consistent with the United Nations’ infrastructure development recommendations (Morgan et al., 2020), we suggest that the South African public education sector adopts an inclusive and gender-sensitive approach in school infrastructure development. For example, include a private family room as part of school designs or remodel existing sick bays to be multi-purpose ‘non-work’ rooms where mothers can express breast milk. In a context where there are limited resources for permanent facilities to support breastfeeding at work, the education department could provide portable breastfeeding booths to schools with poor infrastructure to assist principals in facilitating breastfeeding at work (Vilar-Compte et al., 2021). Paid breastfeeding breaks without access to supportive infrastructure limits principals’ ability to support breastfeeding and perpetuates ignorance of the legislation. Countries with legislated breastfeeding facilities, i.e. those that have explicit instructions on the type of physical space to avail for breastfeeding mothers, have shown less ignorance of breastfeeding legislation and improved breastfeeding at work practices (Cripe, 2017; Ickes et al., 2021). Finally, teachers are powerful and important role models for young learners. Schools that are supportive of work-family responsibilities such as breastfeeding at work have the potential to dismantle masculine workplace norms and destigmatise breastfeeding. Young learners (especially boys), in breastfeeding-friendly schools, may become sensitised to breastfeeding at work and become supportive co-workers and leaders contributing to positive progress towards global nutrition targets and workplace gender equality.

Limitations and future research directions

The study has a few limitations. Some of the research interviews were conducted virtually or telephonically due to the COVID-19 pandemic. This may have hindered observations of the interviewee’s body language and facilities at the schools. Extra effort was made to establish rapport and ensure that participants felt comfortable, and probing was employed to confirm their perspectives. While the focus was on teachers, there is a need for more research from non-teaching employees from the education sector, such as support or grounds staff, to identify possible divergent experiences as they may not be constrained by teaching job demands. Future research should include a more diverse sample by government departments and the private sector to understand transferability of our findings to other workplaces. The education sector is a distinct workplace that differs from other service providing government departments in terms of job type and flexibility however issues identified in this department such as lack of personal office space, and socio-economic and cultural influences, are likely to be found in other departments. Transferability and application of the study findings should be limited to LMICs with similar national cultural norms and demographics. A follow-up quantitative study would be beneficial to investigate socio-cultural and economic contextual factors as important FSSB antecedents or their moderating and mediating effect between FSSB and breastfeeding-related constructs such as mothers’ self-efficacy to breastfeed at work.

Conclusion

Our contribution through a context-sensitive qualitative inquiry demonstrated that the history of colonialism, apartheid, and entrenched patriarchal culture in South Africa informs the manifestation on FSSB for a complex work-family issue of breastfeeding at work. Focusing on teachers and principals’ experiences in the public education sector of an LMIC in the global South, a novel finding was that the pervasiveness of GBV compromised mothers’ access to FSSB, specifically when the principal was male. By underscoring local contextualities, we extend plural ways of understanding FSSB to help dismantle Northern universalisms and advanced FSSB theorising by showing how a range of socio-cultural and economic factors influence the accessibility and application of FSSB for supporting breastfeeding at work. Finally, we recommended gender-sensitive and social justice focused training for supervisors, and gender mainstreaming in social policy to advance workplace support for breastfeeding in particular and gender equality at work in general.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by School of Management Studies Doctoral Scholarship.

Notes on contributors

Bongekile P. Mabaso

Bongekile P. Mabaso is a registered Nutritionist and a doctoral candidate in the School of Management Studies at the University of Cape Town, South Africa. Her research interests include child and maternal health with a major focus on workplace support for breastfeeding within the specificities of low-middle income country contexts embedded in persistent colonial and apartheid histories.

Ameeta Jaga

Ameeta Jaga is an Associate Professor of Organisational Psychology in the School of Management Studies at the University of Cape Town. In Spring 2020, she was a Mandela Mellon Fellow at the Hutchins Centre for African and African American Research, Harvard University. Her research focuses on the work-family interface relating to culture, race, class, and gender. More recently she is using Southern Theory to prioritise context in work-family research while underlining global inequalities in knowledge production. Her current research projects deal with understanding how gender equality (via breastfeeding at work) is understood in twenty-first century South Africa.

Tanya Doherty

Tanya Doherty is a chief specialist scientist in the Health Systems Research Unit of the South African Medical Research Council. Her research focus is child health and nutrition especially primary care and community-based interventions. She has led research in South Africa and several countries in sub-Saharan Africa and has published over 100 peer reviewed papers. Tanya is also an honoroary Professor in the School of Public Health at UWC where she teaches and supervises masters and doctoral students.