In a recent publication in Pediatric Gastroenterology, Hepatology & Nutrition, Basrowi et al. [1] made several comments on the importance of breastfeeding in the workplace for female workers in Indonesia. In the discussion, the breastfeeding policy and support for workers in Indonesia were mentioned, noting the policies adopted in the United States of America, the United Kingdom, Scandinavia, and Asian countries. Being the largest country in South America, both geographically and politically, and recognized worldwide as an exemplar for breastfeeding, Brazil has achieved prominence in this area, and I therefore wish to add some comments. In issue No. 408, the French magazine La Santé de l'homme (Human health), edited by the National Institution for Prevention and Health Education in France, reported on the experience of the Brazilian government in the management of breastfeeding public policies. Brazil has the largest and most complex network of milk banks in the world, with 221 units and 186 collection points. Between 2009 and 2016, the Brazilian Network of Human Milk Banks benefited more than 1.8 million newborns and had support from 1.3 million donors, reducing child mortality by more than 70% and representing an economy of R$180 million.

The profile of the Brazilian family changed during the 1980s, when the number of families headed by women almost doubled. As a result, there was a significant increase in the participation of women in the labor market, contributing directly or indirectly to the composition of family income and being forced to assume a triple life: mother, housewife, and salaried worker [2]. Many women are unable to successfully adapt to this triple life, leading to an interruption in breastfeeding. Women with greater purchasing power and more education tend to have few difficulties in reconciling breastfeeding with a return to work because they rely on private service assistance for the baby and the household. On the other hand, Brazilian women with less schooling and low purchasing power face more obstacles in adapting the life of a mother to that of work. Regardless of maternal labor, another aspect that has relevance in the early weaning process is the number of hours worked. Weaning rates are higher when work is over 20 hours per week. In 2013, Valduga [3] observed in a study with ten mothers that the relationship with employment was one of the reasons for weaning. Of the ten participants, eight had formal paid work and soon after the end of maternity leave were already introducing supplements to their children. In 2008, according to a study by Damião et al. [4] in Rio de Janeiro, the frequency of exclusive breastfeeding in non-working women was double than that of mothers who were salaried employees [56].

Brazilian legislation has a postpartum leave of up to four months and two half-hour intervals during working hours or the option to leave one hour early so that the mother can breastfeed her baby until she is six months old. When the child’s health requires, the period of six months may be extended at the discretion of the competent authority. Even so, the right to maternity leave of 120 days is considered insufficient time to promote the practice of exclusive breastfeeding, which should be six months, a factor detrimental to the continuity of breastfeeding [56]. In 2008, a law created the Citizen Company Program, which, through the granting of a tax incentive, encourages companies to increase the duration of maternity leave to six months. In 2010, the Brazilian Ministry of Health, together with the National Health Surveillance Agency, regulated the implementation of breastfeeding support rooms in companies through a technical note aimed at women workers to comply with the recommendation of exclusive breastfeeding up to the first six months and supplemented up to two years or more. Also in 2010, the Ministry of Health developed the “Supporting Working Women and Breastfeeding” strategy, which consists of making public and private companies aware of breastfeeding practices and encouraging them to respect and support their employees during this period. This strategy has three fundamental axes: maternity leave for six months, implementation of nurseries in the workplace or an agreement with nearby kindergartens, and the implantation of breastfeeding rooms. In addition to the rights women have, parental assistance is needed, and in this regard the new Legal Framework for Early Childhood extended the duration of the established paternity leave from 5 days to 20 days. Among the rights established by law for Brazilian women who breastfeed in the workplace, in addition to maternity leave and the breastfeeding pauses mentioned above, are a) the right to guaranteed employment: the arbitrary or unjust dismissal of working women during gestation and lactation periods, from the confirmation of pregnancy until five months after the birth, is prohibited; b) the right to day care: any establishment employing more than 30 women over 16 years of age should provide an appropriate place where women are allowed to keep their children under surveillance and care; c) the right to joint housing: a 2003 ordinance from the Ministry of Health requires hospitals and maternities to establish joint housing (mother and child together in the same room, 24 hours a day); and d) the right of a pregnant student to carry out homework at home: a law established in 1975 provides women an alternative to carry out chores and follow an exercise regime at home [56].

Although the Brazilian legislation protects and supports breastfeeding for working mothers, these benefits are given only to women employed under a formal contract of employment. Those without such a contract must prove the permanent nature of their work in the courts to obtain the same benefits, a process that can be costly and time-consuming. Data from the Brazilian Ministry of Labor showed that, in 2018, due to the economic and political crisis, there was a significant drop in the number of jobs with formal contracts throughout the country.