title: The experiences of urban, professional women when combining breastfeeding with paid employment in Karachi, Pakistan: a qualitative study.
abstract: BACKGROUND
  Pakistan has the second highest child mortality rate in South Asia. Breastfeeding can promote infant health, prevent infection and possibly mortality. However, a gradual decline in breastfeeding is reported for Pakistan; especially among urban, educated, employed women. Little research exists regarding the experiences of professional women in Pakistan who are breastfeeding and employed.
  
  
  OBJECTIVE
  To describe the experiences of urban, professional women who breastfeed and are employed, as related to facilitators and barriers of breastfeeding.
  
  
  METHODS
  Using a qualitative descriptive design, nine full-time employed women were recruited through purposive sampling from a private tertiary care health setting in Karachi, Pakistan. A pre-tested, semi-structured interview guide was used for an in-depth interview of 40-45min with each participant.
  
  
  RESULTS
  Most women spoke about the challenges of combining breastfeeding with employment, which resulted in early cessation of breastfeeding. The study indicated that positive maternal attributes such as knowledge about breastfeeding, planning, self-commitment, and open communication, as well as availability of social and workplace support is essential to enable urban, professional women in Pakistan to continue breastfeeding while employed.
  
  
  CONCLUSIONS
  Pakistan has high infant and child mortality rate and decreasing prevalence of breastfeeding, especially among employed professional women. Our findings indicate an urgent need for lactation support programs that include integrated interventions for lactating women that offer informational support, social support, and formal workplace support.
authors.affiliation: Aga Khan University, School of Nursing and Midwifery, Stadium Road, P.O. Box 3500, Karachi, Pakistan. shela.hirani@aku.edu
authors.forename: Shela Akbar Ali
authors.initials: SA
authors.lastname: Hirani
authors.forename: Rozina
authors.initials: R
authors.lastname: Karmaliani
mesh_terms: D000328:Adult; D001942:Breast Feeding; D004651:Employment; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D009035:Mothers / Q000523:psychology*; D016134:Organizational Policy; D010154:Pakistan; D036301:Qualitative Research; D012944:Social Support; D012959:Socioeconomic Factors; D014505:Urban Population; D014931:Women, Working; D017132:Workplace; D055815:Young Adult