Breast milk is at the center of many health, work, and legislative initiatives aimed at providing better support to mothers and ensuring a safer environment in both hospitals and workplaces. In recent years, various public institutions and social organizations have been promoting changes to ensure that breastfeeding is a real, protected, and respected option.

From the implementation of evidence-based clinical guidelines in hospitals to technical days focused on occupational health during pregnancy and breastfeeding, a trend is observed towards simplifying procedures that document mothers' continuation of breastfeeding through legal reform proposals: supporting breastfeeding is no longer limited to the health sector, but is also spreading to the fields of work and social rights.

Clinical Practice Guidelines Supporting Breastfeeding

In the public health system, the use of good practice guidelines for breastfeeding is being reinforced. These guidelines aim to standardize care and improve health outcomes. For example, the work carried out by more than twenty professionals from the Integrated Care Management of Albacete, under the Castilla-La Mancha Health Service, stands out for the implementation of good practice guidelines for breastfeeding.

Such documents guide the daily practices of health personnel based on the best available scientific evidence and provide more effective support to families. Suggestions such as early initiation of breastfeeding, support during initial feedings, resolution of difficulties, or simply maintaining breastfeeding are intended to be based on clear and agreed-upon protocols rather than each professional's individual experience.

Similarly, progress is being made in other areas of the health system. The Virgen de las Nieves University Hospital in Granada is celebrating its tenth year as a center committed to care excellence through the implementation of several clinical guidelines. One of these guidelines specifically focuses on promoting, protecting, and supporting breastfeeding.

This accreditation recognizes the hospital's continuous effort to integrate scientific evidence into its daily practices as a Center Committed to Excellent Care (CCEC®/BPSO®), awarded by the Carlos III Health Institute and part of the international Best Practice Spotlight Organizations (BPSO) network. Regarding breastfeeding, the Maternal-Infant Nursing units have ensured that more newborns start breastfeeding within the first two hours of life and have promoted skin-to-skin contact even in cesarean situations.

One of the most remarkable results of this study is the increase in the proportion of babies fed exclusively with breast milk by mothers discharged from the hospital. According to data from the Granada center, the percentage of women leaving the hospital exclusively breastfeeding has risen from around 60% to nearly 100%. This improvement is associated with systematic support from nurses, a review of routines affecting breastfeeding, and the humanization of postpartum care.

These experiences demonstrate that the integration of specific clinical guidelines supporting breastfeeding not only regulates health practices but also provides a more favorable environment for mothers to continue the breastfeeding process by reducing variability among units and professionals.

Pregnancy, Breastfeeding, and Occupational Health: A Preventive Perspective

Beyond the hospital setting, the protection of breastfeeding also finds its place in the field of prevention of occupational health risks. The period of pregnancy and the subsequent breastfeeding period often coincide with the return to work, necessitating a review of conditions, working hours, and exposure to risks to ensure the safety of mothers and babies.

In this context, UGT-Health Workers has organized a technical day specifically focused on occupational health in cases of pregnancy and breastfeeding. This event was held in Santander to commemorate Occupational Health and Safety Day. During the meeting, a moment of silence was observed for approximately fifty occupational health representatives who served as key figures in identifying and managing the risks faced by pregnant or breastfeeding employees.

The event took place at the Santemar Hotel in Santander and was structured in several round tables. The first session focused on analyzing the current prevention situation in the Cantabria community and was conducted with the participation of officials from the Cantabria Institute of Occupational Health and the UGT confederal secretariat. While covering the overall prevention landscape, it positions the reality of pregnant or breastfeeding employees within occupational safety policies.

The second round table directly addressed the prevention of risks during pregnancy and breastfeeding and was conducted with the participation of safety experts from prevention and insurance companies. The aim was to review which working conditions might be incompatible with safe breastfeeding, how positions or functions could be adapted, and the role of insurance companies in assessing exposure to physical, chemical, or biological agents.

Such technical forums bring common situations to the forefront: long or night shifts, jobs requiring intense physical effort, exposure to potentially harmful substances, or environments where the time and space necessary for pumping or breastfeeding are violated. Making these realities visible encourages companies and management to take more concrete protective measures.

Legal Changes Facilitating the Documentation of Breastfeeding

The protection of breastfeeding also has a normative dimension. While exercising their rights, many mothers find that the recognition of their continued breastfeeding encounters bureaucratic requirements that do not align with the realities of the health system. Therefore, legal regulations are being proposed in various parliaments to eliminate unnecessary barriers.

Recently, a legislative initiative presented by Deputy Laura Nayeli Mejía Larios during the LXVII Legislative Period in Veracruz (Mexico) proposes a reform of the Law on the Promotion, Support, and Protection of Breastfeeding. While situated in the context of Latin America, it reflects a discussion affecting many workers: what documentation is required for effective breastfeeding and how access to certain labor rights can be ensured with this documentation.

The proposed reform includes changing the term “document” to “document issued by a doctor from a public institution.” This seemingly simple change pursues a practical goal: to ensure that mothers are not obstructed in cases where health personnel state that they cannot issue an official “document,” but that other documents, notes, or medical reports can serve to document the continuation of breastfeeding.

As the deputy pointed out, in practice, many women who decide to breastfeed for more than six months face institutional barriers. When they approach health centers, they find that professionals do not have the authority to issue a “document” in the strict sense of the law and can only provide reports, prescriptions, or medical notes. When they present these documents at their workplaces, companies often reject them on the grounds that the document does not comply with the letter of the law, leading to restrictions on breastfeeding rights.

The spirit of the proposal is to align the legal text with the actual functioning of the health system, so that the documentation of breastfeeding is based on a medical confirmation of the mother's continued breastfeeding rather than an administrative label. The deputy argued that if a country claims to promote and guarantee breastfeeding, it should simplify such processes and facilitate the continuation of breastfeeding for those who do so after the initial months.

This initiative, despite being outside the European framework, is related to discussions that are also present in Spain and other EU countries. In these discussions, it is debated whether labor laws, collective agreements, and administrative procedures truly comply with public health recommendations; these recommendations suggest exclusive breastfeeding for six months and continuing with other foods for two years or more.

A Joint Effort Between Health, Work, and Legislation

The various actions outlined demonstrate that supporting breastfeeding is being approached from multiple fronts simultaneously. On one hand, healthcare services are being equipped with good practice guidelines to provide mothers with more consistent, homogeneous, and evidence-based support. In hospitals, this is manifested through increased skin-to-skin contact post-birth, early initiation of breastfeeding, greater involvement of nursing staff, and higher breastfeeding rates among discharged patients.

On the other hand, the workplace is beginning to place pregnancy and breastfeeding at the center of strategies for preventing occupational health risks. This aims not only to prevent obvious harms but also to guarantee conditions that allow mothers to continue breastfeeding without jeopardizing the health of mothers and babies. Technical days and the work of prevention representatives are becoming a bridge between laws and daily work life.

In addition, legislative initiatives aimed at ensuring that laws adapt to daily practices prevent women from losing their rights due to details such as the types of documents required to prove that they continue to breastfeed. The discussion on aligning the protection of breastfeeding continues with the actual functioning of healthcare services and companies, with reform proposals aiming for greater flexibility and clarity.

This collective action reflects that breastfeeding should no longer be seen as just a private matter but rather as a public health issue, occupational safety, and social rights agenda among hospitals, union organizations, and parliaments. How these policies will be coordinated is critical to ensure that health, work, or administrative contexts do not hinder more mothers' ability to freely decide how and for how long to breastfeed.