Effectiveness of a breastfeeding program for mothers returning to work in Japan: a quasi-experimental study

Kaori Nakada

doi:10.1186/s13006-020-00351-3

Abstract

BackgroundMaternal employment has been described as a barrier to breastfeeding in many countries. In Japan, many mothers quit breastfeeding after returning to work because they do not know how to continue breastfeeding. The primary objective of this study was to investigate the effectiveness of a breastfeeding support program for mothers. The secondary objective was to explore the effectiveness of a pamphlet for mothers returning to work.MethodsThis was a quasi-experimental design study with a program group (n = 48), pamphlet group (n = 46) and comparison group (n = 47) that took place from February 2017 to August 2018. Participants in the program and pamphlet groups were women who planned to return to work within 4–12 months after giving birth, while the comparison group included women who had been back at work for at least 3 months. The program involved a 90-min breastfeeding class, a pamphlet, a newsletter, and email consultation. The pamphlet group was sent only the pamphlet, while the comparison group received no intervention. The outcome was breastfeeding continuation rate at 3 months after returning to work.ResultsThe breastfeeding continuation rate 3 months after returning to work was significantly higher in the program group than in the comparison group (79.2% vs. 51.1%, p = 0.004). After adjusting for background factors, the program intervention had an effect on breastfeeding rates (adjusted odds ratio = 4.68, 95% confidence interval: 1.57, 13.96; p = 0.006). However, comparing the pamphlet and comparison groups revealed no significant differences in breastfeeding continuation rates at 3 months after returning to work (69.6% vs. 51.1%, p = 0.07).ConclusionsProgram intervention was associated with a significant increase in breastfeeding continuation rates 3 months after returning to work. Randomized controlled trials are needed to make this program applicable in practice. Pamphlet intervention resulted in no significant difference. Further study is necessary after examining the contents of the pamphlet.

Highlights

Maternal employment has been described as a barrier to breastfeeding in many countries
A total of 123 questionnaires were mailed to 22 facilities, and 67 were returned
The breastfeeding continuation rate at 3 months after returning to work was significantly higher in the program group than in the comparison group (79.2% vs. 51.1%, p = 0.004)

Summary

Introduction

Maternal employment has been described as a barrier to breastfeeding in many countries. The primary objective of this study was to investigate the effectiveness of a breastfeeding support program for mothers. Maternal employment has been described as a barrier to breastfeeding in numerous studies across many countries and cultures [4]. Factors affecting working women’s continued breastfeeding include early return to work or timing of return to work, maternal behaviors and characteristics, support at the workplace [2, 5], policy and law [5]. Workplace lactation support enhances working mothers’ capacity to continue breastfeeding with employment [5, 10]. Work environment strategies targeted at mothers themselves, such as providing options for extended maternity leave and part-time work, and childcare options such as on-site childcare may act as facilitators for breastfeeding continuation [3]

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Discussion

Conclusion