Identifying Barriers and Supports to Breastfeeding in the Workplace Experienced by Mothers in the New Hampshire Special Supplemental Nutrition Program for Women, Infants, and Children Utilizing the Total Worker Health Framework.

Eric Lauer,Lissa Sirois,Margaret Henning,Karla Armenti

doi:10.3390/ijerph16040529

Abstract

Variations in the barriers and contributors to breastfeeding across industries have not been well characterized for vulnerable populations such as mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our study used the Total Worker Health Framework to characterize workplace factors acting as barriers and/or contributors to breastfeeding among women participating in the New Hampshire WIC. Surveys were collected from WIC mothers (n = 682), which asked about employment, industry, and workplace accommodation and supports related to breastfeeding in the workplace. We found workplace policy factors supporting breastfeeding (i.e., having paid maternity leave, other maternity leave, and a breastfeeding policy) varied by industry. Women in specific service-oriented industries (i.e., accommodation and retail) reported the lowest rates of breastfeeding initiation and workplace supports for breastfeeding and pumping. Further, how a woman hoped to feed and having a private pumping space at work were significantly associated with industry, breastfeeding initiation, and breastfeeding duration. A substantial portion of women reported being not sure about their workplace environment, policies, and culture related to breastfeeding. Additional studies with larger sample sizes of women participating in WIC are needed to further characterize the barriers to breastfeeding associated with specific industries.

Highlights

Over the last two decades, the global public health community established that working outside the home was negatively associated with breastfeeding [1,2,3,4]
A greater percentage of women who had ever breastfed worked in healthcare (26.3% vs. 20.0%) and a smaller percentage worked in accommodation and retail (20.4% vs. 33.8% and 16.1% vs. 24.6%) than women who had never breastfed (p = 0.011)
Women are encouraged to explore their specific workplace policies and environment during breastfeeding education sessions and counseling appointments, these factors may contribute to the high rates of “not sure” reported in this study

Summary

Introduction

Over the last two decades, the global public health community established that working outside the home was negatively associated with breastfeeding [1,2,3,4]. The World Health Organization has recently recognized the need for increased supports to improve breastfeeding duration and initiation rates, recommending women breastfeed for two years [5]. Research in the United States (U.S.) found only 49% of women breastfeed for 6 months and breastfeeding initiation was impacted by working or planning to work postpartum [1,3,6,7]. Studies have found that breastfeeding incidence and duration were lower among employed, working-age women [1,3,8,9,10]. Public Health 2019, 16, 529; doi:10.3390/ijerph16040529 www.mdpi.com/journal/ijerph

Methods

Results

Discussion

Conclusion