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Raju TNK. Achieving healthy people 2030 breastfeeding targets in the United States: challenges and opportunities. J Perinatol 2023; 43:74-80. [PMID: 36309566 PMCID: PMC9617526 DOI: 10.1038/s41372-022-01535-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To estimate the national and states-specific gaps in breastfeeding rates in the United States for achieving the Healthy People 2030 (HP2030) targets, which are: 42.4% of infants to exclusively breastfeed through 6th months, and 54.1% of infants to breastfeed through 12th month of age. STUDY DESIGN The differences between the HP2030 breastfeeding targets and the respective state-specific baseline rates in the 2022 National Immunization Survey report for infants born in 2019 were computed. RESULTS The gaps in breastfeeding rates for achieving either of the two HP2030 targets varied greatly. Relative to their 2019 baseline estimates, 7 U.S. states need to increase breastfeeding rates between 100% and 207%, 27 states between 50% and 99%, 9 states and 2 territories between 20% and 49% and the remaining 7, between 0% and 19%. CONCLUSIONS Thirty-four of 50 (68%) states face huge gaps in achieving the HP2030 breastfeeding targets.
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Hasan AMR, Smith G, Selim MA, Akter S, Khan NUZ, Sharmin T, Rasheed S. Work and breast milk feeding: a qualitative exploration of the experience of lactating mothers working in ready made garments factories in urban Bangladesh. Int Breastfeed J 2020; 15:93. [PMID: 33160366 PMCID: PMC7648991 DOI: 10.1186/s13006-020-00338-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 10/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Bangladesh 65% of children under 6 months of age were exclusively breastfed with maternal employment being a risk factor that has jeopardized exclusive breastfeeding. As Ready Made Garment (RMG) factories have been the largest employer of low income women in Bangladesh, the objective of our study was to explore the barriers and facilitators of breastfeeding and perceptions about use of expressed breast milk among mothers who worked in the RMG sector. METHODS This formative research was conducted during July-September 2015 in two slums of Dhaka among RMG workers who were mothers and the caregivers of 0-12 month old infants. Qualitative data was obtained from purposively selected participants of 8 in-depth interviews and 4 focus group discussions (mothers and caregivers), and 2 key informant (RMG factory official) interviews. Mothers were from multiple RMG factories while factory officials were from a single factory. Thematic analysis was conducted. RESULTS The main themes of qualitative exploration were knowledge and experience of breastfeeding; structural barriers (home and workplace); consequences of inadequate breastfeeding; and perception and experience of using expressed breast milk. Despite knowledge both of the benefits of breast milk and of the importance of breastfeeding for 6 months, most mothers introduced formula as early as 2 months to prepare for their return to work. Barriers such as excessive workload, inadequate crèche facilities at work, and lack of adequate caregivers at home impeded exclusive breastfeeding. Mothers and caregivers had very little knowledge about the use of expressed breast milk and were concerned about contamination. CONCLUSION As RMG factories are the largest employer of low-income women in Bangladesh, facilitating RMG factory working mothers' ability to use breast milk could help to promote infant health and help women remain in the workforce.
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Affiliation(s)
- A M Rumayan Hasan
- Health Systems and Population Studies Division (HSPSD), icddr,b, Universal Health Coverage, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | | | - Mohammad Abdus Selim
- Health Systems and Population Studies Division (HSPSD), icddr,b, Universal Health Coverage, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Shahinoor Akter
- Faculty of Health and Medicine, Schools of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
- Department of Anthropology, Jagannath University, Dhaka, Bangladesh
| | - Nazib Uz Zaman Khan
- Schools of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Tamanna Sharmin
- Monitoring Evaluation Research and Learning (MERL), Plan International, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division (HSPSD), icddr,b, Universal Health Coverage, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
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Wallenborn JT, Perera RA, Wheeler DC, Lu J, Masho SW. Workplace support and breastfeeding duration: The mediating effect of breastfeeding intention and self-efficacy. Birth 2019; 46:121-128. [PMID: 30051503 DOI: 10.1111/birt.12377] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Given the large proportion of mothers in the United States work force, understanding the implications of workplace support on breastfeeding outcomes is an important public health priority. The current study investigates if (a) workplace support directly influences the working mothers' breastfeeding intention, self-efficacy, and duration, and (b) workplace support indirectly influences breastfeeding duration through the mediating effect of breastfeeding intention and self-efficacy. METHODS Data from the longitudinal Infant Feeding Practices Survey II were analyzed. The main predictor variable, workplace support, was based on a Likert scale from "not at all supportive" to "very supportive." Both mediators, exclusive breastfeeding intention and self-efficacy, were dichotomized (yes; no) while the study outcome, breastfeeding duration, was continuous. Structural equation modeling was used to obtain direct and indirect effects of breastfeeding intention and confidence in attaining breastfeeding goals. RESULTS After adjusting for confounders, there was a statistically significant direct effect between self-efficacy, breastfeeding intention, and breastfeeding duration. A statistically significant indirect effect of workplace support on breastfeeding duration through self-efficacy in attaining breastfeeding goals was also observed. The mediation ratios of the indirect effects showed that self-efficacy in attaining breastfeeding goals accounted for 40.8% (P-value=0.032) of the total effect; however, all other mediation ratios did not show statistical significance. CONCLUSIONS Self-efficacy is an important predictor for breastfeeding duration. Workplaces may help bolster women's self-efficacy by providing environments that are supportive to breastfeeding working mothers. Future research is needed to identify breastfeeding policies that boost self-efficacy.
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Affiliation(s)
| | - Robert A Perera
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Saba W Masho
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA
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Dinour LM, Bai YK. Breastfeeding: The Illusion of Choice. Womens Health Issues 2016; 26:479-82. [PMID: 27444340 DOI: 10.1016/j.whi.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 06/14/2016] [Accepted: 06/17/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Breastfeeding is frequently described as a woman's decision, yet this choice is often illusionary owing to suboptimal social and structural supports. Despite passage of the Patient Protection and Affordable Care Act (2010) that requires all qualifying employers to provide mothers "reasonable" break time and a private, non-bathroom space to express breast milk, the majority of women in the United States still do not have access to both accommodations. THE PROBLEM At least three issues may be influencing this suboptimal implementation at workplaces: 1) federal law does not address lactation space functionality and accessibility, 2) federal law only protects a subset of employees, and 3) enforcement of the federal law requires women to file a complaint with the United States Department of Labor. RECOMMENDATIONS To address each of these issues, we recommend the following modifications to current law: 1) additional requirements surrounding lactation space and functionality, 2) mandated coverage of exempt employees, and 3) requirement that employers develop company-specific lactation policies. CONCLUSIONS If the goal is to give women a real choice of whether to continue breastfeeding after returning to work, we must provide the proper social and structural supports that will allow for a truly personal decision. No mother should have to choose between breastfeeding her child and earning a paycheck.
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Affiliation(s)
- Lauren M Dinour
- Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey.
| | - Yeon K Bai
- Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey
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Bai DL, Fong DYT, Tarrant M. Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum. Matern Child Health J 2016; 19:990-9. [PMID: 25095769 DOI: 10.1007/s10995-014-1596-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Mothers who are employed postpartum are less likely to continue breastfeeding than mothers who are not formally employed. However, as postpartum employment is increasingly necessary for the majority of new mothers, it is important to investigate factors that influence the continuation of breastfeeding in employed mothers. A sample of 1,738 mothers who returned to paid employment postpartum were recruited from the obstetric units of four public hospitals in Hong Kong, and prospectively followed for 12 months or until their infant was weaned. More than 85 % of participants returned to formal employment within 10 weeks postpartum, with over 90 % of these employed full-time. About one-third of the participants (32 %) were able to combine breastfeeding and employment, with breastfeeding defined as continuing for more than 2 weeks after returning to work postpartum. Later return to work and higher maternal education were associated with new mothers being able to combine breastfeeding and employment. Later return to work, shorter working hours, parental childcare, and higher maternal education were also associated with less likelihood of weaning from any or exclusive breastfeeding. Improvements in employment-related conditions for mothers and additional support for lower educated mothers may be effective strategies to enable employed women to continue breastfeeding after their return to work.
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Affiliation(s)
- Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong,
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Problems With Breastfeeding/Breast Milk Feeding Reported by Women Participating in a Workplace Lactation Program. CLINICAL LACTATION 2016. [DOI: 10.1891/2158-0782.7.4.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: The purpose of this study, which was part of a larger study, was to explore the problems with breastfeeding and/or breast milk expression experienced by women participating in a workplace lactation program at a large public sector employer.Methods: A cross-sectional mailed survey approach was used. The sample (n = 128) consisted of women who had used at least one component of the lactation program in the past 3 years and who were still employed at the same organization.Findings: Women who reported having a problem with breastfeeding during the first 2 weeks of their baby’s life or after they returned to work or if they had problems expressing milk all had a shorter mean duration of any breastfeeding/breast milk feeding. However, in this study, the mean duration of breastfeeding/breast milk feeding for all respondents was 10.4 months, and 57% of respondents were exclusively feeding breast milk for milk feedings at 6 months.Conclusions: It is common for women to experience problems in breastfeeding during the first 2 weeks after their baby’s birth and when they return to work. There is some evidence that participation in a workplace lactation program supported a longer duration of breastfeeding in spite of problems experienced by the women. More research is needed.
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Waite WM, Christakis D. Relationship of maternal perceptions of workplace breastfeeding support and job satisfaction. Breastfeed Med 2015; 10:222-7. [PMID: 25831141 DOI: 10.1089/bfm.2014.0151] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Decades of research supports the health benefits of breastfeeding. Prior research has shown that unsupportive work environments are frequently cited as reasons women abandon breastfeeding early. The objective of this study is to determine if mothers' perceptions of workplace lactation support are associated with job satisfaction. MATERIALS AND METHODS Female employees of Seattle Children's Hospital (SCH) and a large corporation were e-mailed a survey to measure perceptions of workplace lactation support. Women were eligible to participate if they had a child born within the last 5 years. Questions were asked about lactation support across five domains; organization, manager, coworker, time, and physical environment. The main outcome was job satisfaction. Linear regression models were run to evaluate the association between workplace support scores and the outcome of interest. RESULTS The survey was completed by 420 women at SCH and 131 women at the large corporation (response rate, 47%). Ninety-eight percent of study participants initiated breastfeeding, and most sustained breastfeeding for at least 6 months. Increased total workplace support score was associated with increased job satisfaction at both companies (p<0.001). Increased support scores within each domain were independently associated with increased job satisfaction (p values<0.005). When all domains were considered together, only manager and coworker supports were significant at SCH (p=0.04), and only time support was significant at the large corporation (p=0.01). The workplace support score was not significantly associated with breastfeeding duration at either institution. CONCLUSIONS Improved lactation support in the workplace may improve new mothers' job satisfaction, which could be beneficial to businesses.
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Affiliation(s)
| | - Dimitri Christakis
- Seattle Children's Research Institute, University of Washington, Seattle, Washington; Center for Child Health, Behavior, and Development, Seattle, Washington
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Marinelli KA, Moren K, Taylor JS. Breastfeeding support for mothers in workplace employment or educational settings: summary statement. Breastfeed Med 2013; 8:137-42. [PMID: 23270434 DOI: 10.1089/bfm.2013.9999] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection, and support of breastfeeding and human lactation. Our mission is to unite into one association members of the various medical specialties with this common purpose.
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Ogbuanu C, Glover S, Probst J, Liu J, Hussey J. The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics 2011; 127:e1414-27. [PMID: 21624878 PMCID: PMC3387873 DOI: 10.1542/peds.2010-0459] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We investigated the effect of maternity leave length and time of first return to work on breastfeeding. METHODS Data were from the Early Childhood Longitudinal Study-Birth Cohort. Restricting our sample to singletons whose biological mothers were the respondents at the 9-month interview and worked in the 12 months before delivery (N = 6150), we classified the length of total maternity leave (weeks) as 1 to 6, 7 to 12, ≥ 13, and did not take; paid maternity leave (weeks) as 0, 1 to 6, ≥ 7, and did not take; and time of return to work postpartum (weeks) as 1 to 6, 7 to 12, ≥ 13, and not yet returned. Analyses included χ(2) tests and multiple logistic regressions. RESULTS In our study population, 69.4% initiated breastfeeding with positive variation by both total and paid maternity leave length, and time of return to work. In adjusted analyses, neither total nor paid maternity leave length had any impact on breastfeeding initiation or duration. Compared with those returning to work within 1 to 6 weeks, women who had not yet returned to work had a greater odds of initiating breastfeeding (odds ratio [OR]: 1.46 [1.08-1.97]; risk ratios [RR]: 1.13 [1.03-1.22]), continuing any breastfeeding beyond 6 months (OR: 1.41 [0.87-2.27]; RR: 1.25 [0.91-1.61]), and predominant breastfeeding beyond 3 months (OR: 2.01 [1.06-3.80]; RR: 1.70 [1.05-2.53]). Women who returned to work at or after 13 weeks postpartum had higher odds of predominantly breastfeeding beyond 3 months (OR: 2.54 [1.51-4.27]; RR: 1.99 [1.38-2.69]). CONCLUSION If new mothers delay their time of return to work, then duration of breastfeeding among US mothers may lengthen.
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Affiliation(s)
- Chinelo Ogbuanu
- Maternal and Child Health Program, Division of Public Health, Georgia Department of Community Health, Atlanta, Georgia, USA.
| | - Saundra Glover
- Department of Health Services Policy and Management, ,Institute for Partnerships to Eliminate Health Disparities, and
| | - Janice Probst
- Department of Health Services Policy and Management, ,South Carolina Rural Health Research Center, Columbia, South Carolina
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and
| | - James Hussey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and
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Abstract
Workplace barriers contribute to low rates of breastfeeding. Research shows that supportive state laws correlate with higher rates, yet by 2009, only 23 states had adopted any laws to encourage breastfeeding in the workplace. Federal law provided virtually no protection to working mothers until the 2010 enactment of the "reasonable break time" provision of the Patient Protection and Affordable Care Act. This provision nonetheless leaves many working mothers uncovered, requires break time only to pump for (not feed) children younger than 1 year, and exempts small employers that demonstrate hardship. Public health professionals should explore ways to improve legal support for all working mothers wishing to breastfeed. Researchers should identify the laws that are most effective and assist policymakers in translating them into policy.
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Affiliation(s)
- Lindsey Murtagh
- Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
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Reasons why women do not initiate breastfeeding: A southeastern state study. Womens Health Issues 2009; 19:268-78. [PMID: 19589476 DOI: 10.1016/j.whi.2009.03.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 02/18/2009] [Accepted: 03/17/2009] [Indexed: 01/07/2023]
Abstract
PURPOSE Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics. METHODS Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n=2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the chi(2) test and multiple logistic regression. RESULTS About 38% of Arkansas mothers of live singletons did not initiate breastfeeding. There was a greater representation of non-Hispanic Blacks among those who did not initiate breastfeeding (32%) than among those who initiated breastfeeding (9.9%). Among those who never breastfed, individual reasons were most frequently cited for noninitiation (63.0%). After adjusting for covariates, Hispanics had three times the odds of citing circumstances than Whites (odds ratio [OR], 3.07; 95% confidence interval [CI], 1.31-7.18). Women who indicated that the hospital staff did not teach them how to breastfeed had more than two times greater odds of citing individual reasons (OR, 2.25; 95% CI, 1.30-3.91) or reasons related to household responsibilities (OR, 2.27; 95% CI, 1.19-4.36) as compared with women who indicated they were taught. CONCLUSIONS Findings suggest the need for targeting breastfeeding interventions to different subgroups of women. In addition, there are implications for policy particularly regarding breastfeeding support in hospitals.
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Fein SB, Mandal B, Roe BE. Success of strategies for combining employment and breastfeeding. Pediatrics 2008; 122 Suppl 2:S56-62. [PMID: 18829832 DOI: 10.1542/peds.2008-1315g] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Return to work is associated with diminished breastfeeding intensity and duration. Although more mothers breastfeed after returning to work now than earlier, research has not documented the strategies that mothers use for combining paid work and breastfeeding or their effect on breastfeeding outcomes. This study examined which strategies are associated with smaller decrements in breastfeeding intensity and longer durations. PARTICIPANTS AND METHODS We analyzed 810 mothers from the Infant Feeding Practices Study II who worked and breastfed. We used regression and censored regression models to analyze 4 strategies that mothers used to combine these 2 activities: (1) feed directly from the breast only; (2) both pump and feed directly; (3) pump only; and (4) neither pump nor breastfeed during the work day. Outcomes were the difference in percentage of milk feeds that were breast milk between the month before and after return to work and duration of breastfeeding after return to work. RESULTS Forty-three percent of mothers pumped milk at work only; 32% fed the infant directly from the breast only. These 2 strategies, along with pumping and feeding directly, were statistically similar and superior to neither pumping nor breastfeeding during the work day for the outcome of change in breastfeeding intensity. For the outcome of breastfeeding duration, the 2 strategies that included directly feeding from the breast were associated with longer duration than pumping only, whereas the strategy of neither pumping nor breastfeeding during the work day was associated with the shortest duration. CONCLUSIONS Feeding the infant from the breast during the work day is the most effective strategy for combining breastfeeding and work. Ways to enable direct feeding include on-site child care, telecommuting, keeping the infant at work, allowing the mother to leave work to go to the infant, and having the infant brought to the work site. Establishing ways for mothers to feed from the breast after return to work is important to meet US breastfeeding goals.
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Affiliation(s)
- Sara B Fein
- Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5100 Paint Branch Pkwy, HFS 020, College Park, MD 20740, USA.
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Stewart-Glenn J. Knowledge, Perceptions, and Attitudes of Managers, Coworkers, and Employed Breastfeeding Mothers. ACTA ACUST UNITED AC 2008. [DOI: 10.1177/216507990805601004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Employer attitudes and practices toward breastfeeding mothers are discouraging overall. Mothers who believe that breastfeeding while employed cannot be done without a considerable amount of additional work and stress may not even consider breastfeeding. Although it is known that lower income women tend not to breastfeed while employed, the relationship between type of employment and sustaining breastfeeding has not been clearly explained. Many women identify employment as a barrier to breastfeeding. Some elements of a workplace environment supportive of breastfeeding have been identified, including private space with a locking door (other than a bathroom stall), time to express milk at work, and adequate refrigeration. In relation to employers, monetary reasons (i.e., decreased productivity) are most frequently cited for not supporting breastfeeding. Only a small percentage of the research on employed breastfeeding mothers has focused on the workplace. Further research is needed to determine how breastfeeding can be beneficial to the mother, the infant, and the employer.
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Stewart-Glenn J. Knowledge, Perceptions, and Attitudes of Managers, Coworkers, and Employed Breastfeeding Mothers. ACTA ACUST UNITED AC 2008; 56:423-9; quiz 430-1. [DOI: 10.3928/08910162-20081001-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Employer attitudes and practices toward breastfeeding mothers are discouraging overall. Mothers who believe that breastfeeding while employed cannot be done without a considerable amount of additional work and stress may not even consider breastfeeding. Although it is known that lower income women tend not to breastfeed while employed, the relationship between type of employment and sustaining breastfeeding has not been clearly explained. Many women identify employment as a barrier to breastfeeding. Some elements of a workplace environment supportive of breastfeeding have been identified, including private space with a locking door (other than a bathroom stall), time to express milk at work, and adequate refrigeration. In relation to employers, monetary reasons (i.e., decreased productivity) are most frequently cited for not supporting breastfeeding. Only a small percentage of the research on employed breastfeeding mothers has focused on the workplace. Further research is needed to determine how breastfeeding can be beneficial to the mother, the infant, and the employer.
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Abstract
The objective of this review is to evaluate the evidence for a link between maternal obesity and poor lactation performance. In nonhuman species, excess maternal fatness is deleterious for lactation and also for maternal health and survival. These effects occur during pregnancy and as milk production is beginning. They may result in poor growth and survival of the young. In women, there is a negative association between maternal obesity and the initiation as well as the continuation of breastfeeding. This appears to be derived from biological as well as sociocultural factors that are still poorly understood. Excessive gestational weight gain, complications of pregnancy and delivery, and the condition of the infant at birth may also contribute to this association. Given the increasingly high rates of obesity among women of reproductive age worldwide and the importance of breastfeeding for infant health, further study of this association is essential.
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Baker JL, Michaelsen KF, Sørensen TIA, Rasmussen KM. High prepregnant body mass index is associated with early termination of full and any breastfeeding in Danish women. Am J Clin Nutr 2007; 86:404-11. [PMID: 17684212 DOI: 10.1093/ajcn/86.2.404] [Citation(s) in RCA: 152] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND An association between high prepregnant body mass index (BMI) and early termination of breastfeeding has been observed, but this finding may have depended on the sociocultural context. OBJECTIVE The objective was to determine whether this association was stronger with increasing maternal obesity, was modified by gestational weight gain, and still existed when there was greater social support for breastfeeding. DESIGN Study participants (37 459 women) were drawn from the Danish National Birth Cohort. The association of prepregnant BMI and gestational weight gain with the termination of full or any breastfeeding by 1, 16, or 20 wk postpartum was assessed with logistic regression analyses, and the risk of early termination of full and any breastfeeding during the first 18 mo postpartum was assessed with Poisson regression analyses. RESULTS The risk of early termination of any (with similar results for full) breastfeeding rose progressively with increasing prepregnant BMI values (in kg/m(2)), from 1.12 (95% CI: 1.09, 1.16) for overweight (BMI = 25.0-29.9) women to 1.39 (95% CI: 1.19, 1.63) for obese class III women (BMI >or= 40) compared with normal-BMI women. Gestational weight gain did not add to or modify the association between prepregnant BMI and breastfeeding. CONCLUSIONS These findings extend the observation to a broader range of BMIs that the greater the prepregnant BMI, the earlier the termination of breastfeeding. Together with the fact that this association was evident in a more supportive social context for breastfeeding, these findings suggest a biological basis for the association.
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Affiliation(s)
- Jennifer L Baker
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
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