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Daniels LC, Mbhenyane XG, Du Plessis LM. Development of a workplace breastfeeding support practice model in South Africa. Int Breastfeed J 2024; 19:32. [PMID: 38711120 DOI: 10.1186/s13006-024-00638-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Globally, mothers have identified work as one of the main obstacles to exclusive and continued breastfeeding. The support a woman receives in her workplace in terms of workplace arrangements can be critical to enable women to continue breastfeeding. This study aimed to develop and assess the face validity of a practice model to support exclusive and continued breastfeeding in workplaces in the Western Cape, South Africa. METHODS An explanatory, sequential, mixed-method research design, was conducted (June 2017 to March 2019) in three distinct phases. Phase one employed a quantitative, descriptive, cross-sectional study design. Phase 2 used a qualitative, multiple case study. Phase three involved the development and face validity of a practice model to support exclusive breastfeeding in workplaces. The face validity included two Delphi rounds for experts to provide input on the draft practice model. This paper will only report on phase 3 of the study. The practice model was developed, drawing on the analysis of data from phases one and two and using programme theory approaches and a logic model. RESULTS The practice model was positively perceived. Participants viewed it as informative, well designed and easy to follow, even for those not knowledgeable about the subject. It was viewed as an ideal tool, if accompanied by some training. Participants were positive that the model would be feasible and most commended the tiered approach to implementation. They felt that workplaces would be more open to a step-by-step approach to implementation and if only a few activities are implemented it would be a start to make the work environment more conducive for breastfeeding employees. There were mixed opinions regarding commitment; a few participants mentioned commitment as a challenge they anticipated in the male-dominant environments in which they worked. The provision of space for breastfeeding at the workplace was also highlighted as a potential challenge. CONCLUSIONS Advocacy around creating an enabling workplace environment for breastfeeding is needed. The practice model has the potential to be internationally relevant, locally applied and may be of particular use to workplaces that want to initiate and/or strengthen breastfeeding support.
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Affiliation(s)
- Lynette Carmen Daniels
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Xikombiso Gertrude Mbhenyane
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lisanne Monica Du Plessis
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Ray R. Individual and Organizational Factors Associated With Breastfeeding Practices in Employed Mothers. Workplace Health Saf 2023; 71:375-383. [PMID: 37254557 DOI: 10.1177/21650799231167580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Breastfeeding is recommended for infants through 6 months of age, when solid foods are introduced, and continued until 12 months of age. However, many mothers in the United States discontinue breastfeeding at an early age and return to work following childbirth. The purpose of this study was to identify individual and organizational factors associated with breastfeeding practices in a sample of employed mothers who participated in the Infant Feeding Practices Study II. METHODS A secondary analysis was conducted on a sample of 953 employed mothers who completed the Infant Feeding Practices Study II between 2005 and 2007. The analysis compares infant feeding status (breastfeeding/feeding pumped milk vs. not breastfeeding/feeding pumped milk) over a 12-month period, using generalized linear mixed modeling (GLMM). FINDINGS Generalized linear mixed modeling (GLMM) revealed that working mothers who were employed part-time (≤34 hours/week) were 97% more likely to continue breastfeed compared with mothers employed full-time over the 12-month follow-up period (OR = 1.97, p = .002). Mothers who perceived high levels of breastfeeding support in the workplace were 178% more likely to continue breastfeeding compared with those with low levels of perceived support (OR = 2.78, p < .001). CONCLUSIONS Prenatal breastfeeding only feeding intentions, non-smoking, part-time employment, and higher levels of perceived breastfeeding support in the workplace were significant predictors of breastfeeding/feeding pumped milk at all time points. APPLICATION TO PRACTICE Occupational health nurses may be able to address barriers to breastfeeding in the workplace and improve supportive workplace practices to promote continued breastfeeding in employed mothers consistent with national and international recommendations.
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Tanaka R, Tsuji M, Shimono M, Morokuma S, Morisaki N, Kusuhara K, Kawamoto T. Association between maternal socioeconomic status and breastfeeding: Results from the Japan environment and children's study. J Child Health Care 2023:13674935231158842. [PMID: 36922156 DOI: 10.1177/13674935231158842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Although breastfeeding has various benefits for mothers and children, there are several barriers to continuing breastfeeding practices. However, little is known about the relationship between breastfeeding in Japan and maternal socioeconomic circumstances. Based on data from the Japan Environment and Children's Study (n = 75,742), we evaluated maternal socioeconomic factors associated with breastfeeding 1 year after giving birth. Socioeconomic status (education, employment status, and household income), working hours, and breastfeeding were assessed using a self-administered questionnaire. After descriptive analysis, a logistic regression analysis was conducted with adjustments for age, educational level, employment status, and household income. Mothers with higher education and full-time homemakers were more likely to breastfeed one-year-old children. Mothers working long hours (both part-time and full-time) were less likely to breastfeed their one-year-old children. To improve breastfeeding among working mothers, it may be helpful to promote awareness of breastfeeding for every mother as well as to make the workplace environment conducive for working mothers to breastfeed.
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Affiliation(s)
- Rie Tanaka
- Department of Environmental Health, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Shimono
- Japan Environment and Children's Study, UOEH Subunit Center, 13137University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, 12923Kyushu University, Fukuoka, Japan
| | - Naho Morisaki
- Department of Social Medicine, 13611National Center for Child Health and Development, Tokyo, Japan
| | - Koichi Kusuhara
- Japan Environment and Children's Study, UOEH Subunit Center, 13137University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,Department of Pediatrics, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Toshihiro Kawamoto
- Department of Environmental Health, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
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Abstract
BACKGROUND Low job control may predict shorter breastfeeding (BF) among working mothers and may contribute to racial disparities in BF. METHODS We used demographic, employment, and health data for n = 631 observations from the Panel Study of Income Dynamics. Job control scores came from a job-exposure matrix.Using path analysis, we assessed whether job control predicted BF and mediated Black-White BF differences. We controlled for education, working hours, marital status, and low birthweight. RESULTS Lower job control predicted decreased odds of BF for at least 6 months (odds ratio, 0.61; 95% confidence interval, 0.31-0.90; reference, no BF). Low job control explained 31% of the Black-White difference for both shorter-term and longer-term BF. CONCLUSIONS Low job contributes to shorter BF and to BF disparities by race. Intervening to enhance job control could improve BF.
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Affiliation(s)
- Margaret D Whitley
- From the Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan (Dr Whitley); Program in Public Health, University of California, Irvine, Irvine, California (Dr Ro); and Center for Work and Health Research, Irvine, California (Mr Choi)
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Hayashi Y, Fisher NM, Hantula DA, Furman L, Washio Y. A behavioral economic demand analysis of mothers' decision to exclusively breastfeed in the workplace. J Exp Anal Behav 2022; 118:132-147. [PMID: 35607847 DOI: 10.1002/jeab.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/15/2022] [Accepted: 05/03/2022] [Indexed: 11/05/2022]
Abstract
The present study determined whether behavioral economic demand analysis could characterize mothers' decision to exclusively breastfeed in the workplace. Females, aged between 18 and 50 who have given birth in the past three years, completed a novel demand task with hypothetical scenarios, in which they returned to work with a 2-month-old baby. Participants rated their likelihood of breastfeeding their baby at a workplace lactation room versus formula-feeding their baby at their desk. The distance to the lactation room ranged from 10 s to 60 min. This assessment was conducted with and without hypothetical financial incentives for 6-month exclusive breastfeeding. Primary dependent measures were demand intensity and change in demand elasticity, which could conceptually represent initiation and continuation of breastfeeding, respectively. Demand for breastfeeding was more intense and less elastic (i.e., more likely to initiate and continue breastfeeding) among mothers with an experience of 6-month exclusive breastfeeding and under the condition with the financial incentives. The novel demand task can potentially provide a useful behavioral marker for quantifying mothers' decision to initiate and continue exclusive breastfeeding in the workplace, informing workplace policy regarding lactation rooms, identifying risk for early cessation, and developing and individualizing an intervention to assist mothers to exclusively breastfeed in the workplace.
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Affiliation(s)
- Yusuke Hayashi
- Division of Social Sciences and Education, Pennsylvania State University, Hazleton
| | - Nicole M Fisher
- Division of Social Sciences and Education, Pennsylvania State University, Hazleton
| | | | - Lydia Furman
- Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International.,Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine
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Amanda Hickey, Henning M, Sirois L. Lessons Learned During Large-Scale Implementation Project Focused on Workplace Lactation Practices and Policies. Am J Health Promot 2021; 36:477-486. [PMID: 34806416 DOI: 10.1177/08901171211055692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This practice-based research funded by the Centers for Disease Control and Prevention (CDC) focuses on the translation of evidence-based practices and policies into real-world applications. To the best of our knowledge, this is the largest study to research the implementation process for lactation accommodations and policies for work sites. DESIGN OR APPROACH Pre-/post-test evaluation of work-site lactation accommodations, and 6-month follow-up with business that worked on the project. SETTING/PARTICIPANTS 34 businesses across New Hampshire. METHOD The team developed work-site selection criteria to award mini-grants; developed trainings and a toolkit; and worked with 34 businesses over a 3-year period. Pre-/post-implementation data were collected using the CDC work-site scorecard. A 6-month follow-up phone interview was conducted with each site. RESULTS We assessed the CDC scorecard and evaluated the challenges of implementing lactation spaces by industry. In our 6-month follow-up, we found that spaces were still being utilized and we identified specific research to inform practical evidence-based applications and lessons learned when implementing a work-site lactation space. CONCLUSION We successfully provided financial/technical support to develop or improve 45 lactation spaces, with policies and practices to support mothers and families for 34 businesses. We identified key takeaway lessons that can be used to guide the development of lactation spaces and policies in work sites. Sites self-report that these work-site changes were sustainable at 6-month follow-up.
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Affiliation(s)
- Amanda Hickey
- Keene State College, Department of Public Health, Keene, NH 03435, USA
| | - Margaret Henning
- Keene State College, Department of Public Health, Keene, NH 03435, USA
| | - Lissa Sirois
- New Hampshire Department of Health and Human Services, Concord, NH 03301, USA
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Agadayi E, Nemmezi Karaca S, Ersen G, Ayhan Baser D, Küçükceran H, Bilgili P, Küçük İG. Breastfeeding frequency of primary healthcare professionals and effective factors. Int J Clin Pract 2021; 75:e14499. [PMID: 34117668 DOI: 10.1111/ijcp.14499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/14/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To determine the frequency of breastfeeding of mothers working in primary care, the differences between different employment groups, and the effective factors. METHODS This descriptive research study was conducted with a self-report online survey design. The snowball sampling method was used for the sample selection, and 151 family physicians and 126 family health professionals were included in the study during the research period (June 2019-December 2019). A 35-item survey was used to collect data. The response rate was 44.9% (49.5% family physicians/40.3% family health professionals). RESULTS The mean duration of exclusive breastfeeding was 3.9 ± 2.0 months, and the mean duration of total breastfeeding was 16.7 ± 8.5 months. There was no significant difference between the family physicians and family health professionals in terms of exclusive breastfeeding (P = .580) and total breastfeeding (P = .325) durations. The most common reasons for weaning were reduced milk supply (25.6%) and not being able to use breastfeeding leave (23.1%) due to problems at work. Of the sample, 41.3% had problems with their coworkers and 41.9% had problems related to patient care when taking breastfeeding leave. Working in a baby-friendly centre (P = .01), prolonged exclusive breastfeeding (P < .001), and increased hours of breastfeeding leave taken (P = .001) had a positive effect on breastfeeding for ≥24 months while experiencing problems with coworkers in taking breastfeeding leave (P = .023) had a negative effect on this variable. CONCLUSIONS All of the factors that were determined to affect the continuation of breastfeeding for ≥24 months are modifiable. It is very important for relevant authorities to undertake necessary action to improve the conditions of working mothers based on these results. Health professional that can maintain the balance between family and work will work more efficiently.
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Affiliation(s)
- Ezgi Agadayi
- Department of Medical Education, Sivas Cumhuriyet University Medical School, Sivas, Turkey
| | - Sanem Nemmezi Karaca
- Department of Family Medicine, Sivas Cumhuriyet University Medical School, Sivas, Turkey
| | - Gamze Ersen
- Family Medicine Clinic, Ankara Akyurt State Hospital, Ankara, Turkey
| | - Duygu Ayhan Baser
- Department of Family Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Hatice Küçükceran
- Department of Family Medicine, Necmettin Erbakan University Meram Medical School, Konya, Turkey
| | - Pınar Bilgili
- Antalya Provincial Health Directorate, Güzeloba Family Health Center No:19, Antalya, Turkey
| | - İzzet Göker Küçük
- Uşak Provincial Health Directorate, Kemalöz Family Health Center, Uşak, Turkey
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Litwan K, Tran V, Nyhan K, Pérez-Escamilla R. How do breastfeeding workplace interventions work?: a realist review. Int J Equity Health 2021; 20:148. [PMID: 34172068 PMCID: PMC8234653 DOI: 10.1186/s12939-021-01490-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/02/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Women are representing an increasing share of the labor force, thus, raising the need to accommodate breastfeeding working mothers at the workplace. While there is an emerging body of evidence supporting the positive influence of workplace lactation programs on breastfeeding outcomes, there is a lack of literature on the mechanisms underlying those interventions. Aims of this realist review were three-fold: to uncover underlying mechanisms, determine who benefits the most from such interventions and important contextual factors influencing uptake. METHODS Purposive bibliographic searches on Medline, Web of Science Core Collection, CINAHL, Global Health, LILACS, Global Index Medicus, Business Source Complete, Proquest Dissertations and Theses and Open Access Theses and Dissertations were conducted to identify relevant publications. Included publications (qualitative and quantitative) described interventions aiming to improve the breastfeeding behavior of working mothers, that were initiated by the employer, reported on breastfeeding outcomes and had a clearly defined workplace. Publications only focusing on maternity leave or that were not published in English, Spanish, Portuguese or German were excluded. A realist approach was followed to identify how workplace interventions work, who benefits the most and the important contextual factors. RESULTS The bibliographic search yielded a total of 4985 possible publications of which 37 publications were included in the realist analysis. Effective workplace breastfeeding interventions activate three mechanisms: 1) awareness of the intervention, 2) changes in workplace culture, manager/supervisor support, co-worker support and physical environments, and 3) provision of time. Contextual factors such as the distance between the workplace and the infant and the type of workplace may influence the degree of activation of the underlying mechanisms for programs to positively impact breastfeeding outcomes. CONCLUSIONS In order to be effective, workplace breastfeeding interventions need to: raise awareness of the intervention(s) available among working mothers as well as their work environment, change the workplace culture, foster manager/supervisor support and co-workers support, provide enough time and adequate space and facilities for women to breastfeed or express breastmilk during the workday.
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Affiliation(s)
- Kathrin Litwan
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, 47 College Street, New Haven, CT 06510 USA
| | - Victoria Tran
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, 47 College Street, New Haven, CT 06510 USA
| | - Kate Nyhan
- Harvey Cushing / John Hay Whitney Medical Library, Yale University, New Haven, CT USA
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT USA
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, 47 College Street, New Haven, CT 06510 USA
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Whitley MD, Ro A, Palma A. Work, race and breastfeeding outcomes for mothers in the United States. PLoS One 2021; 16:e0251125. [PMID: 33951094 PMCID: PMC8099119 DOI: 10.1371/journal.pone.0251125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background In the United States, mothers’ employment status and occupation are related to breastfeeding. However, it is unclear whether not working leads to longer breastfeeding duration even when compared to professional/managerial jobs, which tend to accommodate breastfeeding better than service/manual labor jobs. Furthermore, occupation and breastfeeding are racially patterned, and it is possible that race could moderate the relationships between mother’s work and breastfeeding. Methods Using data from the Panel Study of Income Dynamics, we modeled breastfeeding duration based on mother’s employment/occupation (not working, professional/managerial work, or service/labor work) during the first 6 months postpartum, as well as mother’s race (White, Black or other) and other potential confounders. We used zero-inflated negative binomial regression models and tested an interaction between employment/occupation type and race. Predictive margins were used to compare breastfeeding duration among subgroups. Results Mothers working in service/labor occupations had the shortest breastfeeding duration of the three employment/occupation groups, and there was no significant difference in duration between not working and professional/managerial occupation. White mothers had longer breastfeeding duration than Black mothers on average. When we included an interaction between employment/occupation and race, we found that among White mothers, non-working mothers breastfed the longest, while mothers in service/labor work breastfed for the shortest duration, but among Black mothers, mothers in professional/managerial work breastfed for longer than mothers in the other two work categories. Discussion Race moderated the relationship between employment status/occupation type and breastfeeding such that, for White mothers, not working was the most advantageous circumstance for breastfeeding, in line with traditional work-family conflict theory. In contrast, for Black mothers, professional/managerial work was the most advantageous circumstance. These findings support the idea of the Market-Family Matrix, which allows that different work scenarios may be more or less advantageous for parenting behaviors like breastfeeding, depending on mothers’ circumstances.
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Affiliation(s)
- Margaret D. Whitley
- Program in Public Health, University of California, Irvine, Irvine, CA, United States of America
- * E-mail:
| | - Annie Ro
- Program in Public Health, University of California, Irvine, Irvine, CA, United States of America
| | - Anton Palma
- Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, United States of America
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Taylor YJ, Scott VC, Danielle Connor C. Perceptions, Experiences, and Outcomes of Lactation Support in the Workplace: A Systematic Literature Review. J Hum Lact 2020; 36:657-672. [PMID: 32530352 DOI: 10.1177/0890334420930696] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Despite legislation requiring break time and a private space to express milk, variations exist in accommodations for breastfeeding employees in the United States. RESEARCH AIMS We aimed to describe employee and employer perceptions of and experiences with workplace lactation support in the United States and to identify research needed to inform workplace lactation support programs. METHODS We searched Academic Search Complete, Business Search Complete, CINAHL, MEDLINE, PubMed, and PsycInfo for peer-reviewed articles published from 2009 to 2019 (n = 1638). We included 27 articles. Studies were categorized into four non-exclusive themes: (a) employee perceptions of and experiences with workplace lactation support; (b) employer reports of workplace lactation support; (c) association between workplace lactation support and business outcomes; and (d) association between workplace lactation support and breastfeeding outcomes. RESULTS Analyses of associations between lactation support at work and employee breastfeeding outcomes (n = 14, 52%), and employee perceptions of and experiences with lactation support at work (n = 14, 52%) were most common, followed by employer reports of lactation support (n = 3, 11%) and associations between lactation support at work and job satisfaction (n = 3, 11%). Results indicated that workplace lactation support varied by employer, and that employee perceptions of and experiences with workplace lactation support varied by demographic and employment characteristics. The use of cross-sectional designs, unvalidated instruments, and limited representation from women with low incomes and minorities were common study limitations. CONCLUSIONS More research is needed to learn about experiences of employers and low-income and minority women with workplace lactation support and associations with business-relevant outcomes.
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Affiliation(s)
- Yhenneko J Taylor
- 2351 Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, USA
| | - Victoria C Scott
- 124546 Department of Psychological Sciences, University of North Carolina at Charlotte, Charlotte, USA
| | - C Danielle Connor
- 2351 Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, USA
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Olson BH, Sigman-Grant M, Braun MT. Workplace Lactation Support: Using Implementation Climate to Inform a New Model. Breastfeed Med 2020; 15:417-422. [PMID: 32379484 DOI: 10.1089/bfm.2020.0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Breastfeeding (BF) duration remains problematic, especially among women returning to work. Given that use of workplace lactation support programs has not gained traction in improving BF duration, there appears to be elements missing from lactation support initiatives that need further exploration. The field of Implementation Science, in explaining organizational behavior, provides an opportunity to inform a better model for workplace BF support. Materials and Methods: To inform a new model for workplace lactation support, data from the Breastfeeding and Employment Study (BESt) were combined with Implementation Climate theory. BESt surveyed companies on their BF supports, and used hierarchical linear modeling to determine the association of those supports with company employee perceptions of and manager attitudes toward BF supports. Results: Employee scores were not associated with any company scores. Total company scores were associated with more positive manager attitudes (p < 0.01), due to structural supports, or those supports most visible to managers. Considering these results along with other studies, it is proposed that employees and managers are influenced by tangible (physical) as well as intangible (people) workplace lactation supports. Furthermore, strategies are needed to design and implement approaches to these components to increase workplace lactation support and improve BF durations. Conclusions: Implementation strategies will vary with the diversity of workplaces and how they function. A better understanding of the application of implementation climate for workplace lactation support will help tailor programs and their implementation to improve BF duration in employed women.
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Affiliation(s)
- Beth H Olson
- Department of Nutritional Sciences, University of Wisconsin, Madison, Madison, Wisconsin, USA
| | | | - Michael T Braun
- Department of Management and Entrepreneurship, Driehaus College of Business, DePaul University, Chicago, Illinois, USA
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Accommodating pregnancy and parental leave for the emergency physician: An update. CAN J EMERG MED 2020; 22:277-279. [PMID: 32188527 DOI: 10.1017/cem.2019.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lisbona AM, Bernabé M, Palací FJ. Lactation and Work: Managers' Support for Breastfeeding Enhance Vertical Trust and Organizational Identification. Front Psychol 2020; 11:18. [PMID: 32116889 PMCID: PMC7026252 DOI: 10.3389/fpsyg.2020.00018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/07/2020] [Indexed: 11/25/2022] Open
Abstract
Background In working women, there are barriers when combining the mother and work role, especially during the breastfeeding period. Recent literature shows that improving organizational support increases trust performance via different domains (i.e., organizational identification) and that improving support for breastfeeding increases lactation rates and duration. Breastfeeding support in the workplace is one component that contributes to a mother’s ability to continue to breastfeed once she has returned to work. This is a Human Resource Management practice that facilitates a work–life balance. Working mothers have, at least, two roles: mother and worker and, when mothers return to work, they have to manage both identities. Is lactation a way to keep both identities connected? Is organizational support of breastfeeding a way to improve organizational identification? The aim of this paper is to analyze a hierarchical model to explain how managers and co-worker support to breastfeeding predict trust and organizational identity in a sample of Spanish working mothers (N = 1,028). Materials and Methods To analyze the indirect effect, it was tested using a mediation model with PROCESS in two random samples and carried out structural equation modeling to confirm structural relationship in the proposed model. Results Outcomes reveal effects of managers’ support to lactation and vertical trust in organizational identity but not in co-worker path. Conclusion The findings suggest the manager’s role in maintaining trust from working women and create and maintenance organizational identification.
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Affiliation(s)
- Ana María Lisbona
- Departamento de Psicología Social y Organizaciones, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Miguel Bernabé
- Departamento de Psicología Social y Organizaciones, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Francisco José Palací
- Departamento de Psicología Social y Organizaciones, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
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Whitley MD, Ro A, Choi B. Workplace breastfeeding support and job satisfaction among working mothers in the United States. Am J Ind Med 2019; 62:716-726. [PMID: 31168846 DOI: 10.1002/ajim.22989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Job satisfaction is associated with health and productivity. Workplace support for breastfeeding may affect working mothers' job satisfaction. METHODS We analyzed responses from 488 women from the Infant Feeding Practices Study II (2005-2007). Using logistic regression, we assessed whether workplace breastfeeding problems at 3 months postpartum were related to low job satisfaction concurrently and, for a subsample (n = 265), at 9 and 12 months postpartum. RESULTS Compared with women reporting no problems, women reporting three or more problems had higher odds (odds ratio [OR] = 4.76; 95% confidence interval [CI]: 2.03-11.18) of low job satisfaction at 3 months, and at 12 months (OR = 6.88, 95% CI: 1.33-35.58) after controlling for baseline job satisfaction. Models isolating problems with break time and space to pump/nurse showed more modest results. CONCLUSIONS Work-related breastfeeding problems at 3 months postpartum were associated with low job satisfaction concurrently and at follow-up. Improving workplace breastfeeding accommodations could improve mothers' job satisfaction.
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Affiliation(s)
- Margaret D. Whitley
- Public Health ProgramUniversity of California, IrvineIrvine California
- Behavioral and Policy SciencesRAND CorporationSanta Monica California
| | - Annie Ro
- Public Health ProgramUniversity of California, IrvineIrvine California
| | - BongKyoo Choi
- Department of Medicine and Public Health ProgramUniversity of California, IrvineIrvine California
- Center for Work and Health ResearchIrvine California
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Exploring Human Resource Managers' Decision-Making Process for Workplace Breastfeeding-Support Benefits Following the Passage of the Affordable Care Act. Matern Child Health J 2019; 23:1348-1359. [PMID: 31228146 DOI: 10.1007/s10995-019-02769-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives To explore factors that shape decisions made regarding employee benefits and compare the decision-making process for workplace breastfeeding support to that of other benefits. Methods Sixteen semi-structured, in-depth interviews were conducted with Human Resource Managers (HRMs) who had previously participated in a breastfeeding-support survey. A priori codes were used, which were based on a theoretical model informed by organizational behavior theories, followed by grounded codes from emergent themes. Results The major themes that emerged from analysis of the interviews included: (1) HRMs' primary concern was meeting the needs of their employees, regardless of type of benefit; (2) offering general benefits standard for the majority of employees (e.g. health insurance) was viewed as essential to recruitment and retention, whereas breastfeeding benefits were viewed as discretionary; (3) providing additional breastfeeding supports (versus only the supports mandated by the Affordable Care Act) was strongly influenced by HRMs' perception of employee need. Conclusions for Practice Advocates for improved workplace breastfeeding-support benefits should focus on HRMs' perception of employee need. To achieve this, advocates could encourage HRMs to perform objective breastfeeding-support needs assessments and highlight how breastfeeding support benefits all employees (e.g., reduced absenteeism and enhanced productivity of breastfeeding employee). Additionally, framing breastfeeding-support benefits in terms of their impact on recruitment and retention could be effective in improving adoption.
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Henry-Moss D, Abbuhl S, Bellini L, Spatz DL. Lactation Space Experiences and Preferences Among Health Care Workers in an Academic Medical Center. Breastfeed Med 2018; 13:607-613. [PMID: 30277808 DOI: 10.1089/bfm.2018.0101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Comprehensive workplace lactation support programs can reduce the risk for early breastfeeding discontinuation; however, scant evidence is available to inform user-centered design of employee lactation spaces. This study describes health care workers' preferences for lactation space. MATERIALS AND METHODS In 2016-2017, a convenience sample of 151 women who pumped at work at an academic medical center reported on demographics, lactation experiences, and room and equipment preferences through an online survey. RESULTS Respondents worked in research and administration (32%), were nurses (30%), physicians and medical students (19%), or allied health or clinical support staff (19%). Seventy percent had ever used one of the hospital's dedicated lactation spaces. Forty-nine percent ranked hospital-grade pumps the most important piece of lactation room equipment; 83% preferred multiple occupancy lactation suites; and the average maximum acceptable distance to lactation space was 5.6 minutes. CONCLUSIONS Optimal lactation infrastructure supports the immediate and long-term health of female workers and their children. User needs and preferences can guide design of lactation space to ensure a minimum standard for design, equipment, and distance. Workers may have different preferences depending on roles and experiences; thus, a variety of solutions may be most effective.
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Affiliation(s)
- Dare Henry-Moss
- 1 The Perelman School of Medicine, The University of Pennsylvania , Philadelphia, Pennsylvania
| | - Stephanie Abbuhl
- 1 The Perelman School of Medicine, The University of Pennsylvania , Philadelphia, Pennsylvania
| | - Lisa Bellini
- 1 The Perelman School of Medicine, The University of Pennsylvania , Philadelphia, Pennsylvania
| | - Diane L Spatz
- 2 The Children's Hospital of Philadelphia, The University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania
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Abstract
A return to work and school presents mothers with barriers to breastfeeding. Concerns include negative attitudes toward breastfeeding, scheduling and break-time, and appropriate, private space. Current federal laws require worksite support and provision of adequate accommodations for lactation purposes, as do some state laws. An evaluation of faculty, staff, and students (N = 510) at a large public university, assessed breastfeeding knowledge, attitudes, and support following the implementation of new mother-friendly policies and lactation rooms. Additionally, awareness of the lactation rooms and university policies were assessed. Overall, the university climate reflected high breastfeeding knowledge and positive attitudes. Employees had higher awareness of the new lactation facilities and university policies than did students. Implementation limitations were a need for education and awareness efforts targeted to students. Future directions for worksites and schools are addressed.
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