Workplace breastfeeding support and job satisfaction among working mothers in the United States

Experiences and Perspectives of Female Employees Regarding Work-Family Balance Following Maternity Leave: A Cross-Sectional Survey in Southeastern Iran

Background

Work-family balance has emerged as one of the influencing factors for the physical and mental health of working mothers and their children.

Aims

The present study aimed to understand the experiences and perspectives of working mothers on maternity leave and return to work after childbirth. This cross-sectional survey was conducted in three major cities in southeastern Iran.

Methods

Working mothers who had at least one live birth during the 3 years prior to the survey, aged between 18 and 49 years, and living with their husbands were enrolled using a consecutive sampling method. The sampling framework consisted of all government workplaces that had at least 30 female employees. Using a validated anonymous questionnaire consisting of demographic and attitude variables, we assessed the working mothers' experiences and perspectives regarding the quantity and nature of the last maternity leave and how supportive their workplace was. Descriptive statistics with frequencies and percentages were used. To compare categorical variables between groups, the Chi-square test was used. A P value of less than 0.05 was considered significant. Statistical analysis was done using SPSS version 22.

Results

A total of 900 female employees were invited to participate in the study, and finally, 741 valid questionnaires were analyzed. More than 21% of them reported that the office had changed their position or type of work after returning to work. Women with higher position jobs reported a higher husband's support for baby care (P = 0.03). Almost 51% of mothers agreed their workplace allowed them to use breastfeeding breaks, which was less evident in nurses (P = 0.001). Nearly 86% of them stated that mothering duties are much more important than job-related responsibilities.

Conclusions

Our study identified areas of consideration for investing in family-friendly workplace policies in Iran.

Experience Among Postnatal Nurses With Two or Three Children Returning to Work Within 3 Months in China: A Qualitative Study

AIM

To analyse experience in postnatal nurses returning to work within 3 months following the delivery of a second or third child and recommend appropriate measures to relieve pressure and enhance work engagement among this group.

METHODS

This study adopted a descriptive phenomenological approach. Semi-structured interview was carried out with 12 postnatal nurses who had returned to work in the postpartum period following the delivery of a second or third child. The collected data were analysed using the Colaizzi method.

RESULTS

Experience among postnatal nurses with two or three children was found to stem from three factors: declining physical quality after childbirth (pelvic floor disorder, fatigue, postpartum memory decline and sleep disturbance), poor psychological adjustment after childbirth (work-family conflict, conflict between clinical work and breastfeeding and role maladjustment) and lack of clear career planning.

CONCLUSION

This study emphasised the importance of psychological experience when postnatal nurses returning to clinical work in the early phase. Postnatal nurses and nurse leaders can use these results to make comprehensive solution in order to improve work engagement in the postpartum return.

PUBLIC CONTRIBUTION

No patient or public contribution.

Psychometric Properties of the Breastfeeding and Employment Scale

OBJECTIVE

To evaluate the psychometric properties of the Breastfeeding and Employment Scale (BES).

DESIGN

Secondary analysis of data from the Infant Feeding Practices Study II survey, a longitudinal study on infant feeding practices.

SETTING

United States.

PARTICIPANTS

Women who were employed, breastfeeding, and completed the Infant Feeding Practices Study II BES at the 3-month postpartum assessment (N = 508).

METHODS

Participants reported their perceived level of breastfeeding support in the workplace by responding to the nine binary items on the BES. We evaluated the instrument's internal consistency reliability (Kuder-Richardson 20), test-retest reliability (Cohen's kappa), construct validity (principal component analysis), and convergent validity (relationship with a similar item).

RESULTS

The internal consistency of the BES (Kuder-Richardson 20 = 0.72) supported the reliability of scale. The test-retest reliability was moderate (0.41-0.60). The Spearman's rho correlation coefficient was 0.66, indicating adequate test-rest reliability for the total BES score between the 3-month and 6-month assessments (p < .01). The factor analysis demonstrated that the items cluster into one factor (psychosocial and structural barriers to breastfeeding in the workplace). Participants who reported more barriers to breastfeeding in the workplace also reported a less supportive workplace environment, which supported the convergent validity of the scale.

CONCLUSION

The psychometric testing of the BES provided initial support for the reliability and validity of the instrument. It may be a useful tool for measuring workplace lactation support in a concise manner.

Breastfeeding in US working mothers: A systematic review

BACKGROUND

Previous studies demonstrate that exclusive breastfeeding has positive long-term health effects on the mother and infant, but research has shown that nearly 50% of mothers do not breastfeed for the recommended amount of time.

OBJECTIVE

This article systematizes previous quantitative research on the impact of work on breastfeeding practices to identify the factors that correlate to the cessation of breastfeeding in working mothers.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements, we performed a systematic review that screened PubMed, CINAHL, PsycINFO, and Academic Search Complete databases for articles relating to maternal employment and breastfeeding.

RESULTS

Of the 13,106 articles assessed for eligibility, 21 studies met all requirements and were included in this systematic review. The 21 articles were divided into study type and methods, participant demographics, study outcomes, and additional factors that included stressors and stress levels, factors that increased or decreased rates of breastfeeding, and feeding methods. Articles outside of the United States were excluded due to differences in maternity leave policies of other countries impacting the data.

CONCLUSION

Cessation of breastfeeding and breastfeeding outcomes were seen to have a strong association with maternal employment, specifically with the policies and employer support in the workplace. Other factors such as race, level of education, and stress were also shown to relate to breastfeeding outcomes and are important to consider in future public health interventions and workplace policies.

Achieving healthy people 2030 breastfeeding targets in the United States: challenges and opportunities

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.

Breastfeeding Advocacy: A Look into the Gap Between Breastfeeding Support Guidelines and Personal Breastfeeding Experiences of Faculty Physicians

Objectives: Despite increased lactation support for mothers over the past few decades, physician mothers still face considerable challenges to achieving their breastfeeding goals. Disparities in breastfeeding exist between physician and nonphysician mothers in the United States. To formulate an effective advocacy agenda for this population, we surveyed faculty physician mothers about their breastfeeding experiences. We hypothesized that identifying frequent, modifiable barriers to breastfeeding could generate ideas for improved lactation support for female physicians. Study Design: A deidentified breastfeeding survey was sent to female faculty physicians at an academic children's hospital in 2020. Inclusion criteria included female faculty physicians who had given birth within the past 5 years. The responses of those who selected "yes" when asked if they had breastfed were analyzed. Results: Fifteen percent of respondents stated that they did not meet their breastfeeding goals. The most prevalent theme for both positive and negative factors in the qualitative analysis was pumping breast milk. Physician mothers provided key insight into (1) the impact of their role as physicians on their breastfeeding experience, (2) impact of their return to work on breastfeeding, and (3) ideas for improved lactation support. Conclusion: This study highlights the need to improve maternal and infant health by advocating for faculty physicians who are providing breast milk for their children. Advocacy efforts should focus on improving conditions for breast milk pumping and for effective policies around return to work after delivery. Further development and study of individualized breastfeeding support plans for physician mothers is needed.

Breastfeeding in the Workplace: Attitudes Toward Multiple Roles, Perceptions of Support, and Workplace Outcomes

Objective: American women are consistently tasked with breastfeeding, while returning to work, but little research examines how women perceive support in the workplace and their own working outcomes. This study examined the associations among breastfeeding women's perceptions of breastfeeding support in the workplace (i.e., managerial, organizational, co-worker, time, and physical environment), attitudes toward multiple roles, and workplace outcomes (i.e., affective commitment, job satisfaction, and workplace productivity). Materials and Methods: Survey data from 109 mothers who have or are currently breastfeeding/pumping human milk at their workplace were collected and analyzed. Results: Results indicated significant positive relationships among attitudes toward multiple roles and workplace productivity. In addition, perceptions of breastfeeding support were significantly associated with both affective commitment as well as job satisfaction. Finally, our sample of breastfeeding employees returned to work after having a baby primarily for financial reasons, and do not generally feel very supported in the workplace. Conclusions: Overall, organizations can promote more investment and satisfaction in employees by providing explicit communication about breastfeeding-supportive policies to all employees. These findings underscore the importance of organizational breastfeeding support for mothers as well as their coworkers, which ultimately influences the success of the organization as a whole.

Work, race and breastfeeding outcomes for mothers in the United States

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.