Sage Journals: Discover world-class research

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.

Keywords

breastfeeding breastfeeding barriers breastfeeding experience breastfeeding support lactation workplace programs

Get full access to this article

View all access options for this article.

References

*Abbott

Carty

Batig

A. L

. (2019). Infant feeding practices, workplace breastfeeding/lactation practices, and perception of unit/service support among primiparous active duty servicewomen. Military Medicine, 184(7–8), e315–e320.doi:10.1093/milmed/usy356

*Alvarez

Serwint

J. R.

Levine

D. M.

Bertram

Sattari

. (2015). Lawyer mothers: Infant-feeding intentions and behavior. Southern Medical Journal, 108(5), 262–267.doi:10.14423/SMJ.0000000000000277

*Ames

E. G.

Burrows

H. L

. (2019). Differing experiences with breastfeeding in residency between mothers and coresidents. Breastfeeding Medicine, 14(8), 575–579.doi:10.1089/bfm.2019.0001

Bai

D. L.

Fong

D. Y. T.

Tarrant

. (2015). Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum. Maternal and Child Health Journal, 19(5), 990–999.doi:10.1007/s10995-014-1596-7

Bickerdike

Booth

Wilson

P. M.

Farley

Wright

. (2017). Social prescribing: Less rhetoric and more reality. A systematic review of the evidence. BMJ Open, 7(4), e013384.doi:10.1136/bmjopen-2016-013384

Burns

Triandafilidis

. (2019). Taking the path of least resistance: A qualitative analysis of return to work or study while breastfeeding. International Breastfeeding Journal, 14(15).doi:10.1186/s13006-019-0209-x

*Cantu

R. M.

Gowen

M. S.

Tang

Mitchell

. (2018). Barriers to breastfeeding in female physicians. Breastfeeding Medicine, 13(5), 341–345.doi:10.1089/bfm.2018.0022

Centers for Disease Control and Prevention . (2019, August 1). Breastfeeding among U.S. children born 2009–2016, CDC national immunization survey. https://www.cdc.gov/breastfeeding/data/nis_data/results.html

Cohen

Mrtek

M. B

. (1994). The impact of two corporate lactation programs on the incidence and duration of breast-feeding by employed mothers. American Journal of Health Promotion, 8(6), 436–441.doi:10.4278/0890-1171-8.6.436

10.

Cohen

Mrtek

M. B.

Mrtek

R. G

. (1995). Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. American Journal of Health Promotion, 10(2), 148–153.doi:10.4278/0890-1171-10.2.148

11.

*Dabritz

H. A.

Hinton

B. G.

Babb

. (2009). Evaluation of lactation support in the workplace or school environment on 6-month breastfeeding outcomes in Yolo County, California. Journal of Human Lactation, 25(2), 182–193.doi:10.1177/0890334408328222

12.

Dinour

L. M.

Szaro

J. M

. (2017). Employer-based programs to support breastfeeding among working mothers: A systematic review. Breastfeeding Medicine, 12(3), 131–141.doi:10.1089/bfm.2016.0182

13.

*Dixit

Feldman-Winter

Szucs

K. A

. (2015). “Frustrated,” “depressed,” and “devastated” pediatric trainees: US academic medical centers fail to provide adequate workplace breastfeeding support. Journal of Human Lactation, 31(2), 240–248.doi:10.1177/0890334414568119

http://www.ncbi.nlm.nih.gov/pubmed/25588382

14.

Eidelman

Schanler

R. J

Section on Breastfeeding . (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–841.doi:https://doi.org/10.1542/peds.2011-3552

15.

Froh

E. B.

Spatz

D. L

. (2016). Navigating return to work and breastfeeding in a hospital with a comprehensive employee lactation program: The voices of mothers. Journal of Human Lactation, 32(4), 689–694.doi:10.1177/0890334416663475

http://www.ncbi.nlm.nih.gov/pubmed/27601461

16.

*Guendelman

Kosa

J. L.

Pearl

Graham

Goodman

Kharrazi

. (2009). Juggling work and breastfeeding: Effects of maternity leave and occupational characteristics. Pediatrics, 123(1), e38–e46.doi:10.1542/peds.2008-2244

17.

Hardison-Moody

MacNell

Elliott

Bowen

. (2018). How social, cultural, and economic environments shape infant feeding for low-income women: A qualitative study in North Carolina. Journal of the Academy of Nutrition and Dietetics, 118(10), 1886–1894.doi:10.1016/j.jand.2018.01.008

18.

Hawkins

S. S.

Dow-Fleisner

Noble

. (2015). Breastfeeding and the Affordable Care Act. Pediatric Clinics of North America, 62(5), 1071–1091.doi:10.1016/j.pcl.2015.05.002

19.

*Henry-Moss

Abbuhl

Bellini

Spatz

D. L

. (2018). Lactation space experiences and preferences among health care workers in an academic medical center. Breastfeeding Medicine, 13(9), 607–613.doi:10.1089/bfm.2018.0101

20.

Hilliard

E. D

. (2017). A review of worksite lactation accommodations. Workplace Health & Safety, 65(1), 33–44.doi:10.1177/2165079916666547

21.

*Hojnacki

S. E.

Bolton

Fulmer

I. S.

Olson

B. H

. (2012). Development and piloting of an instrument that measures company support for breastfeeding. Journal of Human Lactation, 28(1), 20–27.doi:10.1177/0890334411430666

22.

*Jantzer

A. M.

Anderson

Kuehl

R. A

. (2018). Breastfeeding support in the workplace: The relationships among breastfeeding support, work–life balance, and job satisfaction. Journal of Human Lactation, 34(2), 379–385.doi:10.1177/0890334417707956

23.

*Juengst

S. B.

Royston

Huang

Wright

. (2019). Family leave and return-to-work experiences of physician mothers. JAMA Network Open, 2(10), e1913054–e1913054.doi:10.1001/jamanetworkopen.2019.13054

24.

Kim

J. H.

Shin

J. C.

Donovan

S. M

. (2018). Effectiveness of workplace lactation interventions on breastfeeding outcomes in the United States: An updated systematic review. Journal of Human Lactation ..

25.

Koppen

I. J. N.

Kuizenga-Wessel

Saps

Lorenzo

C. D.

Benninga

M. A.

Tabbers

M. M

. (2016). Functional defecation disorders and excessive body weight: A systematic review. Pediatrics, 138(3), e20161417.doi:10.1542/peds.2016-1417

26.

Kornfeind

K. R.

Sipsma

H. L

. (2018). Exploring the link between maternity leave and postpartum depression. Women’s Health Issues, 28(4), 321–326.doi:10.1016/j.whi.2018.03.008

27.

Kozhimannil

K. B.

Jou

Gjerdingen

D. K.

McGovern

P. M

. (2016). Access to workplace accommodations to support breastfeeding after passage of the Affordable Care Act. Women’s Health Issues, 26(1), 6–13.doi:10.1016/j.whi.2015.08.002

28.

Krippendorff

. (2018). Content analysis: An introduction to its methodology (4th Edition). SAGE.

29.

Leider

J. P.

Harper

Shon

J. W.

Sellers

Castrucci

B. C

. (2016). Job satisfaction and expected turnover among federal, state, and local public health practitioners. American Journal of Public Health, 106(10), 1782–1788.doi:10.2105/AJPH.2016.303305

30.

Zhao

While

. (2019). Job satisfaction among hospital nurses: A literature review. International Journal of Nursing Studies, 94, 21–31.doi:10.1016/j.ijnurstu.2019.01.011

31.

*Lubold

A. M

. (2016). Breastfeeding and employment: A propensity score matching approach. Sociological Spectrum, 36(6), 391–405.doi:10.1080/02732173.2016.1227286

32.

*Magner

Phillipi

C. A

. (2015). Using a wellness program to promote a culture of breastfeeding in the workplace: Oregon Health & Science University’s experience. Journal of Human Lactation, 31(1), 40–42.

33.

Majee

Jefferson

U. T.

Goodman

L. R.

Olsberg

J. E

. (2016). Four years later: Rural mothers’ and employers’ perspectives on breastfeeding barriers following the passage of the Affordable Care Act. Journal of Health Care for the Poor and Underserved, 27(3), 1110–1125.doi:10.1353/hpu.2016.0111

34.

*Mandal

Roe

B. E.

Fein

S. B

. (2010). The differential effects of full-time and part-time work status on breastfeeding. Health Policy, 97(1), 79–86.doi:10.1016/j.healthpol.2010.03.006

35.

Mangrio

Persson

Bramhagen

A. -C

. (2017). Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: A systematic review. Scandinavian Journal of Caring Sciences, 32(2), 451–465.doi:10.1111/scs.12489

http://www.ncbi.nlm.nih.gov/pubmed/28569436

36.

*Martin

S. E.

Drake

Yoder

Gibson

Litke

C. A

. (2015). Active duty women’s perceptions of breast-feeding support in the military setting. Military Medicine, 180(11), 1154–1160.doi:10.7205/MILMED-D-14-00498

37.

Moher

Liberati

Tetzlaff

Altman

D. G

. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097.doi:10.1371/journal.pmed.1000097

http://www.ncbi.nlm.nih.gov/pubmed/19621072

38.

National Heart, Lung, and Blood Institute (NHLBI) . (n.d.). Study quality assessment tools. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools

39.

Noel-Weiss

Boersma

Kujawa-Myles

. (2012). Questioning current definitions for breastfeeding research. International Breastfeeding Journal, 7(1), 9.doi:10.1186/1746-4358-7-9

40.

*Orth

T. A.

Drachman

Habak

. (2013). Breastfeeding in obstetrics residency: Exploring maternal and colleague resident perspectives. Breastfeeding Medicine, 8(4), 394–400.doi:10.1089/bfm.2012.0153

41.

*Osband

Y. B.

Altman

R. L.

Patrick

P. A.

Edwards

K. S

. (2011). Breastfeeding education and support services offered to pediatric residents in the US. Academic Pediatrics, 11(1), 75–79.doi:10.1016/j.acap.2010.11.002

42.

*Pearson

A. C. S.

Dodd

S. E.

Kraus

M. B.

Ondecko Ligda

K. M.

Hertzberg

L. B.

Patel

Chandrabose

R. K

. (2019). Pilot survey of female Anesthesiologists’ childbearing and parental leave experiences. Anesthesia & Analgesia, 128(6), e109–e112.doi:10.1213/ANE.0000000000003802

http://www.ncbi.nlm.nih.gov/pubmed/31094811

43.

Rollins

N. C.

Bhandari

Hajeebhoy

Horton

Lutter

C. K.

Martines

J. C.

Piwoz

E. G.

Richter

L. M.

Victora

C. G

. (2016). Why invest, and what it will take to improve breastfeeding practices? The Lancet, 387(10017), 491–504.doi:10.1016/S0140-6736(15)01044-2

44.

*Sattari

Serwint

J. R.

Neal

Chen

Levine

D. M

. (2013). Work-place predictors of duration of breastfeeding among female physicians. The Journal of Pediatrics, 163(6), 1612–1617.doi:10.1016/j.jpeds.2013.07.026

http://www.ncbi.nlm.nih.gov/pubmed/24011764

45.

Sattari

Serwint

J. R.

Shuster

J. J.

Levine

D. M

. (2016). Infant-feeding intentions and practices of internal medicine physicians. Breastfeeding Medicine, 11(4), 173–179.doi:10.1089/bfm.2015.0151

46.

*Scott

V. C.

Taylor

Y. J.

Basquin

Venkitsubramanian

. (2019). Impact of key workplace breastfeeding support characteristics on job satisfaction, breastfeeding duration, and exclusive breastfeeding among health care employees. Breastfeeding Medicine, 14(6), 416–423.doi:10.1089/bfm.2018.0202

http://www.ncbi.nlm.nih.gov/pubmed/30994382

47.

*Snyder

Hansen

Brown

Portratz

White

Dinkel

. (2018). Workplace breastfeeding support varies by employment type: The service workplace disadvantage. Breastfeeding Medicine, 13(1), 23–27.doi:10.1089/bfm.2017.0074

48.

Society for Human Resource Management . (2018). 2018 Employee benefits: The evolution of benefits. https://www.shrm.org/hr-today/trends-and-forecasting/research-and-surveys/Documents/2018%20Employee%20Benefits%20Report.pdf

49.

*Spitzmueller

Wang

Zhang

Thomas

C. L.

Fisher

G. G.

Matthews

R. A.

Strathearn

. (2016). Got milk? Workplace factors related to breastfeeding among working mothers. Journal of Organizational Behavior, 37(5), 692–718.doi:10.1002/job.2061

50.

Spitzmueller

Zhang

Thomas

C. L.

Wang

Fisher

G. G.

Matthews

R. A.

Strathearn

. (2018). Identifying job characteristics related to employed women’s breastfeeding behaviors. Journal of Occupational Health Psychology, 23(4), 457–470.doi:10.1037/ocp0000119

51.

*Stack

S. W.

Jagsi

Biermann

J. S.

Lundberg

G. P.

Law

K. L.

Milne

C. K.

Williams

S. G.

Burton

T. C.

Larison

C. L.

Best

J. A

. (2019). Maternity leave in residency: A multicenter study of determinants and wellness outcomes. Academic Medicine: Journal of the Association of American Medical Colleges, 94(11), 1738–1745.

52.

Steurer

L. M

. (2017). Maternity leave length and workplace policies’ impact on the sustainment of breastfeeding: Global perspectives. Public Health Nursing, 34(3), 286–294.doi:10.1111/phn.12321

53.

Thomas-Jackson

S. C.

Bentley

G. E.

Keyton

Reifman

Boylan

Hart

S. L

. (2016). In-hospital breastfeeding and intention to return to work influence mothers’ breastfeeding intentions. Journal of Human Lactation, 32(4), NP76–NP83.doi:10.1177/0890334415597636

54.

*Uriell

Perry

Kee

Burress

. (2009). Breastfeeding in the navy: Estimates of rate, duration, and perceived support. Military Medicine, 174(3), 290–296.doi:10.7205/MILMED-D-03-8807

http://www.ncbi.nlm.nih.gov/pubmed/19354093

55.

U.S. Bureau of Labor Statistics . (2019). Women in the labor force: A databook (No. 1084). https://www.bls.gov/opub/reports/womens-databook/2019/home.htm

56.

U.S. Department of Health and Human Services . (2013, June 28). Affordable Care Act rules on expanding access to preventive services for women. http://www.hhs.gov/healthcare/facts/factsheets/2011/08/womensprevention08012011a.html

57.

U.S. Department of Health and Human Services . (2017, February 9). Business case for breastfeeding. Womenshealth.Gov . https://www.womenshealth.gov/breastfeeding/breastfeeding-home-work-and-public/breastfeeding-and-going-back-work/business-case

58.

U.S. Department of Health and Human Services . (2018, August 24). Maternal, infant, and child health: Healthy people 2020. HealthyPeople.Gov . https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives

59.

*Waite

W. M.

Christakis

. (2015). Relationship of maternal perceptions of workplace breastfeeding support and job satisfaction. Breastfeeding Medicine, 10(4), 222–227.doi:10.1089/bfm.2014.0151

60.

Wallenborn

J. T.

Perera

R. A.

Wheeler

D. C.

Masho

S. W

. (2019). Workplace support and breastfeeding duration: The mediating effect of breastfeeding intention and self-efficacy. Birth, 46(1), 121–128.doi:10.1111/birt.12377

61.

Watson

D. P.

Adams

E. L.

Shue

Coates

McGuire

Chesher

Jackson

Omenka

. (2018). Defining the external implementation context: An integrative systematic literature review. BMC Health Services Research, 18(1).doi:10.1186/s12913-018-3046-5

62.

*Whipps

M. D. M.

Honoroff

. (2019). Time off work after childbirth and breastfeeding supportive workplaces: Associations with near-exclusive breastfeeding trajectory membership. Women’s Health Issues, 29(6), a9h, 506–512.doi:10.1016/j.whi.2019.08.006

63.

*Zhuang

Bresnahan

M. J.

Yan

Zhu

Goldbort

Bogdan-Lovis

. (2019). Keep doing the good work: Impact of coworker and community support on continuation of breastfeeding. Health Communication, 34(11), 1270–1278.doi:10.1080/10410236.2018.1476802

http://www.ncbi.nlm.nih.gov/pubmed/29771151

Perceptions,Experiences,and Outcomes of Lactation Support in the Workplace: A Systematic Literature Review

Abstract

Background

Research Aims

Methods

Results

Conclusions

Keywords

Get full access to this article

References