Balancing Work and Family: The Effect of Employment Characteristics on Breastfeeding Initiation

Background: Despite the widespread knowledge of the benefits of breastfeeding, some women choose not to initiate breastfeeding. Non-initiation has been attributed to work-related issues. Our objectives are to determine the effect of postpartum employment status and occupational type on breastfeeding initiation.

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 (unweighted n~8,750), we classified postpartum employment status as full-time, part-time, and unemployed. Occupational type was classified as ‘management', ‘professional', ‘service', ‘sales', ‘administrative', and ‘other'. Analyses included chi-square tests and multiple logistic regressions (SUDAAN).

Results: Of all mothers of singletons born in the US in 2001, 69.5% initiated breastfeeding. The proportion initiating breastfeeding by employment status was 66.8% (full-time), 71.9% (part-time) and 70.3% (unemployed; p=0.1041). The rate of breastfeeding initiation was highest among women in ‘professional' occupations (83.4%) and lowest among women in ‘other' occupations (58.4%; p <.0001). In adjusted analysis, full-time workers were 0.76 times less likely to initiate breastfeeding compared to unemployed women (95% CI = 0.59, 0.99). Women in ‘professional' occupations had a 1.71 times greater odds of initiating breastfeeding compared to women in ‘other' occupations (95% CI=1.01–2.89).

Conclusions: Findings suggest that postpartum employment status and occupational type are significant predictors of breastfeeding initiation.

Public Health Implications: Efforts should be made to ensure that women resuming employment postpartum can work part-time. Similarly women in other occupations should be afforded the job control needed to make wise infant feeding decisions.