Online Program

Determinants of breastfeeding initiation and duration among employed women in the first year after childbirth

Sunday, November 3, 2013

Rada Dagher, PhD, MPH, Dpt of Health Services Admin, University of Maryland, College Park, MD
Patricia M. McGovern, PhD, MPH, School of Public Health, University of Minnesota, Minneapolis, MN
Jesse Schold, Ph.D., Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
Background: Maternal employment following childbirth is associated with non-initiation and early cessation of breastfeeding. We investigated the personal and employment factors associated with both breastfeeding initiation and duration in the first postpartum year.

Methods: A prospective cohort study design was utilized to recruit women while hospitalized for childbirth. The population included Minnesota women ages 18 and older and admitted to the hospital for childbirth in 2001; the sample criteria included English-speaking, employed mothers with a singleton birth.

Results: On average, women were 30 years old; 86% were Caucasian, and 73% were married. Breastfeeding rates were 81% (N=580) at childbirth; 67% (N=480) at 6 weeks, 49% (N=340) at 12 weeks, 33% (N=230) at 6 months, and 11% (N=75) at 12 months postpartum. Logistic regression revealed the odds of initiation of breastfeeding were higher for women who: were primiparas, earned graduate (versus high school) degrees, held professional jobs (versus blue collar or clerical), did not smoke, and lacked physical problems precluding breastfeeding.

Cox proportional hazards regression showed the hazard for breastfeeding cessation was: 1) higher among single (HR= 2.3) and partnered (HR= 1.6) than married women, and 2) higher for clerical (versus professional) workers (HR=1.3), and for women who returned to work (versus those who did not) (HR=1.8), at any time 12 months postpartum.

Conclusions: These mothers exceeded Healthy People goals 2010 (75%) of ever breastfeeding, but fell below goals for any breastfeeding at 6 and 12 months (HP 2010 goals: 50% and 25%). Workplace interventions that support breastfeeding are warranted.

Learning Areas:

Public health or related research

Learning Objectives:
Describe the personal and work-related factors associated with the initiation and maintenance of breastfeeding during the first year after childbirth Discuss possible workplace interventions to enhance breastfeeding (e.g., designated private space for expressing milk, flexible scheduling to allow milk expression during work, flexible work arrangements (telework, part-time, extended leaves) etc.).

Keyword(s): Breastfeeding

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health services researcher whose research interests and expertise is focused on women's health after childbirth, including physical and mental health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.