Breastfeeding Among Working Mothers: A Systematic Review

PURPOSE: The purpose of this systematic review was to more fully understand the association between return to work and breastfeeding outcomes.

DESIGN: We conducted a systematic review following the PRISMA method.

METHOD: We searched for articles in four electronic bibliographic databases: PubMed, CINHAL, PsycINFO, and Academic search complete. First, we built search terms for PubMed utilizing MESH and natural terms. We then customized search terms for the additional databases. The primary variables that we examined for this systematic review were breastfeeding and maternal work. The following search terms were utilized for the breastfeeding variable: ‘breast feeding’, ‘breastfeeding’, ‘breast milk expression’, ‘milk expression’, ‘breast pumping’, ‘breast milk collection’, ‘infant feeding’, ‘breast milk’, ‘part-time breastfeeding’. The following search terms were utilized for the maternal work variable: ‘working mothers’, ‘mother’, ‘work’, ‘workplace’, ‘job’, ‘employed’, ‘part time work’. All articles containing quantitative data relating to the relationship between maternal employment and breastfeeding were included in the systematic review. This review only includes articles in the English-language and that were published during or after 2014. Any articles that were not written in English or that were published before 2014 were excluded from the review. All studies that were not published in English, did not focus primarily on the mother, included infants greater than 12 months of age, had solely qualitative data, based outside of the United States, or did not discuss breastfeeding and maternal employment were excluded from the review.

RESULTS: Findings from this systematic review demonstrate that 12 of the 14 articles associated breastfeeding practices and its relation to work. There were many factors that influenced the association of work and breastfeeding. Duration of breastfeeding for mothers who work was shown to be related to the support that employers give which can include time and space availability. Other articles went into less depth about why work was a factor for breastfeeding duration and participation but did mention that mothers had said work was a barrier. Even when mothers did not identify work as a barrier to breastfeeding, trends show that breastfeeding cessation increased as mothers returned to work. Out of the articles that were involved in the study, most of them found some type of association of work and breastfeeding and was mostly related to the policies of the workplace that had the most influence.

CONCLUSION: Maternal employment is a major barrier to successful breastfeeding outcomes. Workplace, state, and federal policies should be considered in supporting working mothers achieving their breastfeeding goals.

References

Alvarez, R., Serwint, J. R., Levine, D. M., Bertram, A., & Sattari, M. (2015). Lawyer mothers: Infant-feeding intentions and behavior. Southern Medical Journal, 108(5), 262–267. https://doi.org/10.14423/SMJ.0000000000000277

Augustin, A. L., Donovan, K., Lozano, E. A., Massucci, D. J., & Wohlgemuth, F. (2014). Still nursing at 6 months: a survey of breastfeeding mothers. MCN. The American Journal of Maternal Child Nursing, 39(1), 50–55. https://doi.org/10.1097/01.NMC.0000437534.99514.dc

Clark, C., & Price, K. (2018). Exploring the role of social support in understanding barriers to breastfeeding practices for adolescent mothers in Western North Carolina: A preliminary study. International Public Health Journal, 10(4), 333–342.

Dagher, R. K., McGovern, P. M., Schold, J. D., & Randall, X. J. (2016). Determinants of breastfeeding initiation and cessation among employed mothers: A prospective cohort study. BMC Pregnancy & Childbirth, 16, 1–11. https://doi.org/10.1186/s12884-016-0965-1