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SummaryThe American Academy of Pediatrics recommends that women breastfeed because of improved health outcomes for mothers and children. Because maternal employment during the first year of the child's life has been identified as a reason for breastfeeding cessation, we develop and test a role-theory-based framework to explain women's continuation of breastfeeding after return to work (Study 1) and report results of an exploratory study linking breastfeeding at work with job attitudes and well-being (Study 2). Applying survival analysis to a longitudinal dataset gathered by the Centers for Disease Control (Study 1), we identify pregnant women's perceived employer support for breastfeeding as a predictor of women's breastfeeding goal intentions. Supervisors' negative workplace remarks about breastfeeding related to an eightfold increase of women's likelihood to discontinue exclusive breastfeeding and perceived support for breastfeeding after return to work predicted exclusive breastfeeding continuation. Results of Study 2 suggest that women who return to work and continue breastfeeding experience more family-to-work conflict and overload than women who do not reconcile work and breastfeeding. Further, results of Study 2 provide preliminary evidence suggesting that perceptions of supervisor and coworker support for breastfeeding relate positively to general perceptions of organizational support and negatively to depressive symptoms.

For employed mothers of infants, reconciliation of work demands and breastfeeding constitutes a significant challenge. The discontinuation of breastfeeding has the potential to result in negative outcomes for the mother (e.g., higher likelihood of obesity), her employer (e.g., increased absenteeism), and her infant (e.g., increased risk of infection). Given previous research findings identifying return to work as a major risk factor for breastfeeding cessation, we investigate what types of job characteristics relate to women's intentions to breastfeed shortly after giving birth and women's actual breastfeeding initiation and duration. Using job titles and job descriptors contained in a large Australian longitudinal cohort data set (N = 809), we coded job titles using the U.S. Department of Labor (DOL)'s Occupational Information Network (O*NET) database and extracted job characteristics. Hazardous working conditions and job autonomy were identified as significant determinants of women's breastfeeding intentions, their initiation of breastfeeding, and ultimately their breastfeeding continuation. Hence, we recommend that human resource professionals, managers, and public health initiatives provide breastfeeding-supportive resources to women who, based on their job characteristics, are at high risk to prematurely discontinue breastfeeding to ensure these mothers have equal opportunity to reap the benefits of breastfeeding. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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