A cross-sectional study of lactation room quality and Dutch working mothers’ satisfaction, perceived ease of, and perceived support for breast milk expression at work

Abstract

Background The challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work. Methods We conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017). Results The LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace. Conclusions The availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms.

Effects of lactation room quality on working mothers’ feelings and thoughts related to breastfeeding and work: a randomized controlled trial and a field experiment

“…Moreover, mothers' perceived behavioural control with respect to milk expression at work was also positively affected by lactation room quality (Study 1), particularly for mothers high in environmental sensitivity (Study 2). The current study therefore corroborates and extends the findings of a previous cross-sectional study showing that lactation room quality was positively related to mothers' cognitions about milk expression at work [5]. Interestingly, we did not find any effects of lactation room quality on intention to express milk at work in either study; however, this might be due to a ceiling effect, as the intended duration in Study 1 was already high (on average 15 months), compared to the relatively low breastfeeding rates in the Netherlands [4].…”

“…In line with the tenets of a recent cross-sectional study on lactation room quality [ 5 ], we posit that the quality of lactation rooms is determined by more than just basic functional aspects. Just like the quality of office rooms is enhanced by, for instance, indoor air quality, thermal comfort, lighting, acoustics, and natural, aesthetic and recreational aspects [ 11 ], the quality of lactation rooms is also dependent on more than the bare essentials required by legislation.…”

“…Apart from reducing mothers' stress levels, we hypothesized that high-quality lactation rooms may have additional beneficial effects, in particular on mothers' thoughts related to milk expression at work. Evidence in this direction comes from a recent cross-sectional study that found an association between lactation room quality on the one hand and perceived behavioural control van Dellen et al International Breastfeeding Journal (2022) 17:57 and perceived support for milk expression at work on the other [5]. In the current experimental study, we therefore examined the effects of lactation room quality on perceived behavioural control and perceived support for milk expression at work, and added two additional cognitions that are theoretically considered important in predicting behaviour [21]: attitude towards expressing milk at work, and intention to express milk at work.…”

“…The Dutch law furthermore states that an employer should provide a suitable, lockable, and private space for a breastfeeding employee (Article 4.8, paragraph 1 of the Working Hours Act ), but does not further specify what suitable means in this context. A recent cross-sectional study conducted in the Netherlands showed that lactation room quality was generally low, and that lactation room quality was positively related to mothers’ satisfaction with the room and perceived ease of and support for milk expression at work [ 5 ].…”

“…Fig 5. Moderating effect of environmental sensitivity in the relationship between lactation room quality perceived behavioural control…”