Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis

Dutheil, Frédéric; Méchin, Grégory; Vorilhon, Philippe; Benson, Amanda; Bottet, Anne; Clinchamps, Maëlys; Barasinski, Chloé; Navel, Valentin

doi:10.3390/ijerph18168631

Cited by 25 publications

(24 citation statements)

References 87 publications

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“…The previous meta-analysis showed the rate of breastfeeding after returning to work is about 25% which is widely heterogeneous across the world, ranging from 2% to sixty one percent. Interestingly, both economic status and cultural aspect play an important role in the continuation of breastfeeding [ 30 ]. The result of our study found that about 76% (50/65) of mothers were continuing to breastfeed before returning to work but 24% (12/50) had to stop breastfeeding within three months after returning to work.…”

Section: Discussionmentioning

confidence: 99%

Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace

et al. 2022

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Background The World Health Organization recommends that babies should receive exclusive breastfeeding (EBF) for six months, and mothers should be encouraged to breastfeed until their infant is aged two years or older. The breastfeeding rate in Thailand is currently much lower than the target. One critical factor is lactating mothers returning to work, especially in a hospital workplace with high job stress. In this study, we aimed to identify supporting factors and obstacles to sustaining breastfeeding in hospital-type workplaces. Methods We conducted a mixed methods study between February 2021 and August 2021 at Chulabhorn Hospital, Thailand. Quantitative data were collected using questionnaires, and qualitative data were gathered in a focus group discussion among purposefully chosen participants, including mothers with both successful and unsuccessful continuation of breastfeeding after returning to work. We conducted multivariate analysis and thematic analysis in quantitative and qualitative data analysis, respectively. Results Questionnaires were completed by 65 permanent employees of the hospital, and seven of these participated in focus group discussion. The rate of exclusive breastfeeding from birth to six months was sixty six percent, and was measured by the responses from questionnaires, which defined as a practice whereby the infants receive only breastmilk without mixing it with other food. Seventy-seven percent of participants were continuing to breastfeed when they returned to work, with 24% (12/50) having to stop after three months. Factors associated with exclusive breastfeeding was caesarean delivery (OR 7.9; 95% CI 2.00, 31.08). Additionally, childcare at the workplace and the attitude of colleagues were found to be supporting factors for sustaining breastfeeding. Barriers included inadequate private facilities (location and equipment), lack of a breastfeeding break, workload, and inconvenient uniform. Conclusions Effort is needed to sustain breastfeeding after maternal return to work. Our findings are crucial in determining how best to support nursing mothers in breastfeeding after returning to work, particularly during the ongoing COVID-19 pandemic. A breastfeeding-friendly policy with clear operating guidelines in the workplace is critical to sustaining breastfeeding. Learning from others who have had a positive experience will ensure that all breastfeeding women are better supported in the workplace in future.

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Section: Discussionmentioning

confidence: 99%

Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace

et al. 2022

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“…Yet, it has been shown that most women have accurate recall of duration of breastfeeding their first baby [ 49 , 50 ], and accordingly we do not believe this type of bias is likely to influence our results systematically. We also did not ask participants when they returned to work, which may influence breastfeeding longevity [ 51 , 52 ]. We also did not address other reasons for discontinuation, such as perception of milk supply, in the current study.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with duration of breastfeeding in women giving birth for the first time

Haas

Yang²,

Parker³

et al. 2022

BMC Pregnancy Childbirth

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Objective To examine maternal, psychosocial, and pregnancy factors associated with breastfeeding for at least 6 months in those giving birth for the first time. Methods We performed a planned secondary analysis of an observational cohort study of 5249 women giving birth for the first time. Women were contacted at least 6 months after delivery and provided information regarding breastfeeding initiation, duration, and exclusivity. Maternal demographics, psychosocial measures, and delivery methods were compared by breastfeeding groups. Results 4712 (89.8%) of the women breastfed at some point, with 2739 (58.2%) breastfeeding for at least 6 months. Of those who breastfed, 1161 (24.7% of the entire cohort), breastfed exclusively for at least 6 months. In the multivariable model among those who ever breastfed, not smoking in the month prior to delivery (adjusted odds ratio [aOR] 2.04, 95%CI 1.19–3.45), having a Master’s degree of higher (aOR 1.89, 95%CI 1.51–2.36), having a planned pregnancy (aOR 1.48, 95%CI 1.27–1.73), older age (aOR 1.02, 95% CI, 1.01–1.04), lower BMI (aOR 0.96 95% CI 0.95–0.97), and having less anxiety measured during pregnancy (aOR 0.990, 95%CI 0.983–0.998) were associated with breastfeeding for at least 6 months. Compared to non-Hispanic White women, Hispanic women, while being more likely to breastfeed initially (aOR 1.40, 95%CI 1.02–1.92), were less likely to breastfeed for 6 months (aOR 0.72, 95%CI 0.59–0.88). While non-Hispanic Black women were less likely than non-Hispanic White women to initiate breastfeeding (aOR 0.68, 95%CI 0.51–0.90), the odds of non-Hispanic Black women of continuing to breastfeed for at least 6 months was similar to non-Hispanic White women (aOR 0.92, 95%CI 0.71–1.19). Conclusions In this cohort of women giving birth for the first time, duration of breastfeeding was associated with several characteristics which highlight groups at greater risk of not breastfeeding as long as currently recommended. Trial registration NCT01322529 (nuMoM2b) and NCT02231398 (nuMoM2b-Heart Health)

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“…There are multiple factors for the premature abandonment of breastfeeding. Among these factors, we can find the low weight of the infant, the feeling of lack of milk, smoking, the mother's lack of knowledge about breastfeeding or the incorporation to work [14,15]. Education is other of the factors affecting the initiation and continuation of breastfeeding (BF) [9,16,17], and incidentally it is also related to health literacy (HL) [18,19].…”

Section: Introductionmentioning

confidence: 99%

Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study

Valero‐Chillerón

Mena‐Tudela

Cervera‐Gasch

et al. 2022

IJERPH

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Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24–48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.

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Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 87 publications

Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace

Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace

Factors associated with duration of breastfeeding in women giving birth for the first time

Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study

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