Breastfeeding in US working mothers: A systematic review

Article type: Review Article

Authors: Cunningham, Sarah^a | Penning, Jenna^b | Barboza, Sydnie^b | Hansen, Brooklynn^b | Tonks, Taylor^c | Varnell, Kacey^b | Zhu, Angela^d | Lobato de Faria, Joelly^e | Bright IV, Harold S.^f | Dahl-Popolizio, Sue^b | Wolf, Rebecca L.^{b; *}

Affiliations: [a] Phoenix Children’s Hospital, Phoenix, AZ, USA | [b] Department of Occupational Therapy, A.T. Still University, Mesa, AZ, USA | [c] Piller Child Development, Phoenix, AZ, USA | [d] School of Osteopathic Medicine, A.T. Still University, Mesa, AZ, USA | [e] Department of Occupational Therapy, Creighton University, Omaha, NE, USA | [f] A.T. Still Memorial Library, A.T. Still University, Mesa, AZ, USA

Correspondence: [*] Address for correspondence: Rebecca L. Wolf, Departmentof Occupational Therapy, A.T. Still University, Mesa, AZ, USA; E-mail: [email protected].

Abstract: BACKGROUND:Previous studies demonstrate that exclusive breastfeeding has positive long-term health effects on the mother and infant, but research has shown that nearly 50% of mothers do not breastfeed for the recommended amount of time. OBJECTIVE:This article systematizes previous quantitative research on the impact of work on breastfeeding practices to identify the factors that correlate to the cessation of breastfeeding in working mothers. METHODS:Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements, we performed a systematic review that screened PubMed, CINAHL, PsycINFO, and Academic Search Complete databases for articles relating to maternal employment and breastfeeding. RESULTS:Of the 13,106 articles assessed for eligibility, 21 studies met all requirements and were included in this systematic review. The 21 articles were divided into study type and methods, participant demographics, study outcomes, and additional factors that included stressors and stress levels, factors that increased or decreased rates of breastfeeding, and feeding methods. Articles outside of the United States were excluded due to differences in maternity leave policies of other countries impacting the data. CONCLUSION:Cessation of breastfeeding and breastfeeding outcomes were seen to have a strong association with maternal employment, specifically with the policies and employer support in the workplace. Other factors such as race, level of education, and stress were also shown to relate to breastfeeding outcomes and are important to consider in future public health interventions and workplace policies.

Keywords: Breastfeeding, employment, postpartum period, policy, infant

DOI: 10.3233/WOR-220645

Journal: Work, vol. 78, no. 4, pp. 851-871, 2024