Maternal employment and exclusive breastfeeding : the effect of usual versus current employment status

This study uses longitudinal data to examine the relationships between maternal employment and plans for exclusive breastfeeding at the time of birth and post-partum practices in three urban areas in Latin America. Both usual and current employment status were examined to understand the separate effects of "intentions to work" versus actual work. Usually employed women had positive plans for any breastfeeding: virtually all planned to breastfeed at night and to continue to breastfeed after returning to work. Although the effect of usual employment status on planned duration of exclusive breastfeeding or the prevalence of exclusive breastfeeding was not consistent, the effect of current employment status was strong and negative. Women who had returned to work were not only significantly less likely to exclusively breastfeed, they were also significantly more likely to have introduced other milks and bottles as compared to unemployed women or those who are usually employed but had not yet returned to work. Strong mitigating factors in these relationships were whether women expressed breast milk in the work place and proximity of mothers at work to their infant. The immediate public health implications of this study are as follows. (1) It is important to encourage the positive breastfeeding plans of employed women, such as breastfeeding at night and continued breastfeeding after returning to work. (2) Women should be encouraged to express breast milk in the work place. (3) Efforts should be made to ensure that women have access to child care at or near their work place. (Author abstract)