abstract: 'Objectives: This study examines access to workplace accommodations for

  breastfeeding, as mandated by the Affordable Care Act, and its

  associations with breastfeeding initiation and duration. We hypothesize

  that women with access to reasonable break time and private space to

  express breast milk would be more likely to breastfeed exclusively at 6

  months and to continue breastfeeding for a longer duration.

  Methods: Data are from Listening to Mothers III, a national survey of

  women ages 18 to 45 who gave birth in 2011 and 2012. The study

  population included women who were employed full or part time at the

  time of survey. Using two-way tabulation, logistic regression, and

  survival analysis, we characterized women with access to breastfeeding

  accommodations and assessed the associations between these

  accommodations and breastfeeding outcomes.

  Results: Only 40\% of women had access to both break time and private

  space. Women with both adequate break time and private space were 2.3

  times (95\% CI, 1.03-4.95) as likely to be breastfeeding exclusively at

  6 months and 1.5 times (95\% CI, 1.08-2.06) as likely to continue

  breastfeeding exclusively with each passing month compared with women

  without access to these accommodations.

  Conclusions: Employed women face unique barriers to breastfeeding and

  have lower rates of breastfeeding initiation and shorter durations,

  despite compelling evidence of associated health benefits. Expanded

  access to workplace accommodations for breastfeeding will likely entail

  collaborative efforts between public health agencies, employers,

  insurers, and clinicians to ensure effective workplace policies and

  improved breastfeeding outcomes. Copyright (C) 2016 by the Jacobs

  Institute of Women''s Health. Published by Elsevier Inc.'
affiliation: 'Kozhimannil, KB (Corresponding Author), Univ Minnesota, Sch Publ Hlth,
  Div Hlth Policy \& Management, 420 Delaware St SE,MMC 729, Minneapolis, MN 55455
  USA.

  Kozhimannil, Katy B.; Jou, Judy, Univ Minnesota, Sch Publ Hlth, Div Hlth Policy
  \& Management, Minneapolis, MN 55455 USA.

  Gjerdingen, Dwenda K., Univ Minnesota, Sch Med, Dept Family Med \& Community Hlth,
  Minneapolis, MN 55455 USA.

  McGovern, Patricia M., Univ Minnesota, Sch Publ Hlth, Div Environm Hlth Sci, Minneapolis,
  MN 55455 USA.'
author: Kozhimannil, Katy B. and Jou, Judy and Gjerdingen, Dwenda K. and McGovern,
  Patricia M.
author-email: kbk@umn.edu
author_list:
- family: Kozhimannil
  given: Katy B.
- family: Jou
  given: Judy
- family: Gjerdingen
  given: Dwenda K.
- family: McGovern
  given: Patricia M.
da: '2023-09-28'
doi: 10.1016/j.whi.2015.08.002
eissn: 1878-4321
files: []
issn: 1049-3867
journal: WOMENS HEALTH ISSUES
keywords-plus: 'UNITED-STATES; WORK STATUS; INITIATION; EMPLOYMENT; DURATION; WOMEN;

  EMPLOYERS; FAMILY; IMPACT; TIME'
language: English
month: JAN-FEB
number: '1'
number-of-cited-references: '39'
orcid-numbers: Jou, Judy/0000-0003-2446-1744
pages: 6-13
papis_id: 148c950fe524d8a299df70b12ba29cbf
ref: Kozhimannil2016accessworkplace
times-cited: '77'
title: Access to Workplace Accommodations to Support Breastfeeding after Passage of
  the Affordable Care Act
type: Article
unique-id: WOS:000368262500014
usage-count-last-180-days: '0'
usage-count-since-2013: '24'
volume: '26'
web-of-science-categories: Public, Environmental \& Occupational Health; Women's Studies
year: '2016'