abstract: 'Promoting exclusive breastfeeding among urban employed mothers is a

  complex phenomenon. Understanding the multiple level factors related to

  this and how they influence employed mothers'' regarding exclusive

  breastfeeding could help identify strategies to support mothers

  continuing exclusive breastfeeding. This study aimed to identify

  maternal, social, and workplace level factors and the interaction

  effects among those factors that influence exclusive breastfeeding for

  six months among urban employed mothers. This case-control study

  investigated among 57 cases (exclusive breastfeeding for six months) and

  228 controls (non-exclusive breastfeeding for six months) in six

  purposively-selected hospital settings in Bangkok, Thailand between

  September 2015 and June 2016. Data were collected through six

  self-administered questionnaires; Demographic Questionnaire, Iowa Infant

  Feeding Attitude Scale, Perceived Self-efficacy in Breastfeeding

  Questionnaire, Breastfeeding Knowledge Questionnaire, Perceived

  Breastfeeding Support Assessment Tool, and Infant Feeding Form, and were

  analyzed by descriptive statistics, univariate and multivariate logistic

  regression.

  The results revealed that maternal factors (family income, attitudes,

  intention, confidence, and knowledge) and workplace factors (maternity

  leave and working times) co-predicted exclusive breastfeeding six

  months. In the interaction effect model, the interaction effect between

  workplace policy on maternity leave and attitudes toward breastfeeding

  also exerted significant influence. The findings suggest that multiple

  level interventions to promote exclusive breastfeeding in employed women

  are needed. In clinical practice, nurses and midwives should implement

  antepartum interventions including assessment of maternal attitudes and

  intentions to breastfeed, providing breastfeeding knowledge to increase

  mothers'' confidence, and advice about planning to combine breastfeeding

  and employment. Of great concern was a finding that more than 75\% of

  the non-EBF mothers reported not having sufficient breastfeeding

  facility support in the workplace. Workplace policies should be reviewed

  in terms of sufficient paid maternity leave, workplace breastfeeding

  support, and an appropriate number of working hours, and this has

  implications for governments and multiple workplaces across the country.

  Nurses have a significant role to play in advocating for and

  contributing to such policies to increase the numbers of women

  successfully breastfeeding longer whilst employed.'
affiliation: 'Ratinthorn, A (Corresponding Author), Mahidol Univ, Dept Obstet \& Gynecol
  Nursing, Fac Nursing, Phutthamonthon Dist, Nakhon Pathom, Thailand.

  Tangsuksan, Pornnapa, Mahidol Univ, Ramathibodi Hosp, Fac Nursing, Bangkok, Thailand.

  Tangsuksan, Pornnapa, Mahidol Univ, Ramathibodi Sch Nursing, Fac Med, Ramathibodi
  Hosp, Bangkok, Thailand.

  Ratinthorn, Ameporn, Mahidol Univ, Dept Obstet \& Gynecol Nursing, Fac Nursing,
  Phutthamonthon Dist, Nakhon Pathom, Thailand.

  Sindhu, Siriorn, Mahidol Univ, Fac Nursing, Dept Surg Nursing, Phutthamonthon Dist,
  Nakhon Pathom, Thailand.

  Spatz, Diane L., Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA.

  Spatz, Diane L., Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA.

  Viwatwongkasem, Chukiat, Mahidol Univ, Fac Publ Hlth, Dept Biostat, Phutthamonthon
  Dist, Nakhon Pathom, Thailand.'
author: Tangsuksan, Pornnapa and Ratinthorn, Ameporn and Sindhu, Siriorn and Spatz,
  Diane L. and Viwatwongkasem, Chukiat
author-email: 'pornnapa.tan@mahidol.ac.th

  ameporn.rat@mahidol.edu

  siriorn.sin@mahidol.edu

  spatz@nursing.upenn.edu

  chukiat.viw@mahidol.ac.th'
author_list:
- family: Tangsuksan
  given: Pornnapa
- family: Ratinthorn
  given: Ameporn
- family: Sindhu
  given: Siriorn
- family: Spatz
  given: Diane L.
- family: Viwatwongkasem
  given: Chukiat
da: '2023-09-28'
files: []
issn: 1906-8107
journal: PACIFIC RIM INTERNATIONAL JOURNAL OF NURSING RESEARCH
keywords: 'Influencing factors; Exclusive breastfeeding; Employed mothers;

  Case-control study'
keywords-plus: 'WORKING MOTHERS; BARRIERS; SUPPORT; WOMEN; WORKPLACE; KNOWLEDGE;

  ATTITUDE; INCOME'
language: English
month: JAN-MAR
number: '1'
number-of-cited-references: '39'
pages: 54-72
papis_id: 51b54a93d8b5d35c1eb8a4de2e17ba96
ref: Tangsuksan2020factorsinfluencing
times-cited: '3'
title: 'Factors Influencing Exclusive Breastfeeding among Urban Employed Mothers:
  A Case-Control Study'
type: Article
unique-id: WOS:000505213400005
usage-count-last-180-days: '0'
usage-count-since-2013: '20'
volume: '24'
web-of-science-categories: Nursing
year: '2020'