abstract: 'Background: The U.S. continues to have one of the lowest breastfeeding

  rates in the industrialized world. Studies have shown that full-time

  employment and early return to work decreased breastfeeding duration,

  but little is known about the relationship between leave policies and

  breastfeeding initiation and cessation. This study aimed to identify

  workplace-related barriers and facilitators associated with

  breastfeeding initiation and cessation in the first 6 months postpartum.

  Methods: A prospective cohort study design was utilized to recruit 817

  Minnesota women aged 18 and older while hospitalized for childbirth.

  Selection criteria included English-speaking, employed mothers with a

  healthy, singleton birth. These women were followed up using telephone

  interviews at 6 weeks, 12 weeks, and 6 months after childbirth. The main

  study outcomes were breastfeeding initiation, measured during hospital

  enrollment, and breastfeeding cessation by 6 months postpartum.

  Results: Women were 30 years old; 86 \% were White, and 73 \% were

  married. Breastfeeding rates were 81 \% at childbirth, 67 \% at 6 weeks,

  49 \% at 12 weeks, and 33 \% at 6 months postpartum. Logistic regression

  revealed the odds of breastfeeding initiation were higher for women who:

  held professional jobs, were primiparae, had graduate degree, did not

  smoke prenatally, had no breastfeeding problems, and had family or

  friends who breastfeed. Survival analyses showed the hazard for

  breastfeeding cessation by 6 months was: higher for women who returned

  to work at any time during the 6 months postpartum versus those who did

  not return, lower for professional workers, higher among single than

  married women, higher for every educational category compared to

  graduate school, and higher for those with no family or friends who

  breastfeed.

  Conclusions: While employer paid leave policy did not affect

  breastfeeding initiation or cessation, women who took shorter leaves

  were more likely to stop breastfeeding in the first 6 months postpartum.

  Future research should examine women''s awareness of employer policies

  regarding paid and unpaid leave.'
affiliation: 'Dagher, RK (Corresponding Author), Univ Maryland, Sch Publ Hlth, Dept
  Hlth Serv Adm, College Pk, MD 20742 USA.

  Dagher, Rada K., Univ Maryland, Sch Publ Hlth, Dept Hlth Serv Adm, College Pk, MD
  20742 USA.

  McGovern, Patricia M., Univ Minnesota, Div Environm Hlth Sci, Minneapolis, MN USA.

  Schold, Jesse D., Cleveland Clin, Dept Quantitat Hlth Sci, Cleveland, OH 44106 USA.

  Randall, Xian J., US Dept Housing \& Urban Dev, Washington, DC USA.'
article-number: '194'
author: Dagher, Rada K. and McGovern, Patricia M. and Schold, Jesse D. and Randall,
  Xian J.
author-email: radadagher@gmail.com
author_list:
- family: Dagher
  given: Rada K.
- family: McGovern
  given: Patricia M.
- family: Schold
  given: Jesse D.
- family: Randall
  given: Xian J.
da: '2023-09-28'
doi: 10.1186/s12884-016-0965-1
files: []
issn: 1471-2393
journal: BMC Pregnancy and Childbirth
keywords: Breastfeeding; Family leave policy; Postpartum; Workplace barriers
keywords-plus: 'MATERNAL EMPLOYMENT; POSTPARTUM HEALTH; UNITED-STATES; DURATION; WORK;

  TIME; CHILDBIRTH; FAMILY; IMPACT; LEAVE'
language: English
month: JUL 29
number-of-cited-references: '46'
papis_id: 4b626b78dfd7c99c4c27e9fd7123f5fb
ref: Dagher2016determinantsbreastfe
researcherid-numbers: Schold, Jesse/AAC-5844-2019
times-cited: '77'
title: 'Determinants of breastfeeding initiation and cessation among employed mothers:
  a prospective cohort study'
type: article
unique-id: WOS:000380788300001
usage-count-last-180-days: '0'
usage-count-since-2013: '31'
volume: '16'
web-of-science-categories: Obstetrics \& Gynecology
year: '2016'