Table 7 Workplace breastfeeding interventions assed through qualitative designs
Author (yr) | Country (City) | Population (n) | Design | Type of BF intervention | Data Collection | Type of analysis | Findings | Quality assessment |
|---|---|---|---|---|---|---|---|---|
Abdulloeva S, Eyler AA. (2013) [35] | USA | State and university employees (n = 50. Policies of all 50 states) | Investigation-action | -Written policies to support BF employees | Documentary review of written policies or policy statements & state breastfeeding rates from breastfeeding report card | Content analysis | −11 states had lactation policies with a detailed description of time and space to express milk. -Significant correlation between State law and 6 months EBF rates.1 | Low |
Anderson J, Kuehl RA, Drury SA, Tschetter L, Schwaegerl M, Hildreth M, Bachman C, Gullickson H, Yoder J, Lamp J. (2015) [36] | USA | Business representatives in a rural Midwestern city (n = 32) | Phenomenological | -Support from colleagues | Three focus groups | Thematic analysis | - Interpersonal communication is important to enhance workplace BF support. - Multiple factors like age and the position of the BF employee can affect interpersonal communication about workplace BFsupport. | Low |
Baeza WB., Henríquez KF, Prieto GR (2016) [34] | Region on Araucania, Chile | Working mothers using the public health system & had breastfed at least 1 month and were or are in maternity leave (n = 65) | Grounded Theory | -BF education -Designated space for BF or expressing milk -Other | Five focus groups, five in-deep interviews and 30 telephonic interviews | Thematic analysis | -Mothers recognize lack of knowledge of BF law, policies and rights, lack of the technique of breastmilk extraction, and storage inside the worksite -Returning to work is one of the reasons mentioned by mothers for early weaning, especially when there are no lactation spaces at the worksite. | Low |
Bai YK, Wunderlich SM, Weinstock M. (2012) [37] | USA (New York) | Managers and representatives from human resources at companies with 500 or more employees (n = 20) | Phenomenological | - Support from colleagues -Other | Phone or in-person interviews | Content analysis | -BF support can be helpful to recruit and hold employees. But, the ‘encouragement not to give up breastfeeding early’ was less appreciated as a benefit to the company. -Men, single women or mothers that decided not to breastfeed are unsupportive of a mother-friendly environment. -Space limitation for nursing and pumping rooms, and negative employee dynamics are barriers of workplace BF support. There is also a perception of decreased productivity. | Moderate |
Bradford VA, Walkinshaw LP, Steinman L, Otten JJ, Fisher K, Ellings A, O’Leary J, Johnson DB. (2017) [38] | USA (Washington) | Women and men of 110 organizations of four targeted sectors: hospitals, clinics, early care and education settings, and worksites (n = 125) | Investigation-action | - Written policies to support BF employees - Support from colleagues | Semi-structured interviews | Thematic analysis | -Federal and states laws, policies and performance bring awareness and motivates action. -Organizations have limited financial resources for the development and implementation of supportive breastfeeding policies. -Organization structure affects the ability to develop and implement supportive breastfeeding policies. -Positive experiences facilitate supportive policies and practices. | Moderate |
Froh EB, Spatz DL (2016) [12] | USA (Philadelphia) | Female employees of The Children’s Hospital of Philadelphia (n = 410) | No design (two open questions were added to a survey of a quantitative study - cohort model) | -Written policies to support BF employees - BF education - Support from colleagues | A quantitative survey was deployed to all women (1362), the survey included two qualitative questions. It was optional to answer them. | Content analysis | -Supporting BF mothers after returning to work is key to enable them meeting their BF goals, but even when an institution has a strong lactation policy, mothers may be unaware of the policy, feel internal pressure to avoid frequent pumping breaks, and possibly feel unsupported by both peers and supervisors. | Very low |
Majee W, Jefferson UT, Goodman LR, Olsberg JE. (2016) [39] | USA (Missouri) | Low-income employed and unemployed breastfeeding mothers and key employers of rural area (n = 10 / 7) | Phenomenological | -BF education -Flexible scheduling to support milk expression - Support from colleagues | One focus group and individual interviews and document review | Content analysis | - Workplace milk expression must shift from a reactive stance to regular education for mothers and employees, to allow creating a supportive environment enabling mothers’ BF goals. | Low |
Payne D, James L (2008) [40] | New Zealand | Working mothers of different ethnicities (n = 34) | Phenomenological | - Designated space for BF or expressing milk -Flexible scheduling to support milk expression - Support from colleagues | Semi-structured, open-ended, in-depth and interactive interviews | Thematic analysis | -Implementation of a BF intervention depends on superior’s and colleague’s attitudes towards breastfeeding. Males were less supportive. -Lack of access to a lactation space and limited time to pump influenced women’s decision either not to return to paid employment or to discontinue breastfeeding | Very low |
Spagnoletti BRM, Bennett LR, Kermode M, Wilopo SA, Spagnoletti B (2017) [41] | Indonesia (Yogykarta) | Working women who had given birth in the last 2 years (n = 20) | Ethnography | - Designated space for BF or expressing milk -Flexible scheduling to support milk expression -Work from home (i.e., home-office) or reduced hours | In-depth interviews, focus groups, semi-structured interviews and participant observation | Descriptive analysis | -Majority of women did not have access to a space designated for breastfeeding. Among those who had it, feeling comfortable was imperative to their ability to express breastmilk. | Very low |