Access to Workplace Supports is Positively Associated with Exclusive Breastfeeding among Formally Employed Mothers in Kenya

  • Journal of Nutrition, Volume 152, No. 12, Year 2022

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Study Justification:
This study aimed to investigate the association between workplace-provided breastfeeding (BF) supports and breastfeeding practices among formally employed mothers in Kenya. The study was conducted to address the lack of understanding regarding the impact of workplace benefits on breastfeeding practices in low-income settings. The findings of this study can inform policies and interventions to support breastfeeding among working mothers in Kenya.
Study Highlights:
– The study found that formally employed mothers who had access to workplace-provided BF supports were more likely to practice exclusive breastfeeding (EBF) compared to those who lacked these supports.
– Onsite workplace childcare was associated with a higher prevalence and greater odds of EBF at 6 and 14 weeks postpartum.
– Mothers who visited daycare centers at or near workplaces were more likely to practice EBF at 14 weeks compared to those who did not visit daycare centers.
– Access to workplace private lactation spaces and onsite housing were also associated with higher EBF prevalence.
Recommendations for Lay Readers:
– The findings suggest that workplace-provided BF supports, such as onsite childcare, lactation rooms, and onsite housing, can significantly contribute to promoting exclusive breastfeeding among formally employed mothers.
– Working mothers should be encouraged to utilize workplace-provided BF supports to enhance their ability to practice exclusive breastfeeding.
– Policies and interventions should focus on implementing and expanding workplace benefits, such as lactation rooms, onsite housing, and daycare centers, to support breastfeeding among employed mothers.
Recommendations for Policy Makers:
– Implement and enforce policies that require workplaces to provide breastfeeding supports, such as lactation rooms and onsite childcare facilities.
– Allocate resources to establish and maintain lactation rooms in workplaces to ensure that mothers have a private and comfortable space for breastfeeding or expressing milk.
– Encourage employers to provide onsite housing options for employees who are breastfeeding to facilitate easier access to their infants during breaks.
– Support the establishment and expansion of daycare centers near workplaces to enable working mothers to visit and breastfeed their infants during the workday.
– Develop transportation programs or subsidies to assist working mothers in visiting their children at daycare centers during breaks.
Key Role Players:
– Ministry of Health: Responsible for implementing and monitoring policies related to breastfeeding support in workplaces.
– Employers and Business Associations: Play a crucial role in providing and promoting workplace-provided BF supports.
– Non-Governmental Organizations (NGOs): Can collaborate with the government and employers to advocate for breastfeeding-friendly workplaces and provide technical support.
– Labor Unions: Can advocate for the inclusion of breastfeeding support in collective bargaining agreements and ensure that working mothers’ rights are protected.
Cost Items for Planning Recommendations:
– Construction and maintenance of lactation rooms in workplaces.
– Training and education programs for employers and employees on breastfeeding support.
– Subsidies or incentives for employers to establish onsite childcare facilities.
– Development and maintenance of daycare centers near workplaces.
– Transportation programs or subsidies for working mothers to visit their children at daycare centers.
Please note that the cost items provided are for planning purposes and do not reflect actual costs. The actual budget will depend on various factors such as the scale of implementation, location, and specific requirements of each workplace.

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Background: Mothers in low-income settings who work in agricultural employment are challenged to meet breastfeeding (BF) recommendations. Recent legislation in Kenya mandates maternity leave and workplace supports, yet the relation of these benefits with BF practices is poorly understood. Objectives: We evaluated the associations with workplace-provided BF supports and BF practices among formally employed mothers in Kenya. The availability of supports was hypothesized to be associated with a higher prevalence and greater odds of exclusive breastfeeding (EBF). Methods: We conducted repeated cross-sectional surveys among formally employed mothers at 1–4 d and 6, 14, and 36 wk (to estimate 24 wk) postpartum in Naivasha, Kenya. We used logistic regression adjusted for maternal age, education, physical burden of work, HIV status, and income to evaluate associations between workplace supports and EBF practices. Results: Among formally employed mothers (n = 564), those who used onsite workplace childcare were more likely to practice EBF than those who used community- or home-based childcare at both 6 wk (95.7% compared with 82.4%, P = 0.030) and 14 wk (60.6% compared with 22.2%, P < 0.001; adjusted OR: 5.11; 95% CI: 2.3, 11.7). Likewise, at 14 wk among mothers who currently used daycare centers, a higher proportion of mothers who visited daycare centers at or near workplaces practiced EBF (70.0%) than of those not visiting daycare centers (34.7%, P = 0.005). EBF prevalence was higher among mothers with access to workplace private lactation spaces than among mothers without such spaces (84.6% compared with 55.6%, P = 0.037), and among mothers who lived in workplace housing than those without onsite housing (adjusted OR: 2.06, 95% CI: 1.25, 3.41). Conclusions: Formally employed mothers in Kenya who have access to and use workplace-provided BF supports were more likely to practice EBF than mothers who lacked these supports. As the Kenya Health Act is implemented, lactation rooms, onsite housing and daycare, and transportation to visit children can all support BF and EBF among employed mothers.

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The study recommends implementing workplace supports for breastfeeding mothers to improve access to maternal health. These supports include onsite workplace childcare, workplace private lactation spaces, workplace housing, and daycare centers near workplaces. The study found that formally employed mothers in Kenya who had access to and used these supports were more likely to practice exclusive breastfeeding (EBF) compared to those who did not have these supports.

Specifically, the study found that mothers who used onsite workplace childcare and visited daycare centers at or near workplaces had higher rates of EBF compared to those who used community- or home-based childcare. Similarly, mothers with access to workplace private lactation spaces and onsite housing had higher rates of EBF compared to those without these facilities.

Implementing these workplace supports, such as providing lactation rooms, onsite housing, daycare centers, and transportation to visit children, can help support breastfeeding and exclusive breastfeeding among employed mothers. This can contribute to improving maternal and child health outcomes by ensuring that mothers have the necessary resources and support to continue breastfeeding while working.

The study was published in the Journal of Nutrition, Volume 152, No. 12, in the year 2022.
AI Innovations Description
The recommendation from the study to improve access to maternal health is to provide workplace supports for breastfeeding mothers. The study found that formally employed mothers in Kenya who had access to and used workplace-provided breastfeeding supports were more likely to practice exclusive breastfeeding (EBF) compared to those who did not have these supports.

The specific workplace supports that were associated with higher rates of EBF included onsite workplace childcare, workplace private lactation spaces, workplace housing, and daycare centers near workplaces. Mothers who used onsite workplace childcare and visited daycare centers at or near workplaces had higher rates of EBF compared to those who used community- or home-based childcare. Similarly, mothers with access to workplace private lactation spaces and onsite housing had higher rates of EBF compared to those without these facilities.

Implementing these workplace supports, such as providing lactation rooms, onsite housing, daycare centers, and transportation to visit children, can help support breastfeeding and exclusive breastfeeding among employed mothers. This can contribute to improving maternal and child health outcomes by ensuring that mothers have the necessary resources and support to continue breastfeeding while working.

The study was published in the Journal of Nutrition, Volume 152, No. 12, in the year 2022.
AI Innovations Methodology
To simulate the impact of the main recommendations from this abstract on improving access to maternal health, a possible methodology could involve the following steps:

1. Identify a representative sample of formally employed mothers in Kenya who have recently given birth. This sample should include mothers from various industries and regions to ensure diversity.

2. Divide the sample into two groups: an intervention group and a control group. The intervention group will receive the workplace supports recommended in the study, such as onsite workplace childcare, workplace private lactation spaces, workplace housing, and daycare centers near workplaces. The control group will not receive these supports.

3. Conduct baseline assessments for both groups to collect information on their breastfeeding practices, including exclusive breastfeeding rates, as well as other relevant factors such as maternal age, education, physical burden of work, HIV status, and income.

4. Implement the workplace supports for the intervention group, ensuring that the necessary facilities and resources are provided. This may involve setting up lactation rooms, establishing onsite housing options, and coordinating with daycare centers near workplaces.

5. Monitor and track the breastfeeding practices of both groups over a specified period, such as 6 months or 1 year. Regular follow-up assessments should be conducted to collect data on exclusive breastfeeding rates and other relevant factors.

6. Analyze the data collected from both groups to compare the exclusive breastfeeding rates between the intervention and control groups. This analysis should account for confounding factors by using statistical methods such as logistic regression, adjusting for variables like maternal age, education, physical burden of work, HIV status, and income.

7. Assess the impact of the workplace supports on exclusive breastfeeding rates by comparing the differences in exclusive breastfeeding rates between the intervention and control groups. This analysis will help determine the effectiveness of the workplace supports in improving access to maternal health.

8. Draw conclusions based on the analysis and evaluate the overall impact of implementing the workplace supports recommended in the study. This evaluation should consider the feasibility, cost-effectiveness, and scalability of these supports in the context of improving maternal health outcomes in Kenya.

It is important to note that this methodology is a general outline and may need to be adapted based on the specific research design and resources available for the study.


Statistics:
Citations: 1
Identifiers:
DOI: 10.1093/jn/nxac160
ISSN: 00223166
Research Areas:
Community Interventions, Health System and Policy, Infectious Diseases, Maternal Access, Maternal and Child Health, Social Determinants
Study Countries:
Kenya
Study Design:
Cross Sectional Study
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