Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2004. / Includes bibliographical references.

New mothers struggle to combine breastfeeding and employment. Employers may not realize the benefits of breastfeeding for mothers, their infants, or the businesses themselves. A cross-sectional, descriptive design was used to investigate the characteristics of Central Texas small business employers, their attitude toward supporting breastfeeding in the workplace and explored factors that may mediate or moderate employers' support of breastfeeding in the workplace. Rogers’ Diffusion of Innovation theory guided the study. Data were collected using a Business Characteristics Survey and the Employer Intention to Support Breastfeeding Questionnaire (ESBQ). The final response rate was 148 complete surveys out of the 3817 sent, resulting in a 3.8% response rate. Descriptive statistics showed that 65.5% had some type of lactation support (n = 97) in place for their breastfeeding employees; however only 34.5% provided a designated, private room/place to pump breast milk. Logistic regression of the independent variables attitude (b = .034, p = .535), centralization (b = .045, p = .222), and interconnectedness (b = .002, p = .695) did not predict the presence of lactation support. Business size was not a significant predictor of the presence of lactation support (b = .001, p = .921). The moderator of intent was added to the model and interaction terms created by multiplying intent with each of the following variables: business size, attitude, centralization, and interconnectedness. These results did not support the presence of a moderating effect. Finally, mediator effects were only tested with the independent variable attitude. A significant direct association between attitude and the presences of lactation support was found (p = .045). Attitude appears to be a significant predictor of relative advantage (b = 4.583, p <.001). Relative advantage, while controlling for attitude, was not a significant predictor of presence of lactation support (b = .013, p = .220); however, the direct relationship of attitude to the presence of lactation support was less significant than before (b = .029, p = .655). Attitude appears to be a significant predictor of complexity (b = .407, p <.001). Complexity, while controlling for attitude, was not a significant predictor of presence of lactation support (b = .059, p = .285); however, the direct relationship of attitude to the presence of lactation support was less significant than before (b = .065, p = .181). Attitude appears to be a significant predictor of observability (b = .916, p = .003). Observability, while controlling for attitude, was not a significant predictor of presence of lactation support (b = -.003, p = .834); however, the direct relationship of attitude to the presence of lactation support was less significant than before (b = .091, p = .047). The implications and recommendations based on these findings can help to guide future studies and the planning and implementation of workplace lactation programs. / text

The purpose of this study was to examine influences on the maternal process of maintaining lactation while employed outside of home during the first postpartum year as perceived by the mother. The American Academy of Pediatrics specifies human breast milk as the best source of nutrition during the first 12 months of life (Gartner, et. al., 2005). The United States Department of Labor reports (USBLS, 2009) that 56.4% of American women who have children less than 1 year of age, are employed. Employment is often cited as related to early weaning (Johnston & Esposito, 2007; McInnes & Chambers, 2008; Nichols & Roux, 2004; Rojjanasrirat & Sousa, 2010; Stewart-Glenn, 2008; Ryan, Zhou, & Arsenberg, 2006). This research was undertaken to address a significant gap in the empirical literature regarding mothers’ self-description of the process of maintaining lactation upon return to the workplace. Eleven breastfeeding mothers shared personal perspectives of the process that they face in their everyday work lives in semi-structured interviews. This qualitative study led to the development of a grounded theory of this process, which was labeled, ‘Willfully Struggling to Maintain Daily Balance’. Findings captured personal perceptions of critical elements related to this process that may serve to inform the development of effective nursing interventions or policy in support of breastfeeding and employed mothers. The study found that the breastfeeding and employed mothers began the process with a sense of willful self-determination to combine lactation with employment, the influence of role models, and basic breastfeeding knowledge. Mothers struggled with intervening variables that either bolstered or undermined their efforts during the process, such as adequate sleep and/or breast milk supply, and elements of support or non-support. Mothers developed individual strategies for use in maintaining a daily balance between their `breastfeeding and employment efforts and for addressing any intervening variables. The employed and breastfeeding mothers ultimately found ‘a way to make it work’ and/or ‘made their peace with’ resultant outcomes. The research addressed the question of what influences the maternal process of breastfeeding while employed outside of the home during the first postpartum year in a sample of central Texas women. / text

published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Public Health / Master / Master of Public Health

Breastfeeding is well known to be beneficial to both the mother and the baby. To the baby, it is associated with decreased short-term health problems such as diarrhea and respiratory infections, as well as decreased long-term health consequences such as type 2 diabetes, obesity, and raised blood cholesterol levels. To the mother, it is suggested to reduce type 2 diabetes, breast cancer, as well as ovarian cancer. Increasing exclusive breastfeeding rate, in which higher proportion of infants are given breast milk only, could also benefit the society as a whole. It is shown to reduce health care cost and premature deaths. Despite the gradual elevation of ever breastfeeding rate in Hong Kong up to 83% in 2013, the exclusive breastfeeding rate at 2 months postpartum remained relatively low at 21.7%. On the other hand, postpartum depression is a debilitating condition to both the mother and the baby. The prevalence was about 10-15%. And it could lead to deteriorated quality of life to the mother and increased maternal suicidal rate. It could also affect the long-term development of the baby. Previous studies showed controversial results on the association between breastfeeding and postpartum depression. Some suggested breastfeeding being protective against postpartum depression, while other studies did not show significant results. However, there was still no formal study in the local Chinese population about the issue. In view of that, the current study aimed at assessing the association between breastfeeding and postpartum depressive symptoms in the local Chinese population. This was a cross-sectional study which included 600 mothers with data retrieved from MCHCs’ database. Demographic data and breastfeeding status were included in binary logistic regression analysis with Edinburgh Postnatal Depression Scale (EPDS) result of either screened positive or negative as the outcome. The odds ratio of being screened positive in EPDS with more depressive symptoms for mothers with exclusive breastfeeding, compared with mothers not on breastfeeding (OR=0.42, 95% CI=0.19, 0.93) and mothers with non-exclusive breastfeeding (OR=0.40, 95% CI=0.19, 0.85) were both statistically significant after adjusted for the demographic data. Subgroup analysis on those intended for exclusive breastfeeding shortly after delivery also showed significant results. Those who succeeded in maintaining exclusive breastfeeding at 6-8 weeks postpartum were significantly less likely to be screened positive in EPDS (OR=0.07, 95% CI=0.01, 0.41) compared to those who could not maintain exclusive breastfeeding. This study proposed to assess whether there is an association between breastfeeding and decreased maternal postpartum depressive symptoms in local Chinese population. The results reiterated the advantages of breastfeeding and warranted more intense efforts in promoting and protecting breastfeeding. The large effect shown in the subgroup analysis highlighted the importance of maintaining exclusive breastfeeding. Since this study could only establish association, the results could not show causation and future studies should focus on establishing the temporality of causation between breastfeeding and decreased maternal postpartum depressive symptoms. Stricter adjustment for potential confounders should also be achieved with a prospective study better designed to control for temporality and time-varying confounders in the future. / published_or_final_version / Public Health / Master / Master of Public Health

Breastfeeding self-efficacy is considered one of the key components of a successful breastfeeding experience. The benefits of breastfeeding are well established in the literature and have been widely communicated to the public, resulting in an increasing trend of breastfeeding initiation. However, the United States still falls short of Healthy People 2020 breastfeeding goals. The purpose of this project was to examine the effects of a standardized hospital-based prenatal breastfeeding class on breastfeeding self-efficacy. Dennis's breastfeeding self-efficacy theory was the foundation for the breastfeeding self-efficacy tool used in this project. A quasi-experimental design used a convenience sample of 30 breastfeeding class participants as the experimental group and 30 postpartum women who had no formal breastfeeding education as the control group. The Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) was administered to the intervention group prior to the breastfeeding class, at the end of the class, prior to hospital discharge, and at 2 weeks postpartum. The control group received the survey prior to hospital discharge and at 2 weeks postpartum. Key findings indicated that participants in the breastfeeding class demonstrated a statistically significant increase in breastfeeding confidence after the class (t = 9.55(29), p = 0.00). There was no difference between the intervention and control groups at discharge (t = -.412(47), p = 0.686). Nurses and lactation professionals are in a position to evoke social change by examining the impact of breastfeeding self-efficacy and using the findings to shape breastfeeding education.

Background: In Sweden, the breastfeeding rate has decreased in recent years. Breastfeeding provides short-term and long-term health effects of the child and the woman. Objective: The aim of this study was to investigate planning and duration of breastfeeding, and examine whether there were differences between Swedish-born and foreign-born women regarding duration of breastfeeding during the child's first year. Design / Methodology: This is a survey in which 3390 women responded to a questionnaire at enrollment prenatal, 2581 women responded to a questionnaire in late pregnancy and 1257 women responded one year after pregnancy. The material was analyzed with descriptive statistics. Results: There were 1135 women who responded to both questionnaires regarding planning and duration of breastfeeding. A significant difference was found between the planned breastfeeding and duration of breastfeeding. There were 260 women who breastfed for a shorter period and 265 who breastfed for a longer period than they had planned. This issue included all women regardless of country of birth. A large proportion of women who breastfed the child at the age of 12 months wanted to continue breastfeeding until the baby was 1-1.5 years or as long as the child himself wanted. It showed no difference regarding duration of breastfeeding between Swedish-born and foreign-born women. The most common reasons why women chose not to breastfeed was that the woman or the child did not want to. The most common reasons that women choose to stop breastfeeding was that the child did not get satisfied or that the child did not want to suckle. Conclusion: Differences were observed regarding breastfeeding planning and duration of breastfeeding. Care needs to focus on providing support and education to women in order to increase motivation to breastfeeding.

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