Promotion, protection, and support of breastfeeding at work, and achieving sustainable development: a scoping review

Souza, Carolina Belomo de; Melo, Daiane Sousa; Relvas, Gláubia Rocha Barbosa; Venancio, Sonia Isoyama; Silva, Regina Paula Guimarães Vieira Cavalcante da

doi:10.1590/1413-81232023284.14242022EN

Carolina Belomo de Souza

preparation of the article

read

approved the final version of the manuscript

Departamento de Pediatria, Universidade Federal do Paraná. R. General Carneiro 181, 14º andar, Alto da Glória. 80060-900 Curitiba PR Brasil. belomo.carolina@gmail.com

https://orcid.org/0000-0002-5813-5747

Daiane Sousa Melo

preparation of the article

read

approved the final version of the manuscript

Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil.

https://orcid.org/0000-0002-0560-5645

Gláubia Rocha Barbosa Relvas

preparation of the article

read

approved the final version of the manuscript

Escritório Regional de Saúde de Barra do Garças, Secretaria de Estado de Saúde de Mato Grosso. Barra do Garças MT Brasil.

https://orcid.org/0000-0002-0052-9292

Sonia Isoyama Venancio

preparation of the article

read

approved the final version of the manuscript

Instituto de Saúde de São Paulo, Secretaria de Estado da Saúde. São Paulo SP Brasil.

https://orcid.org/0000-0001-7147-3292

Regina Paula Guimarães Vieira Cavalcante da Silva

preparation of the article

read

approved the final version of the manuscript

Departamento de Pediatria, Universidade Federal do Paraná. R. General Carneiro 181, 14º andar, Alto da Glória. 80060-900 Curitiba PR Brasil. belomo.carolina@gmail.com

https://orcid.org/0000-0002-2467-1760

Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Author, year

Characteristics of the strategies for promoting breastfeeding

Barber-Madden, 1990¹⁶16 Barber-Madden R. Design and implementation of a citywide breastfeeding promotion program: the New York City approach. Fam Community Health 1990; 12(4):71-78.

Promotion actions were developed in order to overcome the shortcomings and challenges for improvements in the prevalence of breastfeeding in the USA during the 1990s. A committee was created to deal with the barriers for promoting breastfeeding. Task groups were formed to implement several actions, including promotion strategies aimed at the working women, with the creation of directives for health and nutrition programs at work for pregnant and breastfeeding women.

Marinelli et al., 2013³³33 Marinelli KA, Moren K, Taylor JS, Ademy of Breastfeeding Medicine. Breastfeeding support for mothers in workplace employment or educational settings: summary statement. Breastfeed Med 2013; 8(1):137-142.

A declaration was issued, with the objective of providing to leading doctors in breastfeeding a summary, based on evidence, of the medical, legal, and political challenges faced by mothers who breastfeed and who are separated from their children at work or in educational environments. The declaration emphasizes that the presence of formalized breastfeeding programs, and of support and physical facilities in schools and workplaces, improves the ability of mothers to breastfeed successfully. Employers are advised to stay informed in order to understand how support to working women who breastfeed will positively affect their businesses.

Author, year	Characteristics of the protection strategies for breastfeeding
Abdulloeva and Eyler, 2013¹⁵15 Abdulloeva S, Eyler AA. Policies on worksite lactation support within states and organizations. J Womens Health (Larchmt) 2013; 22(9):769-774.	State law for breastfeeding: includes breaks during working hours and a private place, other than bathrooms, where mothers who breastfeed may be able to express breastmilk during working hours, for one year after the birth of the child, as necessary.
Alb et al., 2017²⁸28 Alb CH, Theall K, Jacobs MB, Bales A. Awareness of United States' Law for Nursing Mothers among Employers in New Orleans, Louisiana. Womens Health Issues 2017; 27(1):14-20.	Federal law, which supports breastfeeding at work. The Law requires that the employers provide a break and a private location, other than a bathroom, so that breastfeeding employees are able to express breastmilk for one year after childbirth.
Bradford et al., 2017¹⁷17 Bradford VA, Walkinshaw LP, Steinman L, Otten JJ, Fisher K, Ellings A, O'Leary J, Johnson DB. Creating environments to support breastfeeding: the challenges and facilitators of policy development in hospitals, clinics, early care and education, and worksites. Matern Child Health J 2017; 21(12):2188-2198.	State policies and practices of support for breastfeeding in four areas: hospitals, clinics, care environments and early childhood education, and workplaces.
Chen et al., 2006⁴⁵45 Chen YC, Wu YC, Chie WC. Effects of work-related factors on the breastfeeding behavior of working mothers in a Taiwanese semiconductor manufacturer: a cross-sectional survey. BMC Public Health 2006; 6:160.	Maternity leave and the right to have breaks to express breastmilk.
Dozier and McKee, 2011¹⁸18 Dozier AM, McKee KS. State breastfeeding worksite statutes...breastfeeding rates...and... Breastfeed Med 2011; 6(5):319-324.	Existence of a state legislation for breastfeeding at work, which requires a place and a break for breastfeeding.
Grummer-Strawn and Shealy, 2009 ¹⁹19 Grummer-Strawn LM, Shealy KR. Progress in protecting, promoting, and supporting breastfeeding: 1984-2009. Breastfeed Med 2009; 4(Suppl. 1):S31-S39.	Employers allowed women to have time and a space to express milk at work. The States issued legislation in order to guarantee that accommodations were made for female workers and to protect the right of breastfeeding in public places.
Hauck et al., 2020⁴⁶46 Hauck K, Miraldo M, Singh S. Integrating motherhood and employment: a 22-year analysis investigating impacts of US workplace breastfeeding policy. SSM Popul Health 2020; 11:100580.	States applied the Legislation “US workplace breastfeeding policy” which are laws that support breastfeeding in the workplace with different applications, encouraging or demanding that companies provide facilities where mothers may express breastmilk in privacy and store it properly.
Heymann et al., 2011²⁹29 Heymann J, Raub A, Earle A. Creating and using new data sources to analyze the relationship between social policy and global health: the case of maternal leave. Public Health Rep 2011; 126(Suppl. 3):127-134.	Paid Maternity Leave and the right to have breaks for breastfeeding.
Heymann et al., 2013³⁰30 Heymann J, Earle A, McNeill K. The impact of labor policies on the health of young children in the context of economic globalization. Annu Rev Public Health 2013; 34:355-372.	Paid Maternity Leave and the right to have breaks for breastfeeding.
Hilliard and Brunt, 2020²⁰20 Hilliard E, Brunt A. Impact of an infant friendly business designation. Health Promot Prac 2020; 21(4):642-653.	Política estadual de promoção da saúde implementada para prevenir práticas de emprego injustas contra as mulheres, especificamente mães trabalhadoras que amamentam. Direito a intervalos flexíveis e espaço privado para amamentar. A política dá a designação (selo de certificação) de empresa amiga da criança.
Jacknowitz, 2008²¹21 Jacknowitz A. The role of workplace characteristics in breastfeeding practices. Women Health 2008; 47(2):87-111.	Direito à disponibilidade de horário flexível (horas trabalhadas em casa e trabalhadas em cronograma fixo).
Kozhimannil et al., 2016²²22 Kozhimannil KB, Jou J, Gjerdingen DK, McGovern PM. Access to workplace accommodations to support breastfeeding after passage of the affordable care. Act Womens Health Issues 2016; 26(1):6-13.	Direito a intervalo com tempo suficiente para extrair o leite das mamas.
Lee et al., 2015³⁹39 Lee CC, Chiou ST, Chen LC, Chien LY. Breastfeeding-friendly environmental factors and continuing breastfeeding until 6 months postpartum: 2008-2011 national surveys in Taiwan. Birth 2015; 42(3):242-248.	Licença maternidade por seis meses.
Marinelli et al., 2013³³33 Marinelli KA, Moren K, Taylor JS, Ademy of Breastfeeding Medicine. Breastfeeding support for mothers in workplace employment or educational settings: summary statement. Breastfeed Med 2013; 8(1):137-142.	Licença maternidade. Declaração para líderes médicos sobre evidências dos desafios médicos, jurídicos e políticos enfrentados pela mãe que amamenta separada de seu filho no local de trabalho ou em ambientes educacionais. Entre as declarações, inclui a licença maternidade adequada.
Mirkovic et al., 2016²³23 Mirkovic KR, Perrine CG, Scanlon KS. Paid maternity leave and breastfeeding outcomes. Birth 2016; 43(3):233-239.	Licença maternidade remunerada.
Murtagh and Moulton, 2011²⁴24 Murtagh L, Moulton AD. Working mothers, breastfeeding, and the law. Am J Public Health 2011; 101(2):217-23.	Lei federal que exige acomodação para mães que desejam continuar amamentando enquanto trabalham fora de casa e dá o direito de tempo de pausa razoável para extrair o leite das mamas.
Nandi et al., 2018 ³¹31 Nandi A, Jahagirdar D, Dimitris MC, Labrecque JA, Strumpf EC, Kaufman JS, Vincent I, Atabay E, Harper S, Earle A, Heymann SJ. The impact of parental and medical leave policies on socioeconomic and health outcomes in OECD countries: a systematic review of the empirical literature. Milbank Q 2018; 96(3):434-471.	Licença parental remunerada.
Ogbuanu et al., 2011²⁵25 Ogbuanu C, Glover S, Probst J, Liu J, Hussey J. The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics 2011; 127(6):e1414-e1427.	Licença maternidade remunerada.
Rowbotham et al., 2021⁴⁴44 Rowbotham S, Marks L, Tawia S, Woolley E, Rooney J, Kiggins E, Healey D, Wardle K, Campbell V, Bridges N, Hawe P. Using citizen science to engage the public in monitoring workplace breastfeeding support in Australia. Health Promot J Austr 2021; 33(1):151-161.	Direito a horários de trabalho flexíveis.
Rollins et al., 2016²2 Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? Lancet 2016; 30; 387(10017):491-504.	Licença maternidade e direito a intervalos para amamentar.
Ruhm, 2011²⁶26 Ruhm CJ. Policies to assist parents with young children. Future Child 2011; 21(2):37-68.	Licença maternidade remunerada; direitos estendidos não pagos, como menor carga horária de trabalho e licença por tempo prolongado.
Soomro et al., 2016³⁷37 Soomro JA, Shaikh ZN, Saheer TB, Bijarani SA. Employers' perspective of workplace breastfeeding support in Karachi, Pakistan: a cross-sectional study. Int Breastfeed J 2016; 11(1):24.	Licença maternidade paga por três meses; direito a ajustes de tarefas e a intervalos durante o período de lactação.
Stumbitz et al., 2018³²32 Stumbitz B, Lewis S, Rouse J. Maternity management in SMEs: a transdisciplinary review and research agenda. Int J Management Rev 2018; 20(2):500-522.	Direito a tempo para extrair o leite das mamas.
Taylor et al., 2020 ²⁷27 Taylor YJ, Scott VC, Danielle Connor C. Perceptions, Experiences, and Outcomes of Lactation Support in the Workplace: A Systematic Literature Review. J Hum Lact 2020; 36(4):657-672.	Políticas e leis federais que estimulam as empresas a reconhecer e apoiar as necessidades das funcionárias que amamentam.
Tsai, 2014a⁴⁰40 Tsai SY. Employee perception of breastfeeding-friendly support and benefits of breastfeeding as a predictor of intention to use breast-pumping breaks after returning to work among employed mothers. Breastfeed Med 2014; 9(1):16-23.	Direito a intervalos para extrair o leite das mamas.
Tsai, 2014b⁴¹41 Tsai SY. Influence of partner support on an employed mother's intention to breastfeed after returning to work. Breastfeed Med 2014; 9(4):222-30.	Direito a intervalos para extrair o leite das mamas.
World Bank, 2012³⁵35 The World Bank Group (WBG). Mauritius early childhood development: SABER Country Report 2012. Washington, DC: WBG; 2012.	Licença maternidade e paternidade em Mauricius.

Author, year	Characteristics of the breastfeeding support strategies
Burns and Triandafilidis, 2019⁴³43 Burns E, Triandafilidis Z. Taking the path of least resistance: a qualitative analysis of return to work or study while breastfeeding. Int Breastfeed J 2019; 14:15.	Providing a place to store breastmilk expressed by the workers and by the students of the University.
Cervera-Gasch et al., 2020³⁸38 Cervera-Gasch A, Mena-Tudela D, Leon-Larios F, Felip-Galvan N, Rochdi-Lahniche S, Andreu-Pejó L, González-Chordá VM. Female employees' perception of breastfeeding support in the workplace, public universities in Spain: a multicentric comparative study. Int J Environ Res Public Health 2020; 17(17):6402.	The existence of university support policies for their workers who breastfeed. Provision of special facilities to express and store breastmilk after returning to work at the university. Promotion of support groups. Having a female supervisor.
Chen et al., 2006⁴⁵45 Chen YC, Wu YC, Chie WC. Effects of work-related factors on the breastfeeding behavior of working mothers in a Taiwanese semiconductor manufacturer: a cross-sectional survey. BMC Public Health 2006; 6:160.	Existence of policies in the companies, to make the workplace more convenient for breastfeeding. Making locations available to express breastmilk.
Febrianingtyas et al., 2019³⁶36 Febrianingtyas Y, Februhartanty J, Hadihardjono DN. Workplace support and exclusive breastfeeding practice: a qualitative study in Jakarta, Indonesia. Mal J Nutr 2019; 25(1):129-142	Having available facilities at offices to express breastmilk. Receiving support from the managers, supervisors, and workmates.
Fernandes et al., 2018³⁴34 Fernandes VMB, Santos EKA, Zampieri MFM, Gregório VRP, Hernandes MJ, Ribeiro LC. Condutas de gestores relacionadas ao apoio ao aleitamento materno nos locais de trabalho. Texto Contexto - Enferm 2018; 27(3):e2560016.	Support from managers so that the employees may have work flexibility in terms of function, hours, and space that allows for breastfeeding. Offering daycare and providing good treatment to the employee.
Grummer-Strawn and Shealy, 2009¹⁹19 Grummer-Strawn LM, Shealy KR. Progress in protecting, promoting, and supporting breastfeeding: 1984-2009. Breastfeed Med 2009; 4(Suppl. 1):S31-S39.	Providing rooms for breastfeeding or specific locations for breastfeeding.
Hilliard and Brunt, 2020²⁰20 Hilliard E, Brunt A. Impact of an infant friendly business designation. Health Promot Prac 2020; 21(4):642-653.	Companies should provide a private space - other than bathrooms - so that female workers can express breastmilk, which includes a clean source of water for washing, and providing a refrigerator to store the breastmilk.
Jacknowitz, 2008²¹21 Jacknowitz A. The role of workplace characteristics in breastfeeding practices. Women Health 2008; 47(2):87-111.	Availability of daycare services sponsored by the employer.
Kosmala-Anderson and Wallace, 2006⁴²42 Kosmala-Anderson J, Wallace LM. Breastfeeding works: the role of employers in supporting women who wish to breastfeed and work in four organizations in England. J Public Health (Oxf) 2006; 28(3):183-191.	Development of facilities and general company policies for the well-being of the mothers when they return to work. Access to daycare in the workplace.
Kozhimannil et al., 2016²²22 Kozhimannil KB, Jou J, Gjerdingen DK, McGovern PM. Access to workplace accommodations to support breastfeeding after passage of the affordable care. Act Womens Health Issues 2016; 26(1):6-13.	Access to locations for breastfeeding and to express breastmilk in the workplace.
Lee et al., 2015³⁹39 Lee CC, Chiou ST, Chen LC, Chien LY. Breastfeeding-friendly environmental factors and continuing breastfeeding until 6 months postpartum: 2008-2011 national surveys in Taiwan. Birth 2015; 42(3):242-248.	Availability of a room for breastfeeding in the workplace.
Rollins et al., 2016²2 Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? Lancet 2016; 30; 387(10017):491-504.	Availability of a room for breastfeeding
Rowbotham et al., 2021⁴⁴44 Rowbotham S, Marks L, Tawia S, Woolley E, Rooney J, Kiggins E, Healey D, Wardle K, Campbell V, Bridges N, Hawe P. Using citizen science to engage the public in monitoring workplace breastfeeding support in Australia. Health Promot J Austr 2021; 33(1):151-161.	Availability of a location to express milk and store it. Support from the supervisor and workmates.
Soomro et al., 2016³⁷37 Soomro JA, Shaikh ZN, Saheer TB, Bijarani SA. Employers' perspective of workplace breastfeeding support in Karachi, Pakistan: a cross-sectional study. Int Breastfeed J 2016; 11(1):24.	Availability of a location for breastfeeding and/or to express breastmilk and store it, at multinational and national organizations. Availability of a breast pump and of a nursery for daycare.
Stumbitz et al., 2018³²32 Stumbitz B, Lewis S, Rouse J. Maternity management in SMEs: a transdisciplinary review and research agenda. Int J Management Rev 2018; 20(2):500-522.	Company programs for breastfeeding in small and mid-sized companies to handle pregnancy and the return of mothers to work, offering time and a private space to express breastmilk.
Taylor et al., 2020²⁷27 Taylor YJ, Scott VC, Danielle Connor C. Perceptions, Experiences, and Outcomes of Lactation Support in the Workplace: A Systematic Literature Review. J Hum Lact 2020; 36(4):657-672.	Availability of rooms for breastfeeding and to express breastmilk.
Tsai, 2014a⁴⁰40 Tsai SY. Employee perception of breastfeeding-friendly support and benefits of breastfeeding as a predictor of intention to use breast-pumping breaks after returning to work among employed mothers. Breastfeed Med 2014; 9(1):16-23.	Availability of rooms to express breastmilk after the mothers’ return to work.
Tsai, 2014b⁴¹41 Tsai SY. Influence of partner support on an employed mother's intention to breastfeed after returning to work. Breastfeed Med 2014; 9(4):222-30.	Availability of a place in the workplace to express breastmilk after the mothers’ return to work, and the promotion of educational actions that include the mother’s partner.

[1] Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Brasil

Brasil

Promotion, protection, and support of breastfeeding at work, and achieving sustainable development: a scoping review

Abstract