Department of Biological and Health Sciences, Wheaton College, IL, USA.
Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
J Nutr. 2023 Jan 14;152(12):2888-2897. doi: 10.1093/jn/nxac160.
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.
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).
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.
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).
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.
在低收入环境中工作的母亲在满足母乳喂养（BF）建议方面面临挑战。肯尼亚最近的立法规定了产假和工作场所支持，但这些福利与 BF 实践的关系尚不清楚。
我们评估了肯尼亚正式就业母亲的工作场所提供的 BF 支持与 BF 实践之间的关系。假设支持的提供与更高的纯母乳喂养（EBF）流行率和更高的 EBF 几率相关。
我们在肯尼亚奈瓦沙对 1-4 天和 6、14 和 36 周（估计 24 周）产后的正式就业母亲进行了重复的横断面调查。我们使用调整了母亲年龄、教育、工作身体负担、HIV 状况和收入的逻辑回归来评估工作场所支持与 EBF 实践之间的关系。
在正式就业的母亲（n=564）中，那些使用现场工作场所儿童保育的母亲比那些使用社区或家庭儿童保育的母亲更有可能在 6 周（95.7%比 82.4%，P=0.030）和 14 周（60.6%比 22.2%，P<0.001；调整后的 OR：5.11；95%CI：2.3，11.7）时更有可能进行 EBF。同样，在 14 周时，目前使用日托中心的母亲中，更多在工作场所或附近访问日托中心的母亲进行 EBF（70.0%）比不访问日托中心的母亲（34.7%）多（P=0.005）。有机会使用工作场所私人哺乳空间的母亲的 EBF 流行率高于没有这种空间的母亲（84.6%比 55.6%，P=0.037），而居住在工作场所住房中的母亲比没有现场住房的母亲更有可能进行 EBF（调整后的 OR：2.06，95%CI：1.25，3.41）。
在肯尼亚，有机会使用和使用工作场所提供的 BF 支持的正式就业母亲更有可能进行 EBF，而缺乏这些支持的母亲则不然。随着肯尼亚卫生法的实施，哺乳室、现场住房和日托以及探访儿童的交通都可以支持就业母亲的 BF 和 EBF。
