The Association between Work-Related Breastfeeding Policies and Breastfeeding Initiation and Duration: A Survival Analysis Using Population Level Data from 57 Low-and-Middle-Income Countries

Lauren Maxwell, McGill University
José Mendoza Rodriguez, McGill University
Ilona Vincent, McGill University
Efe Atabay, McGill University
Arijit Nandi, McGill University
Linda M. Richter, Human Sciences Research Council of South Africa (HSRC)
John Frank, University of Edinburgh
Jody Heymann, McGill University

Women may have to return to work following their child’s birth and may discontinue breastfeeding during their child’s two first years of life. Workplace regulations that allow women to take additional breaks at work to pump or hand express their breast milk may help women continue breastfeeding during the first two years of life in keeping with the WHO recommendations for breastfeeding duration. We used yearly data on national maternal leave and breastfeeding breaks at work (BBW) policies and population-level data from the Demographic and Health Surveys to estimate the association between these policies and women’s initiation and duration of breastfeeding in 57 countries. Using Poisson models to estimate probability of breastfeeding and stratified Cox proportional hazards models to estimate breastfeeding duration, after matching observations to reduce confounding, exposure to maternal leave and BBW policies was not associated with women’s likelihood of initiating breastfeeding or with women’s duration of breastfeeding.