Access to Workplace Accommodations to Support Breastfeeding after Passage of the Affordable Care Act

Katy B. Kozhimannil, Judy Jou, Dwenda K. Gjerdingen, Patricia M. McGovern

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Objectives: This study examines access to workplace accommodations for breastfeeding, as mandated by the Affordable Care Act, and its associations with breastfeeding initiation and duration. We hypothesize that women with access to reasonable break time and private space to express breast milk would be more likely to breastfeed exclusively at 6 months and to continue breastfeeding for a longer duration. Methods: Data are from Listening to Mothers III, a national survey of women ages 18 to 45 who gave birth in 2011 and 2012. The study population included women who were employed full or part time at the time of survey. Using two-way tabulation, logistic regression, and survival analysis, we characterized women with access to breastfeeding accommodations and assessed the associations between these accommodations and breastfeeding outcomes. Results: Only 40% of women had access to both break time and private space. Women with both adequate break time and private space were 2.3 times (95% CI, 1.03-4.95) as likely to be breastfeeding exclusively at 6 months and 1.5 times (95% CI, 1.08-2.06) as likely to continue breastfeeding exclusively with each passing month compared with women without access to these accommodations. Conclusions: Employed women face unique barriers to breastfeeding and have lower rates of breastfeeding initiation and shorter durations, despite compelling evidence of associated health benefits. Expanded access to workplace accommodations for breastfeeding will likely entail collaborative efforts between public health agencies, employers, insurers, and clinicians to ensure effective workplace policies and improved breastfeeding outcomes.

Original languageEnglish (US)
Pages (from-to)6-13
Number of pages8
JournalWomen's Health Issues
Issue number1
StatePublished - Jan 1 2016

Bibliographical note

Funding Information:
Funding statement: This research was supported by a grant from the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD; grant number R03HD070868 ) and the Building Interdisciplinary Research Careers in Women's Health Grant (grant number K12HD055887 ) from NICHD , the Office of Research on Women's Health , and the National Institute on Aging , at the National Institutes of Health , administered by the University of Minnesota Deborah E. Powell Center for Women's Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2016 Jacobs Institute of Women's Health.


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