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 18–45 who gave birth in 2011–2012. 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 to 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.
Although one-third of US adults report using complementary and alternative medicine (CAM), integration of CAM into the conventional medical system is inconsistent. 1 Patients have shown a desire for their primary care physicians to inquire about CAM and refer to CAM practitioners (acupuncturist, massage therapists, etc), but primary care physicians rarely initiate conversations with patients about their use of CAM. 2,3 Patients have also expressed concerns about discussing the use of CAM with their physicians, fearing disapproval. 4 These communication barriers may prevent CAM from becoming fully integrated into patients' treatment and self-care routines, especially if patients do not disclose their use of CAM to their primary care physicians. Using data from the 2012 National Health Interview Survey (NHIS), we identified patterns of CAM use in the United States and reasons for its nondisclosure from January 1 through December 31, 2012. Homeopathy 134 (48.7
Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18-45 who gave birth in 2011-2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospitalizing their infants (95% CI 0.3, 1.0) and a 51% decrease in the odds of being re-hospitalized themselves (95% CI 0.3, 0.9) at 21 months postpartum, compared to women taking unpaid or no leave. They also had 1.8 times the odds of doing well with exercise (95% CI 1.1, 3.0) and stress management (95% CI 1.1, 2.8), compared to women taking only unpaid leave. Conclusions for Practice Paid maternity leave significantly predicts lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management. Policies aimed at expanding access to paid maternity and family leave may contribute toward reducing socio-demographic disparities in paid leave use and its associated health benefits.
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