Variations in the barriers and contributors to breastfeeding across industries have not been well characterized for vulnerable populations such as mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our study used the Total Worker Health Framework to characterize workplace factors acting as barriers and/or contributors to breastfeeding among women participating in the New Hampshire WIC. Surveys were collected from WIC mothers (n = 682), which asked about employment, industry, and workplace accommodation and supports related to breastfeeding in the workplace. We found workplace policy factors supporting breastfeeding (i.e., having paid maternity leave, other maternity leave, and a breastfeeding policy) varied by industry. Women in specific service-oriented industries (i.e., accommodation and retail) reported the lowest rates of breastfeeding initiation and workplace supports for breastfeeding and pumping. Further, how a woman hoped to feed and having a private pumping space at work were significantly associated with industry, breastfeeding initiation, and breastfeeding duration. A substantial portion of women reported being not sure about their workplace environment, policies, and culture related to breastfeeding. Additional studies with larger sample sizes of women participating in WIC are needed to further characterize the barriers to breastfeeding associated with specific industries.

Despite broad recognition of benefits associated with breastfeeding, rates in the United States continue to be below targets established by Healthy People 2020, especially for economically disadvantaged women. This study engaged field-based professionals through a focus group process to collect perceptions on factors that determine a woman's decision to breastfeed. Field-based professionals participated in one of six focus groups. Following the social ecological model (SEM), focus group questions addressed barriers and contributors to breastfeeding at the individual, interpersonal, community, organizational, and public policy levels. Thematic content analysis was used in identifying, analyzing, and reporting on themes within the focus group data. Commonly reported themes were identified that negatively influence a mother's decision to breastfeed such as modesty/general discomfort to breastfeed in front of others, negative breastfeeding perceptions of family members, friends, boyfriends and co-workers, breastfeeding not being viewed as the societal "norm", and the availability of free formula samples. Despite identified barriers, commonly reported themes that positively influence a mother's decision to breastfeed included general knowledge on the benefits, positive breastfeeding perceptions of family members, friends, boyfriends, and co-workers, the availability of "mom and baby" groups, and Baby Friendly hospital practices. The findings provide field-based perspectives that identify opportunities to support breastfeeding through the lens of the SEM. Opportunities to better support breastfeeding include educating mothers and their social support systems on the specific benefits of breastfeeding, challenging existing breastfeeding norms, and working with hospitals on establishing policy to not provide free formula samples.

IntroductionBreastfeeding-friendly worksites are associated with longer breastfeeding durations, yet currently there is a dearth of research exploring women's experiences of workplace-based wellness programs designed to support continued lactation.MethodUsing semi-structured interviews with a voluntary sample of participants from one rural New England town (N = 18), we examined women's experiences of returning to work at worksites with the Centers for Disease Control and Prevention (CDC)'s Worksite Health ScoreCard (HSC) “breastfeeding-friendly” designation.ResultsFive key themes emerged from participants' narratives; three policy and workplace climate-related themes are described.DiscussionCollectively, findings indicate areas where HSC lactation-support questions might be modified to more precisely identify the psychosocial, structural, and sociocultural needs of breastfeeding employees.

The current study examines perceived hunger, which may result from food insecurity, and its effect on academic and athletic performance in students on a liberal arts college campus in New Hampshire. It also examines how students compensate for hunger and their preferences for different types of resources to address hunger. A review of the literature on food insecurity in college students informed the development of a questionnaire on hunger. A mixed-method approach was used to collect qualitative/quantitative data from students of different disciplines. Three hundred and seventy-one students had complete surveys. Thirty-six percent and 34% of students reported that their academic and/or athletic performance, respectively, had been affected by hunger. Forty-seven percent of students responded they would consider taking advantage of an on-campus food pantry. In an open-ended question, students reported concerns about the social stigma related to economic instability and utilizing a food pantry. Our research findings support many on-campus initiatives including the creation of a student-run on-campus food pantry, longer dining common hours, a Swipe It Forward program, and the creation of a task force to address food insecurity on campus and to work with college systems to develop opportunities to better serve students at the college.

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