Background Breastfeeding rates remain low in China and some mothers stop breastfeeding shortly after returning to work. Our study aimed to investigate the association between breastfeeding practices of working mothers and their employment status (formal versus informal) and occupational fields (agriculture related, industry related, and business and white collar). We also identified key work-related factors that influence breastfeeding practices in Chinese working mothers. Methods This is a mixed-method research consisted of two components. We conducted a cross-sectional study of 10,408 breastfeeding mothers with children under 12 months old from 12 regions in China from July 2017 to January 2018. Multiple logistic regression was used to calculate adjusted odds ratios (AdjORs) and 95% confidence intervals (CIs) for breastfeeding practices. For the qualitative component, semi-structured interviews were conducted with 84 breastfeeding mothers in the study areas from July to December 2017, Content analysis was used for the qualitative component. Results Agriculture related occupations were positively associated with early initiation of breastfeeding (AdjOR 1.32, 95% CI 1.15, 1.51), current breastfeeding (AdjOR 1.76, 95% CI 1.41, 2.20), ever breastfed (AdjOR 1.69, 95% CI 1.09, 2.62), exclusive breastfeeding (AdjOR 1.30, 95% CI: 1.04, 1.62), and predominant breastfeeding (AdjOR 1.72, 95% CI 1.44, 2.05). Business and white collar occupations were positively associated with early initiation (AdjOR1.38, 95% CI 1.23, 1.56) and ever breastfed (AdjOR 1.64, 95% CI 1.12, 2.39), and inversely associated with predominant breastfeeding (AdjOR 0.81, 95% CI 0.68, 0.95). For industry related and business and white collar occupations, informal employment was negatively related to current breastfeeding. In qualitative analysis, four main themes were developed to identify key work-related factors that influence breastfeeding practices: 1) employment benefits; 2) commute time; 3) workplace environment; 4) labor intensity. Mothers who experienced difficulties in one or more of the above would choose to lower breastfeeding frequency or stop breastfeeding. Conclusions Having flexible work schedules and proximity of workplace to home can assist continuance of breastfeeding. Policies promoting supportive breastfeeding environment at work ought to be implemented. Additionally, informally employed mothers require more attention due to limited legal protection.

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Low-and middle-income countries have few mental health professionals, and efforts to increase access to treatment are a global priority. A key gap is the lack of integration of psychotherapy interventions as a part of accessible evidence-based care. Current recommendations suggest that the integration of mental health treatments, including psychotherapy, into existing primary care pathways may serve as a means to address this disparity. Understanding the cultural and contextual factors that affect this process supervision. Lauren C. Ng served as the lead for supervision, funding acquisition, and project administration and in a supporting role for conceptualization and formal analysis.