Effect of a baby‐friendly workplace support intervention on exclusive breastfeeding in Kenya

Abstract

Exclusive breastfeeding (EBF) during the first 6 months of life is crucial for optimizing child growth, development and survival, as well as the mother's wellbeing. Mother's employment may hinder optimal breastfeeding, especially in the first 6 months. We assessed the effectiveness of a baby-friendly workplace support intervention on EBF in Kenya. This pre-post intervention study was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/ breastfeeding women residing on the farm and consisted of workplace support policies and programme interventions including providing breastfeeding flexi-time and breaks for breastfeeding mothers; day-care centres (crèches) for babies near the workplace and lactation centres with facilities for breast milk expression and storage at the crèches; creating awareness on available workplace support for breastfeeding policies; and home-based nutritional counselling for pregnant and breastfeeding women. EBF was measured through 24-h recall. The effect of the intervention on EBF was estimated using propensity score weighting. The study included 270 and 146 mother-child dyads in the nontreated (preintervention) group and treated (intervention) group, respectively. The prevalence of EBF was higher in the treated group (80.8%) than in the nontreated group (20.2%); corresponding to a fourfold increased probability of EBF [risk ratio (RR) 3.90; 95% confidence interval (CI) 2.95-5.15]. The effect of the intervention was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23-15.64) than among those aged <3 months (RR 2.79; 95% CI 2.09-3.73).The baby-friendly workplace support intervention promoted EBF especially beyond 3 months in this setting.

Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review

“…The most frequently reported infant feeding measure was EBF. Most studies [ 17 , 19 , 28 , 30 , [32] , [33] , [34] , [35] , [68] , [149] ] defined EBF on the basis of 24-h recall (24 h preceding the interviews) using the WHO/UNICEF definitions (WHO, 2021). Studies measured the prevalence of EBF at a range of time points, from 1 to 6 mo.…”

“…Only 1 study reported results from a workplace intervention [ 33 ]. This intervention, conducted among tea farm workers in Kenya, tested exposure to a Baby-Friendly Workplace Initiative that included onsite or community-based daycares, lactation rooms, breastmilk pumps, access to refrigeration, and mother and infant-friendly work policies.…”

Between and Within-Country Variations in Infant and Young Child Feeding Practices in South Asia

“…Excessive workload, caesarean section delivery, discouragement and criticism inadequate creche facilities at the workplace, inadequate caregivers at home, inadequate knowledge about expressed milk are barriers to EBF for employed mothers [ 44 , 45 ]. Evidence suggested a baby-friendly workplace for employed mothers was effective for improving EBF practices [ 46 , 47 ]. Also, better knowledge, education, counselling, home support, six-months maternity leave, and flexibility at work are the enablers of exclusive breastfeeding for employed mothers in LMICs [ 44 , 48 ].…”

Improving breastfeeding support through the implementation of the baby friendly hospital and community initiatives: a scoping review

“…The national framework in Kenya included key enablers such as: capacity building, mentorship, integration, social mobilsation and supervision [6]. Integration was also highlighted as critical for Kenya [106,107]. The community basis of Step 10 of the BFHI itself was seen to be critical for sustained improvements [10] and a lack of community services was seen to be a barrier to improvements [71].…”