Impact of an Infant Friendly Business Designation

Abstract

In response to suboptimal breastfeeding rates, North Dakota added a provision to SB 2344 (public indecency legislation) creating an Infant Friendly business designation for employers providing specified lactation accommodations to employees. However, there has been no evaluation of this designation to determine effectiveness. The purpose of this article is to examine the impact of the Infant Friendly business designation in North Dakota on breastfeeding continuation rates within the context of the social ecological model (SEM). Between November 2016 and March 2017, an 85-item online questionnaire, designed using the SEM, was distributed to working women across the state using various sampling methods. T tests, analysis of variance, and regression were used to analyze results. Designated (intervention) and nondesignated (control) businesses were targeted. There was no statistically significant difference in breastfeeding duration between designated and nondesignated businesses. There was a 2-month difference in duration between continually designated businesses and those with lapsing designations. Twenty-eight percent of the women working for Infant Friendly businesses were aware that their businesses were designated, indicating a lack of awareness regarding the designation. The designation is a starting point for worksite breastfeeding support. A policy promotion plan based on the SEM targeting individual awareness and employee education may improve the designation’s effectiveness.

Workplace programmes for supporting breast-feeding: a systematic review and meta-analysis

“…Fourteen studies were included and were reported across eighteen publications, of which nine out of fourteen studies were eligible to be included in the meta-analysis. Two studies (37,38) were ineligible for inclusion in the meta-analysis due to different study designs from other included studies, one study (39) was ineligible due to measuring breast-feeding rate in a different way from other included studies and two studies (40,41) were ineligible as they were qualitative studies.…”

“…Four publications were non-randomised controlled studies (38,(42)(43)(44) , and two of these four also included qualitative results from focus groups (43,44) . Nine publications (37,39,(45)(46)(47)(48)(49)(50)(51) reporting eight breast-feeding support programmes were cross-sectional studies, most of which participants had received an intervention. Three publications across two studies reported only qualitative results on women's breast-feeding experiences (40,41,52) .…”

“…2). Among eighteen articles assessed with the MMAT, four qualitative publications (40,41,52,54) were assessed with only the 'Qualitative Domain' (MMAT Domain 2.0); two mixed methods studies (43,44) were assessed with MMAT Domains 2.0, 3.0 and 5.0; two quantitative non-randomised controlled trials (38,42) , one cross-sectional study (37) and one retrospective cohort study (53) were assessed with MMAT Domain 3.0; and the remaining eight quantitative articles (39,(45)(46)(47)(48)(49)(50)(51) were assessed with MMAT Domain 4.0. Overall, the majority of studies were low-to-moderate quality, although the proportion of articles assessed within the 'qualitative domain' that met the methodological criteria was comparatively higher than the proportion of articles assessed within the 'quantitative domain' (i.e., the green bar represented in Fig.…”

“…The most common component included was the provision of breast milk expression equipment for free or with a discount, with the equipment often provided along with the breast-feeding room. The intervention in two studies (37,40,52) was certifying worksites as 'infant or breast-feeding friendly' by developing criteria for modifying worksites. The measures were similar to those listed above, such as supportive policies and lactation room.…”

“…Seven studies across eight publications (37,38,(45)(46)(47)49,51,53) reported the duration of breast-feeding and all studies reported a positive impact on breast-feeding duration. Five single-arm studies were able to be included in a meta-analysis, reporting mean duration of breast-feeding of participants ranging from 8 months to 10 months.…”