title: Maternal return to work and breastfeeding: a population-based cohort study.
abstract: BACKGROUND
  In recent decades there has been a marked rise in the participation of women with infants in the labour market, while there has been a decline in the prevalence rate of breastfeeding.
  
  
  OBJECTIVE
  To explore the relationship between maternal return to work and breastfeeding.
  
  
  METHODS
  An on-going prospective longitudinal study.
  
  
  METHODS
  Multistage stratified systematic sampling was designed to recruit 24,200 pairs, postpartum women and newborns, from the Taiwan national birth register in 2005. Participating women underwent two home interviews at 6 and 18 months after giving birth, following structured questionnaires. A total of 21,248 and 20,172 women were interviewed, and the completed interview rate was thus 87.8% and 83.4% at 6 and 18 months, respectively. All study participants provided informed consent as approved by the Ethics Review Board of the National Taiwan College of Public Health.
  
  
  RESULTS
  The overall prevalence of initial breastfeeding was 83.7%. Postpartum women returning to work less than or equal to 1 month had the lowest initiation of breastfeeding rate (77.5%), but had a higher prevalence of breastfeeding duration less than or equal to 1 month (34.9%) than the overall population (26.8%). Overall 67.9%, 39.4%, 25.4%, and 12.7% mothers who started breastfeeding still breastfed their infants at the age of 1, 3, 6 and 12 months, respectively. Women with maternal leave of less than or equal to 6 months ceased breastfeeding earlier than those with maternal leave beyond 6 months and those who did not return to work up to 18 months after birth. After adjustment for potential confounders, odds ratios of initial breastfeeding seemed no different, except those for postpartum women who returned to work less than or equal to 1 month and those who did not return to work. Mothers returning to work within 1 year after giving birth were significantly earlier in weaning than those without return to work.
  
  
  CONCLUSIONS
  In our study, an early maternal return to work, especial within 6 months after giving birth, was a barrier to the initiation and continuation of breastfeeding. Thus, a comprehensive strategy is required to encourage the practice of breastfeeding in working women from pregnancy to the return to work, and nurses should work to promote breastfeeding in the different occasion.
authors.affiliation: Department of Nursing, Chang Jung Christian University, Tainan County 71101, Taiwan. chchuang@mail.cjcu.edu.tw
authors.forename: Chao-Hua
authors.initials: CH
authors.lastname: Chuang
authors.forename: Pei-Jen
authors.initials: PJ
authors.lastname: Chang
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chen
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
authors.forename: Baai-Shyun
authors.initials: BS
authors.lastname: Hurng
authors.forename: Shio-Jean
authors.initials: SJ
authors.lastname: Lin
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
mesh_terms: D001942:Breast Feeding; D015331:Cohort Studies; D004651:Employment; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009035:Mothers; D011247:Pregnancy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013624:Taiwan