Evidence

This paper reviewed and present evidence associated with family-friendly policies that support breastfeeding in the interest of optimal early childhood development. A substantial gap in the literature remains surrounding women and work and breastfeeding in low-resource environments and fragile settings. The ILO reports that women provide three times the unpaid care work compared with men. Informal sector employment and unpaid care work restricts women from accessing social protection policies that support breastfeeding, such as maternity leave. In these settings, leave policies and workplace support policies have little to no bearing.

Keynotes

Overall trends in the reviewed literature indicate that national policies and workplace interventions may support increased initiation, exclusivity and longer breastfeeding duration among families choosing to breastfeed. Generally, longer leave is better than shorter leave, and paid leave appears to be associated with better breastfeeding outcomes compared with unpaid leave. Also, national standards may provide greater protection for breastfeeding by requiring compliance in the employment sector to ensure equitable access to supportive services. In turn, on the population level, optimal breastfeeding provides opportunities for children to grow and thrive and reach their full human potential. Based on this summary, the following key points are highlighted:

• Much of the available evidence surrounds maternity leave policies compared with other types of family-friendly policies such as those involving other parents. More research is needed to understand parental leave policies in the context of other partners in a caregiving role to the breastfeeding child.
• Much of the available evidence focuses on interventions to support women who breastfeed in the workplace environment compared with support for breastmilk feeding in the childcare environment. Clinically, both members of the dyad are important. More research is needed to understand how to optimally support the breastfeeding child during times of separation from the parent.
• Evidence from the workplace environment appears to target opportunities for milk expression – e.g., break time and space compared with feeding children directly at the breast. More research is needed to identify and understand innovative workplace environments that promote direct feeding at breast.
• Much of the available evidence pertaining to lactation support in the workplace comes from the United States and other HICs, whereas information about national policy implementation may be more broadly described. More research is needed to identify and evaluate workplace policies and innovative programs in HICs and LMICs alike.