Maternal employment characteristics as a structural social determinant of breastfeeding duration

Abstract Background The European Region exhibits the world’s lowest exclusive breastfeeding rate at 6 months. Addressing work-related breastfeeding challenges is crucial, particularly for women navigating precarious work situations, compounding their adversity. This scoping review surveys research on maternal employment characteristics facilitating breastfeeding continuation post-return to work in the European Region. Methods Studies from 2013 to 2023 were gathered from Scopus, PubMed, and PsycInfo. Inclusion criteria comprised English or French quantitative/qualitative studies exploring links between maternal employment characteristics and breastfeeding status, duration, or experience. Participants were employed mothers of healthy children sustaining breastfeeding post-resumption of work. Key determinants included work-related factors contributing to socially diverse working conditions, encompassing type of employment, working conditions, and work environment. Geographic scope included World Health Organization European Region countries. Results Among 693 hits, 13 studies met criteria. Eight focused on work and breastfeeding, others explored broader breastfeeding determinants. Represented countries: Spain (n = 4), France (n = 4), UK (n = 2), Ireland (n = 2), Netherlands (n = 1). Findings highlighted methodological heterogeneity, indicating a lack of conceptual framework linking work, breastfeeding, and social health inequalities. Nonetheless, self-employment, non-manual professions with time flexibility, workplace breastfeeding facilities, coworker support, and breastfeeding workplace policies emerged as pivotal factors supporting working mothers’ breastfeeding. Conclusions Backing breastfeeding choices for working mothers is crucial amid adversities faced by mothers and children. These results underscore the need for targeted workplace interventions, including time flexibility, breastfeeding facilities, and promotion of breastfeeding-friendly policies. Key messages • Self-employment, non-manual occupations, time flexibility, breastfeeding facilities, support of co-workers and breastfeeding workplace policies promote continuation of breastfeeding. • Policy directives targeting low skilled or precarious jobs are needed to reduce social health inequalities broadly, and in particular, in relation to breastfeeding practices.