Literature review for - Flourish Paediatrics

Sufficient evidence was found to make statements on the relationship between maternal and
breastfeeding outcomes. Return to work or intention to return to work shortens the duration
of breastfeeding.
Search results
Data were extracted from 14 studies, including 10 prospective cohort studies, 2 retrospective
cohort study and 2 cross-sectional studies. Data from 11 studies were used to form the final
body of evidence statement, which included 8 studies of Australian women, 2 studies of
Chinese women and1 study from New Zealand. Data from 3 studies (2 Chinese and 1 UK)
were not used as they were related to occupational prestige and not the return to work.
Breastfeeding outcomes investigated included breastfeeding initiation/ at discharge and
breastfeeding duration.
What is the association between mothers returning to work and breastfeeding outcomes?
Draft Evidence Statement
Intention to work or return to paid employment is
negatively associated with both the initiation of
breastfeeding and breastfeeding duration.
Draft Grade
B
Component Rating Notes
Evidence Base Good 9 prospective cohort studies (8P, 1 N), 1 retrospective cohort
study (P) 1 cross-sectional study (P)
Consistency Good Just over half of the studies found a negative association for
one or more breastfeeding outcomes, whilst the remainder
found no effect
Clinical impact Good Substantial
Generalisability Excellent All studies involved either Australian women or women
from relevant population sub-groups
Applicability Satisfactory Studies of Chinese women not directly relevant to the
Australian healthcare context
Studies of women from Australia, New Zealand or the UK were considered separately to
those of Chinese women. One prospective cohort study reported that intention to return to
work within 6 months was negatively associated with the initiation of breastfeeding and 3
prospective and 1 retrospective cohort study found a negative association between return to
employment and breastfeeding duration. Two prospective cohort studies found no
association with breastfeeding initiation and 3 found no association with duration.
One cohort study involving Chinese women reported a negative association between maternal
employment and the initiation of breastfeeding while another study reported no association.
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