Skip Navigation

Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 4: Breastfeeding

MCH Best Logo baby feeding at it's mother's breast

Strategy. Family Leave, Workplace Policies, State Laws

Approach. Provide trainings and other supports on workplace Mother-Friendly breastfeeding support policies (e.g., employer-provided break time and private space to breastfeed) across the state/jurisdiction.

Return to main MCH Best page >>

Overview. A promising study showed that after interventions related to educating and providing suppor for family leave, workplace policies and state laws, "Breastfeeding initiation rates significantly increased from preintervention (64.6%) to postintervention (74.2%) (p<.05)" and there was a "significant increase in exclusive breastfeeding at 6 months from preintervention (1.3%) to postintervention (3.6%)."1

Evidence. Emerging. There is some evidence of the effectiveness for training on the importance of family leave, workplace policies, and passing of state laws related to breastfeeding initiation and exclusivity at 6 months. Initial studies trend positive for these activities, yet more research is needed for conclusive results. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Employers/Workplaces; State/National.

Outcome. Initiation, Duration, and Exclusivity. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 6 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Provide trainings and other supports on workplace Mother-Friendly breastfeeding support policies across the state/jurisdiction,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of employers who receive information and technical assistance on Mother-Friendly breastfeeding support policies.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of employers who receive information and technical assistance on Mother-Friendly breastfeeding support policies that set up breastfeeding programs for their employees.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of employers who receive information and technical assistance on Mother-Friendly breastfeeding support policies that report being satisfied with their work site's breastfeeding policies

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of mothers in Mother-Friendly places of employment that report having ever breastfed or exclusively at 6 months.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Huang R, Yang M. Paid maternity leave and breastfeeding practice before and after California's implementation of the nation's first paid family leave program. Econ Hum Biol. 2015;16:45-59.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.