Identifying risk factors for sub-optimal breastfeeding and opportunities for breastfeeding promotion among working mothers in Kenya

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Project Abstract Sub-optimal breastfeeding is associated with increased morbidly and mortality in low and middle-income countries. Mothers breastfeeding patterns are influenced by a variety of factors, which vary by context. Generally, these include upstream influences like workplace policies and facility-based initiatives, interpersonal influences like the availability peer-support, as well as individual-level influences such as mother's breastfeeding intentions and breastfeeding self-efficacy. The relationship between women's work and breastfeeding practices is unclear, especially in LMIC where employment is often informal and where workplace lactation-support policies may be less available. In Kenya, exclusive breastfeeding rate remain low, with only 40% of mothers EBF through 6 months, with the lowest rates among mothers employed in unskilled manual labor (4.5%). In Naivasha, Kenya there is a high level of maternal employment in commercial agriculture, mainly due to a large flower production industry, known as flori-culture. This study will 1) identify workplace, socio-demographic, and behavioral risk factors for sub-optimal breastfeeding; 2) describe barriers to successful implementation and use of existing maternity policies and assess the readiness to adopt BF- policies and support practices in workplaces; and 3) determine the impact of adopting BF-supportive policies and practices among mothers working in the flori-culture industry on women's productivity. These aims will collectively identify new testable interventions to improve the implementation and use of BF-support practices among working mothers, which will have generalizable impact to women's employment through LMIC, where maternal employment is rapidly increasing as economies evolve and more women enter the formal workforce.