Presentation Information
[aQrq5kgV-03]Factors Influencing Breastfeeding Continuation After Returning to Work: A Cross-Sectional Study of Women Residing in Japan
*Saori Fujimoto1, Hiromi Kawasaki1, Nanami Funaki1, Mari Murakami1, Kaori Fujita1 (1. Hiroshima University (Japan))
Keywords:
Breastfeeding continuation,Return to work,Cross-Sectional Study,Workplace support,Japan
[Purpose] To identify factors associated with breastfeeding continuation one month after returning to work and compare their relative contributions within a unified analytical framework.
[Method] A cross-sectional online panel survey was conducted in Japan in January 2023 among women who had returned to work after childbirth and whose first child was <36 months old. The outcome was any breastfeeding at one month after return. Key exposures included prenatal intention, supervisor/coworker understanding (three levels), and workplace support use score (seven items). The covariates included children's age at return, weekly working hours, and support recognition. Firth's penalized logistic regression was used to address low-frequency cells, with penalized likelihood ratio (PLR) tests for inference. Incremental contributions were examined by sequentially adding key exposures to the covariate-only model and evaluating the Δ PLR.
[Results] A total of 282 women were analyzed (breastfeeding continuers, n=124; non-continuers, n=158). Prenatal intention (aOR 4.75, p<.0001) and workplace support use (aOR 1.89, p<.0001) were independently associated with continuation, whereas later return was negatively associated (aOR 0.92, p=.002). Support recognition and working hours were not significant. Model fit improved after adding prenatal intention (ΔPLR=87.99, df=1, p<.0001) and support use (ΔPLR=18.54, df=1, p<.0001); supervisor/coworker understanding showed no significant incremental contribution (ΔPLR=3.03, df=2, p=.219). Model performance was acceptable (AUC=0.858; McFadden R²=0.343).
[Consideration] Prenatal intention showed the largest contribution, and actual workplace support use had an independent positive association. Supervisor/coworker understanding had a minimal direct effect. The effect of return-to-work timing should be interpreted cautiously, given the possible confounding effect of age-related natural weaning.
[Conclusion] Prenatal intentions and actual workplace support use were the strongest contributors to early post-return breastfeeding continuation in Japan. Implementing (1) interventions that foster intention during pregnancy and (2) workplace systems that ensure the availability and actual use of support is essential.
[Method] A cross-sectional online panel survey was conducted in Japan in January 2023 among women who had returned to work after childbirth and whose first child was <36 months old. The outcome was any breastfeeding at one month after return. Key exposures included prenatal intention, supervisor/coworker understanding (three levels), and workplace support use score (seven items). The covariates included children's age at return, weekly working hours, and support recognition. Firth's penalized logistic regression was used to address low-frequency cells, with penalized likelihood ratio (PLR) tests for inference. Incremental contributions were examined by sequentially adding key exposures to the covariate-only model and evaluating the Δ PLR.
[Results] A total of 282 women were analyzed (breastfeeding continuers, n=124; non-continuers, n=158). Prenatal intention (aOR 4.75, p<.0001) and workplace support use (aOR 1.89, p<.0001) were independently associated with continuation, whereas later return was negatively associated (aOR 0.92, p=.002). Support recognition and working hours were not significant. Model fit improved after adding prenatal intention (ΔPLR=87.99, df=1, p<.0001) and support use (ΔPLR=18.54, df=1, p<.0001); supervisor/coworker understanding showed no significant incremental contribution (ΔPLR=3.03, df=2, p=.219). Model performance was acceptable (AUC=0.858; McFadden R²=0.343).
[Consideration] Prenatal intention showed the largest contribution, and actual workplace support use had an independent positive association. Supervisor/coworker understanding had a minimal direct effect. The effect of return-to-work timing should be interpreted cautiously, given the possible confounding effect of age-related natural weaning.
[Conclusion] Prenatal intentions and actual workplace support use were the strongest contributors to early post-return breastfeeding continuation in Japan. Implementing (1) interventions that foster intention during pregnancy and (2) workplace systems that ensure the availability and actual use of support is essential.
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