Evaluating Attitudes Toward Workplace Support for Breastfeeding Among Hospital Managers

Background: Although the Patient Protection and Affordable Health Care Act has become a law, the enforcement provisions of the legislation are limited. Identifying attitudes and beliefs held by managerial roles may uncover barriers to breastfeeding support in the workplace and guide International Board Certified Lactation Consultants (IBCLCs) who are designing workplace support programs. Objective: The objectives were (a) to identify factors influencing managers', service line directors', and administrators' attitudes about support for breastfeeding; (b) to develop a Breastfeeding-Friendly Workplace Initiative addressing the identified factors; and (c) to assess the effectiveness of the initiatives in changing employers' attitudes about support for breastfeeding in the workplace. Methods: This descriptive study was conducted from November 2010 to January 2011 in an urban academic medical center. Self-report, pretest, and posttest questionnaires were used in a convenience sample of 49 supervisors, managers, administrators, and charge nurses. Results: Following the implementation of the Breastfeeding-Friendly Workplace program, the overall managers' perceptions and attitudes toward providing breastfeeding support were positive. Posttest scores revealed that most people in managerial roles rated their intent, subjective norms, personal beliefs, and having control over providing support to breastfeeding working women higher than the baseline mean scores. Conclusions: Findings demonstrated that managers' perceptions, beliefs, attitudes, and intention to support breastfeeding improved the implementation of the hospital breastfeeding-support program. Future research is needed to evaluate the effectiveness of the workplace lactation program on the duration and exclusivity of breastfeeding among employed mothers.