Perceptions, Experiences, and Outcomes of Lactation Support in the Workplace: A Systematic Literature Review

Background Despite legislation requiring break time and a private space to express milk, variations exist in accommodations for breastfeeding employees in the United States. Research Aims We aimed to describe employee and employer perceptions of and experiences with workplace lactation support in the United States and to identify research needed to inform workplace lactation support programs. Methods We searched Academic Search Complete, Business Search Complete, CINAHL, MEDLINE, PubMed, and PsycInfo for peer-reviewed articles published from 2009 to 2019 (n= 1638). We included 27 articles. Studies were categorized into four non-exclusive themes: (a) employee perceptions of and experiences with workplace lactation support; (b) employer reports of workplace lactation support; (c) association between workplace lactation support and business outcomes; and (d) association between workplace lactation support and breastfeeding outcomes. Results Analyses of associations between lactation support at work and employee breastfeeding outcomes (n= 14, 52%), and employee perceptions of and experiences with lactation support at work (n= 14, 52%) were most common, followed by employer reports of lactation support (n= 3, 11%) and associations between lactation support at work and job satisfaction (n= 3, 11%). Results indicated that workplace lactation support varied by employer, and that employee perceptions of and experiences with workplace lactation support varied by demographic and employment characteristics. The use of cross-sectional designs, unvalidated instruments, and limited representation from women with low incomes and minorities were common study limitations. Conclusions More research is needed to learn about experiences of employers and low-income and minority women with workplace lactation support and associations with business-relevant outcomes.