Effectiveness Of Baby-Friendly Workplace Support Interventions On Exclusive Breastfeeding In Kenya: A Propensity Score-Weighted Analysis

Abstract Background Exclusive breastfeeding (EBF) during the first six months of life is crucial for optimising child’s growth, development and survival. Mother’s employment may hinder optimal breastfeeding. We assessed the effectiveness of a workplace support intervention on EBF in Kenya. Methods This quasi-experimental study employing a pre-post intervention design was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of: day-care centers, sensitization on available workplace baby-friendly policies, and home-based nutritional counselling of pregnant and breastfeeding women. The effect of the interventions on EBF was estimated using propensity score weighting. Results The study included 223 and 146 mother-infant dyads in the non-treated (pre-intervention) and treated (intervention) groups, respectively. The prevalence of EBF was 20.2% in the non-treated group and 80.8% in the treated group; corresponding to a 4-fold increased probability of EBF (RR 3.99; 95% CI 2.95–5.15). In age-stratified results, the effect of the interventions was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23–15.64) than among those aged < 3 months (RR 2.79; 95% CI 2.09–3.73). Conclusions The baby-friendly workplace support intervention promoted EBF especially beyond three months in this setting. Key messages Maintaining EBF while working is more likely when employers provide the support that women need to do so. Workplace policies and programmes to support women to combine work with breastfeeding are needed.