Exclusive breastfeeding practices among women in formal employment in selected organizations in Kisumu Central Sub-County, Kisumu County, Kenya

Felix M. Nyamiel; Joseph Muchiri; Dennis Butto

doi:10.18203/2394-6040.ijcmph20254017

Authors

Felix M. Nyamiel Department of Community Health, Epidemiology and Biostatistics, School of Public Health, Mount Kenya University, Thika, Kenya https://orcid.org/0009-0005-6704-8302
Joseph Muchiri Department of Community Health, Epidemiology and Biostatistics, School of Public Health, Mount Kenya University, Thika, Kenya https://orcid.org/0000-0003-0469-4866
Dennis Butto Department of Medical Services, School of Health Sciences, Kirinyaga University, Kerugoya, Kenya https://orcid.org/0000-0001-8346-2865

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20254017

Keywords:

Kisumu Central, Kenya, Exclusive breastfeeding, Women in formal employment

Abstract

Background: Encouraging exclusive breastfeeding among working women in metropolitan areas is a multifaceted issue. Comprehending the various facets associated with this and their impact on employed mothers' decisions on exclusive nursing may facilitate the development of tactics to assist mothers in maintaining exclusive breastfeeding. This study investigated exclusive breastfeeding (EBF) practices among women in formal employment in Kisumu Central Sub-County, Kisumu County, Kenya.

Methods: A descriptive cross-sectional design was employed, targeting 92 mothers with infants under 12 months working in selected public and private organizations. Stratified random sampling was used to select organizations, and data were collected via structured questionnaires. Ethical approvals were obtained, ensuring informed consent and confidentiality. Data were analyzed using statistical package for social sciences (SPSS) version 26, employing descriptive statistics and inferential statistics (Chi-square tests and logistic regression) to assess variable relationships. Statistical significance was set at p<0.05.

Results: Breastfeeding policy (χ²(1)=4.50, p=0.034), nursing breaks (χ²(1)=6.25, p=0.012), employer encouragement (χ²(1)=5.76, p=0.016), and co-worker support (χ²(1)=4.00, p=0.046) showed significant relationships (p<0.05), revealing these factors as strong predictors of EBF practice. Schedule flexibility (χ²(1)=3.84, p=0.050) was borderline significant, while daycare availability (χ²(1)=2.25, p=0.134) did not show a significant association.

Conclusions: The study concluded that organizational culture has an influence on exclusive breastfeeding practices among employed mothers. Gaps in workplace infrastructure, including the lack of daycare facilities and inflexible schedules, were identified as notable barriers. The study recommended enhanced collaboration between the government and employers to promote EBF among working mothers.

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References

Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012;2012(8):CD003517. DOI: https://doi.org/10.1002/14651858.CD003517.pub2

Horta BL, Loret de Mola C, Victora CG. Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis. Acta Paediatr. 2015;104(467):30-7. DOI: https://doi.org/10.1111/apa.13133

Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. DOI: https://doi.org/10.1016/S0140-6736(15)01024-7

Mannar V, Micha R, Allemandi L, Afshin A, Baker P, Battersby J, et al. Global Nutrition Report: Action on equity to end malnutrition. Development Initiatives, Global Nutrition Report. 2020. Available at: https://globalnutritionreport.org/reports/2020-global-nutrition-report/. Accessed 18 September 2025.

Mucheru D, McAuliffe E, Kesale A, Gilmore B. A rapid realist review on leadership and career advancement interventions for women in healthcare. BMC Health Serv Res. 2024;24(1):856. DOI: https://doi.org/10.1186/s12913-024-11348-7

International Labour Organization, (% of female employment) ILO modelled estimates – Kenya. 2022. Available at: https://ilostat.ilo.org/data/bulk. Accessed 18 September 2025.

Woldie TG, Kassa AW, Edris M. Assessment of Exclusive Breast-Feeding Practice and Associated Factors in Mecha District, North West Ethiopia. Sci J Public Health. 2014;2(4):330-6. DOI: https://doi.org/10.11648/j.sjph.20140204.24

FAO, IFAD, UNICEF, WFP and WHO. The State of Food Security and Nutrition in the World 2019.Safeguarding against economic slowdowns and downturns. Rome, FAO. 2019. Available at: https://www.unicef.org/media/55921/file/SOFI-2019-full-report.pdf. Accessed 18 September 2025.

Abou-ElWafa HS, El-Gilany AH. Maternal work and exclusive breastfeeding in Mansoura, Egypt. Fam Pract. 2019;36(5):568-72. DOI: https://doi.org/10.1093/fampra/cmy120

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491-504. DOI: https://doi.org/10.1016/S0140-6736(15)01044-2

Oddo VM, Ickes SB. Maternal employment in low- and middle-income countries is associated with improved infant and young child feeding. Am J Clin Nutr. 2018;107(3):335-44. DOI: https://doi.org/10.1093/ajcn/nqy001

Mgongo M, Ickes SB, Leyaro BJ, Mboya IB, Grounds S, Seiger ER, et al. Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review. Adv Nutr. 2024;15(3):100179. DOI: https://doi.org/10.1016/j.advnut.2024.100179

Ejie IL, Eleje GU, Chibuzor MT, Anetoh MU, Nduka IJ, Umeh IB, et al. A systematic review of qualitative research on barriers and facilitators to exclusive breastfeeding practice in sub-Saharan African countries. Int Breastfeed J. 2021;16(1):44. DOI: https://doi.org/10.1186/s13006-021-00380-6

Tacoli C. The urbanization of food insecurity and malnutrition. Environment and Urbanization. 2019;31(2):371-4. DOI: https://doi.org/10.1177/0956247819867255

Malta V, Kolovich L, Martinez LA, Mendes TM. Informality and Gender Gaps Going Hand in Hand. SSRN Electronic J. 2019;34. DOI: https://doi.org/10.5089/9781498314718.001

MacPhail F. Progress of the world’s women 2015–2016: transforming economies, realizing rights, by UN Women. Canad J Develop Stud. 2017:38(2):291-3. DOI: https://doi.org/10.1080/02255189.2017.1303366

Pereira-Kotze C, Feeley A, Doherty T, Faber M. Maternity protection entitlements for non-standard workers in low-and-middle-income countries and potential implications for breastfeeding practices: a scoping review of research since 2000. Int Breastfeed J. 2023;18(1):9. DOI: https://doi.org/10.1186/s13006-023-00542-8

Ickes SB, Sanders H, Denno DM, Myhre JA, Kinyua J, Singa B, et al. Exclusive breastfeeding among working mothers in Kenya: Perspectives from women, families and employers. Matern Child Nutr. 2021;17(4):e13194. DOI: https://doi.org/10.1111/mcn.13194

Mokomane Z. Balancing care and work roles among women working in the informal sector in South Africa. Int J Care Caring. 2021;5(1):129-47. DOI: https://doi.org/10.1332/239788220X15984634358661

Mbuthia JW. Factors Influencing Exclusive Breastfeeding Among Working Mothers at Kangemi Informal Settlement, Nairobi (Doctoral dissertation, University of Nairobi). 2022. Available at: https://erepository.uonbi.ac.ke/bitstream/handle /11295/163394/Mbuthia_Factors%20Influencing%20Exclusive%20Breastfeeding%20Among%20Working%20Mothers%20At%20Kangemi%20Informal%20Settlement%2C%20Nairobi.pdf?sequence=1&isAllowed=y. Accessed on 18 September 2025.

Babalola S, Ajewole IC, Babalola O, Ogunsile SE. Job Influence on Practice of Exclusive Breastfeeding among Working Class Mothers in Urban Communities of Ekiti State, Southwestern; Nigeria. Int J Res-Granthaalayah. 2022;10(11):72-8. DOI: https://doi.org/10.29121/granthaalayah.v10.i11.2022.4800

Rouhanizadeh B, Kermanshachi S. A gender-based analysis of workforce promotion factors in U.S. transportation agencies. Transportation Research Interdisciplinary Perspectives. 2021;12:100457. DOI: https://doi.org/10.1016/j.trip.2021.100457

Vilar-Compte M, Hernández-Cordero S, Ancira-Moreno M, Burrola-Méndez S, Ferre-Eguiluz I, Omaña I, et al. Breastfeeding at the workplace: a systematic review of interventions to improve workplace environments to facilitate breastfeeding among working women. Int J Equity Health. 2021;20(1):110. DOI: https://doi.org/10.1186/s12939-021-01432-3

Daniels LC, Mbhenyane XG, Du Plessis LM. Development of a workplace breastfeeding support practice model in South Africa. Int Breastfeed J. 2024;19(1):32. DOI: https://doi.org/10.1186/s13006-024-00638-9

Kayode OO, Oyedeji AS, Alabi QK. Factors affecting exclusive breastfeeding practices among working-class women in Osun State, Nigeria. J Public Health Afr. 2023;14(6):2191.

Kayode OO, Oyedeji AS, Alabi QK. Factors affecting exclusive breastfeeding practices among working-class women in Osun State, Nigeria. J Public Health Afr. 2023;14(6):2191. DOI: https://doi.org/10.4081/jphia.2023.2191

Snyder K, Hulse E, Dingman H, Cantrell A, Hanson C, Dinkel D. Examining supports and barriers to breastfeeding through a socio-ecological lens: a qualitative study. Int Breastfeed J. 2021;16(1):52. DOI: https://doi.org/10.1186/s13006-021-00401-4