Effect of a baby-friendly workplace support intervention on exclusive breastfeeding in Kenya

Research output: Contribution to journalArticlepeer-review


  • Elizabeth W Kimani-Murage
  • Calistus Wilunda
  • Teresia Njoki Macharia
  • Eva Watiri Kamande
  • Peter Muriuki Gatheru
  • Tadesse Zerfu
  • Hermann Pythagore Pierre Donfouet
  • Laura Kiige
  • Susan Jabando
  • Lynette Aoko Dinga
  • Betty Samburu
  • Paula Griffiths
  • Debra Jackson
  • France Begin
  • Grainne Moloney

Colleges, School and Institutes

External organisations

  • African Population and Health Research Center
  • United Nations Children's Fund (UNICEF)
  • Jomo Kenyatta University of Agriculture and Technology
  • Loughborough University
  • Epidemiology and Prevention Group, National Cancer Center
  • University of the Witwatersrand
  • London School of Hygiene and Tropical Medicine
  • University of the Western Cape


Exclusive breastfeeding (EBF) during the first 6 months of life is crucial for optimizing child growth, development and survival, as well as the mother's wellbeing. Mother's employment may hinder optimal breastfeeding, especially in the first 6 months. We assessed the effectiveness of a baby-friendly workplace support intervention on EBF in Kenya. This pre-post intervention study 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 workplace support policies and programme interventions including providing breastfeeding flexi-time and breaks for breastfeeding mothers; day-care centres (crèches) for babies near the workplace and lactation centres with facilities for breast milk expression and storage at the crèches; creating awareness on available workplace support for breastfeeding policies; and home-based nutritional counselling for pregnant and breastfeeding women. EBF was measured through 24-h recall. The effect of the intervention on EBF was estimated using propensity score weighting. The study included 270 and 146 mother-child dyads in the nontreated (preintervention) group and treated (intervention) group, respectively. The prevalence of EBF was higher in the treated group (80.8%) than in the nontreated group (20.2%); corresponding to a fourfold increased probability of EBF [risk ratio (RR) 3.90; 95% confidence interval (CI) 2.95-5.15]. The effect of the intervention 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). The baby-friendly workplace support intervention promoted EBF especially beyond 3 months in this setting.

Bibliographic note

© 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons, Ltd.


Original languageEnglish
Article numbere13191
Number of pages10
JournalMaternal and Child Nutrition
Early online date8 Apr 2021
Publication statusE-pub ahead of print - 8 Apr 2021


  • baby-friendly workplace, breastfeeding support, infant feeding behaviour, mother-friendlyworkplace, propensity score weighting