Maternal and Child Health Journal

, Volume 23, Issue 10, pp 1348–1359 | Cite as

Exploring Human Resource Managers’ Decision-Making Process for Workplace Breastfeeding-Support Benefits Following the Passage of the Affordable Care Act

  • Alexandra L. MacMillan Uribe
  • Tracie A. Bolton
  • Kaitland R. Woelky
  • Beth H. OlsonEmail author


Objectives To explore factors that shape decisions made regarding employee benefits and compare the decision-making process for workplace breastfeeding support to that of other benefits. Methods Sixteen semi-structured, in-depth interviews were conducted with Human Resource Managers (HRMs) who had previously participated in a breastfeeding-support survey. A priori codes were used, which were based on a theoretical model informed by organizational behavior theories, followed by grounded codes from emergent themes. Results The major themes that emerged from analysis of the interviews included: (1) HRMs’ primary concern was meeting the needs of their employees, regardless of type of benefit; (2) offering general benefits standard for the majority of employees (e.g. health insurance) was viewed as essential to recruitment and retention, whereas breastfeeding benefits were viewed as discretionary; (3) providing additional breastfeeding supports (versus only the supports mandated by the Affordable Care Act) was strongly influenced by HRMs’ perception of employee need. Conclusions for Practice Advocates for improved workplace breastfeeding-support benefits should focus on HRMs’ perception of employee need. To achieve this, advocates could encourage HRMs to perform objective breastfeeding-support needs assessments and highlight how breastfeeding support benefits all employees (e.g., reduced absenteeism and enhanced productivity of breastfeeding employee). Additionally, framing breastfeeding-support benefits in terms of their impact on recruitment and retention could be effective in improving adoption.


Breastfeeding Workplace Affordable Care Act Qualitative methods Human Resource Managers 



Thank you to all Human Resource Managers who participated for their valuable insight.


The authors disclose no financial support for this research.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interests.

Supplementary material

10995_2019_2769_MOESM1_ESM.pdf (113 kb)
Supplementary material 1 (PDF 113 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Nutritional SciencesUniversity of Wisconsin-MadisonMadisonUSA
  2. 2.Ingham County Health DepartmentLansingUSA

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