Four Years Later: Rural Mothers' and Employers' Perspectives on Breastfeeding Barriers Following the Passage of the Affordable Care Act.

For the working rural mother, one key source of support for breastfeeding is the employer. The purpose of this article was to examine workplace barriers and facilitators to breastfeeding in a small rural American community following the passage of the Affordable Care Act in 2010. We used a qualitative research design: semi-structured interviews with major employers and low-income working breastfeeding mothers, and a focus-group with another group of employed and unemployed breastfeeding low-income mothers. While some businesses accommodate breastfeeding mothers, few actively promote breastfeeding. Lack of compliance with the new law, inadequate breastfeeding information for mothers, and lack of support from co-workers and supervisors emerged as the main barriers to successful workplace breastfeeding. To improve workplace breastfeeding support significantly there is need for authentic collaboration among maternal-child and rural health agencies and businesses in creating breastfeeding-tolerant, flexible, and forward-looking work environments that, at a minimum, satisfy the law.