BESt: Breastfeeding and Employment Study Survey

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Employee, Manager, and Organization Surveys on Breastfeeding Support in the Workplace

Issues faced by breastfeeding mothers in the U.S.

Despite the many health benefits that breastfeeding offers to both infants and mothers, the rate of mothers who continue to breastfeed their infants for the recommended 12 to 24 months remains low in the United States.

  • According to the CDC, for babies born in 2015, while 83% of newborns in the United States started out breastfeeding, by 6 months, the number had dropped to 58%, and by 12 months, it was down to 36%.
  • In contrast, global data show that approximately 75% of children aged 12-15 months are still breastfeeding.

Among working mothers in the U.S., the number who continue to breastfeed their infants for a year is even lower. Many working mothers face a lack of support in the workplace for breastfeeding and pumping, have competing time demands, lack a clean or private place to pump, and face other challenges, all of which can contribute to lower than optimal rates of continued breastfeeding.

The Breastfeeding and Employment Study (BESt) surveys

The Breastfeeding and Employment Study (BESt) surveys were created to help address these issues. The surveys – one for employees, one for managers, and one for companies – can help identify which company breastfeeding policies, areas of support, and aspects of the company culture serve as facilitators or barriers to continued breastfeeding after mothers return to work.

The surveys can be used to measure:

  • The climate for breastfeeding support from the perspective of employees (especially pregnant or new mother employees) or managers
  • Any improvement in that climate after breastfeeding supports are implemented
  • Benefits that might be available to support breastfeeding

The surveys are useful to organizations, but may also be used by researchers to examine the climate of breastfeeding support and its relationship to breastfeeding duration of new mother employees, or for its relationship to measures of job satisfaction or success.

Key References

What does the toolkit contain?

The toolkit contains 3 surveys, each of which contains instructions, questions, and space for free text comments.

  • Employee Survey: To be completed by employees in the organization. Questions on the following topics are included: organization support, manager support, co-worker support, time, and physical environment.
  • Manager Survey: To be completed by managers in the organization. Questions on the following topics are included: manager support, co-worker support, company support, outcomes, and experience with breastfeeding.
  • Organization Survey: To be completed by those with knowledge of breastfeeding supports in the organization, such as Human Resources Managers.  Questions on the following topics are included: breastfeeding policy, maternity leave, breastfeeding and pumping milk at work, and supports such as education and facilities.

Who should use the surveys?

These surveys are intended to be used by researchers, organizational leaders and managers, lactation consultants, and others who are interested in understanding the barriers and facilitators to breastfeeding within or across workplaces.

The results of the surveys can also be used to:

  • Discuss and assess workplace policies related to breastfeeding
  • Provide impetus for the creation of new policies to support breastfeeding mothers
  • Identify areas for improvement in the company culture related to breastfeeding support

Researchers may also be interested in using the survey instruments to analyze which factors in the workplace contribute to mothers continuing or discontinuing breastfeeding after they return to work.

Development of this toolkit

The Breastfeeding and Employment Study (BESt) Toolkit was developed by Beth Olson, PhD, who is currently an Associate Professor at the University of Wisconsin-Madison College of Letters & Sciences – Department of Nutritional Sciences.

This project was supported by the Michigan State University FACT Coalition and grant 2006-35215-16703 from the National Research Initiative of the USDA Cooperative State Research, Education and Extension Service. Additional support was provided by the University of Wisconsin School of Medicine and Public Health’s Health Innovation Program (HIP), the Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 9 U54 TR000021 from the National Center for Advancing Translational Sciences (previously grant 1 UL1 RR025011 from the National Center for Research Resources). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.

Please send questions, comments and suggestions to

Toolkit Citation

Olson B, Fulmer I. Breastfeeding and Employment Study (BESt) Toolkit. University of WIsconsin – Madison Department of Nutritional Sciences and UW Health Innovation Program; 2017. Available at:



About the Authors

Beth H. Olson, PhD is an Associate Professor with the University of Wisconsin – Madison Department of Nutritional Sciences, and a Nutrition Specialist with Family Living Programs, UW-Extension. She conducts research and outreach to improve nutrition and education for families with infants, and support to working and low-income mothers for breastfeeding.

Ingrid Fulmer, PhD is the Dean of the School of Labor and Employment Relations at the University of Illinois Urbana-Champaign. Her research expertise is in the areas of human resource management and organizational behavior. She is managing current projects focused on compensation system design, pay communication and transparency, organizational human capital, and management of former (i.e., alumni) employees.