Condições de trabalho e duração do aleitamento materno entre trabalhadoras remuneradas formais e em formas de emprego não-padrão e a visão dos gestores sobre licença maternidade e amamentação após o retorno ao trabalho

Abstract

Introduction: Breastfeeding is a right that society must guarantee to all women, including for paid workers. Strategies to promote, protect and support breastfeeding (BF) in the workplace have been proposed in recent decades in Brazil. Objectives: The present thesis had three four objectives: 1) To analyze the association between working conditions, such as daily working hours and type of contract, and duration of exclusive breastfeeding (EBF) and continuous breastfeeding (BF) among formal workers and in atypical forms of employment; 2) To understand the experience of the BF period in the context of return to formal and atypical work; 3) To know the managers' view on maternity leave and breastfeeding; 4) Identify the presence of strategies to promote, protect and support BF in the workplace. Methods: This study was conducted in Uberlândia, Minas Gerais, Brazil. This is a cross-sectional study with sequential mixed methods (QUANT+QUAL) and the sample consisted of formal workers (n=163) and in atypical forms of employment (n=35). The duration of EBF and BF (outcomes) was estimated using Kaplan Meier. To estimate the association between working conditions (duration of maternity leave, daily working hours, and type of contract) and outcomes, Cox regression was performed, adjusted for health and sociodemographic variables. For qualitative analysis, the content analysis developed by Bardin was used. In parallel, a qualitative study was carried out with eight managers, between January and August 2023, whose data were interpreted by content analysis. A semi-structured script was used, with questions about the way in which the activities performed by the workers were organized at the time of leave for maternity leave and after their return, as well as the manager's view of breastfeeding and the period of maternity leave. Results: Maternity leave equal to or greater than 6 months was associated with longer duration of EBF (HR=0.60; CI95%=0.36-0.99) and the increase in the number of hours of the daily working day was associated with shorter BF time (p-trend=0.036). From the analysis of the interviews with the workers, four major themes were created: 1. maternity leave and reconciliation with BF; 2. environmental working conditions and BF management; 3. Support network; 4. Career and motherhood. The conciliation of work activities with care activities was pointed out by the interviewees as a cause of physical and emotional exhaustion, and maternity leave was highlighted as essential for the maintenance of BF. Regarding the analysis of the managers' vision, three major themes were created: Theme 1: manager's view on the period of maternity and breastfeeding leave; Theme 2: rights, incentives and working conditions; and Theme 3: organization of the company with a view to the period of maternity leave. We found that all work institutions comply, minimally, with what is provided for in the Consolidation of Labor Laws (CLT) by offering 4 months of maternity leave, although most consider the period to be in disagreement with the health recommendations on exclusive breastfeeding up to 6 months. It was also found that there is no unanimous knowledge on the part of government program managers that encourage companies to support AM through tax reduction benefits. Conclusion: The presence of maternity leave of 6 months or more allowed a longer duration of EBF, as well as a shorter duration of daily working hours favors a longer duration of breastfeeding. Managers' views on maternity leave and breastfeeding. It permeates knowledge about the legislation to protect women workers, in addition to personal experience. The pro-AM strategy in the workplace boils down to complying with the period of maternity leave provided for by law.