Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Health Management and Systems Sciences

Degree Program

Public Health Sciences with a specialization in Health Management, PhD

Committee Chair

Wainscott, Barry

Committee Co-Chair (if applicable)

Gagne, Patricia

Committee Member

Esterhay, Robert

Committee Member

Olsen-Allen, Susan


Breastfeeding--Social aspects--Kentucky--Louisville; Mothers--Employment--Kentucky--Louisville; Employee fringe benefits; University of Louisville--Employees


This dissertation is a mixed methods look at the barriers to successful implementation of the Break Time for Nursing Mothers provisions of the Affordable Care Act (ACA) at an upper southern-midwestern university. As public health and medical officials push the desire for an increase in breastfeeding initiation and duration, many mothers must overcome barriers within the employment arena. Previous work has failed to look at how the university setting presents unique challenges with a diverse workforce, varied jobs, and differing space availability. In other settings, barriers have been identified; the goal of this dissertation was to identify what the specific barriers were within a university setting. A mixed methods approach was used interviewing both nursing employees as well as members of the university’s lactation task force; in addition to this, a survey of employees who had utilized the Break Time provisions since 2010 was conducted. The outcomes confirmed that the barriers included space, time, and information, but included lack of social support as an additional barrier. Recommendations are made to the university to help alleviate these barriers to full implementation of the Break Time for Nursing Mothers.

Included in

Public Health Commons