*1.2. The Total Worker Health Program and Benefits of Breastfeeding*

The Total Worker Health (TWH) Program, created by the National Institute for Occupational Safety and Health (NIOSH) in 2012, supports protective and preventive efforts to improve the health and well-being of workers [29]. The TWH framework for worker well-being provides agreed-upon definitions and measures of worker well-being based on comprehensive, multidisciplinary literature reviews and expert panels consisting of occupational safety and health researchers [30]. The framework provides an opportunity to explore and characterize worksite factors that could improve breastfeeding behavior and supports for WIC mothers.

Breastfeeding-friendly worksites have been associated with benefits for both mothers and employers that include reduced employee absenteeism, increased employee retention, increased employee morale and loyalty, healthcare cost savings, and positive public relations and company image [31,32]. Although having space alone is not associated with increased duration of breastfeeding, women need the knowledge, support, encouragement, and environment to be successful in reaching their goals [33]. For every 1000 babies not breastfed, there are an extra 2033 physician visits, 212 days of hospitalization, and 609 prescriptions written [34].
