Date of Award

Fall 2022

Document Type


Degree Name

Doctor of Public Administration (DPA)


Public Policy and Administration

Committee Chairperson

Amanda Olejarski, PhD.

Committee Member

Michelle Wade, PhD.

Committee Member

Kristen B. Crossney, PhD.


Breastmilk produced upon the delivery of babies in human societies was the most nutritionally
valued infant meal, historically. Before World War II, optimal breastfeeding of babies was the
norm in the U.S. However, women involvement in industry during and after World War II,
dropped breastfeeding to suboptimal levels, between 46.3% and 25.8% states average for 3
months and 6 months exclusive breastfeeding respectively, according to the 2018 U.S. National
Immunization Breastfeeding Survey (Cheng, et al., 2019). Four out of five mothers will start
breastfeeding during the first few days after delivery but will discontinue breastfeeding to go
back to work, which led to the drop in breastfeeding. This dissertation employed descriptive
statistical method designed to analyze the 2020 CDC breastfeeding data and focused primarily
on the differences regarding three months and six months exclusive breastfeeding rates in the
U.S. states and territories, based on U.S. household income. The study result indicates that
breastfeeding rates are not explained by breastmilk supplements, culture, and race, but are
instead driven by income and employment. Therefore, if U.S. mothers are incentivized to break
from employment post-partum, breastfeeding rate will increase to the pre-World War II optimal
level. This study’s proposed federally mandated Paid Family Leave to incentivize U.S. working
mothers is supported by a study conducted by (Huang & Yang, 2015, as cited in Steurer, 2017),
based on changes in breastfeeding practices in California after the state’s six weeks maternity
leave mandate with wage replacement of 55% showed increased breastfeeding rate results
(Steurer, 2017).