Beyond the 'Break Time for Nursing Mothers Law'
by Anne Eglash MD, IBCLC, FABM
Returning to work has been shown in several research studies to be associated with a decrease in exclusive breastfeeding, particularly within 1 month before, during, or after returning to work. According to the authors of this week’s article, work barriers include rigid work hours, lack of support from co-workers and employers, inappropriate places to express milk, and insufficient break time.
In 2010, the US Congress enacted the Break Time for Nursing Mothers Law. This law applies to 'non-exempt' employees, people who are paid at least the hourly minimum wage and are entitled to overtime pay. They generally earn less than ‘exempt employees,’ who tend to be salaried and are not entitled to overtime pay. The law requires the employer to provide a private space other than a bathroom, and break time for expressing milk that is not necessarily paid.
According to this research, as of Feb 2019, 27 states have enacted legislation to protect breastfeeding mothers at work, which tend to go beyond the federal law by including exempt employees.
Eight states have active Mother/Infant Friendly Worksite Designations, which are programs typically managed by state health departments that award recognition to businesses meeting certain criteria in supporting breastfeeding employees. The criteria, which vary by state, often include flexible break time to express milk, provision of a space other than a bathroom to express milk, access to clean water for hand cleaning, and a place to store expressed milk. Businesses are typically allowed to publicize this status. Interestingly, 2 states, Oregon and Rhode Island, discontinued their state Mother/Infant Friendly Worksite Designation program. Oregon reported that businesses were not participating, and Rhode Island’s grant funding for the program ended.
The authors point out that the research evidence backing up the Business Case for Breastfeeding is derived from the experiences of very large corporations, and smaller companies may not be able to relate to the programs and outcomes of these large companies. In addition, there is no good data regarding the effect of state-wide Mother/Infant Friendly Worksite Designation programs on breastfeeding rates and missed work days due to infant illness.
- New York
See the Answer
Human milk is the normative infant feeding standard. Yet breastfeeding rates in the United States are suboptimal as many women discontinue breastfeeding upon return to work. As a result, the Unites States Congress included the Break time for Nursing Mothers law in the Patient Protection and Affordable Care Act of 2010 (ACA). The law mandates that employers provide break time and a private space for employees to express breastmilk. This federal legislation does not cover all employees. The purpose of this project was to identify state legislation and Mother/Infant Friendly Worksite Designations (MIFWD) that provide additional protections to working, breastfeeding mothers. We reviewed websites from the United States Breastfeeding Committee and state health departments, and found 27 states have legislation related to breastfeeding in the workplace, and eight states have active MIFWD program. State laws and designation programs are important additions to federal legislation to support employees not covered by the ACA provision.
Texas has both state-level workplace breastfeeding legislation and a Mother/Infant Friendly Worksite Designation, with a robust Mother-Friendly Worksite Initiative. Check out their website for more information on the creation, growth, and sustainability of this program.
This is an area ripe for more research and opportunity for state/local breastfeeding coalitions. It shouldn’t be too difficult to incentivize a variety of small businesses to enhance their breastfeeding support, then research the effect of such support on breastfeeding rates, used sick days, and employee retention. Until we have more data, it may be hard to improve state legislation and dedicate state money for businesses to support their breastfeeding employees.
The Office of Women’s Health recently created a comprehensive website, Supporting Nursing Moms at Work. This very practical website is easy to navigate and spells out in plain English what employers need to do and how employees can advocate for themselves in the workplace.