• Thank you for supporting Missouri breastfeeding mothers.• This presentation is designed to provide information about:

• Benefits of breastfeeding• Federal legislation relating to milk expression in the workplace• Providing support to working mothers• Missouri Breastfeeding Friendly Worksite Program

• Please alter the presentation to fit your audience’s needs. • Contact the State Breastfeeding Coordinator if you have

questions about the content. Kathy Mertzlufft (573) 526-4792 or kathy.mertzlufft@health.mo.gov

**REMOVE THIS SLIDE BEFORE GIVING THIS PRESENTAION**

Healthy Moms. Healthy Babies. Healthy Business.

Topics

• Making the Case for Worksite Lactation Support

• Provisions of the Worksite Lactation Accommodation Law

• Going Beyond the Law• Missouri Breastfeeding Friendly Worksite

Program and Award

Supporting Breastfeeding is

WIN-WIN for Companies and Employees

Bottom-Line Benefits

ROI = 3 to 1

Women in the Workforce

2011 data from U.S. Department of Labor

shows:• 58% of women work outside the home• 61% with children under age 3 are employed• 64% with children under age 6 are employed• Growth rate has increased by 80% over the

last 20 years http://www.bls.gov/cps/wlf-databook-2012.pdf

Breastfeeding Impacts Infants

• Short-Term Health Benefits • Fewer ear infections• Fewer respiratory infections• Fewer gastrointestinal disorders• Lower risk of Sudden Infant Death

Syndrome

• Long-Term Health Benefits• Improved growth and development• Lower risk of obesity• Improved cardiovascular disease

through life• Higher IQ• Lower risk of childhood cancer

(including leukemia)• Lower risk of Type 1 and Type 2

diabetes

Impact on Children in DaycareHealth impact is even greater on infants enrolled in daycare centers• Daycare attendance is associated with double

the odds of needing antibiotic therapy• Infants breastfed at least 4 months significantly

decreased those odds• Protective effect of breastfeeding on children in

daycare persists well into child’s second year of life

Dubois, L & Girard, M. (2004). Breast-feeding, day-care attendance and the frequency of antibiotic treatments from 1.5 to 5 years: a population-based longitudinal study in Canada. Social Science and Medicine, 60(9): 2035-2044.

Breastfeeding Impacts Mothers

• Short-Term Health Benefits• Faster recovery from pregnancy

and childbirth• Faster loss of pregnancy weight• Greater sleep at night!

• Long-Term Health Benefits• Lower risk of breast cancer• Lower risk of ovarian cancer• Lower risk of Type 2 diabetes• Lower blood pressure• Lower risk of cardiovascular

disease past menopause

Making a Difference for Families

National Health Care Savings

If 90% of women breastfeed exclusively to 6 months, the U.S. could save annually

>$13 billion

and prevent the deaths of nearly

1,000 infants Bartick M & Reinhold. (2010). The burden of suboptimal breastfeeding in the United

States: a pediatric cost analysis. Pediatrics, e1048-e1056.

Making it WORK for Business

Lactation Support Lowers Health Care Costs

• For every 1,000 babies who are NOT breastfed compared to exclusively breastfeeding babies, there are an extra:• 2,033 physician visits• 212 hospitalization days• 609 prescriptions

Ball T & Wright A. (1999). Health care costs of formula-feeding in the first year of life. Pediatrics. 103(4):871-876.

Case Study: Mutual of Omaha

• Newborn health care costs were THREE TIMES LESS for mothers in the program ($1,269 vs. $3,415)

• Annual savings: $115,881 total• Annual Savings per participant:

$2,146

(Mutual of Omaha 2001)

Lactation Support Reduces Absenteeism

• One-day absences occur twice as often for employees whose babies are not breastfed (Cohen 95)

• Absenteeism rates are lower for male employees when female partners breastfeed (Galtry 97)

Employee breaks are predictable.

Absences are NOT!

Case Study: CIGNA

• Lactation program resulted in a 77% reduction in lost work time due to infant illness

• Annual savings: $60,000

(Dickson 2000)

Lower Turnover

6 out of 10 women return to work when no support services are offered

8.5 out of 10 women return to work when breastfeeding support services available

RETAIN vs.

RETRAIN

RETAIN vs.

RETRAIN

Lactation Support Satisfies Employees

Employees of companies providing lactation support feel more productive and loyal to the company. (Galtry 97; Frank 98)

Break Time for Nursing Mothers Under the Fair Labor Standards Act

Section 4207 amended Section 7 of the FLSA—requires employers to provide nursing employees with:

• Reasonable break time to express breast milk

• A place, other than a bathroom, that may be used to express milk

• For up to one year after the child’s birth

New requirement became effective March 23, 2010, when President Obama signed the Affordable Care Act

Other Provisions

• Applies to non-exempt (over-time eligible) employees• Does NOT cover salaried employees, teachers, military and

transportation workers

• Employers with less than 50 employees can apply for exemption if they can prove “undue hardship”

• Support must be provided for up to a year after child’s birth

Department of Labor Fact Sheet #73

What Women Need to Express Milk at Work• Milk production is an ongoing process; if it is not

removed, production will decline• Breaks every 2-3 hours (15-20 minutes)• Physical and psychological factors

• Privacy • Ability to relax• Information about how to make it work• Support

Busting a Few Myths

• Breast milk is NOT considered a “bio hazard” according to OSHA; it is considered FOOD

• Human milk can be stored in a cooler or insulated lunch bag

• Nursing employees are NOT more fatigued

• It is NOT okay to make jokes about breastfeeding moms

Beginning a Lactation Support Program in Your Company

• Establish as part of company health benefit services

• House within the wellness division• Convene a task force with key company

stakeholders to identify needs and solutions• Gain assistance from community resources• Promote the program with all employees and

supervisors to gain buy-in and support

What is Reasonable?

• Most women need 2-3 milk expression sessions per 8-hour period

• Around 15-20 minutes needed + time to get to the lactation room

• Nursing needs change over time!

• Most women use their usual breaks and meal period

• Paid vs. unpaid breaks

• Options if extra time is needed

Support

Basic Needs• Support from company managers, supervisors and co-

workers• Mother-to-mother support

Flexible Options• Worksite lactation support policy• Training for supervisors and co-workers• Mother-to-mother support group• Electronic list serves or company web-based connection

network

“Shielded from view and free from intrusion from co-workers and the public.”

Private Place Other than a Bathroom

How Big Should the Space Be?

• Large enough for a chair and a flat surface for the pump

• Electrical outlet is preferred

• Lock is not required, but privacy must be ensured

What Goes IN the Space?• Basic amenities:

• Chair (not a rocker)• Flat surface to put pump • Electrical outlet for pump• Anti-microbial wipes

• Amenities mothers value: • Small refrigerator• Artwork• Bulletin board for baby photos• Breast pump• Sink• Clock• Breastfeeding information

Breast Pump

Examples of Single User Rooms

Multi-Use Rooms

Lactation Rooms Within Ladies’ Lounge

University of Alabama at Birmingham

Shared Room in a Building

Medical Mall Health Department, Jackson, MS

Cubicle Walls

Partitions

Rolling Partitions

Retail Stores

Convenience Stores

Easy Space Solutions

Dressing Rooms

Restaurant Accommodations

Space:•Manager’s office•No camera•Locked HR files

Time:•“no problem”•“as needed”

K-12 Schools

• Create a space within a larger space

• Private offices (teacher, principal, guidance counselor)

• School clinic/nurse office

GOING BEYOND THE LAW

Gradual Return to the Workplace• Gradual phase back to work to allow mother and

baby time to adjust to the separation

Longer Term Options• Part-time for a period of time• Job sharing• Telecommuting• Flexible scheduling (ex: taking off Wednesdays

for a period of time)

Education

Find a Lactation Consultant Directorywww.ilca.org

Babies at Work

• Direct access to baby increases duration of breastfeeding (Fein 2008)

• Babies at Work Programs:• Lower absenteeism and turnover• Lower health care costs• Improve productivity and morale (www.babiesatwork.org)

Breastfeeding Friendly Worksites Award

• Recognizes employers that provide support to their breastfeeding employees

• In partnership with the Missouri Breastfeeding Coalition• Award level based on support offered: Gold, Silver, and Bronze. • Community and statewide recognition

• Recognized businesses will also be listed on the Missouri Breastfeeding Coalition’s website

• Applications can be downloaded from the DHSS website at http://www.health.mo.gov/living/families/wic/breastfeeding/support.php.

Resources Available to Employers

Window Cling

Doorknob SignsPosters

Certificate of Recognition

Help in Our Community

[Insert information about local resources who can assist with establishing a worksite

lactation program, as well as providedirect services to mothers.]

Resources• Missouri Breastfeeding Friendly Worksites

http://health.mo.gov/living/families/wic/breastfeeding/support.php

• U.S. HRSA Distribution Center http://www.ask.hrsa.gov/results_materials.cfm?type=kword&searchterm=439

• U.S. Office on Women’s Health www.womenshealth.gov

• National Business Group on Health www.businessgrouphealth.org

• International Lactation Consultant Association www.ilca.org

• La Leche League www.llli.org

• United States Breastfeeding Committee www.usbreastfeeding.org