vol. 5 no.

4 ICAN: Infant, Child, & Adolescent Nutrition

Commentary

Breastfeeding in the Workplace

Marina Gettas, BA, MPH, and Adriana Morales, BS, MPH, CHES

Abstract: The purpose of this article
is to describe the need for the federal
government to pass Bill S 1463, The
Breastfeeding Promotion Act of 2011.
When this bill is passed, it will allow
working lactating women to breast-
feed (pump) while at the workplace by
requiring reasonable work breaks and
space. The first year of a childs life is
the most crucial, and allowing this bill
to pass will encourage working mothers
to give their baby one of the best gifts a
mother can give her childa healthier
life. Not only will it benefit mothers and
children, when this bill is passed it will
also benefit employers. Employers will
save in health care costs and absentee-
ism costs. The Breastfeeding Promotion
Act must be passed immediately so that
our mothers, children, and employers
can benefit from the many benefits that
this bill will provide.
Keywords: Breastfeeding Promotion
Act of 2011; workplace; lactating, mother
work outside of the home typically expe-
rience much shorter duration of breast-
feeding. Mothers who work full-time have
much lower rates of breastfeeding over-
all. Mothers who are low income are
disproportionally affected since finan-
cial necessity obligates them to return
to work sooner. The Breastfeeding
Promotion Act of 2011, when enacted,
will provide federal protection for lactat-
ing mothers in the workplace by requir-
ing employers to provide areas for them
to pump and reasonable work breaks to
do so. Companies experience great ben-
efits when they support lactating moth-
ers, such as lower absenteeism and
The Breastfeeding Promotion Act of 2011, when
enacted, will provide federal protection for lactating
mothers in the workplace by requiring employers to
provide areas for them to pump and reasonable work
breaks to do so.
in the program and a savings of $115881
per year in health care claims for breast-
feeding mothers and babies.2
In the United States, there is no fed-
eral law that protects mothers in the
workplace. The following states require
employers to give reasonable work
breaks and space for pumping: California,
Connecticut, Hawaii, Illinois, Minnesota,
Mississippi, Montana, New Mexico,
New York, Oregon, Rhode Island, and
Tennessee.1 Of these, only California,
Hawaii, and Oregon have penalties
for employers that do not comply. In
California, the penalty is a paltry $100 per
violation.1 Every state, with the excep-

M
others are a fast growing section
of the workforce. According to
the Centers for Disease Control
and Prevention, 70% of mothers who
have children aged 3 years and younger
work full-time.1 One third of those moth-
ers return to work within 3 months of
giving birth to their child, and two thirds
of these women return to work within
6 months of giving birth. Women who
lower health insurance costs. For exam-
ple, through a lactation support program,
Mutual of Omaha showed a retention rate
of 83% of their female employees, which
is much higher than the national average
of 59% for female employees. The com-
pany reported a cost of $2146 more for
every employee who did not participate
tion of Mississippi, Rhode Island, and
Tennessee, has higher rates of initiation
of breastfeeding than the national aver-
age of 76.9%.3 The states that have penal-
ties if companies do not comply all have
higher rates of exclusive breastfeeding at
6 months as well as breastfeeding at 12
months.3 A federal bill, S 1463, HR 2758,

DOI: 10.1177/1941406413496270. From the University of Southern California, Glendale, California. Address correspondence to Marina Gettas, BA, MPH, University of
Southern California, 2426 Sleepy Hollow Dr, Glendale, CA 91206; e-mail: mgettas@usc.edu.
For reprints and permissions queries, please visit SAGEs Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright 2013 The Author(s)

197
 ICAN: Infant, Child, & Adolescent Nutrition
has been introduced and is known as the
Breastfeeding Promotion Act of 2011, and
has already died and referred to com-
mittee.4 This bill would amend the Civil
Rights Act of 1964 to include lactation
and amend the Fair Labor and Standards
Act of 1938 to include reasonable break
time for lactating mothers to pump or
express their milk. This federal policy is
essential to the health of future gener-
ations in lowering rates of disease and
increasing profits for companies. When
this federal bill is passed, mothers in
states who do not have workplace lacta-
tion rights will be able to have legal right
to express milk at their workplace.
Benefits for the
Child and Mother
Breast milk is the ideal source of
nutrients for an infant. The American
Academy of Pediatrics, World Health
Organization, and the Special
Supplemental Nutrition Program for
Women (WIC) recommend that moth-
ers exclusively breastfeed for at least 6
months.5 The breast milk contains key
nutrients and bioactive substances not
available in formula, such as antibodies,
nucleotides, enzymes, and white blood
cells.6 The combination of the afore-
mentioned nutrients and essential sub-
stances will not only protect a child
from illness but it will also help reduce
the severity of ear infections, respira-
tory diseases, gastrointestinal infec-
tions, spinal infections, and urinary
tract infections.3 Breast milk encour-
ages the growth of healthy bacteria in
the gastrointestinal tract and inhibits
disease-friendly bacteria from growing,
such as Escherichia coli.6 Along with
healthier and strong immune systems
and gastrointestinal health, breastfeed-
ing also promotes strong cardiovascular
mechanisms and proper brain devel-
opment. While there is no doubt that
breastfeeding is beneficial for the baby,
breastfeeding can be extremely bene-
ficial for the mother as well. Mothers
who breastfeed have a quicker phys-
ical postnatal recovery.7 Studies have
also shown that there is an association
between breastfeeding and reduced risk
198
of breast cancer, ovarian cancer, cardio-
vascular disease, and type 2 diabetes.7
Along with those benefits, breastfeed-
ing mothers tend to lose more weight
than mothers who do not breastfeed.
Breastfeeding allows the mother and
baby to bond, creating an environment
of healthy love and safety, which is emo-
tionally beneficial for the entire family.
An additional perk of breastfeeding to
the mother is that it is free and readily
available throughout the day.
Benefits for the Workplace
There are as many benefits for mothers
and children as there are for employers.
Most important, employers will realize
savings in health care costs. Children of
working mothers use the health care sys-
tem less often if they were breastfed,
similar to women who have chosen to
breastfeed, meaning less health care costs
to the employer.8 One study found that
there were an extra 2033 physician visits,
212 extra hospitalizations, and 609 more
prescriptions written for ear, respiratory,
and gastrointestinal infections when com-
paring 1000 formula-fed babies and 1000
breastfed babies.9,10 This does not include
any of the number of other illnesses or
infections a baby or a mother may expe-
rience. In another study, an insurance
company looked at the benefits of lacta-
tion support programs. This study looked
at 343 lactation support program partic-
ipants over a 2-year period. At the end
of the 2 years, the insurance company
found that participation in the lactation
support program provided a savings of
$480000 in health care costs and a sav-
ing of $60000 in absenteeism rates.9,10
Because breastfed children are health-
ier than nonbreastfed children, mothers
who have chosen to formula feed could
miss twice as much work than moth-
ers who have chosen to breastfeed due
to illnesses of either the mother or the
child.8,11 This means that employers will
save money by increasing productivity,
as well as cutting costs for hiring a tem-
porary worker. Another benefit is that
women who have a supportive lactation
environment will naturally be
loyal to their employer, meaning less
August 2013
turnover rates and subsequently less costs
for the employer. Keeping experienced
workers will mean less cost for recruit-
ment, temporary hires, orientation, and
other related costs for a new employee.9
A study found the retention rate for lac-
tating employees was 94.2% when com-
panies provided a supportive lactating
environment.9,12 This is much higher than
the national average retention rate for the
maternal workforce of only 59%.2,9 Last,
a benefit of establishing a lactation sup-
port program in the workplace is that it
creates better morale among workers and
a respected reputation for the company
overall. Employers create the reputation
of being a family-friendly company, which
helps in recruitment, retention, and boosts
the image of the company to the commu-
nity and other counterparts.8,9 Employees
who work in companies that have lactation
support programs report a higher morale,
higher productivity, and are overall more
satisfied with their job.9,13
Rights Given by the
Federal Policy and How
Companies Can Comply
Although there are many benefits to
companies supporting their employees
in their breastfeeding, some companies
may find it a daunting task to accommo-
date their employees. There are many
resources for employers to learn about
what is needed.9,14 For example, the fol-
lowing is necessary for the employee to
express her milk in the work place15:
A space as small as 4 x 5 in size, with
an electric outlet
A private space other than a bathroom
When companies, with support from
the federal law, enact new lactation sup-
port programs, then there are many
options for those in demanding jobs. For
example, one option is job sharing, in
which another employee will take over in
case a mother is lactating and is needed
for work.15 Existing breaks may be used
to pump, and if a woman needs more
time, a suggestion may be to go in early
or work later.
vol. 5 no. 4
Conclusion
The Breastfeeding Promotion Act of
2011 must be passed immediately. There
is clear evidence that breastfeeding sup-
port in the workplace is beneficial for
everyone involved. The Healthy People
2020 objectives include increasing com-
panies with lactation programs and rais-
ing the rates of breastfeeding duration.16
If this Act is passed, these objectives will
be more likely to be met and everyone
from insurance companies to infants will
directly benefit.
Author Note
The authors declared no potential conflicts of interest
with respect to the research, authorship, and/or
publication of this article.
Acknowledgments
We would like to thank and acknowledge Genevieve
Thomas Colvin, Wendy McGrail, Amanda Reyes, Kiran
Saluja, and Hope Wills for their guidance in the writing
of this article.
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