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Most working moms don't have adequate workplace support for breastfeeding, U of M study finds

lactation suites
Minnesota Vikings
The Minnesota Vikings will be the first NFL franchise to install lactation suites for nursing mothers in an NFL stadium.

Less than half of women who return to their jobs after giving birth are provided adequate time and space at their workplaces to pump breast milk, despite requirements by the 2010 Affordable Care Act that employers make such accommodations available, according to a new University of Minnesota study.

Breastfeeding mothers who have low-paying jobs or who are single are particularly unlikely to have access to a clean, private room or to be given the break time necessary to pump breast milk at work, the study found.

The study also found, however, that when workplaces do provide such accommodations, new mothers are more than twice as likely to breastfeed their babies exclusively for six months, which is the length of time recommended by the American Academy of Pediatrics and other major health organizations.

The research was published earlier this week in the journal Women’s Health Issues.

“I was really surprised [by the findings],” said Katy Kozhimannil, the study’s lead author and an associate professor at the U of M’s School of Public Health, in an interview with MinnPost. “I don’t know if it was naïve of me — or just hopeful — to expect that the Affordable Care Act would have had a greater influence on what women report in terms of their actual access to breastfeeding accommodations in the workplace.”

After all, she added, the required accommodations are “so very basic.”

Long list of benefits

Under the Affordable Care Act (ACA), employers with more than 50 employees must provide both a reasonable amount of break time and a private place (not a bathroom) for breastfeeding mothers to express and store milk for at least one year. (A free electric breast pump is also now available to all new mothers under the ACA.)

Associate Professor Katy Kozhimannil
Associate Professor Katy
Kozhimannil

Research has shown that without these provisions, working women tend to give up on breastfeeding — a result that raises a serious public health concern. For, as Kozhimannil and her colleagues point out in their study, breastfeeding is associated with much better health outcomes for infants and nursing mothers.

Babies who are breastfed have lower rates of respiratory and gastrointestinal tract infections, sudden infant death syndrome (SIDS) and asthma, for example, and are less likely to develop obesity or diabetes later in childhood.

For women, breastfeeding is associated with a lower risk of developing postpartum depression, breast and ovarian cancers, diabetes and rheumatoid arthritis.

It’s for these reasons that most health officials strongly recommend that babies be exclusively breastfed for six months and then breastfed for at least another six months once solid foods are introduced.

Working mothers thus need to pump their breast milk at their place of employment — for about 15 minutes every three hours — and then store it in a safe place until it can be taken home.

Key findings

For their new study, Kozhimannil and her colleagues analyzed data from a national survey of 2,400 women who gave birth in U.S. hospitals in 2011 and 2012. A follow-up survey was also conducted among the same group of women in 2013.

Here are the main findings from that analysis:

  • Only 59 percent of breastfeeding women who returned to work after giving birth were allowed enough break time by their employers to pump milk.
  • Only 45 percent of the women’s workplaces had a clean, private, non-bathroom space where they could pump milk.
  • Only 40 percent of breastfeeding women who returned to work had access to both adequate break time and space for pumping milk.
  • Low-income women and single mothers were significantly less likely to have access to either break time or private space for pumping breast milk. For example, women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) — a government program for low-income mothers — were half as likely to have access to private space at their workplace as other women. And married women were three times more likely than single women to have such access.

The study also found that new mothers who had both adequate break time and private space were 2.3 times more likely to exclusively breastfeed for at least 6 months.

“Having those facilities seemed to really make a difference for women,” said Kozhimannil. 

Needed: greater awareness and accountability

Although Kozhimannil doesn’t believe that most employers are purposely disobeying the breastfeeding accommodation requirements under the ACA, “there is a need,” she says, “for greater awareness and greater accountability.”

“A lot of workplaces may think they are meeting their obligations by providing space within a bathroom, but that’s not really complying with the law,” she said.

Some employers find it difficult to designate a private space on their worksite for breastfeeding mothers, and thus request a “hardship exemption,” as permitted under the ACA. 

But a better solution in such situations, said Kozhimannil, would be for lawmakers to provide employers with resources — such as freestanding lactation “pods” — to help them meet their obligations. 

“Having access to these accommodations is a right for women,” she stressed. Therefore, policymakers as well as employers need to make expanding that access a greater priority.

“The number of women who currently have access is just too low,” she added. “We need to do better than that.” 

You can read the new study on the Women’s Health Issues website.

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