Workplace supports for breastfeeding

Evidence Rating  
Some Evidence
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  

Workplace policies and practices to support breastfeeding include encouraging breastfeeding breaks to nurse or express milk, allowing babies at work, offering flexible schedules, telework options, or extended maternity leave with or without pay. The 2010 Fair Labor Standards Act (FLSA) requires employers to provide a private space, other than a bathroom, and reasonable break time to breastfeed or express milk. Employers can also equip lactation rooms with a high quality pump, microwave to sterilize equipment, refrigerator, sink, and comfortable furniture; offer on-site or nearby childcare; or provide professional lactation services. Workplace supports vary depending on company resources, size, and budget1, 2.

Expected Beneficial Outcomes (Rated)

  • Increased breastfeeding rates

Other Potential Beneficial Outcomes

  • Reduced absenteeism

  • Increased productivity

  • Increased job satisfaction

Evidence of Effectiveness

There is some evidence that workplace supports for breastfeeding increase breastfeeding among women returning to work after childbirth3, 4, 5. Women with access to both lactation spaces and adequate break time, as mandated by the Fair Labor Standards Act (FLSA), are more likely to exclusively breastfeed 6 months after birth than women without these supports3, 6. Comprehensive and more basic supports both appear to positively affect continuation, duration, and exclusivity of breastfeeding among working women; as workplaces implement greater levels of support the likelihood employees will initiate and continue breastfeeding increases3. However, additional evidence is needed to confirm effects7.

Women with access to workplace supports such as a space for lactation, breastfeeding breaks, and comprehensive lactation support programs have higher job satisfaction and job commitment than women without these supports3. Workplace support programs may also reduce absenteeism, and increase productivity, morale, and retention7.

Surveys suggest that workplace supports for breastfeeding vary significantly across employment sectors; women working in service, production, and transportation industries often receive the lowest levels of support for breastfeeding8. Surveys also suggest that single mothers and women with low incomes are significantly less likely to have access to private lactation spaces and sufficient break time to express milk than women with higher incomes3, 6.

Establishing a well-written lactation policy, maintaining equipped lactation facilities, increasing communication about breastfeeding, building networks to support training, and supporting schedule flexibility for working breastfeeding mothers are often components of successful employer-based programs4, 9. Limited understanding of the need for breastfeeding policies can be a challenge to policy development and implementation9.

Employers can tailor workplace support policies for breastfeeding to fit their company’s budget and resources. Many workplace breastfeeding supports can be provided at little or no cost to the employer. Studies suggest that employers save an average of three dollars for every dollar invested in workplace supports for breastfeeding3

Impact on Disparities

No impact on disparities likely

Implementation Examples

As of 2017, 28 states, Washington DC, and Puerto Rico have workplace breastfeeding legislation that complements federal legislation2, 10, 11, 12. Several state and local public health agencies have developed programs to increase workplace supports for breastfeeding and to ensure compliance with the federal law, as in Minnesota, South Carolina, and Texas13.

A 2013 survey suggests that only 40% of employed women with infants have access to both break time and a private lactation space6.

Implementation Resources

CDC-Breastfeeding 2013 - Centers for Disease Control and Prevention (CDC). The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: US Department of Health and Human Services (US DHHS); 2013.

US DHHS OWH-Breastfeeding - US Department of Health and Human Services (US DHHS), Office on Women’s Health (OWH). Breastfeeding.

US DHHS OWH-Breastfeeding employer solutions - US Department of Health and Human Services (US DHHS), Office on Women’s Health (OWH). Breastfeeding supporting nursing moms at work: Employer solutions.

CDC DNPAO-Breastfeeding resources - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Breastfeeding: Strategies and resources.

Footnotes

* Journal subscription may be required for access.

1 CDC-Breastfeeding 2013 - Centers for Disease Control and Prevention (CDC). The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: US Department of Health and Human Services (US DHHS); 2013.

2 US DOL-Nursing - US Department of Labor (US DOL); Wage and Hour Division. Break time for nursing mothers.

3 Dinour 2017* - Dinour LM, Szaro JM. Employer-based programs to support breastfeeding among working mothers: A systematic review. Breastfeeding Medicine. 2017;12(3):131-141.

4 Hilliard 2017* - Hilliard ED. A review of worksite lactation accommodations: Occupational health professionals can assure success. Workplace Health & Safety. 2017;65(1):33-44.

5 Paddock 2017* - Paddock JD. Breastfeeding patterns among employees at a land grant university. Workplace Health & Safety. 2017;65(12):580-594.

6 Kozhimannil 2016* - Kozhimannil KB, Jou J, Gjerdingen DK, McGovern PM. Access to workplace accommodations to support breastfeeding after passage of the Affordable Care Act. Women’s Health Issues. 2016;26(1):6-13.

7 Cochrane-Abdulwadud 2012 - Abdulwadud OA, Snow ME. Interventions in the workplace to support breastfeeding for women in employment. Cochrane Database of Systematic Reviews. 2012;(10):CD006177.

8 Snyder 2018 - Snyder K, Hansen K, Brown S, et al. Workplace breastfeeding support varies by employment type: The service workplace disadvantage. Breastfeeding Medicine. 2018;13(1):23-27.

9 Bradford 2017* - Bradford VA, Walkinshaw LP, Steinman L, et al. Creating environments to support breastfeeding: The challenges and facilitators of policy development in hospitals, clinics, early care and education, and worksites. Maternal and Child Health Journal. 2017;21(12):2188-2198.

10 NCSL-Breastfeeding - National Conference of State Legislatures (NCSL). Breastfeeding laws.

11 NPHL-Breastfeeding - The Network for Public Health Law (NPHL). Maternal and child health issue brief: Breastfeeding in the workplace.

12 AMCHP-Breastfeeding 2012 - Association of Maternal & Child Health Programs (AMCHP). Health reform: What is in it to promote breastfeeding? Washington, DC: Association of Maternal & Child Health Programs (AMCHP); 2012.

13 CDC DNPAO-Breastfeeding resources - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Breastfeeding: Strategies and resources.

Date Last Updated