Health Care Reform Boosts Support for EmployedBreastfeeding Mothers (Attn: Small Business Owners!)

United States Breastfeeding Committee ^

[narses]

Frequently Asked Questions

With the inclusion of this provision in health care reform legislation, the U.S. joins the rest of the industrialized world in recognizing breastfeeding as the natural outcome of pregnancy, and workplace lactation programs as the natural outcome of a society where the majority of mothers and infants are separated due to work.

** NEW ** Department of Labor Fact Sheet issued July 15, 2010

Download USBC's Background Paper: Workplace Accommodations to Support and Protect Breastfeeding

What does the Reasonable Break Time for Nursing Mothers law do?

• Section 4207 of the Patient Protection and Affordable Care Act (also known as Health Care Reform), amends the Fair Labor Standards Act (FLSA), or federal wage and hour law. The new provision states that employers shall provide breastfeeding employees with “reasonable break time” and a private, non-bathroom place to express breast milk during the workday, up until the child’s first birthday.

• Download the text of Section 4207 only.

What types of employers are covered?

• All employers covered by the FLSA are included, but those with less than 50 workers do not have to comply if they show that complying with the law would cause "an undue hardship by causing the employer significant difficulty or expense when considered in relation to the size, financial resources, nature, or structure of the employer’s business."

What types of workers are covered?

• The law is an amendment to existing federal minimum wage and overtime laws, so it covers the workers subject to those laws, so-called "non-exempt workers." Generally, this means hourly workers (many retail workers, factory workers, restaurant workers, and call center workers, for example) and other employees who work on an hourly basis and who are subject to overtime laws.

• "Exempt" workers are those on a salary ("exempt" from overtime), often in managerial positions. They are not covered by the new federal law. Many of these workers, particularly those employed by large companies, have workplace accommodation as part of company policy. The National Business Group on Health has recently published case studies highlighting several of these.

When does the law take effect?

• The law was effective immediately upon President Obama’s signing of the Patient Protection and Affordable Care Act, however, the rules for enforcement have not yet been put in place. Breastfeeding employees should be assured that the Department of Labor is working swiftly to establish these rules, and should give their employers time to comply once those rules take effect.

• While the Department of Labor works to define terms and processes for enforcement of the law, USBC stands ready to support employers and breastfeeding employees with tools, information, and resources. View resources for employers and managers and resources for breastfeeding employees.

Why is the law necessary?

• The longer a woman breastfeeds her child, the lower her risk of serious diseases such as diabetes, heart disease and breast cancer, and the lower the child’s risk of infections, obesity, diabetes, and other diseases and conditions.
• That’s why medical experts agree with the Department of Health and Human Services in recommending exclusive breastfeeding for six months and continued breastfeeding for the first year of life and beyond.

• Mother-child separation due to work presents a serious challenge to meeting breastfeeding goals when employers do not meet the relatively simple needs of breastfeeding employees: time to regularly express milk (approximately every three hours), in a clean, private space.
• Women now comprise half the U.S. workforce, and are the primary breadwinner in nearly 4 out of 10 American families. The fastest growing segment of the workforce is women with children under age three.
• The Centers for Disease Control and Prevention’s National Immunization Survey indicates that nearly 75% of women initiate breastfeeding, but breastfeeding rates at six months and 12 months drop precipitously.
• Returning to an unsupportive work environment has been identified as a major reason for the avoidance or early abandonment of breastfeeding. Workplace support can bridge this gap and help more women to balance working and breastfeeding.
• While there are increasing numbers of worksite lactation programs, low-wage earners have had less access to this support. A mother’s decision to breastfeed her child should not be predetermined by where a mother works.

Aren’t there state laws that already protect employed breastfeeding mothers?

• Currently, 24 U.S. states, Puerto Rico, and the District of Columbia have legislation related to breastfeeding in the workplace. One of the strongest and most detailed was passed in Oregon in 2007. The Oregon law served as a model for the federal provision, introduced into health reform legislation in 2009 by Senator Jeff Merkley (D-OR). A federal law was needed to cover the many states without worksite protection for breastfeeding mothers. The new federal law will provide a minimum level of support in all states, but if an existing state law provides stronger protections, the state law will prevail.

What does an employer stand to gain?

• The Business Case for Breastfeeding, published in 2008 by DHHS, demonstrates an impressive return on investment for employers that provide workplace lactation support, including lower health care costs, absenteeism, and turnover rates. Employees whose companies provide breastfeeding support consistently report improved morale, better satisfaction with their jobs, and higher productivity. As part of The Business Case for Breastfeeding initiative, coalitions in 32 states and territories received training to assist employers in establishing lactation support programs.
• The National Business Group on Health, a nonprofit organization representing large employers on national health policy issues, says that creating a breastfeeding-friendly work environment reduces the risk of long-term health problems for women and children, decreases employee absenteeism, reduces health claims to employers, and increases retention of female employees.

• Research shows that worksite lactation programs are good for business: there has been a steady trend of growth in worksite lactation programs over the last ten years.

Level of Support		Components of Program	Return on Investment
	Basic Accommodation	Reasonable time Clean, private space		$1 investment $2 return
Comprehensive Accommodation	Supportive policy Lactation consultations Pump provision Flexible schedule On-site childcare	$1 investment Up to $3 return

What do the time and space requirements in the new law mean?

• The Department of Labor will define terms used in the law, such as “reasonable break time” and “significant difficulty or expense.”

• An example of how the Department of Labor might interpret the law can be found in Oregon’s Rest Breaks for Breast Milk Expression law, which served as the model for the federal law. In Oregon, the Bureau of Labor and Industry Administrative Rules defined the time and space provisions as follows:

In Oregon, “reasonable” time for milk expression is defined as: “a 30-minute rest period to express milk during each four-hour work period, or the major part of a four-hour work period, to be taken by the employee approximately in the middle of the work period.” This matches wage and hour law, and also covers exempt and part-time employees. The effort is to match the biological rhythm of a breastfeeding mother and child to the structured rhythm of the workday as closely as possible. A breastfeeding employee needs to express milk regularly to maintain her milk supply. Research and experience have shown that a 30-minute break in every four-hour work period is the minimum time needed for the employee to get to the designated space, set up the pump, express adequate milk, clean pump parts, get the milk to cold storage, and return to the work station. The Oregon law’s definitions have provided great flexibility in designating space for milk expression, while still meeting the threshold of the law. Unlike the Americans with Disability Act, businesses in Oregon are not required to make major changes to the built environment. Examples of creative solutions include: Designated, permanent space, at least 4’ x 6’ with a chair, sink, and electrical outlet. Space designated with a sign or reserved on a calendar that rotates throughout the workspace between offices, conference rooms, clinic rooms, etc. Temporary use of manager office space in fast-food restaurants, police departments, or settings that lack other spaces with a locking door. A curtained-off area that is non-accessible to the public, and meets privacy threshold because of clear, well-communicated policy with co-workers. This can even mean a chair behind a curtain in an employee-only bathroom lounge, if there is truly no other space available. A designated space that serves employees from several employers, located in the employee-only areas of malls, airports, and retail strips. An agreement between worksites, where a breastfeeding employee can visit a neighboring business to access a designated space within. Privacy panels to block the windows of work vehicles such as patrol cars or construction vehicles on the road. Use of City or County buildings by public employees on route, such as police on patrol, bus drivers, or meter readers.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 What about complaints, enforcements, penalties, and “undue hardship”?

• These are some of the important questions the Department of Labor will be working to answer in the coming months. USBC and Senator Merkley’s office will be closely monitoring and supporting this process.
• There are many resources available with tools to help employers implement the law. Bookmark this page and check back often!

Resources for employers and managers:

• The Business Case for Breastfeeding
  • Easy Steps to Supporting Breastfeeding Employees
  • Tool Kit: Resources for Building a Lactation Support Program
  • List of states that participated in the Business Case training initiative
• Employer Perspective on Accommodating a Nursing Employee: a video by the Colorado Breastfeeding Coalition

• National Business Group on Health
  • Toolkit: Investing in Workplace Breastfeeding Programs and Policies
  • Issue Brief: Workplace Breastfeeding Programs: Employer Case Studies
  • Workplace Breastfeeding Programs: Tips for Employers

• International Lactation Consultant Association Worksite Lactation Support Directory

Resources for breastfeeding employees:

• The Business Case for Breastfeeding
  • Employee’s Guide to Breastfeeding and Working

• Breastfeeding and Working: moms share their stories in a video by the Colorado Breastfeeding Coalition
• WorkAndPump: Support and information for mothers committed to providing the best nutrition for their babies
• Ask Dr. Sears: 20 Tips for Working and Breastfeeding
• Babies At Work: Carla Moquin has extensively researched how trailblazing companies are allowing mothers to bring their babies to work

[narses]

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[pnh102]

I fail to see how there is any interstate commerce related to expressing breast milk at work, unless of course the woman’s job function involves going across state lines or into and out of the country. Of course, since when did silly old things like the Constitution matter anymore anyway.

[narses]

Clearly you have use of higher cortical synapses, you fail and cannot ever (absent severe brain damage) see the world as a liberal, or Congressman of long tenure (but I repeat myself). Good for you. Procreate, early and often (with your lawful spouse, by Design) and we will work up a real majority soon.

[xtinct]

First the family and medical leave of 8 - 12 weeks...

now they want the babies to come to work?

Why does this so sound like Soviet Russia?

Next... remove child age 3 from parents for total indoctrination

[flowerplough]

“but those with less than 50 workers do not have to comply if they show that complying with the law would cause “an undue hardship by causing the employer significant difficulty or expense”

More than 50 workers? Willing to whine about undue hardship, difficulty or expense?

Can you say waiver? Sure you can!

[Tax-chick]

Great, raise the costs of an employee *again*. Employers will make additional efforts to avoid hiring any women of childbearing age, when they should simply be focussed on providing a market-demanded product or service.

[Pollster1]

I fail to see how there is any interstate commerce related to expressing breast milk at work, unless of course the woman’s job function involves going across state lines or into and out of the country. Of course, since when did silly old things like the Constitution matter anymore anyway.

In Wickard v. Filburn, the Supreme Court interpreted the Commerce Clause to say that because Filburn's wheat growing activities (growing wheat on his own land to feed to his own chickens on the same land) reduced the amount of wheat he would buy for chicken feed on the open market and because wheat was traded nationally, Filburn's production of wheat could be regulated by the federal government. By the same reasoning, breastfeeding is interstate commerce. In other words, there are no limits to federal power. Carried to an absurd extreme, for hyperbole only, if they wanted, they could even reach into your underwear to feel you up as part of their power to regulate, and they could fine you $11,000 if you tried to leave without being felt up to their "satisfaction".

[narses]

Yeah. Ugly people in office, for the moment.

[narses]

If the Lopez case could just grow legs....

[pnh102]

What a disgusting ruling. This ranks up up there with Dred Scot or Kelo.

[Pollster1]

What a disgusting ruling. This ranks up up there with Dred Scot or Kelo.

That's why I remember that ruling so well.

[Pollster1]

If the Lopez case could just grow legs....

Did you mention JLo and legs in the same sentence?

[GailA]

obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors

[SunkenCiv]

[narses]

Wrong Lopez, I think. The instant case had to do with carrying arms, not baring them.

[outhousepatrol]

If women can breastfeed. then it should be not much of a stretch to allow sodomites to “zipperfeed”!