The trend toward greater legislative support for breastfeeding women has largely leveled off following the passage of the ACA.
What's the Issue?
There is widespread scientific agreement that breastfeeding is beneficial for both infants and their mothers, and national public health goals reflect increased attention to helping ensure that mothers and babies have the opportunity to experience these benefits. Various legal and policy approaches for promoting and protecting breastfeeding have accompanied the evolution of evidence and the development of national goals.
This brief provides an overview of the various federal and state laws concerning workplace and public accommodations for nursing mothers in the United States and identifies the gaps that persist between public health goals and reality for breastfeeding women in this country.
While the passage of the ACA’s provisions has altered the landscape of accommodations for some breastfeeding women, including those who pump breast milk at work, the trend toward greater legislative support for breastfeeding women has largely leveled off following the passage of the ACA.
Even where the law requires workplace accommodations, women may not actually be able to access these accommodations because of limited implementation and enforcement and lack of paid break time. Research shows that workplace accommodations for breastfeeding significantly predict breastfeeding outcomes at six months postpartum, as well as breastfeeding duration up to twenty months postpartum. Improving access to workplace based breastfeeding support has important health and financial implications for US families and employers.
Researchers and advocates have argued that federal policy makers could boost the potential benefits of the ACA by enacting provisions that would enforce current law and encourage employer compliance (such as requiring employers to provide information about workplace breastfeeding accommodations to employees alongside information about maternity leave) and by pressing for the resources needed to implement the current law (such as grant programs to employers to purchase or 57% The breastfeeding rate among infants in families with lower incomes is 57 percent, compared to 74 percent in families with higher incomes. “Since 2010 only four states have passed laws protecting women who breastfeed in public.” health policy brief workplace and public accommodations for nursing mothers 6 rent portable lactation stations, or additional appropriations to the Department of Labor for enforcement activities).
At the state level, researchers point to a number of steps that could advance women’s access to workplace accommodations: first, identifying and extending protections to the classes of employed mothers who are ineligible for the FLSA protections or relevant state statutes for breastfeeding employees; second, identifying constraints and bolstering the resources employers have to implement relevant laws; third, improving enforcement provisions of state or municipal laws to penalize employers who do not comply with legal requirements; and fourth, encouraging hospitals to implement baby-friendly policies and practices to provide support for women who intend to breastfeed so that they can get off to a good start.
Regional and sociodemographic variation of breastfeeding practices in the United States also suggests the need for policies that take into account the diversity of breastfeeding mothers and their families, and the places where breastfeeding or breast milk expression occurs. In addition, all state Medicaid programs should include coverage of breastfeeding supplies and counseling for beneficiaries to reduce barriers to breastfeeding among low-income women.
Although the need for public education to overcome gaps in knowledge and family and social support is critical, without additional federal and state support—including statute changes—the United States may not reach its breastfeeding goals by 2020.