The Findings: Breastfeeding women who return to work may face daunting challenges as they figure out their rights in the workplace. The investigators involved in this study reported thatPhiladelphia and New York are just 2 of 151 cities from across the United States that have workplace regulations outlining protections for a nursing mother who wants to breastfeed or express milk at her place of employment. Their findings suggest that the limitations of existing federal and state legislation are not met by protections at the city-level. There is a “paucity of city-level legislation to protect the employed breastfeeding and/or pumping employee.”
Why it matters: The number of women in the workforce continues to rise, but workplace regulations to protect women who choose to breastfeed or express milk when they return to work are limited. The Fair Labor Standards Act is a federal law that requires employers offer “reasonable break time” and a place that’s not a bathroom for breastfeeding mothers who are employed. The law, however, covers only hourly employees at companies with 50 or more workers and annual company earnings of $500,000 or more. This means many working breastfeeding mothers aren’t covered, and their lack of legal protections could negatively affect breastfeeding duration and exclusivity. Here at CHOP, we recommend exclusive human milk for all infants through the first 6 months of life but most women return to work shortly after the birth of their infants. Without sound policy, a large proportion of women will face hardships when they return to work while balancing a desire to continue breastfeeding and pumping. This imbalance of recommendations by leading healthcare organizations and existing legislation makes it challenging for women and families to reach their personal breastfeeding goals.
Who conducted the study: Elizabeth Froh, PhD, RN, is a nurse scientist at CHOP’s Center for Pediatric Nursing Research and Evidence-based Practice. She also is an adjunct assistant professor at Penn Nursing. Diane Spatz, PhD, RN-BC, is a nurse researcher and manager of the lactation program at Children’s Hospital of Philadelphia. She also is a professor of Perinatal Nursing and the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania School of Nursing. Six research assistant who graduated from Penn Nursing in 2017 and 2018 also participated in the project.
How they did it: The eight-person team spent a year of effort on the research study. To collect the data, the team used a three-tiered approach to delve into a nationally representative sample of the 151 largest cities in the U.S. The researchers reviewed every city’s website, emailed each mayor’s office, and followed up with phone calls. Often, they found it difficult to access information for their survey about existing local legislation for nursing mothers returning to work outside the home. The experiences of the team suggest that it is burdensome for breastfeeding mothers to determine their rights at the city-level as often, city representatives struggled to answered the researchers’ leading question, “Does your city have city-level legislation specific to accommodating women returning to work during the first postpartum year in regard to breastfeeding and/or pumping at work?”
Quick thoughts: “Fifty-six percent of the workforce in the United States is now women,” Dr. Froh said. “With all of the limitations in the federal law, there is a huge segment of the working population that isn’t covered. We see this as a social-justice issue and a public-health issue.”
What’s next: Ideally, the researchers would like this study to inform grassroots efforts to create stronger city-level legislation that would provide comprehensive protections for breastfeeding for all working women, regardless of their occupation, how many hours per week the work, how often they get paid, and what size company or organization employs them.
Where the study was published: Breastfeeding Medicine
Where to learn more: Find out more about the Breastfeeding and Lactation Program