Washington Business Journal Examines Implementation Of Protections For Breastfeeding Women In Health Reform Law

A provision in the federal health reform law (PL 111-148) requiring employers to provide breastfeeding women with break times and a private place to express milk or breastfeed their infants is a "huge victory" for breastfeeding advocates who have been fighting for a national measure since at least 1992 , the Washington Business Journal reports. As recently as last summer, the Ohio Supreme Court ruled that it was legal for an employer to fire a woman who took breaks to express milk. The law also could provide significant cost savings for employers, "with more breast-fed children leading to fewer sick days and fewer diseases," the Journal reports.

According to the Journal, federal health experts recommend women feed their infants only breastmilk for at least the first six months, which can boost the infant's immunity and decrease the woman's risk of breast cancer later in life. The American Academy of Pediatrics in April released a study showing that 911 infants' lives and $13 billion in health care costs could be saved each year if 90% of breastfeeding women adhered to those recommendations. The Centers for Disease Control and Prevention reports that while nearly 80% of U.S. women breastfeed initially after birth, only 44% breastfeed for six months, largely due to workplace barriers.

The Journal reports that some groups -- including breastfeeding advocates -- are concerned that the language in the law is too vague and could lead to implementation issues. Gina Ciagne, director of breastfeeding and consumer relations for breastfeeding products manufacturer Lansinoh Laboratories, said, "It's amazing and great that they have this language in the bill, but it still leaves so much ambiguity for moms and employers." She added, "If an employer doesn't understand why and how a mother needs to pump milk, maybe a five-minute break seems 'reasonable.'"

Ciagne said that it is an "unfair burden to put on a working mother," adding, "You've got all these agencies and organizations telling moms, 'Oh you really have to do this for the sake of your child, but we’re not going to help you figure out how to do it.'" She added, "There needs to be an overarching voice for pumping, working moms."

In March, almost 100 public health organizations -- including AAP -- petitioned Congress to allocate $15 million to fund a centralized body to provide employers and employees guidance on workplace lactation. Ciagne said that employers should not wait for government guidance to figure out how to support breastfeeding women. Ciagne said, "Some people in this country can't even get permission to go to the bathroom -- and in these economic times, a mom doesn't want to rock the boat."

Lisa Horn, a government relations specialist for the Society for Human Resource Management, said, "It's not one of those provisions that's gotten homed in on yet, because there are so many other provisions to worry about." She added, "But a lot of this is going to have to get fleshed out for employers to know what a reasonable break time is and when that provision will be effective."

In 2008, HHS found that employers who accommodate breastfeeding women see higher rates of employee retention and lower health care costs. Women who are breastfeeding also miss work less often, as mothers of formula-fed infants take off work twice as often to care for sick children. A two-year study of 343 employees of health insurer Cigna who participated in their lactation support program found that about $600,000 was saved by reducing absenteeism rates. Moreover, the company's program resulted in annual savings of $240,000 in health care expenses and 62% fewer prescriptions (Castro, Washington Business Journal, 4/30).


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