Use These Resources and Tips for National Breastfeeding Month

Janet Wasylyshen-Velasco MD, MPH, IBCLC, Julie Ware MD, MPH, IBCLC, Vanessa Shanks, MD, CLC, Kam Lam, MD, MPH, MS, IBCLC

We Are Human
I recall a conversation with a physician colleague several years ago. – Question: “How’s the new baby?”  Answer: “It’s going well, sleep is getting better, routine is beginning, growth is on track and joy is beyond measure, but I just can’t manage pumping at work.  I had to start stretching time between pumps, it’s so busy and everyone has their own workload.  I got mastitis, couldn’t recover my volume, and finally had to abandon breastfeeding completely.  I had just hoped I would be able to manage it all – longer.  I’m supposed to be a superhuman, right. How do mothers do this?”

Conversations like this capture fundamental issues and first hurdles to population health for infants and nursing parents in our workplaces, in our clinical care settings and across the US health care system.  We care for our patients.  AGE, asthma, hypertension, unhealthy weight, antibiotic prescriptions, notes for work, notes for school, documenting acute care, and so on.  We understand the science, as the relationship between food and health becomes ever more defined.  We see the maternal and infant morbidity and mortality2,3.  We know the CDC, WHO, AAP, AAFP, ACOG and US Dietary Guidelines.  The American Heart Association4.  We recognize the value in this first food, yet the challenges of providing human milk for two years or longer can be insurmountable for many women.

August is the month to celebrate World Breastfeeding Week and National Breastfeeding Month.  This year we are celebrating an important legislative update that expands the rights of working parents to  address challenges to infant feeding.

It’s likely that you, or an organization that you are affiliated with, joined the Unites States Breastfeeding Committee (USBC) to lobby for bipartisan congressional approval for the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act.  The PUMP Act updates the 2010 Fair Labor Standards Act (FLSA) amendment Break Time for Nursing Mothers.  The PUMP Act was signed into law December 29, 2022, and took effect April 23rd 2023, providing federal protections for break time and shielded space for all lactating employees covered by the FLSA.

PUMP Act Basics

Applies to: §  All employees covered by the FLSA

§  Railway/motorcoach workers have phased and specific protections (2025)

§  Airline flight crewmembers are exempted from this protection

§  Does not preempt state law if that law provides greater protections

§  Applies without regard to the size of business; employers with < 50 employees may be exempted from compliance if they apply for and can  demonstrate undue hardship.

Applied how: §  Employers must provide reasonable time and space to express breastmilk

§  Applies for one year after child’s birth

§  Applies to telework employees

§  Space cannot be a bathroom. It must be shielded from view, free from intrusion by coworkers or the public, and must be functional and available when needed

§  Pumping time must be paid unless employee is completely removed from work duties (phone, vocera, etc).  Time must be paid if employer provides paid breaks and an employee expresses milk during a break

Rights: §  Right to file a complaint with the Wage and Hour Division for appropriate remedies which include: employment, reinstatement, compensatory damages, make-whole relief, and punitive damages where appropriate

§  Employees may be required to provide employer with notice of failure and 10 days to come into compliance

§  Prohibits retaliation against employees for exercising their rights, filing a complaint or cooperating with an investigation

Employer and employee resources: §  US Dept of Labor – PUMP Act explained, FLSA office poster, Fact Sheet #73, FAQ’s

§  USBC Pump Act Implementation Resources – resources for employers/employees, additional links

§  A Better Balance – Talking to your boss (English/Spanish), free legal hotlines, additional links

Ohio resources: §  Ohio Workplace PLUS (Providing Lactation Upgrades and Support) toolkit

Employer and employee resources, posters, videos

§  Ohio Breastfeeding Friendly Workplace Award

Award application/recognition, Gold/Silver/Bronze designations valid 3 yrs

What Providers Can Do:

  • Medical providers are an important source of education for employees and employers. Post or display resources, add dot phrase links to your after visit summaries, ensure the FLSA poster is in place at work.
  • Let parents know they are not alone! Protections through the FLSA applies to us all as we navigate the workforce.
  • Integrate routine lactation education, care, and referral as part of pre-pregnancy counseling, infant and toddler care, reproductive counseling, substance use counseling and long term non-communicable disease risk reduction strategies as they apply to individual clinical care.
  • Share National Breastfeeding Month resources with your new parents – being part of community is a wonderful parenthood opportunity that you can foster.

National Breastfeeding Month Resources

Week 1

August 1-7

World Breastfeeding Week

Theme: Enabling Breastfeeding: Making a difference for working parents

Week 2

August 8-14

Indigenous Milk Medicine Week

Theme: From the Stars to a Sustainable Future

Week 3

August 15-21

Asian American Native Hawaiian and Pacific Islander Breastfeeding Week

Theme: Telling Our Stories, Elevating Our Voices!

Week 4

August 25-31

Black Breastfeeding Week

Theme: We Outside!: Celebrating Connection & Our Communities

Week 5

September 5-11

Semana de La Lactancia Latina

Latina/x Breastfeeding Week

Did You Know?

  • Workplace challenges are the #1 most common reason not to breastfeed or to breastfeed for shorter durations than recommended by guidelines
  • Less than three months of maternity leave is associated with shorter breastfeeding durations
  • The PUMP Act expanded coverage to nearly 9 million female employees including:
    • nurses, teachers, farm workers, software engineers, domestic service workers
  • Employers will typically experience a 3:1 ROI (return on investment) for money allocated toward lactation accommodations5

Test your knowledge:
US Department of Labor Wage and Hour Division Example6

True or False?
Lauren’s employer requires all employees to attend a team-building meeting at 3pm on Thursdays. Lauren requests break time to pump during the Thursday meeting which her employer denies.

This is ok – Lauren can adjust her pumping schedule to accommodate the meeting.

ANSWER: False. Lauren’s employer denies her request in violation of the FLSA. Lauren must be paid for the time attending the meeting and must be permitted time and space to pump.


References:

  1. https://www.human-milk.com/science
  2. Babic A, et al. Association Between Breastfeeding and Ovarian Cancer Risk. JAMA Oncol. 2020 Jun 1;6(6):e200421. doi: 10.1001/jamaoncol.2020.0421.
  3. Li R, Ware J, Chen A, Nelson JM, Kmet JM, Parks SE, Morrow AL, Chen J, Perrine CG. Breastfeeding and post-perinatal infant deaths in the United States, A national prospective cohort analysis. Lancet Reg Health Am. 2022 Jan;5:100094.
  4. Even a little breastfeeding goes a long way in protecting heart health of baby and mom AHA News, Aug. 23, 2022.
  5. US Breastfeeding Committee, https://www.usbreastfeeding.org/pump-act-implementation-resources.html
  6. https://www.dol.gov/agencies/whd/fact-sheets/73-flsa-break-time-nursing-mothers
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