By Kathryn Doyle
NEW YORK (Reuters Health) - Under the Affordable Care Act, employers must provide time and space for new mothers to express milk for their babies until the child turns one year old.
“This is a terrific opportunity to show businesses that lactation is important and that women should be accorded the right to provide milk for their babies,” said Dr. Richard J. Schanler, director of neonatal services at Cohen Children’s Medical Center of New York in New Hyde Park.
This requirement has been “sort of on the books for a while,” Schanler told Reuters Health, but the ACA provision makes the rule concrete.
“Most women go back to work and one of the problems women face is how are they going to provide milk for their babies, that tends to be a stumbling block,” he said.
The law allows women to pump for a “reasonable amount of time,” as often as necessary, and requires employers to provide a clean, private space other than a bathroom for them to do so.
“It should be a room, a separate quiet place, not a bathroom, and let the mother express her milk and have a place to store it,” Schanler said.
If other employees are compensated for their break times, so too must mothers who use that time to pump or breastfeed be compensated, according to the law.
If the new mother works while pumping, she should be paid for the time and the work done.
Dr. Tonse N. K. Raju of the National Institutes of Health in Bethesda, Maryland, detailed the provisions of the reasonable break time law in an editorial in Pediatrics.
A woman experienced with lactation will only need about 15 minutes to pump each time, and may need to take a break to do so midmorning, at lunch and again mid-afternoon, but these times can vary greatly depending on the women, Schanler said.
Businesses with fewer than 50 employees may be exempt from the break time law if it would be an “undue hardship,” causing difficulty or expense for the employer.
But the spirit of the law is to make this available for all working women, Schanler said, and it’s hard to imagine what difficulty or expense an employer would face.
“Worker retention rates seem to be greater when they allow this to happen rather than not being very supportive of the women,” he said.
Women whose workplaces do not provide a lactation area may complain orally or in writing to the U.S. Department of Labor Wage and Hour Division, and in either case they are protected from discrimination by the Fair Labor Standards Act prohibition on retaliation.
The new law may improve national breastfeeding statistics, but that’s hard to gauge seeing as many health care providers, employers and employees are unaware of the law, Raju wrote.
The American Academy of Pediatrics recommends exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least one year of age.
According to the Centers for Disease Control and Prevention Breastfeeding Report Card for Infants born in 2010, one quarter of babies are never breastfed, and only 38 percent of babies are exclusively breastfed at three months of age.
Without legal support we will not meet optimal public health goals for breastfeeding, said Dr. Arthur I. Eidelman, past president of The Academy of Breastfeeding Medicine and current professor emeritus of pediatrics at Shaare Zedek Medical Center in Jerusalem.
“It must be emphasized that breastfeeding should not be conceived as a life style choice of the mother but rather as a basic and priority health decision that each mother must make and thus it is critical to create a supportive environment for this decision process,” Eidelman told Reuters Health by email.
Studies have shown that employers make back two to three dollars for every dollar they spend on workplace lactation resources due to greater employee productivity, less employee turnover and less time off for mothers who have to take care of their sick child, given that infants have 30 to 50 percent fewer infections when receiving breast milk, he said.
This issue of legally protecting breastfeeding in the workplace is primarily an American issue, he noted, as all industrialized countries other than the U.S. have paid maternity leave for up to one year.
In the U.S., mothers can and do pump at work, and deserve as many accommodations as they need, Schanler said.
“I’ve had women truck drivers continue to lactate and use pumps while they drive, just pulling over to the side of the road,” Schanler said. “It can be done if you plan and think about it ahead of time.”