WBW 2016: 5 tips for a strong nursing relationship while working away from home

wbw2016-logo-textEditor’s note: Among the 17 Sustainable Development Goals central to World Breastfeeding Week this year is a call for better workplace support of breastfeeding women. Certainly employers have a large part to play in meeting this goal, but women also need step up to advocate for themselves, their babies, and their right to express breastmilk while at work:

It’s that day…the dreaded day that no new mother wants to face — the last day of maternity leave.

For a mother able to take 12 weeks of unpaid leave afforded by the Family & Medical Leave Act, the last 3 months in baby bliss may instead feel like 3 short weeks, but regardless of the maternity leave length, the end of that special period arouses many emotions, especially for a nursing mother.

Naturally, a nursing mother’s mind becomes occupied with fears and questions:

  • How will I be able to provide enough milk while I am away?
  • What if my baby refuses a bottle?
  • Where will I find enough time to pump while I’m trying to work?
  • How will my boss and coworkers feel when I need time to pump?
  • What will happen to our nursing relationship?

This uncertainty creates even more stress and anxiety for the breastfeeding and working-away-from-home mother for she knows the important role breastfeeding plays in a secure attachment in addition to the numerous health benefits.

Mommy Kissing Baby LContinued nursing after the maternity leave period helps maintain a strong attachment between mother and baby. In his book, The Attachment Parenting Book, Dr. William Sears includes a chapter entitled “Working and Staying Attached,” in which he points out that giving your baby your milk is a very important way of staying attached to your baby after returning to work. Expressing milk for baby to drink during the day allows mother to, in a sense, be with baby while she is away at work. When mother and baby are reunited, their attachment through breastfeeding can resume as if she never left.

Nursing beyond maternity leave not only helps strengthen attachment but also provides numerous health benefits for the nursing mother and her nursling.  In 2012, The American Academy of Pediatrics (AAP) published their policy statement, “Breastfeeding and the Use of Human Milk,” in Pediatrics. In this document, the AAP notes the numerous benefits of nursing, including those of nursing beyond 3-4 months. Some of these benefits for baby include a lower risk for developing serious colds, asthma, and other allergies; Sudden Infant Death Syndrome; and childhood and adult obesity. For the nursing mother, benefits include a lower risk of diabetes for mothers not diagnosed with gestational diabetes, a lower chance of arthritis, and breast and ovarian cancers. Essentially, the longer a mother can provide her baby with mother’s milk, the more health benefits received by both mother and baby.

In order to continue a secure attachment and experience the health benefits of breastfeeding, nursing mothers can maintain a strong nursing relationship while working away from home by following a few simple tips:

  1. Know your breastfeeding rights — Under the Patient Protection and Affordable Care Act, many U.S. employers must provide a nursing mother with break time and a place to pump for up to 1 year after the birth of her baby. It is to be noted that companies with less than 50 employees are exempt from this law and instead offer pumping breaks at the discretion of the employer. Information, along with instructions for filing a complaint, can be found through the United States Department of Labor. Many other countries have generous allowances for nursing mothers at work, so be sure to check with your nation’s laws.
  2. Plan a pumping schedule — This schedule will differ from mother to mother. Planning to nurse right before being separated from baby and as soon as mother and baby are reunited can help reduce the amount of pumping sessions needed at work. While at work, a mother should try to pump about every 3-4 hours. For a mom working an 8-hour shift, she might pump once in the morning, once during her lunch, and once in the afternoon. The idea is that for each time baby receives expressed milk from his or her care provider, mother is pumping. In doing this, mother should be able to pump the amount of milk that baby will consume the following day. Talk with a local breastfeeding specialist for a pumping schedule tailored to your work environment and other needs.
  3. Discuss needed accommodations with employer — When a mother meets with her employer, she should be prepared by knowing her legal rights. A working-away-from- home mother should inform her employer of the needed accommodations before returning to work. The employer may need some time to make changes in order to accommodate the nursing mother. When the mother meets with her employer, she should provide her employer with a copy of her nursing schedule. This may also include pumping space accommodations. For example, the room where milk will be expressed needs to have an easy-to-access electrical outlet and should be heated and cooled.
  4. Nurse on demand — Although a working mother must have a pumping schedule while at work, at home, she can nurse her baby on demand. Nursing on demand means that a nursing mother nurses when cued by the baby. This might be every 30 minutes or every 2 hours. Since how much milk produced is based on demand, a nursling can help increase a mother’s supply by nursing frequently. Nursing on demand also allows baby to re-establish the nursing bond that was missed during the day. Nursing on demand can continue during the night. Frequent night nursing may lead to reverse cycling, meaning the baby will nurse more frequently during the night than he or she does during the day. Some mothers who encourage reverse-cycling find that they don’t need to pump as much while at work during the day. For example, a baby may only drink 4-5 ounces of milk while his or her mother is at work, but the remaining amount of milk needed will be attained during the evening and all through the night. Essentially, in 24 hours, the baby will have consumed his or her total amount of milk needed.
  5. Get support — Most nursing mothers need support throughout the breastfeeding journey, and nursing mothers that work away from home are no exception. La Leche League International and other nonprofit organizations provide local and online opportunities for mothers to connect and support each other.

While the end of maternity leave marks a transitional period for mother and baby, a strong nursing relationship can be maintained by carefully preparing for this changed and remaining dedicated to the desire to nourish baby with mother’s milk.

The cost of denying employee accommodations for actual breastfeeding

Editor’s note: Because many parents come to Attachment Parenting by questioning the status quo, many members of Attachment Parenting International (API) become passionate advocates in their communities for this approach to parenting, such as through the API Leader and Support Group program. Some API members become parent educators, lactation consultants, birth doulas, babywearing consultants, infant massage educators, positive discipline educators or join another profession linked closely with Attachment Parenting.

kate frederickOthers, like Kate Frederick of New Hampshire, USA, find their voice in another way — advocating in the policy- and lawmaking process. Today, Kate introduces the piece of legislation that she wrote and that was debated during this year’s session of the New Hampshire Legislature. While this bill was not passed during this spring’s legislative session, its introduction and debate has made great headway in breastfeeding laws, particularly for working mothers. Thanks, Kate, for your advocacy!

If an employee requests workplace accommodations for breastfeeding, what is the financial risk for the employer if they deny the request? Simply put, it can cost more to deny the accommodation than to grant it.

With the employer’s costs incurred for unemployment insurance from the many health insurance companies that offers this service, an investigation by the Human Rights Commission, the Department of Labor and/or Equal Employment Opportunity Commission (EEOC), and the potential for a private cause of action, it’s just not cost effective to deny breastfeeding accommodations. This is something legislators, the employment sector, breastfeeding advocates and attorneys considered as they weighed in on the bipartisan New Hampshire State Senate Bill 219, relative to breastfeeding.

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New Hampshire SB 219, Relative to Breastfeeding

The 2015 bill was submitted to Prime Sponsor, Senator Martha Fuller Clark (Democrat), by myself and Kary Jencks with the New Hampshire Citizens Alliance. SB 219 was intended to address goals set for each state by the U.S. Surgeon General to achieve better breastfeeding support in the employment setting. So far, New Hampshire has not yet met those goals.

By addressing cultural obstacles to lactation, the bill also served to clarify already existing employer obligations, by putting the context of several Federal and State laws all into one place.

It also brought New Hampshire legislation up to the level that Vermont, Maine and most other states already have on the books.

Impressive savings and benefits to employers are already well documented in the U.S. Department of Health And Human Services’ Business Case for Breastfeeding. Savings on employee healthcare costs are cited. The longer a woman breastfeeds, the greater she can reduce her risk of breast and ovarian cancer as well as diabetes. Breastfed children tend to have less illness, so an employee has less absences due to childcare.

Breastmilk has proven superior over any other alternative. It is even being prescribed to chemotherapy patients to improve their immune systems, while extreme athletes are buying breastmilk online as a performance-improving, protein-packed energy drink.

Employers may value the benefits of breastmilk, but they need to think about paying salaries and serving their customers. The costs incurred for denying workplace breastfeeding accommodations is now causing employers to think even more about these issues, as a direct result of the Federal suit filed on my behalf: Kate Frederick vs The State of New Hampshire Department of Health and Human Services, which addresses the need for workplace pregnancy and breastfeeding accommodations.

Notice the irony of who published the Business Case for Breastfeeding and who is named in the suit.

Supporters of the Bill

The New Hampshire Senate passed the breastfeeding bill with amendments. The New Hampshire Business and Industry Association’s senior vice president Dave Juvet testified in support of SB 219 during the bill’s public hearing on March 31 in the House Commerce and Consumer Affairs Committee, along with the bill’s prime sponsor Senator Martha Fuller Clark (D), Senate Majority Leader Jeb Bradley (Republican) and Commerce Committee member Representative Ed Butler (Democrat). Sponsors Senator Molly Kelly (Democrat) and House Representative Karen Umberger (Republican) singed in for support. Additional testimony also in support came from the American Civil Liberties Union-New Hampshire, Civil Rights Attorney Benjamin King, The New Hampshire Citizens Alliance, the New Hampshire Breastfeeding Rights Coalition, the New Hampshire Departments of Labor and Public Health, the NHBTF, the Dartmouth-Hitchcock Medical Center and New Hampshire Voices for Health.

In her testimony, Senator Fuller Clark explained the distinction between using a breast pump and actual breastfeeding. This is significant for employers, because many of them are confused or misled by unclear language to think they are not already obligated to provide accommodations for breastfeeding.

Lactation as a Medical Condition Related to Pregnancy

The EEOC has been cracking down on the prevalence of unlawful sex discrimination experienced by breastfeeding employees, for needing to breastfeed as referenced in their 1979 and 2014 enforcement guidance:

“Lactation is a medical condition related to pregnancy, and it is illegal to discriminate against employees for breastfeeding activity during a workday.”

The EEOC 2014 Enforcement Guidance was referenced recently in the Supreme Court of the United States.

SB 219 would serve to clarify employer requirements and keep New Hampshire in compliance with current Federal laws and court decisions, including the March 25 Supreme Court ruling on Young vs United Parcel Service (UPS), which ruled in favor of Peggy Young to reverse the lower court’s decision and to have a trial, after she sued UPS under the federal Pregnancy Discrimination Act, for failure to provide pregnancy accommodations.

Young’s Supreme Court ruling directly affects SB-219 in that it makes clear the instances when employers are mandated to provide accommodations and when sex discrimination may be inferred if they don’t. If there are both Federal and State laws that exist, it is the law with the greater protection that applies. As the Pregnancy Discrimination Act includes protections to accommodate medical conditions related to pregnancy, such as lactation, employers are considering their vulnerabilities to liability.

Cost of Unemployment Insurance Benefits: $14, 500 (in New Hampshire)

It would be cautionary for an employer to consider the current federal laws, including the Fair Labor Standards Act, the Family and Medical Leave Act, Title VII of the Civil Rights Act: Pregnancy Discrimination Act, the Americans with Disabilities Act and state laws against pregnancy and disability discrimination, in order to avoid the expense of unemployment insurance benefits.

An employee who needs a medical accommodation, such as for lactation, may be eligible for New Hampshire unemployment even if the employer acted in compliance with current law when denying the employee’s request for accommodation and even if the employee quit, was fired or is still employed, but their hours were reduced. Employer costs for an employee receiving unemployment insurance in New Hampshire can be up to $555 per week for 26 weeks. This can increase to almost a year, if the employee is granted an extension of her unemployment insurance
benefits.

In order to qualify for unemployment insurance benefits, a breastfeeding claimant must meet a number of requirements including, but not limited to, proper documentation from her medical provider and demonstrating that she is able and available to work with accommodations.

Employers should also factor in additional costs for their unemployment insurance rates going up, time spent on fact-finding interviews from adjudicators, potential hearings and a backlogged appeals process.

Cost of Replacing the Employee: $50,000

Another consideration for employers when it comes to the bottom line is the potential expenses to replace the employee. Costs for advertising, recruiting, interviewing, training and loss of production can amount to an average of $50,000, according to businessman and Patagonia Inc. founder Yvon Chouinard.

With government subsidies for on-site child care centers, tax deductions that mitigate costs incurred for lactation sites and employee retention, granting breastfeeding accommodations can even become a profit center.

Cost of Agency Investigations That Lead to Lawsuits: Thousands

What if the employee does in fact qualify for the accommodations under a State or Federal law, but the employer was unaware of their obligation or otherwise fails to comply? In this scenario, an employer can expect additional costs related to investigations and complaints under the U.S. Department of Labor, the EEOC and the Human Rights Commission. A lawsuit and a legal defense can take years to resolve, while back pay, damages and attorney’s fees accrue.

Moving Forward

With legislative bills like New Hampshire’s bipartisan SB 219 moving forward, even resistant employers are realizing that the bottom line is not just about good health for the employee and her family, but about the accounting of financial prudence.

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