Project Overview

The U.S. Department of Health and Human Services “Healthy People 2010” goals include objectives to increase the number of women initiating breastfeeding to 75 percent, and increasing duration rates of breastfeeding at both 6 months (50 percent) and 12 months (25 percent) (Healthy People 2010).  The Healthy People 2010’s Midcourse Review released in December 2006 also reflects the addition of two new goals for breastfeeding exclusivity at 3 months (60 percent) and 6 months (25 percent).  Mounting evidence in the field of infant and child health demonstrate that breastfeeding exclusivity and duration contribute to significant health advantages for infants, as well as for mothers.  In fact, the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately the first 6 months, and supports continued breastfeeding for the first year and beyond as mutually desired by the mother and child (AAP 2005).

Despite the wide body of evidence supporting the importance of breastfeeding, the breastfeeding duration goals at 6 months and 12 months have not been met in most U.S. states.  Rates of exclusive breastfeeding are also low nationally, with only 30.5 percent breastfeeding exclusively at 3 months and 14.2 percent breastfeeding exclusively at 6 months (CDC 2007).  Research shows that one of the most significant barriers to continuing breastfeeding is the mother’s return to work or school (Ryan 2002).  Currently nearly 60 percent of new mothers with children under the age of 3 are in the work force  (U.S. Department of Labor 2007), and several studies show that this decision to resume employment impacts both how long mothers breastfeed (Arlotti 1998) and how long they will exclusively breastfeed (McLeod 2002).  Full-time employment decreases breastfeeding duration by an average of 8.6 weeks (Taveras 2003) and the first month back at work appears to be the time when most working women wean (Cardenas 2005).
A growing trend among businesses is offering lactation support programs that include a private area for women to breastfeed or express milk during the work day, flexible breaks for feeding or expressing milk, prenatal/postpartum education and access to professional support from a lactation consultant or other breastfeeding expert, and support from management and other workers. 

Research shows that employers who provide comprehensive lactation programs have enjoyed numerous business advantages, including lower absenteeism and turnover rates (Galtry 1997; Cohen 1995; Lyness 1994), lower health care costs (Mutual of Omaha 2001; Dickson 2000), and improved productivity and loyalty among employees (Cohen 2002).  These programs have also been proven to increase breastfeeding duration rates (Cohen 1995; Cohen 1994).  However, few employers are aware of these benefits (Brown 2001).  According to the 2007 Benefits Survey conducted by the Society for Human Resource Management, 26 percent of all employers offer lactation related benefits (SHRM 2007).

The U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau developed a national workplace lactation resource kit, The Business Case for Breastfeeding to address these issues.  The resource kit is designed (a) to improve support for breastfeeding mothers who return to work; (b) to encourage and equip employers and human resource managers with tools needed to establish and sustain lactation programs; and (c) to equip local breastfeeding educators and advocates with resources for effectively engaging employers in their community.  The materials, which target a broad spectrum of individuals and groups involved in supporting working mothers, are divided into five sections packaged together in a polished, professional format and designed for versatile storage in a file drawer or on a bookshelf.  Reproducible templates are provided on a CD-ROM diskette for personalization by a business or outreach worker.  This resource kit is available by visiting the HRSA information center web site at or by calling them at 1-888-ASK-HRSA.

In addition to the resource kit, The Business Case for Breastfeeding, a separate curriculum, titled “Implementing The Business Case for Breastfeeding in Your Community,” was developed to assist State and local breastfeeding coalitions, Healthy Start programs, lactation consultants, and other health care professionals with implementing the resource kit in their community.  The curriculum includes speaker notes, handouts, PowerPoint presentations, and guidance on implementing The Business Case for Breastfeeding.   This curriculum is available through participation in the “Implementing The Business Case for Breastfeeding in Your Community” training.

References

American Academy of Pediatrics. (2005).  Breastfeeding and the use of human milk.  Pediatrics 115(2), 496-506.  Available online at: http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;115/2/496.  Accessed 1-15-08.

Arlotti J, Cottrell B, Lee S & Curtin J.  (1998). Breastfeeding among low-income women with and without peer support.  Journal of Community Health Nursing. 15(3):163-178.

Brown C, Poag S & Kasprzycki C (2001).  Exploring large employers’ and small employers’ knowledge, attitudes, and practices on breastfeeding support in the workplace.  Journal of Human Lactation.  17(1):39-46.

Cardenas R & Major D.  (2005). Combining employment and breastfeeding: utilizing a work-family conflict framework to understand obstacles and solutions.  Journal of Business and Psychology.  20(1):31-51.

Cohen R, Lange L & Slusser W.  (2002). A description of a male-focused breastfeeding promotion corporate lactation program.  Journal of Human Lactation. 18(1):61-65.  Available online at www.mchservicesinc.com. Accessed 1-03-08.

Cohen R & Mrtek MB.  (1994). Impact of two corporate lactation programs on the incidence and duration of breast-feeding by employed mothers.  American J of Health Promotion.  8(6):436-441.  Available online at www.mchservicesinc.com. Accessed 1-03-08.

Cohen R, Mrtek MB & Mrtek RG. (1995). Comparison of maternal absenteeism and infant illness
rates among breastfeeding and formula-feeding women in two corporations. American J of Health
Promotion.  10(2):148-153.  Available online at www.mchservicesinc.com. Accessed 1-03-08.

Dickson V, Hawkes C, Slusser W, Lange L & Cohen R.  (2000). The positive impact of a corporate lactation program on breastfeeding initiation and duration rates: help for the working mother.  Unpublished manuscript.  Presented at the Annual Seminar for Physicians, co-sponsored by the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and La Leche League International, on July 21, 2000.   

Galtry J. (1997).  Lactation and the labor market: breastfeeding, labor market changes, and public policy in the United States.  Health Care for Women International.  18:467-480.

Lyness K, Thompson C, Francesco A & Judiesch M.  (1999). Work and pregnancy: individual and organizational factors influencing organizational commitment, timing of maternity leave, and return to work.  Sex Roles.  41 (7-8):485-508.

McLeod D, Pullon S & Cookson T. (2002).  Factors influencing continuation of breastfeeding in a cohort of women.  Journal of Human Lactation.  18(4):335-343.

Mutual of Omaha.  (2001). Prenatal and lactation education reduces newborn health care costs.  Omaha, NE: Mutual of Omaha.    

Ryan A, Wenjun Z & Acosta A.  (2002). Breastfeeding continues to increase into the new millennium.  Pediatrics. 110:1103-1109.

Society for Human Resource Managers (SHRM).  (2007). 2007 benefits: a survey report by the Society for Human Resource Managers.  Alexandria, VA: SHRM.

Taveras E, Capra A, Braveman P, Jensvold N, Escobar G & Lieu T.  (2003).  Clinician support and psychosocial risk factors associated with breastfeeding discontinuation.  Pediatrics.  112:108-115.

U.S.  Centers for Disease Control and Prevention (CDC).  (2007). National Immunization Survey.  Available online at: http://www.cdc.gov/vaccines/stats-surv/imz-coverage.htm#nis. Accessed 4-2-08.

U.S. Department of Health and Human Services (HHS). (2000). Healthy People 2010.  Washington, D.C.: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.   Available at: www.healthypeople.gov.  Accessed 1-03-08. 

U.S. Department of Labor, Women’s Bureau.  (2007). Employment status of women and men in 2006.  Available online at: www.bls.gov/cps/wlf-databook2007.htm. Accessed 1-03-08