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[REMOVE THIS SLIDE BEFORE PRESENTING][DSHS logo]Thank you for your partnership with the Texas Department of State Health Services to build a healthier Texas.

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[Presenter Name][Presenters title or one-sentence bio]

Texas Mother-Friendly Worksite DesignationOverview For Managers

THE CASE FOR BREASTFEEDING SUPPORT

Support of Breastfeeding is a PriorityReduced Risk for Infants with Exclusive Breastfeeding1, 2:ObesityEar InfectionsRespiratory InfectionsAsthmaGastrointestinal InfectionsAtopic DermatitisType 1 & Type 2 DiabetesLeukemiaSudden Infant Death SyndromeNecrotizing Enterocolitis

Public Health CaseBreastfeeding is the standard for infant feeding and protects infants and children from many significant infectious and chronic diseases. $13 billion of direct pediatric health-care costs and more than 900 lives would be saved annually if 90% of women were able to breastfeed exclusively for six months as recommended.2Women who breastfeed have a reduced risk of breast and ovarian cancer, type 2 diabetes, postpartum depression, and cardiovascular disease.3-5

Work Remains a Barrier to Breastfeeding6-10Full-time employment decreases breastfeeding duration by an average of more than eight weeks.Mothers are most likely to wean their infants within the first month after returning to work.Only 10% of full-time working women exclusively breastfeed for six months.58% of new mothers returning to work in Texas are unable to reach their breastfeeding goals.

U.S. Women Achieving Personal Breastfeeding GoalsSource: Centers for Disease Control and Prevention, 2007 Infant Feeding Practices Surveyhttp://www.cdc.gov/ifps/results/ch3/table3-35.htm

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Women Need Worksite Lactation Support11Breaks for lactation are similar to other work breaks for attending to physical needs: Time to eat/drink, restroom breaks, accommodation for health needs (e.g., diabetes)When mother and child are separated for more than a few hours, the woman must express milk. Missing even one needed pumping session can have undesirable consequences: Discomfort Leaking Inflammation Infection Decreased Milk ProductionBreastfeeding Cessation

How to Support Breastfeeding EmployeesIn general, women need 30 minutes (15 to 20 minutes for milk expression, plus time to get to and from a private space and to wash hands and equipment) approximately every 2 to 3 hours to express breastmilk or to breastfeed.Needs may vary from woman to woman and over the course of the breastfeeding period.

BENEFITS FOR OUR BUSINESS

Business Case11Lactation programs are cost-effective, showing a $3 return for every $1 invested. By supporting lactation at work, employers can reduce turnover, lower recruitment and training costs, cut rates of absenteeism, boost morale and productivity, and reduce health-care costs. Lactation accommodation is not one-size-fits-all. Flexible programs can be designed to meet the needs of both the employer and employee.

Breastfeeding reduces illness of the baby = fewer absences of parent employees = immediate return on investment.Breastfeeding support in the workplace helps families meet their breastfeeding and childrearing goals = higher job satisfaction, increased loyalty, increased ability to focus on job responsibilities, higher return to work postpartum, and lower turnover = immediate return on investment.Breastfeeding prevents chronic disease in women who breastfeed and contributes to a healthier future workforce through reduction of obesity and chronic disease = long-term payoff that keeps on giving.

Breastfeeding = Increased Productivity11

Fair Labor Standards ActSection 7 of the Fair Labor Standards Act was amended effective March 2010:

Employers are required to provide reasonable break time for an employee to express breast milk for her nursing child for 1year after the childs birth each time such employee has need to express the milk.

Employers are also required to provide a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, that may be used by an employee to express breastmilk.

Legal Basis

Family Medical Leave Act: Job protection can help women take maternity leave to establish breastfeeding.

Texas Health &Safety Code 165: Affirms a womans entitlement to breastfeed in any location in which she is authorized to be.Provides the basis for Texas Department of State Health Services (DSHS) Mother-Friendly Worksite Designation.

Other Relevant Legal Standards

TEXAS MOTHER-FRIENDLY WORKSITE DESIGNATION

Texas Mother-Friendly Worksite DesignationMinimum Requirements for Designation:Have a written breastfeeding support policy that provides for:Flexible scheduling to allow time for the expression of milk.Accessible, private space other than a bathroom (does not need to be a dedicated space).Accessible, clean water source.Accommodation of milk storage (may include moms own cooler, employer provided cooler, shared refrigerator space such as in a break room, or a refrigerator dedicated for the purpose of breastmilk storage).

TexasMotherFriendly.org


Common Concerns of Breastfeeding Mothers11ModestyTime and social constraintsLack of supportMaking enough milk for their babies

Definition of Worksite Lactation SupportA comprehensive Mother-Friendly program assures:Support from supervisors, colleagues, and other mothers.Time to express milk at work and flexible return-to-work options.Access to education and professional lactation support.Private space for women to express milk or to breastfeed when they are at work.



Program Components11

OUR LACTATION SUPPORT INITIATIVES

What do our employees think? Allowing women to take additional unpaid breaks to express/pump milk is fair to me and to my co-workers.

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What do our employees think? Allowing women to take additional unpaid breaks to express/pump milk will interfere with productivity.

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What supports do our employees have?

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What do our nursing employees need?

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What are our managers concerned about?

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What do our managers want?

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Our PolicyInsert Policy and Procedures

Manager ResponsibilitiesOutline expectations for managers: Communicate with all employees. Communicate with employees going on / returning from maternity leave. Complete required paperwork, if any.

ResourcesWhat resources are available for managers?Specific procedures.Training.Whom to contact with questions (HR, committee).

What resources are available for employees?Educational materials, professional support.Whom to contact with questions (HR, committee).

References (1-4)Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. (Tufts-New England Medical Center Evidence-based Practice Center). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment No. 153. Rockville, MD: Agency for Healthcare Research and Quality; 2007 Apr. AHRQ Publication No. 07-E007. Contract Nu. 290-02-0022. 415 pp. Available from: http://www.ahrq.gov/Clinic/tp/brfouttp.htmAmerican Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-41.Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the in the United States: A pediatric cost analysis. Pediatrics. 2010;125(5): e1048-56.Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, Cauley JA. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009;113(5):974-82.

References (5-10)5. Gunderson EP, Jacobs DR, Chiang V, et al. Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: A 20-year prospective study in CARDIAThe Coronary Artery Risk Development in Young Adults Study. Diabetes. 2010;59(2):495-504.6. Fein B, Roe B. The effect of work status on initiation and duration of breast-feeding. Am J Public Health. 1998:88(7): 1042-46.7. Cardenas R, Major D. Combining employment and breastfeeding: Utilizing a work-family conflict framework to understand obstacles and solutions. J Bus Psychol. 2005; 20(1): 31-51.8. Galtry J. Lactation and the labor market: Breastfeeding, labor market changes, and public policy in the United States. Health Care Women Int. 1997;18(5): 467-80.9. Texas Department of State Health Services. WIC Infant Feeding Practices Survey, 2009. 10. United States Breastfeeding Committee. Workplace Accommodations to Support and Protect Breastfeeding. Washington, DC: United States Breastfeeding Committee; 2010. Available from: http://www.usbreastfeeding.org/Portals/0/Publications/Workplace-Background-2010-USBC.pdf

References (11-12)Department of Health and Human Services (U.S.). The Business Case for Breastfeeding. Steps for Creating a Breastfeeding Friendly Worksite: Bottom Line Benefits [Kit]. US Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau. 2008. HRSA Inventory Code: MCH00254. Available from: http://www.womenshealth.gov/breastfeeding/programs/business-case/index.cfm12. US Department of Labor. Break Time for Nursing Mothers. [Online]. 2010. Available from: http://www.dol.gov/whd/nursingmothers/

*PRESENTER: Please update this slide with your personal information. We recommend adding your organizations logo, as well.

***U.S. Department of Health and Human Services. The Surgeon Generals Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011. http://www.surgeongeneral.gov/topics/breastfeeding/index.html

*********Consider adding imagery for this slideModesty Concerns. Although there is growing public support for women to breastfeed wherever they go with their baby, the reality is that many new mothers are sensitive about breastfeeding, and often feel shy about speaking with supervisors about their breastfeeding needs. Some worry about what their colleagues might say. Women are particularly concerned if there is no designated area at work to express milk in privacy. Management and supervisors can help ease that discomfort by providing supportive policies and a place for women to express milk in privacy.Time and social constraints. Employment (especially full-time) is a primary consideration in a womans infant feeding decision. The reverse is also true. A womans decision to breastfeed often affects when and if she will return to work. Many women do not know that lactation can continue after returning to work and decide to either wean their baby earlier than they would prefer, or choose not to return to work at all if they can afford it. Workplaces that provide employee education and a supportive environment can help ease these stresses and help mothers feel good about their decision to combine working and breastfeeding.Lack of support. Lack of support and misconceptions about breastfeeding within families, workplaces, and the community create additional challenges. An environment where breastfeeding is accepted and supported will encourage women to meet their breastfeeding goals. Further, a workplace support program helps fathers and family members assist the new mother. Making enough milk for baby. Many women worry about how being separated from their babies during employment will impact their ability to make enough milk. Although separation can indeed affect the amount of milk a mother makes, research shows that regular milk expression in a comfortable, relaxing environment can help women produce ample milk to nourish their babies.

Consider adding imagery for this slideAdd your companys logo here. *Add your own organizations results.

Discuss how this policy is in place to build a culture of support.How does it include all of the STEP (support, time, education, place) componentsAdd your own organizations results.

Discuss how this policy is in place to build a culture of support.How does it include all of the STEP (support, time, education, place) componentsAdd your own organizations results.

Add your own organizations results.



Discuss how this policy is in place to build a culture of support.How does it include all of the STEP (support, time, education, place) components

It is important that managers understand not only how to talk to breastfeeding employees about the program, but all employees. If coworkers are concerned with fairness or do not understand the point of the program, they may resent the breastfeeding employee. Managers can help create a culture of support by citing the policy and information presented earlier in this presentation. There is also a Common Myths handout that can be used to help all employees better understand how this program benefits everyone.

Communication with the breastfeeding employee is particularly important. If there is a particular form/letter that should be used to establish enrollment in the program or express the need for flexible scheduling, managers should receive a copy. Explain the process that needs to be followed to insure that all employees know about the program and are able to access it. There are letter and schedule templates available. How will managers handle problems when they arise? Where can they get more information?

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