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Presenter Name

• Presenters title or one-sentence bio

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Planning a Texas Mother-Friendly Worksite

• Overview For Committee

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Goal of Initiative

• Develop worksite lactation support policies and a
  program that is
• Responsive to needs of employees and their
  babies.
• Feasible and sustainable for our business.
• Beneficial for the health of Texans.

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Supporting breastfeeding is a public health
priority
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• Breastfeeding Is Obesity Prevention
• Breastfed infants have a reduced risk of obesity
  throughout the life span.
• Risk of obesity is reduced by up to 4 for each
  month of breastfeeding (up to 36)1.
• The longer and more exclusively a mother
  breastfeeds, the greater the risk reduction.
• Breastfeeding promotion is a cornerstone of the
  Centers for Disease Control and Preventions
  obesity-prevention efforts.

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The case for breastfeeding support
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Support of Breastfeeding is a Priority

• Reduced Risk for Infants with Exclusive
  Breastfeeding1, 2
• Obesity
• Ear Infections
• Respiratory Infections
• Asthma
• Gastrointestinal Infections
• Atopic Dermatitis
• Type 1 Type 2 Diabetes
• Leukemia
• Sudden Infant Death Syndrome
• Necrotizing Enterocolitis

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Public Health Case

• Breastfeeding 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.2
• Women who breastfeed have a reduced risk of
  breast and ovarian cancer, type 2 diabetes,
  postpartum depression, and cardiovascular
  disease.3-5

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Work Remains a Barrier to Breastfeeding6-10

• Full-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.

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U.S. Women Achieving Personal Breastfeeding Goals
Source Centers for Disease Control and
Prevention, 2007 Infant Feeding Practices
Survey http//www.cdc.gov/ifps/results/ch3/table3-
35.htm
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Main Reasons For Weaning
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Main Reasons For Never Breastfeeding
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Women Need Worksite Lactation Support11

• Breaks 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 Production
• Breastfeeding Cessation

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How to Support Breastfeeding Employees

• In 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.

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Benefits for our business
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Business Case10

• Lactation 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.

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Breastfeeding Increased Productivity11

• 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.

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Legal Basis
Fair Labor Standards Act Section 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
one year 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.
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Other Relevant Legal Standards

• ?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.

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Texas Mother-Friendly Worksite Designation
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Texas Mother-Friendly Worksite Designation

• Minimum 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.
• Accessible, clean water source.
• Accommodation of milk storage.

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Definition of Worksite Lactation Support

• A comprehensive Mother-Friendly program assures
• Private space for women to breastfeed or express
  breastmilk when they are at work
• Flexible return-to-work options and time to
  express breastmilk at work
• Education and access to professional lactation
  support
• Support from supervisors, colleagues, and other
  mothers

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Program Components10
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Tasks and milestones
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Initial Planning Key Milestones

• Create, educate, and engage committee.
• Conduct an employee Needs Assessment, including
  Worksite Assessment and Survey.
• Target Completion Date XXX
• Develop recommendations for Texas Mother-Friendly
  Worksite designation based on assessment.
• Target Completion Date XXX

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Strategy Planning Key Milestones

• Consider program options and develop plan based
  on needs and feasibility. At minimum
• Allow flexible options for time.
• Construct, renovate, or convert a designated
  space for lactation room OR find flexible space
  alternatives.
• Plan for equipment, milk storage, and handling.
• Gain buy-in from other employees.
• Track and consider feedback mechanism.
• Inform, educate, communicate.
• Target Completion Date XXX

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Program Development Key Milestones

• Present strategy to decision makers to gain
  approvals and buy-in.
• Create committee for program development (nuts
  and bolts) and sustainability planning.
• Develop regional/site-specific protocols.
• Complete physical improvements.
• Target Completion Date XXX

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Program Implementation Key Milestones

• Plan a coordinated approach to announce and
  promote the program.
• Orient department heads and supervisors to the
  program.
• Communicate about the program to employees.
• Provide brief training orientation about the
  program to program participants.
• Initiate protocol and procedures.
• Target Completion Date XXX

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Program Tracking and Evaluation Key Milestones

• Establish a feedback system for breastfeeding
  employees, co-workers, and supervisors to gain
  ongoing input into streamlining the process
  (maintenance).
• Review impact and communicate findings with
  management and key stakeholders.
• Target Completion Date Ongoing

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References (1-3)

• Harder T, Bergmann R, Kallischnigg G, Plagemann
  A. Duration of breastfeeding and risk of
  overweight A meta-analysis. Am J Epidemiol.
  2005 162397-403.
• Bartick M, Reinhold A. The burden of suboptimal
  breastfeeding in the United States A pediatric
  cost analysis. Pediatrics. Vol. 125, No. 5, May
  2010, e1048-e1056. Available fromhttp//pediatric
  s.aappublications.org/cgi/content/abstract/125/5/e
  1048
• 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.htm

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References (4-7)

• 4. 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.
  2009113(5)974-982.
• 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. Published online before print
  December, 2009. Available from
  http//diabetes.diabetesjournals.org/content/early
  /2009/11/12/db09-1197
• Fein B, Roe B. The effect of work status on
  initiation and duration of breastfeeding. Am J
  Public Health.199888(7) 1042-1046.
• Cardenas R, Major D. Combining employment and
  breastfeeding Utilizing a work-family conflict
  framework to understand obstacles and solutions.
  J Bus Psychol. 200520(1) 31-51.

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References (8-11)

• 8. Galtry J. Lactation and the labor market
  Breastfeeding, labor market changes, and public
  policy in the United States. Health Care Women
  Int. 199718467-480.
• 9. Texas Department of State Health Services,
  WIC Infant Feeding Practices Survey, 2009.
• Department of Health and Human Services (US). 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.cf
  m
• 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/Publicati
  ons/Workplace-Background-2010-USBC.pdf