32 Breastfeeding Moms on What Works at Work Emily Waldron Mel and Enid Zuckerman College of Public Health University of Arizona

Background Affordable Care Act amended section 7 of the Fair Labor Standards Act to require employers to provide “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s 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, which may be used by an employee to express breast milk.”

Arizona Specific Breastfeeding Policy Healthy Arizona Policy Initiative (HAPI) Promote breastfeeding as a component of worksite wellness Strategy 7 of CDC Grant 1305 Provides resources for ADHS to ensure workplaces are complying with the federal lactation accommodation law (Section 4207 of the Affordable Care Act)

Internship Goal Develop a workplace lactation guide designed for county health departments to distribute to local employers to assist with breastfeeding promotion at the workplace.

Objective One Perform a literature review to inform policy development recommendations and interview protocol “The Business Case for Breastfeeding” by the United States Department of Health and Human Services Texas Mother Friendly Worksite Initiative Texas Department State Health Services CDC Grant Communities Putting Prevention to Work-State and Territory Initiative-Special High Impact Initiative Businesses can apply to be designated as mother-friendly

Objective Two Develop interview questions, recruit interview participants, and conduct and analyze interviews with 30 women who are currently lactating or have lactated in the past two years Interview questions developed from HRSA’s The Business Case for Breastfeeding Recruitment Strategy Designed a recruitment flyer and distributed the flyer to 10 daycares and preschools in Tucson, Arizona and to lactation consultants at University of Arizona’s Medical Center Social Media: “Badass Breastfeeding Tucson Moms” Facebook group

Objective Two Continued Interview Methods Conducted 30 interviews by phone, 2 in-person 29 interviews conducted with participants living in Tucson; 3 participants lived in Phoenix Answers recorded during the interview and coded immediately following the interview

Objective Three Create a handout on the benefits of breastfeeding for ADHS to distribute to Arizona businesses Return on Investment Employee Perspective Qualitative Data How to Invest in Breastfeeding at Work (based on interview results)

IndustryNumber of Interviews Education (University)7 Non Profit6 Healthcare4 Government4 Retail2 Education (K-12)2 Grocery1 Transportation (Bus Driver)1 Defense1 Law1 Accounting1 Technology1 Engineer1 Interviewee Workplace

Results Overview 32 interviews conducted between June-August 2014 Average Age: 32.7 Average months spent pumping at work: % of workplaces had a designated lactation space; 53% did not 78% of interviewees used a public-shared refrigerator to store breast milk at work (scale of 1-4) 2.8 rating Support from colleagues (scale of 1-4): 3.34 Support from supervisor (scale of 1-4): 3.32

Key Findings Three Key Findings Employee Lactation Breaks Employee Lactation Rooms Workplace Lactation Education

Employee Lactation Breaks Positive “No questions asked” “Took as long as I needed” “Trust” Negative “ The only option to pump was in a male supervisor’s office. I had to kick my supervisor out of his office every time I pumped” “Meeting with clients” “My lunch break was only 20 minutes long which was not enough time”

Employee Lactation Rooms Positive “Comfortable chairs” “Sink in the lactation rooms” “Refrigerator for breast milk located in lactation room” “Quiet” Negative “Wanted to put us in a bathroom. I had to explain the law to my employer” “The curtains on the lactation room were sheer. Co-workers could see” “Pumped in the car at off-site meetings” “I pumped in the greenroom at school where plants were being grown. Finally demanded a different pumping location when mushrooms began to grow”

Workplace Lactation Education Positive “Online workplace community for new mothers” “Respectfulness from co-workers. Nobody has ever said anything” “Provided with a ‘back to work’ packet after returning from maternity leave with lactation room locations listed and a ‘know your rights’ insert” Negative “Supervisor said he would not have hired me if he knew I was pregnant.” “Colleagues suggested going to the car to pump” “My boss asked me if I had a battery pack for my pump so I could use the bathroom to pump”

Next Steps Definition of “reasonable time” of the Fair Labor Standards Act A venue for employees to anonymously file workplace lactation complaints Enforcement of Affordable Care Act policies at the workplace Positive recognition for workplaces going above and beyond the basic lactation requirements Standardized lactation education for co-workers and employers

Thank You