1. Easy Steps to Supporting Breastfeeding Employees

2. Sneak Preview – Section 3  Learning objective: List the four components of a successful worksite lactation support program targeting male and female employees.  Topics: Program implementation options  Resources from The Business Case for Breastfeeding:  Folder #2: “Easy Steps to Supporting Breastfeeding Employees”  Folder #3: “Tool Kit”  Folder #5: “Outreach Marketing Guide”

3. Components of a Lactation Support Program

4. Where to House the Program  Human Resources Department  Employee benefits division  Fits well as part of employee health benefit platform  Other options: work/life, benefits, health/wellness/fitness, employee relations  Model Health Benefit Plan (National Business Group on Health) www.businessgrouphealth.org

5. Getting Started  Convene a task force of stakeholders  Conduct a needs assessment  How many women and men will benefit?  What options do employees have/need?  What department will provide oversight?  What policies are needed?  What documentation will be required?  Identify community resources See “Resource Guide” in Folder #3, “Tool Kit” CD-ROM

6. Building the Team Company Stakeholders  HR, work-life, employee relations staff  Wellness division staff  Medical staff  Facilities management  Public relations  Supervisors  Current and previous breastfeeding employees  Male and female co-workers Community Stakeholders  Local breastfeeding coalition  Lactation consultants  Healthy Start staff  WIC program staff  Health care providers  La Leche League Leaders

7. Lactation Program Components  Focus on OPTIONS  Folder #2, “Easy Steps,” focuses on Good/Better/Best options for all 4 components  Tailor to unique needs of the business  A comprehensive program brings about best ROI; but meet employers where they are and help them build

8. Options for Managerial Support  Top-level support company leaders/workers  Rationale for a lactation program  Expectations of support  Eliminating inappropriate jokes, comments  Training for supervisors See Folder #3, “Tool Kit” CD-ROM and Folder #5, “Outreach Resources” for useful templates

9. Options for Managerial Support  While lactation support policies are important, many companies are not prepared to institutionalize formal policies at first  Options for lactation support policies  Integrating it with other employee health benefits policies  Including it in personnel policies  Addressing inappropriate comments in sexual harassment policies  Integrating into existing gender bias laws See Folder #3, “Tool Kit” CD-ROM

10. Options for Mother-to-Mother Support  Monthly lunchtime support group meetings  Other regularly scheduled meetings  Bulletin boards in lactation rooms  Electronic discussion forum on Web site  Shared journal See Folder #3, “Tool Kit” CD-ROM for sample promotional items

11. Options for Maternity Leave  Women need 6 weeks minimum for recovery; 16 weeks is optimal (Galtry 97)  Adequate leave could increase breastfeeding enough to prevent 0.6 to 1.0 post neonatal deaths per 1,000 births (Ruhm 2000)  Of 170 countries, only 4 do not offer paid maternity leave (U.S., Liberia, Papua New Guinea, Swaziland) (Heymann 2007) CountryLeave Policy Sweden 15 months paid leave + 3 months unpaid leave Canada6 months @ 55% U.K. 18 weeks @ 90% the first 6 weeks and then flat rate Germany 14 weeks @ 100% + 2 years paid at a flat rate Italy 5 months @ 80% + 6 months @ 30% France 16 weeks @100% + additional unpaid leave

12. Options for Maternity Leave: Federal Level  Family Medical Leave Act (FMLA)  Eligibility criteria  Workplace with more than 50 employees  Employment > 24 hours/week  Continuous employment at that company for at least 1 year (Galtry 97)  Senate Bill #S1681 – “Family Leave Insurance Act” (Dodd D-CT)  House Bill HR626 – paid leave for federal employees (Maloney-NY)  HR 2236 – “Breastfeeding Promotion Act” (Maloney D-NY)

13. Options for Maternity Leave: State Level  Temporary Disability Insurance Program (TDIP)  Partial wage replacement (around 50%)  Eligible States: California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico  “California Paid Family Leave Program” provides 6 more weeks of partial wage replacement beyond TDIP  Washington provides 5 weeks of paid leave  New Jersey paid leave program

14. Options for Maternity Leave: Company Level  Paid family leave:  33% of U.S. companies offer paid family leave options, and 21% offer leave beyond Federal FMLA and state options  Large companies more likely to offer paid leave or leave beyond FMLA (37% vs. 14%) (SHRM 2007)  Bring baby to work:  43% of small companies allow women to bring infants to work in emergencies (SHRM 2007)  Examples: Patagonia, Arizona Department of Health  On-site child care

15. Options for Flexible Break Time  Why breastfeeding women need flexible time  Milk production is an ongoing process  Frequent breast drainage keeps mothers comfortable and stabilizes milk production  2-3 milk expression sessions needed during a typical 8-hour work period (Slusser 2004)

16. Options for Flexible Break Time  Employers like to know milk expression is temporary  As babies begin solid foods the number of sessions often declines  Most women have discontinued expression by 12-15 months  Lunch and routine breaks are usually adequate. Options if more time is needed:  Consider extra time paid leave  Take unpaid leave  Come in early or stay later  Continue working while expressing milk

17. Program Options  Contract with an International Board Certified Lactation Consultant (IBCLC) for one-on-one consults  Provide onsite classes and support group meetings for parents (both male and female)  Provide educational materials to mothers  Make referrals to physicians, IBCLCs, WIC, La Leche League, and other health care professionals See “Resource Guide” in Folder #3 for options for qualified lactation educators

18. Options for Classes  Prenatal classes  Getting a good start with breastfeeding  Preventing and managing concerns  Building and sustaining milk production  Expressing, storing, and handling human milk See Folder #5, “Outreach Resources” CD-ROM for sample lesson plans  Back to work classes and consultations  Options for combining breastfeeding and work  Preparing baby for separation  Setting a milk expression schedule  Educating supervisors and co- workers  Options for class instructors  IBCLCs  Medical staff at the business  WIC staff  La Leche League Leaders  Other lactation experts in the community

19. Options for Professional Support  Contract with an IBCLC or lactation expert for:  Prenatal assessments  Postpartum assistance during maternity leave  Back to work consultations  Provide names of IBCLCs and lactation experts in the community  How to access an IBCLC  Local hospital or private practice  ILCA – www.ilca.orgwww.ilca.org  “Find a Lactation Consultant” Directory  Directory of IBCLCs Providing Workplace Lactation Support

20. Options for a Designated Lactation Room  Traditional offices  Private office  Office of a co-worker  Conference room  Establish designated space  Size can be as small as 4’ x 5’  Easily accessible  Convert closet or small storage space  Build walls in larger rooms or lounges  Partitions, screens, curtains  Dressing room  Include in future building renovations

21. Number of Rooms Needed  Factors in determining number of rooms:  Types of work spaces  Physical size of the company (and number of buildings)  Numbers of women of childbearing age

22. Options for Non-Office Settings  Jobs requiring travel  Environments with little privacy  Expressing milk in non-office settings

23. Options for Milk Expression  Hand expression  Breast pump  Purchase or rent a hospital-grade quality multi-user electric breast pump; provide, subsidize, or sell attachment kits  Provide or subsidize the cost of a single-user portable electric breast pump  Ask mothers to make their own arrangements for equipment

24. Options for Storing Milk  Standard employee refrigerator  OSHA regulations state breast milk is not “occupational exposure”  Provide a small refrigerator in or near the lactation room  Provide a portable electric breast pump packaged with cooler compartment  Ask employees to provide their own coolers

25. Promoting the Program  Promotion increases awareness, usage and better ROI  Promotion ideas :  Ribbon-cutting event  Coordinate with World Breastfeeding Week (Aug.1-7)  Annual promotion during World Breastfeeding Week  Employee paycheck stuffers  Include information in new employee orientation  Posters and fliers  Employee newsletters  Table tents in lounge and cafeteria areas  Employee health fairs and wellness events See Folder #3, “Tool Kit” CD-ROM for reproducible promotional items

26. Collecting Feedback and Evaluation the Program’s ROI  Encourage employers to:  Keep usage logs  Track # of class attendees, Web site usage, and IBCLC consults  Collect data on:  absenteeism and turnover rates  employee satisfaction with the company  disability costs  health care costs  breastfeeding duration See Folder #3, “Tool Kit” CD-ROM for feedback and assessment forms