1. Project Overview

2. Implementing The Business Case for Breastfeeding in Your Community Sponsored by: U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration Maternal and Child Health Bureau With additional support from: HHS Office on Women’s Health

3. Project Goals  Increase breastfeeding exclusivity and duration rates among employed breastfeeding women  Increase worksite lactation support for breastfeeding women  Equip lactation consultants, breastfeeding advocates, and Healthy Start programs for conducting effective outreach with employers  Increase collaboration between State Breastfeeding Coalitions and community Healthy Start programs [www.healthystartassoc.org]

4. Train the Trainer Program  Training manual with  PowerPoint presentation  Speaker Notes and Handouts  CD-ROM  Training focus:  Communicating effectively with businesses  Ways to improve support  Strategy planning

5. Sneak Preview: Section 1  Topics  Health implications of breastfeeding  Rationale for supporting employed mothers  Project overview  Resource  The Business Case for Breastfeeding

6. Getting to Know You

7. Profits and People  Nearly 60% of women are in the work force; of these, 62% are of childbearing age  Women comprise nearly half of the U.S. labor force  Women with children are the fastest growing segment of the work force  Over 70% of women with children are in the work force

8. Women in the Work Force

9. U.S. Breastfeeding Rates Source: Centers for Disease Control and Prevention

10. Why We Care  Breastfeeding initiation is high, but duration and exclusivity rates rapidly decline  Family-friendly policies assist in providing the support women need to meet their breastfeeding goals Photo credit: Mutual of Omaha

11. Health Implications for Babies  NOT breastfeeding increases risk of:  Obesity  Ear infections  Respiratory infections  Gastrointestinal infections  Skin conditions  Type 1 and Type 2 diabetes  Leukemia  Sudden Infant Death Syndrome (AHRQ 2007)

12. Increased Risks for Babies of Employed Mothers  Infants in child care centers are at 69% increased risk of hospitalization for respiratory infection (Kamper 2006)  Being in a child care setting doubles odds of needing antibiotics by age 1.5-5 years (Dubois 2005)  Exclusive breastfeeding at least 4 months had protective effect for 2.5 years  Among infants of employed mothers who were never sick during the first year, 86% were breastfed (Cohen 1994)

13. Health Implications for Employed Mothers  Mothers who breastfeed are at lower risk of:  Premenopausal breast cancer  Ovarian cancer  Type 2 diabetes (AHRQ 2007)  Breastfeeding mothers:  Recover from pregnancy faster  Enjoy a delayed menses  Healthier employees are more productive

14. Impact of Employment on Breastfeeding  Full-time employment shortens breastfeeding duration (Fein and Roe 1998)  Most women wean before end of first month back at work (Cardenas 2005)  Full-time employment an economic necessity for many (Galtry 1997)

15. Direct Breastfeeding vs. Pumping at Work  Women who breastfeed baby at work breastfeed longer durations than mothers who only express milk at work (Fein 2008).  Women who do not breastfeed or express milk do not breastfeed as long.  Women in supportive worksite environments breastfeed as long as mothers who exclusively breastfeed at the breast ( Whaley 2002; Ortiz 2004)

16. Concerns of Special Population Groups  Concerns of African American mothers  Lower breastfeeding rates  More likely to work full-time and return to work sooner (Caulfield 1998, Galtry 1997)  African American and Hispanic mothers tend to experience a higher rate of poverty and are more likely to be employed in low-wage job settings (Beers 2001)  Welfare Reform Act of 1996 has led to earlier return to work and significant issues maintaining lactation (Haider 2003)

17. Support in the Workplace  Maternity leave  Flexible return to work options  Onsite child care  Private areas to breastfeed or express milk  Managerial support

18. The Business Case for Breastfeeding  Funded by U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau  Research and Strategy Formation  Worksite lactation resource kit  National training and technical assistance initiative for State Breastfeeding Coalitions and communities with Healthy Start programs

19. The Business Case for Breastfeeding  Targets varied groups who impact employed mothers  Packaged in 5 individual file folders  Cover “box” designed for versatile storage  Select individual pieces for the audience groups targeted  Full kits and additional pieces are available from MCHB at: www.ask.hrsa.gov www.ask.hrsa.gov 1-888-275-4772 (ASK HRSA)

20. “The Business Case for Breastfeeding”  Folder #1  Target: Employers  Key content:  Bottom line benefits to supporting breastfeeding employees  Quick overview of components of a lactation support program

21. “Easy Steps to Supporting Breastfeeding Employees”  Folder #2  Target: Human Resource Managers  Key content:  Lactation support program options  Strategies for implementing  Gaining buy-in  Promoting the program

22. “Tool Kit”  Folder #3  Target: Human Resource Managers  Key Content: CD-ROM with reproducible templates  Worksite policy  Assessment and feedback forms  Promotional items  Resource Guide  Employer Snapshots

23. “Employees’ Guide to Working and Breastfeeding”  Folder #4  Target: Pregnant and Breastfeeding Employees  Key content :  Tips for combining breastfeeding and employment  Ways to talk with supervisor and colleagues about breastfeeding needs

24. “Outreach Marketing Guide”  Folder #5  Target: Outreach Workers  Key content:  Strategies for conducting effective outreach with businesses  Strategies for supporting working mothers  “Outreach Marketing Resources” CD-ROM  PowerPoint presentation  Templates for outreach letters  Sample legislative language  Lesson plans

25. Project Expectations  Develop a plan for utilizing The Business Case for Breastfeeding to conduct outreach with businesses in your community  Identify appropriate businesses to target for outreach, and partners who can help  Conduct outreach with targeted employers  Train others in your community who can assist you with this outreach effort

26. Technical Assistance  Ongoing technical assistance via telephone, email and teleconferences for 1 year  Toll-free hotline: 1-866-435-4808  Web site: www.hcdi.com/hrsa/worksitelactationsupport/index.html www.hcdi.com/hrsa/worksitelactationsupport/index.html