Employers Consider Lactation Support amid Formula Shortage 

As employers look for new ways to differentiate their programs to improve attraction and retention, we’ve seen growing interest in providing support to working parents who choose to breastfeed. Given the national shortage in baby formula, it’s important that all those who are able and choose to breastfeed can do so. However, many employees find that their jobs present significant barriers to breastfeeding their babies.

Why it matters

The health benefits of breastfeeding for both infants and mothers are extensive. Yet, only 26% of babies in the US are exclusively breastfed for the recommended six months, and as many as 45% of US women report early/undesired weaning. Rates are even lower in some states and among certain demographics (e.g., only 20% of non-Hispanic black women exclusively breastfeed for six months). The CDC estimates that low rates of breastfeeding add more than $3 billion a year to medical costs for mothers and children in the United States.

How employers can help

Given that 40+ hours per week may be spent in the working environment, support from employers can be critical to long-term breastfeeding success. When not directly breastfeeding, pumping every 2-3 hours is typically needed to maintain milk supply. Each “pump session” can take 15-30+ minutes, adding up to potentially 90 minutes or more in a typical workday.

Here are some actions employers can take to support the long-term breastfeeding goals of working parents.

• Allowing parents to have direct access to their infants during work hours, for example, by permitting remote work or providing onsite daycare
• Giving new parents stipends to cover in-home lactation visits, extra pump parts/accessories, or other supplies to support breastfeeding/infant feeding needs. Importantly, the Affordable Care Act (ACA) requires that nongrandfathered group health plans provide comprehensive lactation support services (including consultation, counseling, education by clinicians and peer support services, and breastfeeding equipment and supplies) during the antenatal, perinatal, and postpartum periods without participant cost-sharing. Breastfeeding equipment and supplies include, but are not limited to, rented or purchased manual and double electric breast pumps (including pump parts and maintenance), as well as breast milk storage supplies.
• Providing reasonable break time for an employee to express breast milk in a dedicated, private lactation space (other than a bathroom). While this is required under the ACA (with a potential “undue hardship” exception for employers with less than 50 employees), employers can ensure the space is comfortable (e.g., with a comfortable chair and table/desk large enough to accommodate lactation supplies and a laptop) and has the necessary equipment (e.g., refrigerator for milk storage, sink/soap for washing pump parts, phone/computer access, availability of a hospital grade pump).
• Training managers on how to support lactating parents as part of broader training on how to support parents in the workplace and returning from leave.
• Reviewing workplace policies to ensure adequate break time (or other scheduling flexibility) is allowed for pumping/breastfeeding. If possible, consider providing paid break time for pumping/breastfeeding.
• Extending length of leave time under parental leave policies (or putting a policy in place) and providing phased return to work options.
• Ensuring leave and lactation polices are inclusive. Not all lactating individuals have had live births (e.g., adoptive parents can also induce lactation) and not all lactating parents identify as “mothers” (e.g., non-binary individuals) or breastfeed (e.g., some exclusively pump).

In addition to these actions, providing lactation and behavioral health resources can be critical to breastfeeding success. Lack of support for breastfeeding from providers, employers, health plans and the larger community, along with the physical and emotional toll of breastfeeding, as well as infant care in general, can create stress and anxiety. While, as noted above, the ACA requires that lactation support be covered by group health plans as preventive care, finding International Board Certified Lactation Consultants (IBCLCs) who are considered “in-network” can be difficult. Further, in-home visits from IBCLC providers are often not covered, creating an additional barrier to the swift intervention that may be needed to resolve issues. Providing educational materials on the benefits of breastfeeding, how to access support (e.g., how to find IBCLC support or Baby-Friendly designated hospitals) can be helpful. Consider outside vendors that can enhance access to support, such as 24/7 virtual access to lactation consultants and infant nutritionists.

Providing empathy and understanding to parents as they navigate the complexities of feeding their infants while working is a great first step. Given the many potential benefits to employees’ health and productivity, providing robust support for this critical life stage is a win-win for new parents and their employers.