Wednesday, March 24, 2010

Obama's health care bill protects breastfeeding moms at work, but we can do more

President Obama's health care bill is symbolic for a number of reasons. But one of the gems is the provision that employers will be held accountable for providing a private place for breastfeeding moms to pump their milk at work. What a victory!

For years, because of the sporadic laws in only 25 states and accommodations offered by a handful of employers, working moms were left on their own to fend for themselves. They had to fight for a private place to pump (NOT the bathroom), or felt forced to give up breastfeeding early because of the barriers that work posed. Now, according to the bill,
Employers would be required to provide an unpaid "reasonable break time for nursing mothers" in the first year after giving birth. Women would be provided a private place, other than a bathroom, to use a breast pump. The provision exempts companies with fewer than 50 workers if the requirement would impose "an undue hardship," a determination left to the employer to make.
While this is a giant step for breastfeeding, the way the language in this section is written might leave the pumping mom in a precarious situation. It's possible she might not be protected under this bill if her employer does not understand the importance of pumping and her keeping up her milk supply.

The words "reasonable break time" are vague, and what defines an "undue hardship" is debatable. This can leave a mom with an employer who is seemingly justified in not providing accommodations for her, and without other options.

The duration of a pumping session depends on each individual mom, so it is troublesome to leave the definition of "reasonable time" up to an employer. Leaving it open to interpretation still places the burden on the mom to figure out how she is going to make it work with her employer, especially for those moms working in a smaller company with less than 50 employees.

Obama's health care bill opens the door for breastfeeding moms, but they must walk through it, and might have to continue to fight for the "reasonable time" they need to pump and express their breastmilk.

Again, with all that said, the health care bill is still a huge leap, and it offers such validation for the importance of breastfeeding, breastpumping, and breastmilk within the context of health and preventive medicine.

In the U.S., breastfeeding initiation rates are at their highest. But duration rates (the rate of breastfeeding beyond first few days or weeks) are still low among developing nations. Work has been cited as one of the key barriers.

What is really needed is structural change in the United States around breastfeeding and breastpumping accommodations. A joint letter was just initiated by the American Public Health Association (APHA) and co-signed by several leading organizations, including the American Academy of Pediatrics (AAP), American College of Obstetrics and Gynecology (ACOG), American Academy of Family Physicians (AAFP), and Women, Infants, Children (WIC) under the USDA, and others.

They are asking Congress for a $15 million "breastfeeding budget" that would promote breastfeeding and protect and support breastfeeding mothers. As it is now, each mom is left on her own to fight her own battle.

The preventive health benefits of breastfeeding impact a baby's health, the mother's health, and the health of our society at large. Babies turn into adults, and breastfed babies have been shown to have reduced risk for illnesses, chronic conditions, and diseases. This leads to fewer health care costs, fewer insurance claims, and less absenteeism by moms and babies because they're sick less often.

To fully underscore these benefits, we need to have a concerted effort to make the structural shifts that truly take the burden off the mother, and give her the backup she needs to make this a reality. And that's whether she is a white-collar office worker, a farm hand, or factory line worker.

Breastfeeding benefits and reduction of risks is not selective based on a mother's income or job description. Why should language, such as in the health care bill, be so selective with who can have the right and who can't?

Having said all this, the health care bill is a step in the right direction in acknowledging breastfeeding accommodations for women, and I hope many more positive steps are taken to recognize and implement this beneficial mandate.


Pam (Minnesota Health Care Programs) said...

I think it's a perfect solution that the government is promoting breastfeeding to working mothers. Because millions can be saved from increasing the number of breastfeeding mothers.

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