The Breastfeeding Task Force of Greater LA NEVHC-WIC

The Breastfeeding Task Force of Greater LA NEVHC-WIC

Goals Develop written materials for all CA WIC participants Educate employers in the San Fernando and Santa Clarita Valleys about the CA Accommodation Law Provide information to WIC staff 2

Mothers are returning to work in greater numbers than ever before

2005 data from U.S. Department of Labor 1 shows: 60 percent of women work outside the home Mothers are the fastest growing segment of the U.S. workforce 55 percent with children under age 3 are employed 62 percent with children under age 6 are employed 78 percent are employed full-time Growth rate has increased by 80 percent over the last 20 years

American Academy of Pediatrics recommends breastfeeding for at least one year Health impact on infants is the greatest with increased duration

Source: AHRQ, 2007 6

Health impact is even greater on infants enrolled in daycare centers Daycare attendance is associated with double the odds of needing antibiotic therapy Infants breastfed at least 4 months significantly decreased those odds Protective effect of breastfeeding on children in daycare persists well into child s second year of life Dubois, Social Science and Medicine, 2004

0% Risk Difference -5% -10% -15% -20% -25% -21% -12% -30% -28% Ip, AHRQ, 2007 8

More mothers are exclusively breastfeeding More mothers are returning to work WIC recognizes the trends and has purchased pumps

NEVHC 2600 exclusive x 10% employed mothers=260 pumps Or if we assume a higher employment rate: 2600 exclusive x 20% employed mothers=520 pumps At the time, we had 90 multiuser pumps for employed mothers. Therefore we decided to identify why more mothers are not using our pumps for work

Reasons for Stopping Breastfeeding Percent Return to work/school 24.6% Baby refused 15.5% Sore nipples 15.5% WIC of Hartford, Connecticut Haughton, JHL, 2010

Case Example One-day absences to care for sick children occur more than twice as often for mothers of formula feeding infants. 4

For every 1,000 babies not breastfed, there is an excess of 2,033 physician visits 212 days in the hospital 609 prescriptions 2

Case Example: CIGNA reported in a 2-year study of 343 employees an annual savings of $240,000 in health care expenses, 62 percent fewer prescriptions, and $60,000 in reduced absenteeism rates 5

Case Examples Mutual of Omaha s lactation support program resulted in a retention rate of 83 percent of female employees compared to the national average of 59 percent 6 A study of multiple companies with lactation support programs found an average retention rate of 94.2 percent. 7

Case Example: Mutual of Omaha had a yearly savings of $115,881 in health care claims among families enrolled in the program. Per person costs were $1,246 MORE for employees who did not participate in the program. 6

Earlier return from maternity leave Higher employee productivity and morale Higher employer loyalty Recognition as a family friendly business

Mothers have the LAW on their side 20

Part of the Affordable Health Care Act of 2010 Requires reasonable break time and space for nursing mothers Applies to non-exempt employees 21

Local Department of Labor staff is actively supporting mothers Distributing Break Time for Nursing Mothers Fact Sheet at all investigations http://www.dol.gov/whd/nursingmothers/ Complaints can be filed by calling 1-866- 487-9243. Mothers are directed to the nearest office for assistance. There are over 200 offices throughout the country with trained professionals to help

Every employer shall provide a reasonable amount of break time to accommodate an employee desiring to express breast milk for the employee s infant child The employer must allow you to use your break time to pump If pumping takes longer than the normal break time, the employer does not need to pay you for the extra time 23

The employer shall make reasonable efforts to provide the employee with the use of a room or other location, other than a toilet stall, in close proximity to the employee's work area, for the employee to express milk in private Employers must TRY to find a clean, private space for you to pump The employer does not have to furnish a breast pump, a sink to wash pump parts, or a refrigerator to store milk 24

An employer is not required to provide break time under this chapter if to do so would seriously disrupt the operations of the employer The employer can say that giving time to pump would make it difficult for their business 25

An employer who violates any provision of this chapter shall be subject to a civil penalty in the amount of one hundred dollars ($100) for each violation Mothers can report employers for not giving them the time or place to pump, and there are fines if found guilty Claims can be made with the California Division of Labor 26

Needs Assessment

Needs Assessment Participant Focus Groups English and Spanish Successful pumping moms and Moms who found Pumping too difficult A total of 4 groups Waiting Room Surveys 342 women were questioned about the services that they thought WIC could offer them and their knowledge of the lactation accommodation law.

The moms wished they had known about: The law How to schedule pumping into their work day How to talk to their child care providers The Spanish group informed us that they knew about the law, but none of the English speaking moms knew about the law. No populations knew about the specifics of the law.

62% of WIC participants knew that WIC provided pump loans 28% of WIC participants said they had heard about the CA accommodation law 6% of the WIC participants surveyed could state that the law provided BOTH time and space for pumping No difference in English vs Spanish speakers Some differences between clinic sites

Our learner needs assessment showed Staff wanted to know about the law They wanted how to help the mom Their greatest concerns were: Moms had a lack of time Moms had a lack of place to pump Staff needed to think outside of the box about where mothers could pump

The Handouts

Defines the Law in Language that is easy for moms to understand Talk to your employer When What to talk about Educating your co-workers Filing a complaint

Which handout tells a mother how to file a claim?

Which handout gives ideas about what do to do at home in the evening and morning to make working and breastfeeding work?

Which handout is designed for the mother sign and then give away?

Which handout is about educating coworkers?

Which is your favorite handout?

We did all agency training 30 minutes We did counselor training 3 hours Evaluations showed Staff liked hearing stories of what real mothers did to be successful

A to Z brainstorming in small groups about where mothers can pump at work that meet this definition: The employer shall make reasonable efforts to provide the employee with the use of a room or other location, other than a toilet stall, in close proximity to the employee's work area, for the employee to express milk in private Case studies with an emphasis on Using open ended questions Meeting the mother where she is at Supporting any breastfeeding while guiding toward fully breastfeeding

Traditionally, we think of a dedicated lactation/pumping room The law does not require it Mothers find a variety of spaces to pump With your neighbor, list 10 non-traditional places where women can pump at work

Automobile Basement Cubicle Desk Exam room Fitting Room Garage Hallway Janitor s Closet

Kitchen Lab room Manager s office Nurse s office On the roof Partition or screen Quiet room Restroom Stairway

Tent Utility room Visitor s lounge Waiting room Xray changing room Your Manager s Office ZZZZ room

Employer Outreach

We ask the mothers who get a pump if we can visit their employer We have 100 identified employers We contact the employer and offer assistance with developing worksite lactation policy and program We help them brainstorm about space

Food for Less Grocery Store Very receptive store manager Posted the law Purchased a screen to partition off part of the employee break room Home Depot Burger King Prime Time Nutrition

What s Happening Now

Let mothers know that we provide pumps for employed mothers Prenatal classes Newborn enrollment Support Groups Provide Working Mother Brochures During individual counseling Outreaching to employers Two part-time people dedicated until Sept. 30

Monitor pump usage Repeat waiting room surveys to assess level of knowledge Award employers who adopt policy or change practices Compiling lessons learned when contacting employers

The Task Force can help assist moms filing claims against their employers if they have been fired, discriminated against, etc. until the end of the grant period.

Are available now at: www.breastfeedingworks.org/downloads.html

For more information, contact Rebeca Pastrana NEVHC WIC RebecaPastrana@nevhc.org Rachel Hays Breastfeeding Task Force of Greater Los Angeles rhays@breastfeedla.org

1 U.S. Department of Labor Women s Bureau. (2005). Employment status of women and men in 2005. Available online at: www.dol.gov/wb/factsheets/qf-eswim05.htm. Accessed January 2007. 2 Ball, T., & Wright, A. (1999). Health care costs of formula-feeding in the first year of life. Pediatrics, 103(4):871-876. 3 Dubois, L & Girard, M. (2004). Breast-feeding, day-care attendance and the frequency of antibiotic treatments from 1.5 to 5 years: a population-based longitudinal study in Canada. Social Science and Medicine, 60(9): 2035-2044. 4 Cohen, R, Mrtek, MB, & Mrtek, RG. (1995). Comparison of maternal absenteeism and infant illness rates among breastfeeding and formula-feeding women in two corporations. American J of Health Promotion, 10(2):148-153. 5 Dickson, V., Hawkes, C., Slusser, W., Lange, L., Cohen, R. Slusser, W. (2000). The positive impact of a corporate lactation program on breastfeeding initiation and duration rates: help for the working mother. Unpublished manuscript. Presented at the Annual Seminar for Physicians on Breastfeeding, Co-Sponsored by the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and La Leche League International. Chicago, IL: July 21, 2000. 6 Mutual of Omaha. (2001). Prenatal and lactation education reduces newborn health care costs. Omaha, NE: Mutual of Omaha. 7 Ortiz, J, McGilligan K, & Kelly P. (2004). Duration of breast milk expression among working mothers enrolled in an employer-sponsored lactation program. Pediatric Nursing, 30(2):111-119.6. 8 Galtry, J. (1997). Lactation and the labor market: breastfeeding, labor market changes, and public policy in the United States. Health Care Women Int., 18:467-480. 9 National Immunization Survey. (2005). Centers for Disease Control. Available online at: www.cdc.gov/breastfeeding/data/nis_data/data_2005.htm