Testimony of the Pennsylvania Breastfeeding Coalition H.B. 1100 and H.B. 1176 October 8, 2015 Introduction I'm Lisa Mccloskey, a Registered Nurse with a Bachelor of Science degree in Nursing and I am an International Board Certified lactation Consultant with 27 years of experience in maternity care. It's a privilege to have a career where I provide educational workshops for doctors, nurses and the community, clinical care and counseling for nursing mothers, and advocate for breastfeeding families. am on the Executive Committee of the Pennsylvania Breastfeeding Coalition and I represent this statewide organization today in full support for these two proposed laws. This legislation takes an important step to enable pregnant workers to continue to work and to support all women who choose to breastfeed and return to work giving them the freedom to provide optimal nutrition for their children. Historical Perspective Historically, babies depended on human milk for survival. When mother's milk was unavailable, infants died. With the industrial revolution, women went to work in the factories, stimulating a need for breastmilk substitutes. Manufacturing of infant formula grew and successful marketing strategies resulted in women choosing to breastfeed less and less. Today families could spend up to $3100 a year for infant formula, but the manufacture of breastmilk continues to be free. Health Benefits of Breastfeeding Human milk is scientifically proven as optimal nutrition for infants. Every medical authority and health organization recommends that mothers breastfeed exclusively for 6 months and continue to breastfeed for the first year and beyond. Breast milk provides natural immunization for babies and reduces infant and maternal acute and chronic illnesses for their entire life, therefore reducing medical costs.
For babies breastfeeding reduces the risks for: ear infections asthma eczema childhood obesity gut infections diabetes respiratory illnesses leukemia sudden infant death syndrome Preterm infants are even more vulnerable to these risks than full term infants, because any illness can threaten their lives. If 90% of United States mothers met public health goals for breastfeedrng, we could save $13 billion annually on medical and other expenses incurred. This figure includes the cost of obesity. The Pennsylvania Joint State Government Commission Report of the Advisory Committee on Childhood Obesity (2014) recognized the preventive effects of breastfeeding on obesity. The report stated, "The Advisory Committee recognizes the significance of Section 2407 of the federal Patient Protection and Affordable Care Act, which guarantees workplace opportunities and protections for breastfeeding mothers. The advisory committee recommends that the General Assembly work to ensure compliance with federal lactation accommodation law, Section 4207 of the Affordable Care Act, which states that all breastfeeding employees have reasonable break times and a private pjace (that i1s not a bathroom) to express milk, as well as laws protecting breastfeeding women from being fired or discriminated against in the workplace.'' House Bills 1100 and 1176 achieve this by protecting hourly and salary paid women in the workplace, enabling them to continue working throughout pregnancy and to breastfeed for longer than a year. Women who breastfeed also experience important health protections, reducing their lifetime risks of the following conditions: breast cancer high blood pressure ovarian cancer high cholesterol diabetes stroke One of our founding fathers, Benjamin Franklin coined this phrase in 1776, "An ounce of prevention is worth a pound of cure" when advocating for creation of the first firefighting organization in Philadelphia to prevent tragic loss of infrastructure. Breastmilk many ounces of prevention; it saves lives of mothers and infants and billions of healthcare dollars. Increasing breastfeeding initiation and duration rates
through workplace breastfeeding support is a simple way to improve the health of our nation and reduce healthcare costs. Easy Steps for Supporting Pregnant and Breastfeeding Employees As breastfeeding rates continue to rise, employers need the tools to establish and sustain employee lactation programs to retain these valuable employees. Women with children are the fastest growing segment of the workforce. Currently women work throughout their pregnancy and 73% of new mothers in Pennsylvania breastfeed and nearly 55% of women with children under the age of 3 are employed. The needs of pregnant and breastfeeding employees are minimal and can be tailored for each organization. Pregnancy accommodations can be as simple as providing a stool and lactation support programs can be very basic or as elaborate as desired, requiring few business changes. With administrative support they can be implemented quickly. The Pennsylvania Breastfeeding Coalition began promoting workplace lactation support in 2009. We received grant funding (through the U.S. Department of Health and Human Services, Health Resources and Services Administration's Maternal and Child Health Bureau) to participate in a national initiative called The Business Case for Breastfeeding. I was one of 100 professionals in the state to receive training on this project and I have personal experience in setting up an employee lactation program. After nearly 10 years of saying, "we need to support our breastfeeding employees" I finally had the tools to help make it happen where I worked at Susquehanna Health.. In Williamsport, home of The Little League World Series, we pitch a good idea. I met with the Director of Human Resources and pitched this new employee benefit. Immediately it was a hit. We assembled a team and used the Business Case Toolkit to seek support from the Corporate Operations Board. After learning about the program, the first question asked, was why wouldn't we do this? It made sense to launch the program during World Breastfeeding Week, but that was only 3 weeks away! The game was on! Various departments excitedly worked together to clear and clean unused rooms, install locks on the doors and bring a chair, table, and trash can into each room. It was a grand slam home run! On August 4, 2010, we held an open house and within 30 minutes of the overhead announcement a surgical technician arrived with a pump on her shoulder to use the space. It reminded me of the movie, "The Field of Dreams". "Build it and they will come."
We never realized the number of employees in need of the program and we didn't know that some employees were pumping wherever they coutd find space. In one day, our hospital lactation room was uses 12 times. Even though the employees stationed off campus couldn't use the beautiful employee lactation rooms, they were grateful simply to have a private place to pump. Many areas of a workplace are too cluttered or provide no privacy for mothers to pump breast milk. A bathroom is not a sanitary place to prepare food for anyone, much less pump milk for a baby
Employees appreciate even a simple "no frills" milk expression area. Facilities management provides solutions for adapting or converting space for use as a lactation room. Screens and furniture can creatively provide a private area.
'.. If you build it, t hey will come - a very satisfied employee. Mothers Seek Help Mothers from across the state seek information about workplace and breastfeeding on the Pennsylvania Breastfeeding Coalition website. Data of website usage shows "workplace breastfeed;ng" is the most frequently searched subject with as many as 200 inquiries a month. Women also email or call the Coalition with questions. We provide them with information on maintajning breastfeeding at work and discuss solutions for their individual employment situations. We refer hourly paid workers to information from the Business Case for Breastfeeding and to the U.S. Department of Labor concerning the law for breastfeeding at work. Unfortunately, salaried workers are unprotected, allowing employers to legally deny them accommodat ions. They are unable to pum p at work.
Mother's Experiences at Work In Pennsylvania both large and small employers successfully accommodate pregnant employees and breastfeeding mothers. Pregnant women appreciate minor assignment changes or flexible schedules when diagnosed with pregnancy complications. Women returning to work after childbirth greatly appreciate being able to provide milk for their babies while at work. These mothers report their employers gave them flexible pumping breaks and created private spaces. Some employers went beyond these basic needs. They frosted windows, hung blinds, purchased private refrigerators and created especially comfortable environments. The support of fellow employees "Again I never had a conflict with anyone over a pumping schedule and was able to reach and exceed my goal of breastfeeding for a year. " Ange I a Knepp and management made sustaining breastfeeding simple to do. Appendix Ill cites a number of employers who have received recognition for the accommodations for breastfeeding ~mployees~ 1G11.
The messages from women across the Commonwealth have a common thread. We provided their stories for you in Appendix I. Mothers are surprised and shocked when their requests to pump at "I look forward to the passing of this legislation since I am now expecting once again and will soon be in this predicament come next school year." Elizabeth Miller work are met by negative resistance. As they try to meet the needs of their babies for breastmilk, they frequently cite feeling humiliated, embarrassed and powerless. When an employer denies time and space to express milk, women desperately try to maintain breastfeeding any way possible. These mothers skip meals and pump in unsanitary places. Lack of milk expression leads to prolonged engorgement causing physical pain and risk of infection. Some mothers cannot pump at all resulting in weaning. Mothers describe emotional distress and even clinical depression due to the inability to be good employees and breastfeeding mothers. Salaried workers feel cheated by t he fact that hourly employees are protected to pump at work and they are not The Value of Employee Lactation Support Workplace lactation support is a "win-win-win", benefiting businesses, families and the economy. Employee lactation programs are good for the company, financially yielding at least a 3-1 Return on Investment. For every dollar spent, three to even five dollars are saved. Lactation support may increase retention rates for breastfeeding mothers from the current national rate of 59%, to as high as 94%. Health insurance claims are reduced by up to 1/3 for breastfeeding mothers and babies. Breastfeeding mothers take half as many one-day absences to care for sick children, as compared to formula feeding mothers. Employers who support breastfeeding gain bottom-line benefits through: lower health care costs improved morale lower turnover ra tes improved job satisfaction less absenteeism productivity When breastfeeding continues for the long as recommended by public health goals, Pennsylvania and families benefit through tax dollars savings. This could reduce Medicaid costs in our state. An analysis
for North Carolina, a demographically similar state, estimated a savings of $7.1 million dollars to Medicaid from reductions in only lower respiratory infections, gastroenteritis and necrotizing enterocolitis. The Georgia Health Policy Center determined the reducing costs associated with covering otitis media, lower respiratory infections and necrotizing enterocolitis would save Georgia $19 million in Medicaid expenses. The Women, Infants and Children's (WIC) program provides Federal grants to states for food for lowincome women and children. The Federal program spent approximately $850 million on infant formula in fiscal year 2009. While not coming out of Pennsylvania tax dollars, this is a significant taxpayer funded government expense. One Mothers request - "Please do the right thing and pass the law so that all lactating mothers are covered with the same protection and rights. No individual entity, company, or organization should be able to determine how a mother decides to feed her child" The economic growth of Pennsylvania depends on the productivity and health of the workforce. The Workplace Accommodations for Nursing Mothers Act and Pregnant Workers Fairness Act provide/air and uniform accommodations, allowing women to maintain their careers during pregnancy and enjoy the ability to provide optimal nutrition as mothers. Providing employee accommodations involves only a small investment oftime and resources and it assures future generations reach their full potential. Pennsylvania has a long tradition of enacting laws that protect our children. As legislators, you have the incredible opportunity to protect the health of both mothers and babies. With rising healthcare costs, it makes sense to do everything possible to support a woman's decision to breastfeed. The Pennsylvania Breastfeeding Coalition represents many experts in lactation who can guide employers and the Pennsylvania General Assembly to accommodate breastfeeding and working mothers. We welcome the opportunity to support implementation of this enacted legislation. Thank you for your time today and for consideration or our comments.
.. Appendix I Mothers Experience of Employee Lactation Support: Lisa Marzka, employer: Centre Daily nmes Newspaper. When it was time for me to return after my 12 week maternity leave, I feared having to figure out how to pump while working in the advertising sales department. The team was great and showed me (and another who was pumping shortly after my return) the conference room that was converted into a pumping room. There was a lock on the door as well as new curtains hung for privacy. There was electricity and heat in that room (wasn't turned on previously). They also gave us space for a mini-fridge in our department to store our milk. I never had to ask for time to go and pump. My goal was three to four times a day. I went home over lunch and usually pumped there one time and the others at work. I was able to achieve pumping for 6 months until I decided to ween my child. My coworker continued through a full 12 months (if not more).
.. My name is Angela Knepp, and I've been employed for my company for 2 years. I gave birth in July 2014 and was given the standard 6 weeks off, I ultimately took 11 weeks due to breastfeeding and life as a first time mom being so difficult. Upon my return to work I was granted access to an office of one of the VP's. They had the windows frosted out and purchased a mini fridge. After a brief conversation with my supervisor I had my pumping schedule worked out with as much flexibility as I needed. When plans were made to remodel the office the company Included plans for a private key access pumping room. The room was complete with a comfy chair, a mini fridge for private storage, and a table. Again I never had a conflict with anyone over a pumping schedule and was able to reach and exceed my goal of breastfeeding for a year. I'd had the privacy and time I needed to be successful while working full time! I started at Penn State when my son was 5 months old. Being able to pump was a must in any new job I had. I was worried to mention it to my supervisor who was male. Once I brought it up to him it was not awkward at all and he completely understood. Do whatever you need to do- he said! I was very fortunate that my office was away from everyone else's and the door locked. I would just lock the door and get my work done while pumping. I didn't even have to worry about anyone distracting me. I know for certain that if I didn't have my locker office, they would have accommodated in whatever way I needed. My office also had a mini fridge so I could store anything needed in there for myself. I was always super concerned that I wouldn't produce enough, so I pumped when my son would be nursing--about every 3-4 hours which came out to about 3 times a day. I also work overtime at certain times, I was still able to pump during those busy times (my husband even brought my son in to nurse at times). I nursed my little guy until he was two, and was able to continuing pumping until about 18mos (my choice to stop). I'm very very happy with Penn State and how they accommodate pumping mothers. I work at Restek. Right around the time my son was born, Restek designated a bathroom for nursing mothers. I was fortunate to have as much time as needed for pumping. This was the case for 1 and 1/2 years for my son and 1 year with my daughter, two years later. Since then,
there 1 s been a boom in the number of pumping mothers and they have made improvements in terms of providing key-only access and a good scheduling mechanism. Let me know if you want additional details. Cheers! My name is Natalie Fetterman and I teach high school. I am allowed to pump twice a day thankfully at my work place. I arrive late to one of my duties and they have provided coverage for me during that time. In addition, I also can pump during my prep time. My administration has been wonderful accommodating me this year for pumping while at work. There are many rooms available but t choose to use my own so that I continue working while pumping. Mothers Experience without Employee Lactation Support My name is Elizabeth Miller and I am a teacher in a large urban school district in PA. Last year (2014), I returned to work from a maternity leave in which I was blessed to be able to exclusively breast feed my daughter. Initially, I had a schedule for the school year that would give me the ability to use my lunch and prep to pump, however at the last minute my schedule was changed and it was no longer conducive to allowing me to pump twice throughout the day. I met with my principal to discuss how we could handle this situation giving me the ability to continue to exclusively breast feed my daughter. Although, we came up with a plan it quickly became apparent that more than not the solution was not going to work. Another coworker volunteered to give up part of her prep to sit in my room with my students and student teacher whue I excused myself for approximately 10-15 minutes to pump. The problem was this that sooner was this plan created then we began having many teacher absences resulting in the need for teachers to cover classes due to the lack of subs. With no notice there would be days that I would have my coworker to relieve me and then there would be days that she couldn't do to coverage.
I routinely suffered through clogged milk ducts and reduced milk supply. As a result I had to accept the fact that I would not be able to continue to exclusively breast feed my daughter and instead I would have to begin mixing formula with my breast milk. I can't begin to express how excited I am about the possibility of this legislation being passed. was so disappointed to learn that the federal law pertaining to breast feeding did not apply to my profession. I worked so hard to nourish my daughter with my milk and it took an emotional toll on me when I had to begin mixing her bottles while I was at work. I look forward to the passing of this legislation since I am now expecting once again and will soon be in this predicament come next school year. Appendix II The Business Case for Breastfeeding The U.S. Department of Health and Human Services: Office on Women's Health offers a turn-key program for employers to meet the needs of mothers in the workplace. This information is publicly available to employers and employees on their internet website. http://www.womenshealth. gov/breastfeeding/business - case ~for- breastfeeding. html "Breastfeeding Support: Industry Solutions" are comprehensive resources and models for many types of workplace settings. These are the links to information for various industry types. Accommodation and Food Service Administrative Support Services and Waste Management Agriculture/Fishing/Hunting Arts, Entertainment, Recreation Construction Education
.. Finance and Insurance Health Care Information Management Manufacturing Mining Personal and Laundry Services Professional, Scientific and Technical Services Public Administration Real Estate and Rental and Leasing Services Religious, Grant making, Civic Repair and Maintenance Retail Trade Transportation and Warehousing Utilities Wholesale These businesses were granted awards by our Pennsylvania Breastfeeding Coatition Aetna Mental Health Association, Bentleyville Walmart, Washington Excela Health Westmoreland Hospital, Greensburg Susquehanna Health Maternity Care Coalition - Philadelphia Area Breastfeeding Friendly Workplaces Abington Memorial Hospita5 Albert Einstein Medical Center The Children's Hospital of Philadelphia CIGNA
.. The City of Philadelphia The College of Physicians Congreso De Latinos Unidos Gla><oSmithKline The Health Federation of Philadelphia, Early Head Start Program Representative Babette Josephs laura Solomon, Esq. & Associates Lutheran Settlement House Office of Representative Curtis Thomas Pennsylvania Hospital Philadelphia Works Inc. Philadelphia Youth Network Saint Joseph's University The School District of Philadelphia SEI Investments Trolley Car Diner White Dog Cafe Women In Transition Senator Connie Williams Allegheny County Health Department has recognized Breastfeeding Friendly Workplaces with awards since 1996. Masaro Construction, LP
.. Mascaro Construction has demonstrated a strong commitment to breastfeeding moms by offering a friendly atmosphere and a large, clean, private and carpeted room, close to their work space, with a private entrance and occupied/vacant signage. The room has a rocking chair with a foot stool, end table, good lighting, wall-to+wall counter space with a sink in the middle, a refrigerator and plenty of storage. The Midwife Center for Birth and Women's Health Midwife Center has a homey, warm and welcoming atmosphere with a large waiting room and comfortable chairs for moms to breastfeed their babies. Staff members are supportive of any woman wishing to breastfeed and will offer a private area for breastfeeding upon request. H.J. Heinz Company (Heinz 57 Center) H.J. Heinz Company has demonstrated a strong commitment to new moms by offering employees a very large lactation area with four private cubicles and a table and chair in each cubicle. The lactation room also has a mini-refrigerator, microwave for mom's food, mirror, hand sanitizer and a large lounging chair. Kids Plus Pediatrics Kids Plus Pediatrics provides three lactation rooms for patients as well as staff and gives employees who breastfeed time to pump whenever necessary, offering comfortable recliner chairs, tables, good lighting and a dressing table very close to the work area. The University of Pittsburgh's Graduate School of Public Health in Oakland The University of Pittsburgh's Graduate School of Public Health provides a private, clean, comfortable office with a desk and chair and two other soft chairs and table, a farge window with beautiful plants and blinds for added privacy, refrigerator for milk storage, tea pot with variety of teas available, blackboard and journal for writing notes and comments. MEDRAD, INC MEORAD, INC. was recognized in the workplace category for outstanding efforts to support and promote breastfeeding. It provides two specially-built and well-appointed private rooms to pump breastmilk. The rooms are equipped with a work table/computer desk, wall-to-wall sink, full-length mirror and a refrigerator for storing pumped milk. Nursing moms are able to schedule the room for pumping sessions and allowed the time needed to pump.
.. Heinz History Center The Heinz History Center offers a warm inviting atmosphere, helpful and supportive staff, three comfortable wooden rocking chairs on the main level, a cozy cafe with chairs and tables as well as two private rooms with tables, desk and chairs that a mom can use to nurse her baby. Shuman Juvenile Detention Center Shuman Center has demonstrated a strong commitment to breastfeeding staff as well as detained moms by offering a clean, private room with a comfortable chair, sink, counter top and storage space for breast pumps. Caring staff is very supportive of the young women who pump breast milk for their babies. Bayer Corporation Bayer Corporation was recognized in the workplace category for outstanding efforts to support and promote breastfeeding. Bayer not only provides nursing moms with private and secure lactation rooms with comfortable seating, but also offers various maternity leave options for new parents. In addition, Bayer was lauded nationally by Working Mother magazine as a Top 10 company for breastfeeding moms in 2006 Ernst & Young, LLP Ernst & Young, an accounting firm, was recognized in the workplace category for having a corporate lactation program that provides an electric breast pump and telephone counseling on breastfeeding for pregnant and postpartum women. The firm offers nursing moms a private room with a sink, counter, storage area, telephone, comfortable recliner chair with an end table, and a refrigerator for storing pumped milk. The firm also supports breastfeeding women who must travel by providing special shipping services for pumped milk to be sent home during travel. Previous workplace winners were Federal Reserve Bank of Cleveland Pittsburgh Branch, Community Technical Assistance Center, MEDRAD, The Children's Home and Lemieux Family Center, office of Dr. Arman Kilic, FedEx Ground, Nova Chemicals, Development Dimensions International, PNC Financial Services Group, Crouse & Company, Magee-Womens Hospital, Sewickley Valley Hospital, Deloitte Consulting Group, Mellon Bank, and Price and Associates.