CUWFA TALKS Helping New Moms: Breastfeeding and Lactation Support in the University Setting

1. CUWFA TALKSHelping New Moms: Breastfeeding and Lactation Support in the University Setting  Thursday, April 28, 2011 Panelists: Lonna Hampton, University of California, Davis Lactation Consultant Susan Abramson, Yale University Manager, WorkLife and Child Care Programs Stephanie Duckett, Oregon State University Coordinator, Childcare & Family Resources

2. A little bit about us… University Spotlights U. Of Cal, Davis Yale University Oregon State University Staff: 1,325 Faculty: 3,481 Undergraduates: 19,599 Grad & Prof.: 4,190 380 buildings, 1 ¼ miles wide 12 dedicated lactation rooms • Staff – 9627 • Faculty – 3695 • Grad & Prof. Students – 6318 • Post doc’s 1500 • 439 buildings –main campus is about 2 miles wide and 8 blocks long • West Campus (former Bayer Pharmaceutical site 7 miles from downtown New Haven) • 12 dedicated lactation rooms • Staff: 15,303 • Faculty: 4,453 • Undergraduates: 24,655 • Grad & Prof: 7,498 • Campus is 8 square miles • 33 dedicated • lactation rooms

3. Agenda • Part I • Benefits of Breastfeeding • To Mother & Baby • To University • Components of a successful program • Finding a Lactation consultant • Breastfeeding Program Resources • Part II • Steps for creating lactation rooms on campus • Find champions • Benchmark data • State & Local Regs. • Space & Funding • Space Management • Lactation Room Resources • Checklist

4. Why is Breastfeeding Important to Working Women? • Health Advantages for Babies: • Optimal nutrition • Enhanced immune system: • Less risk of: • ear infections • diarrhea • pneumonia • SIDS • asthma • allergies • childhood cancers • obesity • diabetes • Health Advantages for Mothers: • Less risk of: • breast cancer • ovarian cancer • metabolic syndrome • type 2 diabetes • postpartum depression

5. Other Benefits of Breastfeeding: Environmental Benefits: • No pollution or waste created in formula: • Manufacturing • Packaging • Transporting • Container disposal Psychological Benefits: • Less risk of postpartum depression • Decreased maternal neuroendocrine response to stressors • Improved maternal mood • Enhanced mother-baby bonding • More job satisfaction upon returning to work when the workplace doesn’t cause mothers to compromise their breastfeeding goals Economic Benefits: • Saves $1500 for one year of formula • Reduced healthcare costs: • Fewer health insurance claims • Fewer clinic visits • Fewer prescription medications for sick infants • Fewer missed work days for parents needing to stay home to care for a sick child • Recent study in Pediatrics journal estimated that if 90% of US families breastfed for 6 months, the US would save $13 billion in reduced healthcare costs.

6. “Research is clear that breastfeeding has a profound impact on the health of both babies and their mothers… Babies who are breastfed are healthier…Their mothers are also healthier...Breastfeeding is the ultimate preventive health care strategy, and programs that enable women to meet their breastfeeding goals are well worth the investment!” Dr. Joan Younger Meek Pediatrician, United States Breastfeeding Committee Chair

7. Benefits to the University: • Recruit and retain top-notch faculty, staff & students • Increase: • productivity • morale • loyalty • Women return to work/school sooner after having a baby • Healthier babies = fewer missed workdays for parents • Healthier babies = lower healthcare costs

8. National Breastfeeding Statistics: • In 2010, the CDC reported that 75% of US mothers initiated breastfeeding. Only 13% exclusively breastfed for 6 months. A primary reason for weaning early: “returning to work/school.” • “Healthy People 2020” objectives are for 82% of mothers to initiate breastfeeding and 61% to continue breastfeeding for 6 months. • Breastfeeding-friendly workplaces are critical in order for the US to meet these nationally established public health goals.

9. Components of a University Breastfeeding Support Program: • Lactation Policy: ensures lactation accommodation for all faculty, staff, and students • Facilities: designated sites for milk expression • Education: courses on balancing work and breastfeeding • Support: support groups and the assistance of a lactation consultant

10. The International Board Certified Lactation Consultant A lactation consultant helps families successfully breastfeed their babies by providing: • Breastfeeding classes and support group meetings: • Getting breastfeeding off to a good start after the birth • Establishing a good milk supply during maternity leave • Preparing for the return to work/school • Creating a pumping schedule to meet mothers’ individual needs • Tips on getting the best results from a breast pump • Safe handling of human milk • How much milk to leave for baby’s needs at each stage of development • Information on appropriate breast pump equipment to purchase or rent • Lactation consultations for breastfeeding mothers: • Prenatal counseling about risk factors that may affect breastfeeding • Strategies for resolving common breastfeeding problems • (poor latch, inadequate milk transfer or supply, nipple or breast pain, difficulty pumping) • Clinical support for breastfeeding in challenging situations • (twins, a premature or sick infant, infants with special needs, mothers with medical conditions)

11. How to Find A Certified Lactation Consultant: 1. Check your local hospital or physician’s office. 2. The International Lactation Consultant Association www.ilca.org website includes a directory of consultants who specialize in workplace lactation support. Breastfeeding success happens with support.

12. Other Breastfeeding Support Resources: • Business Case for Breastfeeding: http://www.womenshealth.gov/breastfeeding/government-programs/business-case-for-breastfeeding/index.cfm • Tools to help employers provide lactation support in the workplace • US Department of Health & Human Services: www.womenshealth.gov/breastfeeding • Breastfeeding Help Line for mothers: 1-800-994-9662 • WIC: http://www.fns.usda.gov/wic/Breastfeeding/breastfeeding • Lactation consults and pumps for eligible mothers • Breast pump information and equipment: • www.ameda.com • www.medela.com • Academy of Breastfeeding Medicine:www.bfmed.org • American Academy of pediatrics:www.aap.org • La Leche League International: www.llli.org Recommended book for mothers: Nursing Mother, Working Mother: The Essential Guide for Breastfeeding and Staying Close to Your Baby After you Return to Work, by Gale Pryor

13. Steps For Creating Lactation Rooms On Campus: • Find champions • Provide benchmark data for peer institutions (and others as needed) • Knowledge of local and state regulations • Identify Space • Determine cost per space (varies for each space) • Determine who will manage the space

14. 1. Find Champions Key players: • Leadership: Higher Administration & Department Chairpersons • Facilities: includes architects & maintenance crews • Human Resources • Supervisors • Health and Wellness partners • School of Nursing/School of Medicine leaders if on campus • Breastfeeding mothers (staff and students) • Future breastfeeding mothers (staff and students) • Women’s groups

15. 2. Benchmark Data Use CUWFA!! • A chart can help visualize where your school is in comparison to others. Shown: a matrix comparison of Oregon State’s peer institutions

16. 3. Knowledge Of Local And State Regulations • Connecticut State Policy: Sec. 31-40w. Breastfeeding in the workplace. (a) Any employee may, at her discretion, express breast milk or breastfeed on site at her workplace during her meal or break period.      (b) An employer shall make reasonable efforts to provide a room or other location, in close proximity to the work area, other than a toilet stall, where the employee can express her milk in private.      (c) An employer shall not discriminate against, discipline or take any adverse employment action against any employee because such employee has elected to exercise her rights under subsection (a) of this section.      (d) As used in this section, "employer" means a person engaged in business who has one or more employees, including the state and any political subdivision of the state; "employee" means any person engaged in service to an employer in the business of the employer; "reasonable efforts" means any effort that would not impose an undue hardship on the operation of the employer's business; and "undue hardship" means any action that requires significant difficulty or expense when considered in relation to factors such as the size of the business, its financial resources and the nature and structure of its operation. http://www.cga.ct.gov/2009/pub/chap557.htm#Sec31-40w.htm

17. Continued: Knowledge Of Local And State Regulations • State of Oregon Law Highlights: • Effective January 1, 2008, employers with 25 or more employees must make reasonable efforts to provide private space and time for nursing mothers who request a place to express milk for their newborns 18 months of age and younger. • The location must be in close proximity to the employee’s work area, and cannot be a toilet stall or restroom. • Businesses would not necessarily have to have a dedicated lactation room.  A vacant office or conference room could suffice, so long as it is private. A cubicle is not considered private. • An employee must provide reasonable written or verbal notice to her employer that she intends to express breast milk at work.  (A sample letter is available in English and Spanish.) • All employers must comply unless they can prove it would cause undue hardship. • There is a $1,000 fine per incident for non-compliance. http://public.health.oregon.gov/HealthyPeopleFamilies/Babies/Breastfeeding/Pages/hb2372.aspx • OSU’s Milk Expression in the Workplace Policy Highlights: • “The University will endeavor to include a lactation room in new building designs and, if feasible, in renovation or remodeling projects.” • “An employee may use a University designated lactation area to breastfeed her child who has been brought to her during her rest breaks by a care provider or another such individual.” http://oregonstate.edu/fa/manuals/gen/milk

18. 4. Space and Funding Yale Oregon State We started small, with two rooms that women were already using to pump. Each room cost around $5,000 to convert. Received $45,000 from central admin. Used the funding as mini-grants to implore department to create their own spaces. • Our biggest barrier is space. • Funding sources include Facilities, individual departments, and the WorkLife program • Examples • Space carved out of a storage closet in a science building. Users are students, post-docs and staff. • New space in an existing building .

19. 5. Space Management • Each space needs a dedicated contact person • Room access, safety and privacy are critical components to any space • Reservations and calendars managed per need of space and owner • Locations on University website including contact person and content of rooms. • Monitoring utilization • Monitoring cleanliness OSU’s lactation room sign

20. Checklist Listed below are several components of breastfeeding support rooms in the workplace. Not all of them apply to every workplace situation. They are offered as a guide to employers and employees who are considering ways to support breastfeeding as a health behavior. This checklist may be most useful when considered in conjunction with the USBC issue paper Workplace Breastfeeding Support. • Space • Dedicated, private pumping/breastfeeding room • Floating, multipurpose room (space available) • Restroom • Other (please specify) __________________ • Furnishings (check all that apply) • Lock • Chair • table • sink • refrigerator • Pumps • Multi-user pump provided on site • Employer provides pump rental • Employer subsidizes pump rental • Employer subsidizes pump purchase • Employee provides own pump • Breast pump personal supplies • Provided by employer • Subsidized by employer • Purchased by employee • Training • train all employees, supervisors and co-workers on the policies • communicate policy to all pregnant employees

21. Other Potential Accommodations • Mother brings child to work • Care giver brings child to mother for feedings • On-site child care with accommodation for breastfeeding • Contract with nearby child care center that accommodates breastfeeding mothers • Breaks for expressing milk or breastfeeding • 2 breaks and a lunch period in an 8½ hour day • paid breaks for pumping (breaks are not deducted from work time) • expanded unpaid breaks • Workplace education and clinical support • hire a skilled lactation care provider • contract with a skilled lactation care provider on an as-needed basis • provide a list of community resources to employees • offer breastfeeding education to partners as well as employees • offer breastfeeding education to employees • include protection for pregnant and breastfeeding women in company sexual harassment policy and training Adapted from the 2003 United States Breastfeeding Committee

22. UC Davis Resources and contact information: • Breastfeeding Support Program at University of California Davis: • http://www.hr.ucdavis.edu/worklife-wellness/Life/breastfeeding-support-program-1 • Includes links to campus lactation policy, California State laws related to breastfeeding, and breastfeeding resources for mothers • Lonna Hampton, Board Certified Lactation Consultant • lmhampton@ucdavis.edu • Contact me if I can be of any help to you!

23. Yale Resources & Contact Information • Breastfeeding/lactation rooms at Yale (PDF) • http://www.yale.edu/hronline/worklife/documents/LactationRoom11-23-09.pdf • Connecticut Breastfeeding Policy • http://www.cga.ct.gov/2009/pub/chap557.htm#Sec31-40w.htm • Susan Abramson, Manager, Yale WorkLife and Child Care • ph: 203-432-8069 • e-mail: susan.abramson@yale.edu • website: www.yale.edu/worklife

24. Oregon State University Resources & Contact Information Photo tour of OSU’s lactation rooms: http://oregonstate.edu/childcare/breastfeeding OSU’s Milk Expression in the Workplace Policy: http://oregonstate.edu/fa/manuals/gen/milk Stephanie Duckett Childcare & Family Resources 541-737-4906 Stephanie.duckett@oregonstate.edu http://oregonstate.edu/childcare

25. Questions and Answers