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Ensure Compliance with Reform Law's Lactation Room Requirements

Best practices sought for interactive database

Effective practices for meeting and exceeding the health care reform law's requirements to provide a lactation room for breastfeeding mothers were shared by Cathy Carothers, co-director of the not-for-profit Every Mother Inc. and president of the International Lactation Consultant Association, speaking at the Society for Human Resource Management (SHRM) 2012 Employment Law & Legislative Conference, held March 4-7 in Washington, D.C.

Section 4207 of the Patient Protection and Affordable Care Act (PPACA) requires that employers “provide a reasonable break time for an employee to express breast milk for her nursing child for one year after the child’s birth each time such employee has need to express milk.” Moreover, employers must “provide a place, other than a bathroom, that is shielded from view and free from intrusion from co-workers and the public” for nursing employees. The requirement became effective in March 2010. Employers with less than 50 employees can apply for an exemption if they can prove "undue hardship."

"Most women need two to three milk expression sessions per eight-hour period," Carothers explained. "Around 15 to 20 minutes is needed, plus time to get to the lactation room." However, "nursing needs change over time," she emphasized, and employers should provide extra time if needed.

Explaining why meeting the law's requirements, at a minimum, is in an employer's best interest, Carothers pointed to research studies showing that "lactation programs resulted in a 77 percent reduction in lost work time due to infant illness" and that "one-day absences occur twice as often for employees whose babies are not breastfed." In addition, employees of companies providing lactation support say they feel more productive and loyal to the company.

"Employee breaks are predictable. Absences are not," Carothers noted.

Compliance Steps

To make support for breastfeeding mothers part of the company culture, Carothers recommended convening a task force to explore employee needs. The task force should include:

Current and previous pregnant/breastfeeding employees.

Lactation consultants in the community.

Representative supervisors and co-workers.

Facilities managers.

Public relations, communications and marketing staff.

Welness program staff.

The task force should develop a plan to meet employee needs, examine company policies, identify potential lactation room space, provide training for supervisors and co-workers and "promote the program widely," Carothers advised.

Appropriate Amenities

The lactation room should be large enough for a chair with a flat surface for the pump, she noted. An electrical outlet is preferred. A lock is not required, but privacy must be ensured. Although they are not required by law, she recommended the room contain:

A breast pump (so employees needn’t tote their own back and forth).

A sink.

Anti-microbial wipes.

A small refrigerator.


A bulletin board for baby photos.

For additional resources and information, Carothers suggested the websites of the U.S. Department of Health and Human Services (HHS) Maternal and Child Health Bureau and the U.S. Breastfeeding Committee, with which HHS hascontracted to enhance the coordination and reach of the nursing mothers provision of the PPACA.

Share Your Best Practices

The U.S. Department of Health and Human Services Office on Women’s Health (OWH) is compiling a database of employer practices surrounding workplace support for nursing mothers. Phase 1 involves collecting data from employers who would like to participate and share their effective practices.

An online submission portal,, has been launched at the website of the nonprofit Every Mother Inc. to collect solutions on providing time and space for nursing employees. Every Mother is under contract with OWH to develop these resources. The organization hopes to collect examples from businesses in all industry sectors that have implemented creative solutions.

The information collected will be used in Phase 2 of the project to populate an interactive website scheduled to launch in Fall 2012. This resource will enable businesses to search by industry sector or state in order to identify similar types of businesses that have implemented nursing services, including options for space in challenging environments and solutions for providing breaks unique to those business sectors. An additional interactive feature will allow businesses to receive options tailored to their space and work schedule constraints. The site will enable businesses to continue sharing solutions.

Help from SHRM Chapters Sought

"State and local SHRM chapters can be valuable partners in this major national initiative," said Cathy Carothers, co-director of Every Mother. She asked that SHRM chapters post the link to the online submission site on their websites and in online communications with their members to "tell us about members that have already implemented services for nursing employees" and to promote the final interactive website once it's developed.

For more information about the project, contact Carothers at

Stephen Miller, CEBS, is an online editor/manager for SHRM.


SHRM Video:

Lactation Programs Are Worth the Space

A small investment in space for a lactation room can pay dividends by reducing health care costs, says lactation consultant Cathy Carothers, interviewed in this episode of SHRM's Focus on HR video series (see the final segment).

Related Articles:

SHRM Legal Report: Reasonable Break Time for Nursing Mothers Clarified, SHRM Legal Report, July 2011

Most Workers Unaware of Lactation Support Mandate, SHRM Online Benefits Discipline, April 2011

BreastfeedingBreaks: What is the definition of ‘a private place,’SHRM HR Q&As, July 2010

Quick Links:

SHRM Online Benefits Discipline

SHRM OnlineHealth Care Reform Resource Page

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