# Presentation: 515025

## U. S. Department of Health and Human Services Health Resources and Services Administration (HRSA)Maternal and Child Health Bureau (MCHB)

***Breastfeeding in the United States*****:**
**Current Activities of the **
**Health Resources and Services Administration**
** ****CAPT Karen Hench**
**Breastfeeding DataSpeak Webcast**
**May 11, 2005**

## HRSA-Supported Breastfeeding Activities

- U.S. Breastfeeding Committee (USBC)
- Provider Support
- Hospital Support
- Work Site Support

## Academy of Breastfeeding Medicine
AAP Breastfeeding Promotion in Physicians’ Office Practices              (BPPOP – Phase II)

- Academy of Breastfeeding Medicine
- AAP Breastfeeding Promotion in Physicians’ Office Practices              (BPPOP – Phase II)

## Hospital Support

- Baby Friendly hospital project jointly funded by HHS Office on Women’s Health, CDC, and MCHB
- Best Start Social Marketing, Healthy Children’s Project, and Baby-Friendly USA to identify barriers to implementing the TEN Steps to Successful Breastfeeding

## Women at Work*

- In 2002, 63.5 million women in the U.S. were employed
- 75% worked full time (FT)
- 25% worked part time (PT)
- 62% of employed women were between 16 - 44 years of age
** **Employed women with children < 3 yrs
-  2002 = 61%
-  1977 = 34%

- *2004 Women in the Labor Force: A Databook

**Notes:**
Women made up 47% of employees in civilian jobs.
Women in the Labor Force: A Databook 2004 from the U.S. Department of Labor, Bureau of Labor Statistics

In May 2001, a Department of Labor report indicated that of the 43.6 million women employed full time, only 27.4 % had flexible schedules that enabled them to vary or make changes in their beginning and ending hours of work, whether or not they had a formal flexitime program on their jobs.
Of the 61% of employed women with children under 3, a higher proportion were unmarried mothers compared to married mothers

## Employment and Breastfeeding (BF)

- FT employment reduces BF duration by an average of 8 weeks (Fein & Roe, 1998)
- #1 influence on BF initiation & duration = employment (McLeod, 2002)
- African-American women are more likely to:
-  return to work full time
-  return to work sooner
-  have lower BF rates (Cricco-Lizza, 2002; Bronner, 1996)

**Notes:**
Women employed full time stop breastfeeding 8 weeks sooner than women who are not employed

## Employment and Breastfeeding (cont’d)

- Higher BF initiation rates are associated with_ >_ 6 weeks of maternity leave
- Only 20% of mothers are covered by the Family and Medical Leave Act of 1993**      ****(Galtry, 1997)**

**Notes:**
1993 Family and Medical Leave Act includes provisions for maternity leave but only 20% are covered by the legislation. The eligibility criteria target women employed in large workplaces who work more than 24 hours per week and have been employed for at least 1 year of continuous service.

## Legislation and Breastfeeding (BF)

- Over 30 States have legislation allowing breastfeeding in public places
- Several States have expanded legislation regarding the workplace:
- Provision of reasonable time
- Provision of private accommodations for milk expression (CRS Report for Congress, July 23, 2003)

**Notes:**
1993 Family and Medical Leave Act includes provisions for maternity leave but only 20% are covered by the legislation. The eligibility criteria target women employed in large workplaces who work more than 24 hours per week and have been employed for at least 1 year of continuous service.

## The Good News About Work and BF

- Breastfeeding mothers are half as likely to miss a day of work for a sick child compared to mothers of formula feeding infants          (Cohen, Mrtek & Mrtek, 1995)
- Healthcare costs and insurance claims are significantly lower for breastfed infants

## Breastfeeding and Health Care Expenditures

- For every 1,000 babies not breastfed:
- 2,033 excess physician visits
- 212 excess hospitalization days
- 609 excess prescriptions for ear, respiratory, and gastrointestinal infections                   (Ball & Wright, 1999)

## Workplace Success Stories

- Annual savings attributed to BF by CIGNA:
- $240,000 in health care expenses
- 62% fewer prescriptions
- $60,000 saved in reduced absenteeism rates               (Dickson, Hawkes, Slusser, Lange, Cohen, & Slusser, 2000)
- Mutual of Omaha’s lactation support program yields:
- 83% employee retention rate vs 59% national average (Mutual of Omaha, 2001)

**Notes:**
Annual savings attributed to employees who continue breastfeeding after maternity leave at CIGNA:

## HRSA Work Site Support

*The Business Case for Breastfeeding   *
- Resource Kit for:
- employers
- human resource managers
- lactation consultants
- employees

## Project Goals

- Increase awareness among employers of the economic benefits of breastfeeding
- Outline manageable, flexible, models for implementing or enhancing a worksite breastfeeding support program
- Increase number of U. S. employers that utilize a worksite breastfeeding support program

## Project Methods

- Review of the literature
- Interviews with public/private sector employers
- Strategy formation session with BF and employment experts
- Additional concept feedback from public health professionals

**Notes:**
Interviews with public/private sector employers with corporate lactation programs
- Strategy formation session with experts knowledgeable about breastfeeding and employment issues

## Resource Kit Components

*Outreach Marketing Guide* for advocates
*The Business Case for Breastfeeding* for employers
*Building the Lactation Support Program* for workplace staff
- Reproducible templates on a compact disk
- Promotional Posters for the workplace

**Notes:**
Outreach Marketing Guide 
A self-guided ‘how to’ training for health professionals, community educators, 
and breastfeeding advocates who wish to outreach employers in their community. 
The guide includes successful strategies, references, template resources, and a Power Point presentation that can be used in educating business groups and managers.
The Business Case for Breastfeeding
A guide for employers highlighting bottom line outcomes for promoting breastfeeding in the workplace and implementing an employee lactation support program.
Building the Lactation Support Program
A practical, step-by-step approach to setting up an employee lactation support program.
Tool Kit
A handy implementation guide with reproducible resources that can be tailored to the company’s needs.
Posters
A promotional tool to encourage a supportive environment for breastfeeding employees in the workplace.

## Additional Resources

- State Title V MCH Directors
- mchb.hrsa.gov/programs/default.htm
- Maternal and Child Health Information Resource Center
- www.mchb.hrsa.gov/mchirc/
- National Center for Education in MCH
- www.ncemch.org/
- National Healthy Start Association
- www.healthystartassoc.org
- Women in the Labor Force: A Databook, 2004
- www.bls.gov/cps/wlf-databook.pdf

## Contact Information

- Karen Hench, R.N., M.S.
- Captain, U.S. Public Health Service
- Division of Healthy Start and Perinatal Services
- MCHB, HRSA, DHHS
- 5600 Fishers Lane, 18-12
- Rockville, MD 20857
- khench@hrsa.gov  or  301-443-9708