A baby’s first year is filled with milestone moments and new experiences, along with a slew of challenges. For the millions of working mothers in the United States, finding support in the workplace to meet the demands of parenting a newborn can be a struggle. Research has shown that for working mothers, the ability to breastfeed their babies is critical to the moms physical, mental and economic health and to their babies’ cognitive and physical development. It might sound simple enough, but according to researchers at the University of Missouri, finding an employer, particularly one in a rural setting, who supports and encourages breastfeeding can be a challenge.
Breastfeeding and the ACA
In light of the benefits of breastfeeding, both for mothers and their babies, the Affordable Care Act requires employers of more than 50 employees to provide enough space and time for mothers to breastfeed during the first year of their babies’ lives. This can be difficult for women in rural settings, however, where MU researchers found a lack of compliance with the law, inadequate breastfeeding information for mothers and lack of support from co-workers and supervisors.
“In our analysis, we found most rural employers are treating women’s lactation needs in the workplace on a case-by-case basis,” says Wilson Majee, assistant professor of health sciences in the MU School of Health Professions. “These women often feel that their breastfeeding needs are a burden for their employers rather than a workplace right.”
For the study, Majee, along with Urmeka Jefferson, assistant professor in the MU Sinclair School of Nursing, partnered with a county health agency serving a rural community with a population of 21,500. A high percentage of the community’s jobs were low-paying manufacturing positions, and the population also possessed poor education; less than 16% of those over the age of 25 had a college degree or higher, as compared to 26% for the state. By conducting focus groups and interviews with 17 breastfeeding mothers and seven managers at key employers in the community, researchers determined the barriers to breastfeeding from the perspective of rural employers and working, low-income breastfeeding mothers.
Findings and the future
For a majority of large employers observed for the study, especially those employing primarily women, MU researchers found employers were aware of the federal regulations but typically offered accommodations only when requested. Not only that, but many mothers also said they were met with direct ridicule from their managers and co-workers when attempting to pump milk at work. Inevitably, this unsupportive and reactive work environment made pumping during working hours increasingly difficult.
“While we found that most employers were tolerant and at least attempted to be flexible in the permitting of pumping milk in the workplace, none were proactive in the sense of encouraging the practice of breastfeeding,” Majee says. “In our case study, we found that employers often saw breastfeeding as a personal decision and therefore were unwilling to bring up the issue to their employees, even at crucial moments, such as when mothers file the required paperwork for family medical leave.”
Going forward, the researchers called for collaboration between businesses and rural health agencies to help create ACA-friendly environments that encourage breastfeeding in the workplace. During baby’s first year, when the potential health benefits of breastfeeding are at their peak, a supportive work environment can make the difference between a mother’s ability to continue breastfeeding and the pressure to stop.
“To help these young mothers, proactive discussions should occur at all levels — family, workplace and community,” Majee says.
“Four years later: rural mothers’ and employers’ perspectives on breastfeeding barriers following the passage of the Affordable Care Act” was recently published in the Journal of Health Care for the Poor and Underserved, a journal from Johns Hopkins University Press. This research was part of a community-based case study with the MU Healthy Communities Initiative.