in Support of Oregon Senate Bill 783
to Breastfeeding in the Workplace
Cynthia Good Mojab, MS, IBCLC, RLC
Corcoran, members of the General Government committee, my name is Cynthia
Good Mojab. I am a mother, breastfeeding advocate, author, educator, Research
Associate in the Publications Department of La Leche League International,
La Leche League Leader, and International Board Certified Lactation Consultant.
I am pleased to join you today to talk about why your support of Oregon
Senate Bill 783 is so important.
feeding is a major health, environmental, economic, and political issue.
The information included in this testimony is just a small excerpt from
our current wealth of research demonstrating the importance of breastfeeding
and the importance of legislation protecting breastfeeding mothers in the
A Health, Economic, and Environmental Issue
feeding poses many risks to the health of mothers and their children in
both developed and developing countries (Lawrence 1997). For example, formula-fed
children have a higher risk of SIDS, juvenile diabetes, ear infections,
allergies, obesity, heart disease and childhood leukemia. Mothers who formula
feed have higher rates of breast and ovarian cancer, anemia and osteoporosis.
The health risks of formula have economic as well as human consequences.
Looking only at three illnesses (lower respiratory tract illnesses, otitis
media, and gastrointestinal illness), the excess cost of health care services
due to more office visits, prescriptions, and hospitalizations in formula-fed
infants in the first year of life is between $331 and $475 per infant (Ball
& Wright 1999).
recognition of the risks of formula feeding, the objectives of Healthy
People 2010 include increasing breastfeeding initiation rates from
64% to 75%, the percentage of women who continue to breastfeed at six months
from 29% to 50%, and the percentage of women who continue to breastfeed
at 1 year from 16% to 25% (US Department of Health and Human Services 2000).
The American Academy of Pediatrics (1997) recommends that breastfeeding
continue for at least one year. Breastfeeding a child for at
least two years is recommended by the United Nations Children's Fund;
World Health Organization; United Nations Educational, Scientific and Cultural
Organization; United Nations Population Fund; United Nations Development
Programme; Joint United Nations Programme on HIV/AIDS, World Food Programme,
and the World Bank (UNICEF 2002).
addition to increasing health risks and healthcare costs, formula feeding
causes waste and uses valuable resources. The production, shipping and
preparation of artificial substitutes for human milk requires large amounts
of water, fuel, paper, glass, rubber, and plastic (Michels, Good Mojab
& Bromberg Bar-Yam 2001). Feeding infants with formula produces significant
amounts of solid waste. Over half a million women in the US formula feed
their infants from birth. If these formula-feeding mothers breastfed their
babies for a full year (introducing solids after six months), we would
million pounds of steel from formula cans
million gallons of oil used in production, transportation and refrigeration
million pounds of carbon dioxide (produced by the use of those 6 million
gallons of oil), requiring 35,000 acres of forest to absorb
million pounds of paper
million pounds of HDPE from plastic milk containers
million gallons of milk (and the 465 million pounds of dairy feed needed
to produce it) (Michels, Good Mojab & Bromberg Bar-Yam 2001).
rarely hear about the risks and costs of formula feeding. Instead, they
hear about the "benefits" of breastfeeding, as though they are special
perks above and beyond what mothers could want for themselves and their
children (Good Mojab 2002). These "benefits" are measured against the poorer
health outcomes of formula feeding—outcomes so common in the United States
that they are seen as the "norm" by which we measure health (Good Mojab
2002). Accurate comparisons of breastfeeding and formula feeding require
nothing less than a paradigm shift: there are no "benefits" of breastfeeding.
In reality, breastfeeding is the foundation of biologically normal—not
superior—human health and development.
woman's decision not to breastfeed must always be respected. Yet women
can know all the risks of formula feeding, have the desire to breastfeed,
and not breastfeed. When this happens—and it often happens—it's time to
stop and ask: "What is it about our society that is preventing so
many women from breastfeeding?"
about infant feeding and breastfeeding behavior are embedded in a historical,
cultural, economic and political context (Dettwyler 1995). Barriers to
breastfeeding include misinformation, lack of breastfeeding role models,
lack of family support, insufficient maternity leave, and inadequate training
of healthcare providers on the importance and management of breastfeeding.
Barriers include the unethical marketing of human milk substitutes by formula
companies who profit from our declining health. And barriers include workplace
policies that force women to choose between making a living and breastfeeding
and Harassment in the Workplace
Carolyn Maloney (2001) documents how breastfeeding is being discouraged
in many ways in the workplaces of our country. Women are facing discrimination
and harassment for breastfeeding their children. They have been fired,
told "we don't want that kind of thing on our premises," and asked by male
coworkers for milk to put in their coffee. They have pumped milk in their
cars and in bathrooms because their employers fail to provide clean, private,
and appropriate space in which to express their milk. The story is no different
in Oregon: breastfeeding mothers are at the mercy of workplace policies
that vary from employer to employer across the state. But the economic,
environmental, and health consequences of formula feeding are far too great
to fail to enact legislation supporting breastfeeding in the work place.
spoke about breastfeeding at the first annual Washington County WIC Breastfeeding
Open House in Hillsboro, Oregon in August of 2002. After my presentation,
a young Latina woman in her fourth month of pregnancy approached me asking
for information about combining work and breastfeeding. She had heard that
it was very difficult to breastfeed in most work situations—yet she wanted
to breastfeed her baby and she needed to work. She wanted to know: How
could she maintain her milk supply if her employer wouldn't provide time
for her to express her milk? How could she collect and store her milk if
her employer wouldn't provide facilities for her to do so? I gave her information,
referred her to resources and support, and gave her suggestions on how
to negotiate with her employer. Yet I could not tell her that Oregon law
would protect her needs as a breastfeeding mother in the workplace, because,
as of that moment, it did not.
Support in the Workplace: A Win-Win Situation
women really have to choose between working outside the home and breastfeeding?
Is it really so difficult for employers to provide support for breastfeeding
mothers? The answer is clearly: No! Providing accommodations for breastfeeding
mothers in the workplace is a win-win situation. Studies have shown that
mothers who continue to breastfeed after returning to work miss less time
from work because of illness in their infant, and have shorter absences
when they do miss work, compared with women who do not breastfeed (which
really means that formula-feeding mothers miss more work than breastfeeding
mothers) (Cohen, Mrtek, and Mrtek 1995). Aetna, Inc. saved $1,435 in medical
claims and three days of sick leave per breastfed baby (which really means
that every formula-fed baby cost Aetna $1,435 in medical claims and three
days of sick leave); Bankers Trust, Cigna, Kellogg's, Chase Manhattan Bank,
Eastman Kodak, PricewaterhouseCoopers and Electronic Data Systems are among
other companies who have found supporting breastfeeding in the workplace
to be good business (Maloney 2001). Workplaces that value women's roles
in mothering as well as in employment increase their workers' morale, dedication,
loyalty and productivity (Bromberg Bar-Yam 2001). In one study, worksite
lactation programs were shown to increase breastfeeding rates among employed
women to a level similar to rates among women not employed outside the
home—which really means that the lack of support for breastfeeding in the
workplace has been shown to decrease breastfeeding rates (Cohen & Mrtek
do breastfeeding mothers need to successfully continue breastfeeding when
they return to work outside the home? Time and a clean, private location
in which to express their milk or to breastfeed, formal and informal support
at the workplace, gatekeepers at the workplace who make sure that this
support happens, and legislation to make sure that whether they are able
to continue breastfeeding isn't based on the luck of the draw (Bromberg
Bar-Yam 2001). The amount of milk a mother makes is based on supply and
demand. The more she nurses or expresses her milk, the more milk her breasts
will make. Milk supply will gradually decrease if a mother is unable to
breastfeed or express milk during her workday, which can mean premature
weaning of the nursling, increased health risks for mother and child, and
increased healthcare costs. Mothers are also at risk for the development
of engorgement (painful swelling of the breasts) if they cannot express
milk or breastfeed during their workday. Engorgement can result in milk
leaking onto the mother's clothing, the development of plugged milk ducts,
the development of mastitis (breast inflammation or infection that causes
fever and flu-like symptoms), the use of antibiotics, and the need for
six out of every ten mothers in America with a child under one year of
age are employed in the workforce (Bachu & O'Connell 2001). The separation
of mothers and children during the workday is routine (Maloney 2001). Women
working outside their homes want to do right by their children as well
as to do right by their employers. Yet many employers do not recognize
the importance of breastfeeding or the expense to their own businesses
from failing to support breastfeeding in the workplace. Oregon Senate Bill
783 (Relating to Breastfeeding in the Workplace) requires employers to
provide unpaid rest periods if doing so does not cause undue hardship on
the operation of the employer's business. It requires employers to make
reasonable efforts to provide a private area in which employees can breastfeed
or express milk and to allow employees to temporarily change job duties.
It prohibits discrimination in the workplace against mothers who breastfeed.
It permits employers to receive certification as a "Breastfeeding Mother-Friendly
Employer." Enactment of this legislation would increase the incidence and
duration of breastfeeding in Oregon, help employers avoid the business
expense resulting from mothers being forced by workplace policies to formula
feed, and help change public opinion about breastfeeding.
barriers to breastfeeding are removed, women are enabled to make a significant
contribution to human health and development, economic stability, and environmental
protection. Breastfeeding mothers are worthy of the greatest protection
and support that any of us can provide, including in the workplace. Please
help pass Senate Bill 783. Thank you very much for the opportunity to testify
before you today.
testimony is dedicated to the memory of Elizabeth Baldwin, Esq., Director
of La Leche League International’s Legal Associates Program, who passed
away March 12, 2003. Liz was a steadfast supporter of the legal rights
of breastfeeding mothers in the US and elsewhere.
Good Mojab, MS clinical psychology, is a private researcher, author, educator,
and International Board Certified Lactation Consultant. She writes about
issues related to psychology, culture and the family—particularly as they
relate to breastfeeding. Ms. Good Mojab is Research Associate in the Publications
Department of La Leche League International, was a member of the LLLI Editorial
Review Team for The Breastfeeding Answer Book (3rd edition), and
has been a La Leche League Leader since 1998. She is a member of the Expert
Panel on Mothering magazine's website, answering questions about
breastfeeding, and is an Affiliate of the Alliance for Transforming the
Lives of Children. Her website, Ammawell (http://home.attbi.com/~ammawell/),
provides breastfeeding information and support. She lives in Oregon with
her husband and their young daughter.
Academy of Pediatrics. Breastfeeding and the Use of Human Milk (RE9729).
December 1997; 100:6:1035-1039. Online: http://www.aap.org/policy/re9729.html
A. and O'Connell, M. Fertility of American Women: June 2000. Current
Population Reports (20-543RV). Washington, DC: US Census Bureau 2001.
T. M and Wright, A. Health care costs of formula-feeding in the first year
of life. Pediatrics 1999; 103 (4 Pt 2):870-6.
Bar-Yam, N. What every breastfeeding employee should know. Breastfeeding
Annual International 2001. Platypus Media: Washington, DC 2001, pp.
R. and Mrtek, M. The impact of two corporate lactation programs on the
incidence and duration of breast-feeding by employed mothers. American
Journal of Health Promotion July/August 1994, 8:6:436-41.
R., Mrtek, M., and Mrtek, R. Comparison of maternal absenteeism and infant
illness rates among breastfeeding and formula-feeding women in two corporations.
Journal of Health Promotion Nov/Dec 1995, 10:2:148-53.
K. Beauty and the breast. In P. Stuart-Macadam and K. Dettwyler (Eds.)
Biocultural Perspectives. New York: Aldine de Gruyter 1995; p. 168.
Mojab, C. The real breastfeeding issue goes far beyond mere guilt. The
Oregonian. Thursday, July 25, 2002. Online: http://home.attbi.com/~ammawell/realbreastfeedingissue.html
R. A Review of the Medical Benefits and Contraindications to Breastfeeding
in the United States (Maternal and Child Health Technical Information
Bulletin). Arlington, VA: National Center for Education in Maternal and
Child Health 1997. Online: http://www.mchlibrary.info/pubs/PDFs/BreastfeedingTIB.pdf
C. Foreword. Breastfeeding Annual International 2001. Platypus Media:
Washington, DC 2001, pp. xv-xix.
D., Good Mojab, C. and Bromberg Bar-Yam, N. Breastfeeding at a Glance:
Facts, Figures and Trivia About Lactation. Washington, DC: Platypus
for Life 2002. New York: UNICEF 2002. Online: http://www.unicef.org/pubsgen/ffl/factsforlife-en-full.pdf
Department of Health and Human Services. Healthy People 2010: Understanding
and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing
Office, November 2000. Online: http://www.healthypeople.gov/document/
Good Mojab, C. Testimony in Support of Oregon Senate Bill 783: Relating
to Breastfeeding in the Workplace. Oregon Senate General Government Committee
Hearing, Salem, Oregon. March 31, 2003.
Cynthia Good Mojab, 2003. All rights reserved. This testimony may be printed
once for individual use.