The Business Case for Breastfeeding

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The Business Case for Breastfeeding

• Cathy Carothers, BLA, IBCLC
• Every Mother, Inc.

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Compliance with The International Code of
Marketing ofBreastmilk Substitutes Grant
Support from HHS Maternal and Child Health Bureau
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Women in the Workforce

• 60 percent of women work outside the home 78
  employed full-time
• Mothers are the fastest growing segment of the
  U.S. workforce
• (U.S. Department of Labor 2007)

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Women in the Work Force
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Impact of Employmenton Breastfeeding

• Full-time employment shortens breastfeeding
  duration (Fein and Roe 1998)
• Most women wean before end of first month back at
  work (Cardenas 2005)
• Full-time employment an economic necessity for
  many (Galtry 1997)

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Health Implications for Infants

• Impacts
• Obesity
• Infections (otitis media, respiratory, GI)
• Skin conditions
• Type 1 and Type 2 diabetes
• Leukemia
• SIDS (AHRQ 2007)

http//www.ahrq.gov/
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Increased Risks for Babies of Employed Mothers

• Infants in child care centers are at 69
  increased risk of hospitalization for respiratory
  infection (Kamper 2006)
• Being in a child care setting doubles odds of
  needing antibiotics by age 1.5-5 years (Dubois
  2005)
• Exclusive breastfeeding at least 4 months had
  protective effect for 2.5 years
• Among infants of employed mothers who were never
  sick during the first year, 86 were breastfed
• (Cohen 1994)

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Health Implications for Employed Mothers

• Mothers who do NOT breastfeed have higher risk
  of
• Premenopausal breast cancer
• Ovarian cancer
• Type 2 diabetes (AHRQ 2007)
• Breastfeeding mothers
• Recovery from pregnancy
• Have delayed menses

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The Business Case for Breastfeeding
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• Business perspective
• Designed for multiple groups
• Based on research and strategy
• Includes
• Resource kit The Business Case for Breastfeeding
  
• Full kit and individual components available from
  MCHB at www.ask.hrsa.gov or 1-888-ASK HRSA
• Training and TA

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The Business Case for Breastfeeding

• Folder 1
• Target Employers
• Key content
• Bottom line benefits to supporting breastfeeding
• Quick overview of what comprises a lactation
  support program
• Available individually

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Easy Steps to SupportingBreastfeeding Employees

• Folder 2
• Target Human Resource Managers
• Key content
• Lactation support program options
• Implementation strategies
• Gaining buy-in
• Promotion
• Available individually

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Tool Kit

• Folder 3
• Target Human Resource Managers
• Key Content CD-ROM with reproducible templates
• Worksite policy
• Assessment and feedback forms
• Promotional items
• Resource Guide
• Employer Snapshots

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Employees Guide to Breastfeeding and Working

• Folder 4
• Target Pregnant and Breastfeeding Employees
• Key content
• Combining breastfeeding and employment
• Ways to talk with supervisor and colleagues about
  breastfeeding needs
• Available individually

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Outreach Marketing Guide

• Folder 5
• Target Lactation educators and outreach workers
• Key content
• Conducting effective outreach w/businesses
• Supporting working mothers
• Outreach Marketing Resources CD-ROM
• PowerPoint presentation
• Templates for outreach letters
• Legislative language
• Lesson plans

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Implementing The Business Case for Breastfeeding
in Your CommunityNational training and
technical assistanceFunded by HHS/HRSA/MCHB
and the HHS Office on Womens Health
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Training WorkshopsYear 1

• 10 State Breastfeeding Coalitions
• California
• Connecticut
• Georgia
• Hawaii
• Indiana
• Louisiana
• Oregon
• Rhode Island
• Texas
• Utah

• 6 Healthy Start Cities
• Baltimore, MD
• Birmingham, AL
• Dublin, GA
• Fresno, CA
• Grand Rapids, MI
• Washington, D.C.

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Training WorkshopsYear 2

• Alaska
• Arizona (Navajo Nation)
• Kansas
• Iowa
• Michigan

• New York
• Pennsylvania
• South Carolina
• Vermont
• West Virginia

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Components of a Lactation Support Program
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Options for Support

• Support from Managers
• Support from Colleagues
• Mother-to-mother
• Monthly lunchtime support group meetings
• Bulletin boards in lactation rooms
• Electronic discussion forum on Web site
• Shared journal

Photo courtesy of Cate Colburn-Smith
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Options for Flexible Return to Work

• Gradual return to work
• Part-time work for a period, gradually increasing
• Flex-time (taking off Wednesdays)
• Telecommuting all or part of the time
• Job sharing for a period of time
• Returning to work at end of the week
• Split shifts (works well for fast-food workers)

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Options for Flexible Milk Expression Time at Work

• Employers like to know milk expression is a
  temporary need
• As babies begin solid foods the number of
  sessions often declines
• Most women have discontinued expression by 12-15
  months
• Lunch and routine breaks are usually adequate.
  If more time is needed
• Consider extra time paid leave
• Take unpaid leave
• Come in early or stay later
• Continue working while expressing milk

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Options for Education

• Prenatal classes
• Getting a good start with breastfeeding
• Preventing and managing concerns
• Building and sustaining milk production
• Expressing, storing, and handling human milk
• Back to work classes and consultations
• Options for combining breastfeeding and work
• Preparing baby for separation
• Setting a milk expression schedule
• Educating supervisors and co-workers

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Options for Professional Support

• Contract with an IBCLC or lactation expert
• Prenatal assessments
• Postpartum assistance during maternity leave
• Back to work consultations
• Provide names of IBCLCs and lactation experts in
  the community

Photo credit International Lactation Consultant
Association
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Options for a Designated Lactation Room

• Traditional offices
• Private office
• Office of a co-worker
• Conference room
• Establish a lactation room
• Size can be as small as 4 x 5
• Convert closet or small storage space
• Build walls in larger rooms or lounges
• Partitions, screens, curtains
• Dressing room

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What Employers Need
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Todays Changing Market

• Economic climate
• Changing labor market
• Issues of presenteeism

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Supporting Breastfeeding More Than Just the
Right Thing to Do

• The right choice may not always be the easy
  choice
• Show me the money must be a prominent theme

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What Motivates Employers

• Profits the bottom line!
• Retaining valuable employees
• reducing absenteeism, presenteeism, turnover
• Recognition and positive public relations
• Knowing strategies have worked before
• Legislation

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State Legislation
21 U.S. States plus the District of Columbia and
Puerto Rico have legislation related to working
and breastfeeding
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Presenting the Business Case to Employers
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The Bottom LineBreastfeeding is GOOD for
Business

• Lactation support does not deplete funds from
  human resource benefitsit puts money back INTO
  it

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Lactation Support Reduces Health Care Costs

• For every 1,000 babies NOT breastfed compared to
  exclusively breastfed infants, there are an
  extra
• 2,033 physician visits
• 212 hospitalization days
• 609 prescriptions (Ball 1999)

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Health Care CostsMutual of Omaha Case Study

• Newborn health care costs were THREE TIMES LESS
  for mothers in the program (1,269 vs. 3,415)
• Annual savings 115,881 (for health care costs
  alone)
• The Bottom Line annual savings per participant
  2,146
• (Mutual of Omaha 2001)

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Absenteeism RatesCIGNA Case Study

• One-day absences occur twice as often for
  employees whose babies are not breastfed (Cohen
  95)
• Lactation program resulted in a 77 reduction in
  lost work time due to infant illness
• Annual savings 60,000
• (Dickson 2000)

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Turnover Rates

• National retention rate is 59
• Companies with lactation programs have higher
  retention rates
• Mutual of Omaha 83 (Mutual of Omaha 2001)
• 9-company study 94.2 (Ortiz 2006)
• Replacement costs
• 150 of that persons annual salary (Reh 2005)
• 70 for a receptionist 200 for manager
• (U.S. Dept Labor)

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Lactation SupportSatisfies Employees

• Employees of companies providing lactation
  support feel more productive and loyal
  (Galtry 97 Frank 98)
• Family-friendly benefits
• Lower turnover rates
• Improve job satisfaction and loyalty
• Result in employees working later into pregnancy,
  returning to work faster, and working more on
  their own time
• Have a spillover effect less perceived stress
  at home
• (Schwartz 1996)

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With all these benefits, why doesnt EVERY
employer provide lactation support benefits?
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Common Concerns

• Common Concerns
• Lack of awareness
• Discomfort with intimate issues
• Potential resistance from other employees
• Cost
• Lack of space

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Making the Business Case

• Do your homework!
• Approach the right people
• Schedule in-person visits/avoid mailings
• Use professional materials
• Speak the language employers understand the
  bottom line

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Making the Business Case

• Offer OPTIONS not mandates
• Give examples
• Provide recognition
• Offer TA and local resources

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What States are Doing

• Hawaii
• Approaching the big ones
• Media visibility

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What States are Doing

• Indiana
• SHRM conference display
• Overwhelming response due to legislation
• Louisiana
• WIC partnership
• Mall and Wal-Mart outreach
• Georgia
• Atlanta Airport Authority
• Faith-based collaboration
• Worksite wellness council (CDC)

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What States are Doing

• Oregon
• Received 10,000 mini grant from WIC for
  community training events
• Rhode Island
• Developed localized versions of the kit
• Collaboration with WIC on materials for mothers
  with tear-off cards

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Important National Initiatives

• HHS Office on Womens Health National
  Breastfeeding Program
• National Business Group on Health
• www.businessgrouphealth.org
• American Association of Health Plans
  www.ahp.org
• American Association of Architects www.aia.org

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Proposed Federal Legislation

• Family Leave Insurance Act S11681
• (Chris Dodd, D-CT)
• http//www.opencongress.org/bill/110-s1681/
  show
• House Bill HR626 paid leave for federal
  employees (Maloney-NY)
• Maloney Breastfeeding Promotion Act H.R. 2236
• (Carolyn Maloney, D-NY)
• www.maloney.house.gov

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The Business Case for Breastfeeding

• HRSA Information Center
• www.ask.hrsa.gov
• 1-888-ASK-HRSA

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Webcast
HRSAs Maternal and Child Health Bureau Healthy
Start Webcast Archives www.mchcom.com
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If you want to go fast, go alone.If you want to
go far, go together. --Kenyan
proverb
EVERY MOTHER, INC. www.everymother.org Cathy
Carotherscathy_at_everymother.org