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Dear Employer: We know that you are concerned about the well-being of your employees, their productivity and morale. We invite you to participate in an important worksite endeavor, the development of worksite policies and support for breastfeeding employees. WithinReach and its Breastfeeding Coalition of Washington, the Washington Chapter of the American Academy of Pediatrics, Washington Academy of Family Physicians, and the Washington State Department of Health share the belief that breastfeeding is beneficial to individuals, families, employers and our state. Therefore, we are providing information and assistance to employers statewide in the development of worksite policies and support for breastfeeding employees. When an employee returns from maternity leave, she wants to be a productive and profitable employee and a good mother. That is why so many women today are choosing to breastfeed their babies, even as they return to work. Studies indicate that women who breastfeed are more productive on the job and worry less about their babies. Because their children are healthier, breastfeeding employees take less time off work to care for their sick infants. These benefits positively and directly affect an employer’s bottom line. It takes little time and investment to create a supportive breastfeeding environment. Enclosed is information to help you support your employees. It includes: • • • •

Fact sheets entitled “Potential Healthcare Savings Associated with Breastfeeding” and “Easy Steps to Supporting Breastfeeding Employees.” A sample company policy supportive of breastfeeding. A description of a few Washington State breastfeeding-friendly workplaces. A copy of the Boeing Company’s lactation program brochure.

Thank you for being a leader in your community. If you have questions or would like more information, please feel free to contact Rachel Schwartz, Program Manager for the Breastfeeding Coalition of Washington, at (206) 281-8032 or at

Best Regards,

Maxine Hayes, MD, MPH Washington State Health Officer Department of Health

Anne Montgomery, MD FAAFP, FABM, IBCLC Vice President, Washington Academy of Family Physicians Eastern Region Chair, BCW

Beth Harvey, MD, FAAP President, Washington Chapter American Academy of Pediatrics

Employer information

Potential Health Care Savings Associated with Breastfeeding Why do employers want to support breastfeeding employees?

When a child is ill, everyone pays. Parents must often miss work to provide care. If they are at work, they are distracted and less productive. Breastfeeding plays a major role in protecting infants and children against a variety of illnesses and infections. Consequently, breastfeeding can also protect and improve the health of adult employees by decreasing their susceptibility to infectious disease. Consider the cost saving and enhanced productivity at work when children are breastfed.

Ear Infections By age three, one-third of all children have had more than three episodes of ear infections. In the U.S. ear infections cost more than $1 billion annually in visits to the doctor. Breastfed children have a 60 percent decrease in the occurrence of ear infections compared with formula fed children.

Estimated cost for each episode of an ear infection:

Determining the bottom line on children illnesses‌

Office visit and treatment: $90-$150

For each of the following diseases or illnesses, we have provided the average cost of care for each occurrence, the average number of days the child would be out of child care and this the average number of days an employee could be absent.

Days off for employee: 1-2

Chronic ear infections may require surgery to implant ear tubes.

Estimated cost for each episode of ear tube surgery: Treatment: $700-$1800

Allergies Proteins the infant is unable to digest often trigger food allergies. The child with a family history of respiratory or food allergies is at higher risk for a severe reaction due to an immature immune system. Breastfeed infants and children have a significantly lower risk for food allergies and other protein reactions. Breastmilk also protects the child from other respiratory allergies.

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References Estimated cost for each allergic child: Allergy work-up and treatment: $400-$600

Dewey K.G., Heining M.J. Nommsen-Rivers L.A., Differences in Morbidity Between Breastfed and Formula Fed Infants. Journal of Pediatrics 1995: 126: 696-702. U.S. Department of Health and Human Services. HHS Blueprint for Action on Breastfeeding, Washington, D.C., U.S. Department of Health and Human Services, Office on Women’s Health, 2000.

Days off for employee: 1-2

Bronchiolitis/Pneumonia These conditions often start as mild respiratory infections and can sometimes be caused by a common respiratory tract virus called respiratory synctial virus (RSV). As these infections spread to the lower respiratory tract, they increase in severity, with fever and breathing problems. Breastfed infants have an 80 percent decrease in the risk for lower respiratory infections and a significant decrease in the severity of RSV, with fewer hospitalizations.

Bonuck K., et al., Breast-Feeding Promotion Interventions: Good Public Health and Economic Sense. Journal of Perinatology 2002; 22 (1): 78-81.

Estimated cost for each episode of RSV: Treatment: $60-$195 Hospital Room: $800-$2000* *Does not include diagnostic testing or treatment in the hospital.

Walker, M., Selling out Mothers and Babies: Marketing Breastmilk Substitutes in the USA. Weston, MA, NABA REAL, 2001. Weimer, J.P., The Economic Benefits of Breastfeeding. FoodReview Vol. 24, Issue 2, United States Department of Agriculture, 2001: 23-26.

The data related to disease are based on a random survey by health care providers in Washington State. Adapted from “The Potential Health Care cost of Not Breastfeeding.” BEST STARTKentucky Resources.

Days off for employee: 2-7

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employer information

Eight Easy Steps for Supporting Your Breastfeeding Employees

By taking a few simple steps to encourage employees to continue to breastfeed, businesses can save money, increase employee morale and decrease time lost to care for sick children.

Companies that recognize breastfeeding as a benefit to the workplace can encourage that recognition in all their employees. Some workplace conditions to help the breastfeeding employee include:


A written policy which states the employer’s support of a woman’s right to breastfeed her child and describes the worksite accommodations and/or benefits available to her. (A) The policy is part of the employer’s written policy on parenting and/or maternity benefits. (B) All pregnant employees are informed of this policy as early in their pregnancy as possible. (C) New employees are informed of the existence of this policy or are given a copy as part of new employee orientation. (D) Encourage co-workers and management to have a positive, accepting attitude toward breastfeeding employees.


A 20-30 minute break both in the morning and afternoon for the woman to (A) nurse her child or (B) express her breastmilk. If necessary, the beginning and/or ending times of work can be adjusted

to accommodate these breaks. For example, if two, 15-minute breaks are allowed employees, the breastfeeding employee starts work 10 minutes earlier and leaves work 10 minutes later to allow for two, 25 minute breaks.


A private area is available for breastfeeding or expressing milk. The room should be quiet and clean and ideally have enough room for a comfortable chair and a safe electrical outlet. A clean, safe water source and a sink should be available somewhere within the worksite for washing hands and cleaning pumping equipment.


A place for storing breastmilk such as an employee refrigerator or a safe place to keep an ice chest or thermos.

Conditions that provide additional support...

At least four weeks is needed to establish the mother’s milk supply and for mother and baby to become comfortable with breastfeeding. Mothers with a longer leave are more prepared when they return to work.


Part-time employment, job sharing, flexible work and leave schedules, and/or a gradual return to work. These options support breastfeeding mothers and all employees in general.


Availability of childcare in an on-site or near-site facility. This option makes it possible for the breastfeeding mother to nurse her baby instead of pumping breastmilk for later use.


Employer-provided breastfeeding education and support before and after the birth. An employee assistance person, an employee with interest and concern about breastfeeding, or a work group could design this.


Maternity leave of at least six weeks, or the more common, three months.

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This support system may include: 1. Written educational materials provided by breastpump companies and lactation consultants. 2. On-site prenatal/postpartum classes or support groups. This can be done during a lunch break in a “brown-bag” format. 3. Information about breastfeeding consultation services.

Helpful Websites Motherwear, Publishes and distributes free literature on breastfeeding including worksite support for breastfeeding employees.

and encourage breastfeeding among their workforce. Specific information about lactation programs and their costs is available an eight page issue brief entitled, Breastfeeding Support at the Workplace.

The National Business Group on Health, www.

Center for Disease Control breastfeeding/index.htm

Represents over 200 employers, health care companies, benefits consultants and vendors. This non-profit organization is devoted to finding innovative and forwardthinking solutions to health care and related benefit issues. The National Business Group on Health has an online resource to raise awareness of health and cost benefits of breastfeeding employers and business leaders with relevant information to support

Provides various employment related information including Lactation Support Programs in Federal Workplaces; information on Healthy People 2010, National Objectives on Breasfeeding; and the CDC Guide to Breastfeeding Interventions, a document which lists promising breastfeeding promotion activities including support for breastfeeding in the workplace: pdf/BF_guide_2.pdf.

United States Breastfeeding Committee (USBC) The USBC is a collaborative partnership of organizations. The mission of the committee is to protect, promote and support breastfeeding in the U.S. This website contains useful information about working and breastfeeding, including a helpful checklist for breastfeeding accommodations in the workplace: http://www. html.

In Washington State The Breastfeeding Coalition of Washington, a program of WithinReach, 206-2818032 or www.withinreachwa. org/bcw. Includes information on breastfeeding, legislation, discrimination and more.

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Breastfeeding Support Policy You can adapt this template to easily incorporate breastfeeding support into your company. Company X recognizes a mother’s responsibility to both her job and her child when she returns to work. We are aware that employees who breastfeed may miss less work caring for ill children because of the many health benefits associated with breastfeeding. At Company X, we support breastfeeding mothers, and are committed to providing services which enable our employees to continue breastfeeding after returning to work. In keeping with this philosophy, Company X will provide, at little or no cost to the employee, the following services: Establishment of a company policy or subtopic, such as “Breastfeeding is Healthy,” under an existing policy. A description of worksite accommodations and options available to women who breastfeed as part of new employee orientation. A flexible work schedule and a 30minute morning and afternoon break to enable breastfeeding employees to express their milk. Beginning and ending work times will be adjusted to accommodate these breaks.

“Going back to a work environment that completely supports breastfeeding, and where I am able to pump in private, will make returning to work a positive experience. It gives me piece of mind. I am happy that my employer supports me—giving my baby the best nourishment that I can give.” Debbie, eight months pregnant.

A private break area for breastfeeding employees wishing to express their breastmilk during the workday. The area will contain a comfortable chair. A sink and a cooler or refrigerator for breastmilk storage will be in the room or nearby. Education for employees about why breastfeeding mothers need employer support. Note: Your company may want to consider developing an on-site or near-work childcare program so children can breastfeed during the day.

Additional Resources American Academy of Family Physicians (AAFP). Position Statement on Breastfeeding. en/home/policy/policies/b/ breastfeedingpositionpaper.html. American Academy of Pediatrics (AAP). Breastfeeding and the Use of Human Milk, 2005. http:// reprint/pediatrics;115/2/496.pdf. Association of Women’s Health Obstetric and Neonatal Nurses (AWHONN). Position Statement on Breastfeeding and Lactation in the Workplace. http://www.

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Washington State Promotes a Woman’s Right to Breastfeed! Washington enacted a law in 2001 that sets forth the importance of breastfeeding. The law clarifies that breastfeeding is not indecent exposure and encourages employers to accommodate breastfeeding mothers. The law also set up an incentive program for employers by allowing them to advertise that they are ‘infant friendly’ if they set up lactation support for their employees. For more information about this please visit the Breastfeeding Coalition of Washington website: forprof/BCW/legislation/legislation. htm.

Cohen R, Mrtek MB, Mrtek RG. Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. Am J Health Promotion 1995;10: 148-153. International Labor Organization, Maternity Protection Recommendation, 2000

Photo purchased from the State House of Representatives.

Spring, 2001. Members of the Breastfeeding Coalition of Washington and other interested parties including Sen. Jeri Costa and Rep. Eileen Cody, co-sponsors of HB1590, look on as Gov. Gary Locke signs the bill into law.

US Department of Health and Human Services, Office on Women’s Health. HHS Blueprint for Action on Breastfeeding. Washington, DC: US Department of Health and Human Services, Office on Women’s Health; 2000. http:// index.cfm?page=233. United Nations Children’s Fund (UNICEF). Facts for life: Breastfeeding. http://www.unicef. org/ffl/04/.

United States Breastfeeding Committee. Issue Papers including; Economic Benefits of Breastfeeding, Workplace Breastfeeding Support, Checklist for Accommodations in the Workplace. http://www. html. National Business Group on Health. The Health and Cost Benefits of Breastfeeding. http://www.businessgrouphealth. org/prevention/breastfeeding.cfm.

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A Few Washington State Companies with Lactation Services The following is a small sample of the many supportive workplace lactation programs in Washington State. It is hoped these descriptions can help you tailor a program to fit the needs of your company. Columbia Valley Community Health and WIC Services 600 Orondo Avenue, Suite 1 Wenatchee, WA 98801 Contact: Laurie Riegert, MPH, RD 509-664-4586 •

Columbia Valley Community Health Services is a nonprofit health clinic with approximately 120 employees serving Chelan and Douglas counties in central WA. In 1998, a written breastfeeding policy and a room for breastfeeding was created. It is furnished with a Medela “Lactina” breastpump, chair, table and breastfeeding literature. A sink and regrigerator are located nearby. (Spanish speaking).

Agilent Technologies* 2401 Mission Avenue East Liberty Lake, WA 99019 Contact: Fred Krassowski, HR Manager 509-921-4242 • Agilent Technologies is a technology company with 1,000 employees in its Spokane, WA office. Since 1996 Agilent has provided breastfeeding employees with a private room equipped with an electric breastpump, breastpump kits and various supplies. Agilent contracts with a local Lactation Consultant when needed. The room is 4 feet by 6 feet and contains a chair, refrigerator, and bulletin board with lactation information, artwork and magazines. The room is attached to the women’s locker and shower room. It is clearly marked and has a sliding sign designating “Occupied/Vacant.” Agilent also provides a Medela “Pump in Style” for women to borrow when traveling.

Russell Investment Group* 909 A Street Tacoma, WA 98402 Contact: Human Resources Department 253-439-5757 • Russell is headquartered in Tacoma, WA and provides investment products and services in more than 39 countries. Russell is known as a family-friendly workplace and in 2003, established several “Mothers Rooms” to support breastfeeding employees. The rooms provide a comfortable space for pumping in private. Employees also receive information about returning to work and breastfeeding, and resources for breastfeeding support.

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Russell believes that supporting breastfeeding employees offers a considerable return by lowering healthcare costs, enhancing productivity, improving employee satisfaction, increasing retention and improving image. Russell also believes these rooms are a significant and supportive investment in the future health and well-being of Russell employees and their children.

Pay Plus Benefits, Inc.* 1110 North Center Parkway, Suite B Kennewick, WA 99336 Contact: 509-735-1143 • Pay Plus Benefits, Inc. is a successful entrepreneurial HR and payroll company employing 16 people in Kennewick, WA. John Heaton, CEO, realized many years ago that the focus and productivity of employees can be compromised by off-site, unreliable childcare, a situation that also causes considerable stress. In response, Pay Plus Benefits opened the Small Wonders Child Care center in May 1999. The center is on-site and partially subsidized by the company. This makes it easy for employees to continue nursing after returning to work. Pay Plus Benefits is convinced that the child care center makes a significant contribution to morale and productivity. One of the company’s top priorities is to ensure that all employees and their families have access to the resources needed to maintain a healthy and happy work and family life. Ensuring all employees and their families have the resources to maintain a healthy, happy work and family life is a top priority and it makes good business sense to Pay Plus Benefits.

DaVita Inc.* 1423 Pacific Avenue Tacoma, WA 98402 Contact: Marah Halbgewachs 253-382-1761 • DaVita Inc. is a leading provider of dialysis services in the United States. Their business office is located in Tacoma, WA with over 650 employees. Soon after the Washington Breastfeeding law was passed in 2001, DaVita developed a policy supporting breastfeeding employees and set up a private space designed especially for lactating women. The room has soft lighting, glider rockers, artwork, a refrigerator, literature, electric breastpumps and a bulletin board for pictures of mothers’ newborns. Extra pump accessory kits are available through payroll deduction. “I feel (this award) is both an honor and an embarrassment. An embarrassment to business leaders generally because we are being recognized for something that should be common place in companies. I offer our support to you to help encourage other businesses to follow our lead. Any employer who does not make simple accommodations for this important and basic need is simply foolish.”

-Gary Beil, VP and Controller, DaVita, breastfed as an infant and father of three breastfed children upon receiving the 2002 Outstanding Employer Award

*Award Recipients. Each year Washington State companies who have shown leadership and significantly contributed to promoting and supporting breastfeeding as a vital part of the health and development of children and their families are nominated for the Breastfeeding Coalition of Washington’s Outstanding Employer Award. To learn more about this award please visit

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