1. Spatz, Diane L. PhD, RN-BC, FAAN

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In the United States, the need for lactation accommodations in the workplace is urgent as families continue to face many barriers on their lactation journeys. The exclusive breastfeeding rate in the United States at 6 months remains suboptimal. Only 25% of U.S. infants receive exclusive human milk (Centers for Disease Control and Prevention, 2021) for the first 6 months, which means three out of four American children may experience increased morbidities both short- and long-term. Return to work has long been cited as a significant reason people cannot meet their personal breastfeeding goals. In 2022, the American Academy of Pediatrics changed their policy to recommend breastfeeding for 2 years (Meek et al., 2022). Although this updated policy statement brings the United States recommendations in line with the World Health Organization, there was a lot of negative media attention about the policy change due to the ongoing U.S. formula shortage and the failure of the PUMP for Nursing Mothers Act to pass in congress.


The PUMP Act would have closed existing loopholes in the 2010 Break Time for Nursing Mothers Law and increased workplace lactation protections for an estimated 9 million women. Those who voted against the bill said it would be too burdensome for employers to support and give time to working mothers to express milk. This outcome should serve as a call to action for everyone to do more to address the needs of lactating working people. Thirty states, the District of Columbia, and Puerto Rico have laws that support breastfeeding in the workplace (National Conference of State Legislatures, 2022). Given gaps in state and local policy, nurses must advocate to employers to make sure there are comprehensive lactation policies and resources so working families can meet their personal breastfeeding goals.


For over a decade, Children's Hospital of Philadelphia (CHOP) has had a comprehensive employee lactation program. Our policy is stronger than the national law in that it applies to both hourly employees and salaried employees and spells out specific breaktime requirements for pumping. We have over 75 lactation rooms equipped with hospital grade computer chip pump technology, a loaner pump program for employees who work at offsite locations that do not have lactation rooms, and specific pumps dedicated to our physician residency program. In one study, the number one priority for lactating women in the workplace was having access to a hospital grade electric breast pump (Henry-Moss et al., 2018). This level of access enables women to express much more efficiently and effectively while at work and this is key to being able to sustain milk supply long term.


At CHOP, nurse employees can take the Breastfeeding Resource Nurse course that provides 14 hours of continuing education credits. All other employees (pregnant person or partner) can take the employee breastfeeding class during their workday at no charge and with permission of their supervisor. Employees can rent lactation equipment through our rental station for use at home. There are also comprehensive web-based resources. Does such programming and resources work? Yes! We have demonstrated through our research that employees have significantly higher breastfeeding initiation, exclusivity, and duration rates when compared with national data (Spatz et al., 2014). It is critical that health care professionals including nurses can meet their own personal breastfeeding goals so that they can serve as role models and advocates for the families they care for.




Centers for Disease Control and Prevention Breastfeeding Report Card 2020. (2021). Breastfeeding Report Card United States, 2020 ( [Context Link]


Henry-Moss D., Abbuhl S., Bellini L., Spatz D. L. (2018). Lactation space experiences and preferences among health care workers in an academic medical center. Breastfeeding Medicine, 13(9), 607-613.[Context Link]


Meek J. Y., Noble L.American Academy of Pediatrics Section on Breastfeeding. (2022). Breastfeeding and the use of human milk (Policy Statement). Pediatrics, 150(1), e2022057988.[Context Link]


National Conference of State Legislatures Breastfeeding State Laws. (2022). Breastfeeding State Laws ( [Context Link]


Spatz D. L., Kim G. S., Froh E. B. (2014). Outcomes of a hospital-based employee lactation program. Breastfeeding Medicine, 9(10), 510-514.[Context Link]