Sue Ducat
Director of Communications
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Melissa Blair
Robert Wood Johnson Foundation
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Workplace and Public Accommodations for Nursing Mothers

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation examines federal and state laws concerning workplace and public accommodations for nursing mothers in the United States. Because of breastfeeding's proven health benefits to infants, the Affordable Care Act (ACA) contains several provisions to help increase the number of nursing mothers, with specific target goals by 2020. The American Academy of Pediatrics supports exclusive breastfeeding for the first six months of a baby's life; however, the Centers for Disease Control and Prevention estimated that in 2011 only 19 percent of new mothers were exclusively breastfeeding after six months. With nearly half of new mothers working outside the home in the year after giving birth, employment is a frequently mentioned barrier to breastfeeding, along with other cultural and institutional impediments.

Topics covered by this policy brief include:

  • What's the law? This section of the brief details how the ACA requires health insurance plans to provide coverage of certain services for women at no out-of-pocket expense. It also explains the amendments made to the federal Fair Labor Standards Act (FLSA) to provide women time and space to pump breastmilk while at work. However, as the brief explains, the FLSA applies only to certain employers and employees. The brief offers an overview of state laws about aspects of breastfeeding, such as allowing breastfeeding in public, or in the workplace, which are detailed in Exhibit 1.

  • What's the debate? Despite the ACA provisions for nursing mothers, the brief points to research showing that women continue to face challenges getting their insurance companies to abide by the new requirements. Also, as Exhibit 1 demonstrates, most states have not enacted new breastfeeding legislation and policies since the passage of the ACA. As the brief notes, early research suggests that both enforcement of current laws and consideration of additional legislation might be necessary to address the current gaps in legal support for breastfeeding mothers in the United States.

  • What's next? Uncertain that the United States will reach its breastfeeding goals by 2020, advocates have recommended new provisions, such as requiring employers to provide information about workplace breastfeeding accommodations to employees, and have pressed for the resources needed to implement the current law. The brief also outlines other steps that could be taken at both the federal and state levels to overcome gaps in both knowledge and funding.

About Health Policy Briefs

Health Policy Briefs are aimed at policy makers, congressional staffers, and others needing short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

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About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print and online, with additional Web First papers and health policy briefs published regularly at Read daily perspectives on Health Affairs Blog and customize the content you want to see in Health Affairs Alerts.

About the Robert Wood Johnson Foundation

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit Follow the Foundation on Twitter at or on Facebook at