- Associated Press - Wednesday, June 17, 2015

BLOOMINGTON, Ind. (AP) - Margie Schrader did it in her office. Kirstin Milks did it in her classroom. Jami Hamman did it in her cubicle. And Jean Bauer did it wherever she could find a lockable door.

“I pumped in bathrooms, closets,” Bauer said.

Bauer started breast-feeding immediately after giving birth to her daughter, Lillian, in 2009. Because she was a nursing student at Ivy Tech, Bauer could only take a month off for maternity leave before returning to school and student clinical work at IU Health Bloomington Hospital.

Every two to three hours of her 12-hour nursing shifts, Bauer needed to find a private space to set up her breast pump, pump enough breast milk to feed her daughter the following day and dismantle and clean her equipment for later use.

“It was frowned upon,” Bauer remembers six years later. “You don’t leave clinic. You’re here to learn and do this full time. You can’t just leave.”

Even as a student, Bauer was experiencing the frustration of many new working moms- making time in their busy 9-to-5 (or longer) schedules to pump breast milk, and often having to explain to employers that taking a break to pump is their right, protected by federal and state law.

Bauer is one of the 70.1 percent of mothers participating in the workforce who have children younger than 18, according to 2014 data from the U.S. Department of Labor. Mothers with young children are less likely to be in the workforce. Last year, the participation rate for mothers with children 6 or younger was just 64.2 percent. For mothers with infants younger than 1, it was 57.1 percent.

Returning to work after giving birth is a major worry for many new moms, said Ann Marie Neeley, an International Board Certified Lactation consultant with St. Vincent Women’s Hospital. Neeley teaches classes on breast-feeding and pumping, and said it can be difficult to focus a lesson on starting to breast-feed successfully when more than half of the women in the room plan to return to their offices in a matter of weeks.

“They’re already jumping ahead in their mind past maternity leave and wanting to know how they’re going to go back to work,” Neeley told The Herald-Times (https://bit.ly/1elhLpo ).

Some mothers even hesitate about starting to breast-feed when they know they’ll need to pump soon after. The U.S. Centers for Disease Control and Prevention’s 2014 Breastfeeding Report Card showed that 74.1 percent of Hoosier infants born in 2011 had breast-fed at some point, but only 38.6 percent of infants were breast-feeding at 6 months, after many mothers return to their jobs. The national average for breast-feeding at 6 months was 49.4 percent. Even fewer infants in Indiana, 21.5 percent compared with the national average of 26.7 percent, were breast-feeding at 12 months.

“Initiating and maintaining breast-feeding while going back to work is a daunting task for anyone,” said Dr. Jennifer Walthall, deputy state health commissioner. “The barriers are many; the supports are many; and the long- term goal is to make the support outweigh the barriers.”

Now, the Indiana State Department of Health is focusing on increased breast-feeding as a part of its larger Labor of Love initiative to reduce infant mortality in the state. Indiana has had one of the nation’s highest rates of infant mortality for years, and Gov. Mike Pence has asked the state health department to makes its No. 1 priority reducing the number of babies who die before their first birthday. By 2020, the state health department hopes to increase the rate of breast-feeding at 6 months to 60.6 percent, according to the state’s 2015 breast-feeding strategic plan.

“We know across the board that breastfeeding has many significant benefits not only to infants, but their mothers as well,” Walthall said.

Another aspect of the state’s breast-feeding initiative is educating employers and employees on women’s right to pump in the workplace, and Hoosier women’s right to breast-feed wherever a woman has a legal right to be.

When the federal Affordable Care Act became law in 2010, break time for mothers to pump breast milk at work also was added to the Fair Labor Standards Act. Businesses with more than 50 employees must provide a private place that is not a bathroom, and will be undisturbed by co-workers, for employees to express breast milk for up to one year after a child is born.

For Margie Schrader, who returned to work as an assistant city attorney for the city of Bloomington in 2009 after giving birth to her daughter, Zadie, that space was her office, with use of the employee break room fridge to store her expressed milk.

“I would lock my door and put out my sign. You’ve got your tubes and your flanges and the part that connects the tubes to the flanges is like three parts, so you have to put all those together,” she said. “After a while it was just so easy I could turn it on and keep working. I didn’t make any phone calls, but I could keep working on my computer.”

“I tried to make it feel as normal as I could and project that to everyone. This is just a normal thing that I’m doing because I’m feeding my baby this way. Nipples and breasts are what they are.”

The ACA does not pre-empt more extensive state laws that provide additional protections to breast-feeding mothers. Indiana is one of 27 states and the District of Columbia with a law related to breast-feeding in the workplace, according to the National Conference of State Legislatures. Hoosier working mothers have had a lactation law on the books since 2008.

Employees of businesses with more than 25 employees have the right to pump breast milk in a private location other than a bathroom toilet stall during a paid or unpaid break. Employers should also make efforts to provide a cold storage space for storing an employee’s breast milk, or allow the employee to bring her own for use until the end of the work day. Lactation rooms do not need to become permanent installations in a business, but can be created as needed.

“It’s one thing to write a rule or a code or a law, but it’s another thing to educate and make it possible to do,” Walthall said.

Health workers, however, are still fighting to uphold the law. Unlike the federal law, which is enforced by the U.S. Department of Labor’s Wage and Hour Division, Indiana’s law does not have a provision to enforce it.

“Even though there’s a law to protect them, there’s no teeth to the law,” Neeley said. “There’s no consequence for not following the law.”

A complaint would have to be filed not with the state, but with the federal Department of Labor for a noncomplying workplace to be investigated, said Tina Cardarelli, state breast-feeding coordinator for the Indiana Perinatal Network. Even six years after enacting the law, health officials are also combating an uninformed public.

“I speak to companies pretty much every day that don’t know there is a law,” Cardarelli said. “Businesses will argue the point with me, ‘Well, what’s going to happen to us if we don’t do it?’ Well, nothing, actually.”

When the lights are off in Kirstin Milks‘ classroom, her students say she’s “busy being a mom.”

The Bloomington High School South science teacher conveniently gave birth to her daughter, Nemora Cloud, at the end of the school year, and was able to take summer vacation as an extended maternity leave. When school started again in the fall, Milks was still breast-feeding, and had to pump at least twice during the school day.

“It’s one thing for office workers to take a break, but I needed to schedule me without children at certain times so I could sit and pump,” Milks said. “Because it was totally obvious to my supervisor that I’d given birth to a kid and this is what I needed, they gave me the schedule that I needed.”

Support in the workplace is critical to allow breast-feeding mothers to continue pumping, Neeley said. But that often takes a new mother who feels comfortable explaining the law to her boss and fighting for a place close to her work station where she can pump without being interrupted or disturbed by co-workers.

“I feel like women who may not be as outspoken for their needs and don’t stand up for themselves like they should, they’re not going to be able to get that, and that’s sad,” said Jami Hamman, who works at Indiana University’s Office of Environmental, Health and Safety Management and has a 20-month-old daughter named Katelin.

Hamman pumps in her cubicle, which has high walls and a lockable door.

“I had to listen to all the people around me working and talking, which doesn’t let you fully relax and be able to let the milk flow,” Hamman said. “To give the person time to actually take nursing breaks is very difficult, obviously with different people’s jobs and depending on how much management support they have.”

“I can see where the employer could get frustrated. But at the same time, the benefits far outweigh it. I think when a mom feels that she’s supported, she’s going to work better and harder in the long run.”

IU, Bloomington’s largest employer, has 12 privacy rooms across campus for use by pumping moms, which can either be accessed on a first-come, first-served basis, or can be reserved with the building or department providing the space. Each building and department hosting a lactation or nursing room is responsible for the room’s use and upkeep, Jenny Fleetwood, work-life balance coordinator for university human resources, said in an email.

The Greater Bloomington Chamber of Commerce has approximately 153 member businesses with more than 25 employees, based on data businesses voluntarily provided to the chamber. Neither the Bloomington Chamber, nor the statewide Indiana Chamber of Commerce have received negative feedback from member businesses since the federal and state breast-feeding laws were enacted, Jeb Conrad, president and CEO of the Greater Bloomington Chamber of Commerce, said in an email.

“Knowing our members, I would expect they would comply in order to not only meet the requirement, but also accommodate their valuable workforce,” Conrad said.

IU Health Bloomington Hospital, the city’s third-largest employer, has two specific places in the hospital for lactation: a convenience room near the Outpatient Surgery area, and another on the Mother Baby Unit on the second floor, hospital spokeswoman Amanda Roach said in an email.

“In my experience, most employers want to support breast-feeding moms and want their employees to be happy and will do what they need to do,” Neeley said. “I think when there’s a lactation policy in place, everyone in the workplace needs to be educated about it and why it’s important.”

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Information from: The Herald Times, https://www.heraldtimesonline.com

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