1. 1 Oregon Legislation to Support Breastfeeding in the Workplace Kenneth D. Rosenberg, MD, MPH Katherine J. Bradley, PhD, RN Office of Family Health Public Health Division Oregon Dept of Human Services MCH Epidemiology Meeting Atlanta, GA December 8, 2008

2. 2 Overview  History of Workplace Support for Breastfeeding  Oregon Data  Legislative Keys to Success  HB 2372

3. 3 Breastfeeding Think Tank  Breastfeeding Think Tank: Monthly meeting of breastfeeding program staff and researchers; for many years  Program and data staff share what they are doing and brainstorm about long-term planning.

4. 4 Welfare Reform and Workplace Breastfeeding  In the late-1990s, new Welfare-to-Work legislation led to more low-income breastfeeding women returning to work.  There were anecdotal reports that women were discontinuing breastfeeding because of barriers to breastfeeding in their workplaces.  WIC staff began work with employers to make workplaces more breastfeeding mother friendly.

5. 5 Oregon DHS Leadership: Breastfeeding a priority since 1997  WIC staff training  Breastpumps over 34,000 distributed  Employer education  Media promotion  Protection Wallet cards SAFENET  Partner with community

6. 6 Work/school as Barrier to Continuing Breastfeeding  Early data from Oregon PRAMS (1998-1999) showed that over 90% of Oregon women initiated breastfeeding and that many of the initiators had stopped breastfeeding by the time of the survey (3-4 months old).  37% of those who reported barriers to breastfeeding said that they had stopped because they were planning on going to work or school.

7. 7 Making State Office Building Breastfeeding-Friendly This led us to focus on making workplaces more breastfeeding-friendly. Several staff members began by working to get private space and refrigeration for breastfeeding workers in our state office building.

8. 8 Breastfeeding-Friendly Workplaces  After this was accomplished, local health department buildings were encouraged to become breastfeeding mother friendly.  And a program was developed to encourage all employers to become breastfeeding mother friendly.  The program has distributed materials to employers and has designated 61 Oregon employers (with over 60,000 employees) as being breastfeeding mother friendly.

9. 9 Data for Legislators  Some of the numbers used in the Oregon legislative deliberations that led to the passage of Oregon House Bill 2372 (now known as Rest Periods for Expression of Breast milk):  In addition to the Oregon PRAMS data: National Immunization Survey data on breastfeeding in Oregon (for 2000 births):  Initiated breastfeeding: 90.6%  Any breastfeeding at 6 months: 54.3%  Any breastfeeding at 12 months: 28.1%

10. 10 Data for Legislators Ross Mothers Survey, Oregon, 2000  Initiated breastfeeding: 88.6%  Any breastfeeding at 6 months: 44.6%

11. 11 Why legislation?  Limited impact of DHS voluntary recognition program  Growing body of research on sustained health effects  Sharp decrease in breastfeeding rates at six & twelve months  Work/School barrier

12. 12 Legislative Sessions (2005 & 2007) Keys to success  Oregon Women's Health & Wellness Alliance (bipartisan legislative group)  Broad coalition of organizations  Abundance of pro-breastfeeding “lay” organizations  National & State Data

13. 13 Diane Garrett, Mother & Community Advocate Extraordinaire

14. 14 2005 Legislature

15. 15 2007 Legislature – HB 2372  Business benefit & recruitment tool  Mother and infant health impacts  Democratic House & Senate  Legislative experiences

16. 16

17. 17 HB 2372 Requires Employers of 25+ Employees Employers shall:  Provide unpaid rest periods (30 min/4 hours)  Provide a private location Employees shall:  Provide reasonable notice  Try to utilize standard breaks and meals

18. 18

19. 19 Impact to Date  10% of Employers, 70% of Employees  Under Oregon Bureau of Labor & Industries  Advisory Committee for “undue hardship” exemptions  No requests for exemptions  No complaints from consumers

20. 20 HRSA/MCHB Business Case for Breastfeeding Toolkit 5 individual file folders target varied groups who impact employed mothers: 1.Business case -Employers 2.Easy steps -HR managers 3.Toolkit -- HR managers 4.Employees Guide 5.Outreach workers

21. 21 Thank You