Provide education about the importance of comprehensive lactation support to breastfeeding success and associated health benefits for families and businesses
Medela appreciates this opportunity to comment on how the Department of Labor can best assist mothers who need lactation support, including adequate break time and space at work. Going back to work after having a baby is a challenging time for new parents, especially those who want to continue breastfeeding their babies, and it is one of the most significant risk factors preventing moms from meeting their breastfeeding goals. Helping these families feel truly supported during this time is one of the most valuable actions employers can take to attract and retain working women. We hope the Department will incorporate some of the information below into educational materials for employees and businesses. Employers are much more likely to create a supportive work environment for families with breastfed infants when they understand both short and long-term benefits of breastfeeding for families, businesses, and the health care system.
Returning to work after childbirth often leads to early cessation of breastfeeding for many families. Moms have a lot of barriers to overcome when they start on their breastfeeding journey. Returning to work to support their family, unfortunately, is a choice that prevents too many moms from meeting their goals for breastfeeding exclusivity and duration. In a recent survey of 1,000 working moms, eighty-nine percent reported breastfeeding their babies, pumping or using a mix of both.1 In the same survey, a third of mothers reported that returning to work was the reason they stopped breastfeeding, and 19% even reported receiving pressure from work to stop. The proportion of babies receiving breast milk drops precipitously at the one to two-month mark as more mothers return to work.2 Employers who understand the challenges associated with breastfeeding are more likely to want to enact policies that offer moms the full range of support they need to be successful in their journey.
Lactation support programs can save businesses money on healthcare costs, reduce absenteeism, and help with employee retention and job satisfaction. Lactation support is a cost-saver for employers. For example, Cigna found in a two-year study of 343 employees that enrollment in a corporate lactation program led to annual savings of $240,000 in health care expenses, 62 percent fewer prescriptions, and $60,000 in reduced absenteeism rates.3 Additionally, researchers found that one-day absences due to a sick child were twice as likely to occur for mothers who formula-fed versus women who breastfed their babies.4 A study published last month in the Journal of Breastfeeding Medicine found that organizational and managerial support are key aspects of workplace lactation support, which may positively impact job satisfaction, rates of exclusive breastfeeding, and duration of exclusive breastfeeding among female health care employees.5 The most successful lactation support programs provide the educational materials, equipment and supplies, private lactation spaces, access to support from trained lactation professionals, and milk shipping services for employees who are away from home overnight due to business travel.
The health benefits of breastfeeding babies are indisputable. Breast milk in the first year of life reduces the most common and costly childhood illnesses: otitis media (i.e. ear infections), diarrhea, and respiratory infections.6 Additionally, babies who are given breast milk are less likely to develop asthma, obesity, and sudden infant death syndrome.7 Furthermore, the clinical community has found that young infants in critical care who receive breast milk have sharply reduced rates of necrotizing enterocolitis (NEC), a devastating gastrointestinal infection, resulting in a significant reduction in morbidities and mortality, fewer hospital readmissions, and less costly medical bills in the longer term.8 Optimal breastfeeding rates could result in savings of at least $518.8 million dollars per year in the Medicaid population alone.9 Leading medical societies, including the American Academy of Pediatrics (AAP), American Congress of Obstetricians and Gynecologists (ACOG), and American Academy of Family Physicians (AAFP), as well as the Centers for Disease Control and Prevention (CDC) and the U.S. Surgeon General, strongly recommend that babies exclusively receive breast milk for the first six months and complimentary breast milk for at least the first year of life.
Lactation is associated with improved health outcomes for mothers. Initiation and duration of breastfeeding have been shown to reduce disease risks of breast and ovarian cancers, as well as diabetes type 2, hypertension, myocardial infection and perinatal depression.10,11 Earlier this year, Kaiser Permanente published findings from a thirty-year national study that showed that women who breastfeed six months or more cut in half their risk of developing type 2 diabetes.12
Breastfeeding support, supplies, and counseling is an extremely low-cost, high-value benefit. Medela commissioned Milliman, a non-partisan actuarial firm, to assess the impact of the breastfeeding support, supplies, and counseling benefit on health insurance premiums. According to Milliman, the total cost for breastfeeding support, supplies, and counseling for the commercial health insurance population in 2017 dollars is $1.27 per member per year ("PMPY") or approximately 0.023 percent of total premium dollars. To provide context, if an individual had employer-sponsored health insurance with a $500 monthly premium, approximately $0.12 would be attributable to the breastfeeding benefit.13
Similarly, for the Medicaid population, the total cost for the breastfeeding support, supplies, and counseling benefit is approximately $1.82 PMPY in 2017 dollars or approximately 0.034 percent of total per-enrollee expenditures. For reference, if the total per-enrollee expenditures for a Medicaid enrollee was $500 per month, approximately $0.17 would be attributable to the breastfeeding benefit.14
About Medela. Medela is one of the world's leading advocates for breast milk with a focus on babies' health and nutrition. Medela supports babies receiving mothers' milk early in life by providing research-based products together with clinical education. Every year, over a million mothers in the U.S. rely on our technology. Medela has proudly served hospitals and American families for over 35 years from our U.S. headquarters in rural Illinois. Our company is fully dedicated to supporting mothers in providing breast milk to their babies for as long as possible.
Please feel free to email firstname.lastname@example.org if you'd like to learn more about how Medela supports employers and nursing mothers in the workplace.
2 Centers for Disease Control and Prevention. National Immunization Survey. Rates of Any and Exclusive Breastfeeding by Age among Children Born in 2013. Samples from 2014 and 2015 National Immunization Surveys. Available at: https://www.cdc.gov/breastfeeding/data/nis_data/.
3 Dickson, Hawkes, C., W., L., Cohen, R. Slusser, W. (2000). The positive impact of a corporate lactation program on breastfeeding initiation and rates: help for the working mother. manuscript. Presented at the Annual Seminar for Physicians on Breastfeeding, Co-Sponsored by the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and La Leche League International. Chicago, IL: July 21, 2000.
4 Cohen R, Mrtek MB, and Mrtek RG. Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. Am J Health Promot. 1995 Nov-Dec;10(2):148-53. Available at: https://www.ncbi.nlm.nih.gov/pubmed/10160049.
5 Victoria C. Scott, Yhenneko J. Taylor, Cecily Basquin, and Kailas Venkitsubramanian.Breastfeeding Medicine.Jul 2019
6 Ball, Thomas M., and Wright, Anne L. Health care costs of formula-feeding in the first year of life. Pediatrics 103.Supplement 1 (1999): 870-876.
7 U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011
8 Institute of Medicine. Clinical Preventive Services for Women: Closing the Gaps. July 18, 2011. Available at http://www.nationalacademies.org/hmd/Reports/2011/Clinical-Preventive-Services-for-Women-Closing-the-Gaps.aspx.
9 United States. Cong. House. Committee on Appropriations Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies. Members Day Hearing, March 09, 2017. 115th Cong. 1st sess.
10 Institute of Medicine. Clinical Preventive Services for Women: Closing the Gaps. July 18, 2011. Available at http://www.nationalacademies.org/hmd/Reports/2011/Clinical-Preventive-Services-for-Women-Closing-the-Gaps.aspx.
11 Victora et al. Breastfeeding in the 21st century: epidemiology, mechanisms and lifelong effect. The Lancet. Vol 387. January 30, 2016. (article attached).
13 Henry D, Pantely S, and Philip S. Milliman Client Report. Impacts of Breastfeeding Support, Supplies, and Counseling on Health Insurance Premiums and Costs. Apr. 24, 2017.