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Rural Employers Failing to Meet Needs of Working Breastfeeding Mothers

Collaboration between businesses and rural health agencies is needed

September 26th, 2016

Story Contact: Sheena Rice, 573-882-8353,

COLUMBIA, Mo. – Research has shown that for working mothers, the ability to breastfeed their babies is critical to their physical, mental and economic health as well as to their babies’ cognitive and physical development. The Affordable Care Act (ACA) requires employers of more than 50 employees to provide sufficient space and time for mothers to breastfeed during the first year of their babies’ lives. Researchers from the University of Missouri conducted an analysis of ACA’s requirement to determine if any barriers exist for women living in rural areas; they found a lack of compliance with the law, inadequate breastfeeding information for mothers and lack of support from co-workers and supervisors. The researchers suggest a need for collaboration between businesses and rural health agencies to create ACA friendly environments that remove barriers to breastfeeding in the workplace.

“In our analysis, we found most rural employers are treating women’s lactation needs in the workplace on a case-by-case basis,” said Wilson Majee, assistant professor of health sciences in the MU School of Health Professions. “These women often feel that their breastfeeding needs are a burden for their employers, rather than a workplace right.”

Majee, along with Urmeka Jefferson, assistant professor in the MU Sinclair School of Nursing, partnered with a county health agency serving a rural community with a population of 21,500 people; a high percentage of the communities’ jobs were low-paying manufacturing jobs, and the population possessed poor education. The researchers conducted focus groups and interviews within the community to determine the barriers to breastfeeding from the perspective of rural employers and working, low-income breastfeeding mothers.

The researchers found that a majority of large employers, particularly those employing primarily women, were aware of the federal regulations; however, they mainly offered accommodations only when requested. Many mothers also said that they were met with direct ridicule from their managers and coworkers when attempting to pump milk at work. The researchers say this unsupportive and reactive work environment made pumping during work hours difficult for mothers.

“While we found that most employers were tolerant, and at least attempted to be flexible in the permitting of pumping milk in the workplace, none were proactive in the sense of encouraging the practice of breastfeeding,” Majee said. “In our case study, we found that employers often saw breastfeeding as a personal decision, and therefore were unwilling to bring up the issue to their employees, even at crucial moments, such as when mothers file the required paperwork for family medical leave. To help these young mothers, proactive discussions should occur at all levels—family, workplace and community.”

Four years later: rural mothers’ and employers’ perspectives on breastfeeding barriers following the passage of the Affordable Care Act,” recently was published in the Journal of Health Care for the Poor and Underserved, a journal from Johns Hopkins University Press. This research was part of a community-based case study with the MU Healthy Communities Initiative.