Rona Cohen: An Interview about Corporate Lactation Programs

Rona Cohen is a Certified Lactation Consultant based in Los Angeles, California and President of MCH Services, Inc. Her company provides breast pump equipment and customizes lactation support programs for employers that enable working mothers to continue breastfeeding their babies upon returning from maternity leave and for as long as they choose. Rona established some of the first corporate lactation programs in the United States for Transamerica Life Companies, the Los Angeles Department of Water and Power and the Aerospace Corporation. She is a Family Planning Nurse Practitioner (FPNP), Sex Educator and Counselor and an International Board Certified Lactation Consultant (IBCLC). In addition, she is an Assistant Clinical Professor at the University of California at Los Angeles, School of Nursing and lecturer on women and family work issues. HMHB recently spoke with Rona about her experiences with corporate lactation programs.

Q. Rona, you’re considered a pioneer in the field of workplace lactation programs. What was the culture with respect to working and breastfeeding 20 years ago?

A. The concept of working and breastfeeding wasn’t even on the radar screen back then. Most people didn’t even know the meaning of the word lactation. Rather than say the word “breastfeeding” in a corporation, I had to use the term “nursing”! The business world was just starting to make the connection that family and work have an impact on each other. Two decades ago, when you walked into a corporation you left your family at home. I’m not sure if my program was the absolute first, but it may have been the first time a lactation program was officially provided at a company. It wasn’t until the late 1980’s that companies realized that there were no legal problems with providing breast pumps for employees to use. My experiences showed me that a corporation had a crucial role in supporting the mom who chose to provide breast milk for her baby, especially during her return to work after maternity leave. I knew that employers had unique opportunities to provide prenatal education so women could make more informed choices about how to feed their babies and feel more comfortable about breastfeeding upon returning to the workplace.

Q. What data speaks to the business case, and how much do companies save by encouraging their employees to breastfeed? Otherwise, how much does this affect the bottom line?

A. A lactation program is one of the easiest ways for a company to get a good return on an investment in its workforce. Once established, it is also one of the most highly used, highly valued programs for working parents. We know that employees who have breastfed babies are less likely to be absent from work because their babies have stronger immune systems and experience less illness. One study quantified that the reduced illness and subsequent health care costs for infants that were exclusively breastfed ranged from $331 to $475 per child in the first year of life. [Health Care Costs of Formula-Feeding in the First Year of Life by Thomas M. Ball, MD, MPH and Anne L. Wright, PhD, PEDIATRICS Vol. 103 No. 4 April 1999]. Data from CIGNA’s Working Well Moms program revealed a savings of $240,000 annually in health care expenses for breastfeeding mothers and their children as compared to their counterparts. Moreover, an additional savings of $60,000 annually was realized through reduced absenteeism among breastfeeding mothers at the company, with 62% fewer prescriptions for children who received the benefits of breast milk. [CIGNA Research News Release 6/15/04 by CIGNA Corporation]. A very important long-term benefit in the business equation is the reduced risk of breast cancer for women who breastfeed their babies.

Q. What do you have to say about the state of corporate lactation programs and attitudes toward working and breastfeeding today?

A. We’ve come a long way in the past 20 years. Not only can breastfeeding promotion be discussed openly in most circles, articles about working and breastfeeding are now common in mainstream publications and business magazines. In addition to understanding what lactation management entails, worksite support is being recognized as important and integral to the family-friendly corporation’s health benefits as well as work/life and wellness programs. In some states (not enough!), we now have laws mandating a woman’s right to pump at the worksite. However, we still have a long way to go to make sure all employers fully understand their role and the potential to have an impact for mothers, babies and families.

Q. What has evolved in terms of the father’s role in breastfeeding support programs?

A. Again, significant progress has been made, but much work remains to be done. More and more fathers want to take an active role in supporting their partner in breastfeeding. In cases where males are given an option to participate in educational programs or have the ability to take advantage on discounted equipment, the breastfeeding duration rates of their spouses and partners are almost equal to those of female employees in the same programs. [A Description of a Male-Focused Breastfeeding Promotion Corporate lactation Program by Rona Cohen, RN,MN,FPNP, IBCLC, Linda Lange, RN, DrPH, & Wendy Slusser, MD, MS, J Jum Lact, 18(1). 2002.] However, many corporations do not yet view breastfeeding as a broad family issue, and education is still required in this area. If lactation programs only focus on the female employees they only reach half of the population and have significantly less of an impact. Expanded efforts increase results. That translates into higher breastfeeding initiation and duration rates and reduced health care costs. I am happy to report that when I share this with corporations, they often respond by creating programs that market to and involve both men and women.

Q. What are some of the challenges for the working woman who wants to breastfeed?

A. Women in lower-paying jobs and those that are not in an office setting face the biggest obstacles. Unfortunately, the majority of companies in certain industries (assembly lines, food service, construction, non-traditional jobs, etc.) do not provide any type of lactation support. Women who have less resources, training and education are working for a minimum hourly wage or earning lower salaries. They have fewer options available to them, including quality breast pumps. They also have a much harder time speaking up about their need for support. Female employees continue to question whether or not they are entitled to use break time to express breast milk, or they feel guilty about doing so. These women are less likely to be able to speak to their supervisor about the health and economic issues at hand or, in some cases, discrimination. For example, some businesses allow employees to take smoking breaks, which are counterproductive to health. However, these same businesses may not afford employees in the same jobs to take time to use a breast pump, which promotes health and saves the company money. There is a lot of education and policy change needed.

Q. What characteristics are common to the most successful lactation support programs?

A. It’s important to note that access to a pump or even a lactation room does not quantify as a program. A comprehensive approach must also incorporate education and counseling in order to be effective and to have the most return on investment. Support from upper management as well as front line supervisors and managers are equally important. Finally, a company must work hard to market the program so that people will use it. Participants usually provide the best benchmark for success. When you hear a mom say she never would have been able to continue to breastfeed without the company’s program, it means you’re making a huge difference. When you have a parent say “I really know my employer really cares about me and my baby,” it tells you that you’ve gone way beyond a quality program that makes good business sense.

Q. What can coalition partners do to advance this issue and encourage additional worksite support for breastfeeding mothers?

A. The breastfeeding goals outlined in Healthy People 2010 call for an increase in the number of mothers breastfeeding their babies (from 64% of all mothers in 1998 to 75% by 2010). Every partner has an important role in this national prevention initiative. Businesses play a role regardless of their budget, size or industry. Lactation consultants, pediatricians, nurses, health clinics, WIC, baby-friendly hospitals and breast pump manufacturers all need to come together. Collectively, we can have a stronger voice to see that appropriate health policies are instituted, and we will be better able to see that all women have access to information about the benefits of breastfeeding as well as a support system to foster a healthy experience. If no coalition exists, start talking to key stakeholders to see if one can be formed to help move forward on this important issue. All babies have a right to have the healthiest start in life, no matter where their mother spends her work day.

For more information about MCH Services, Inc., contact them at 1-800-822-6688.