Women make up the majority of employees in the healthcare industry. According to the Bureau of Labor Statistics, in 2018, 75 percent of hospital staff and nearly 80 percent of the staff of other health services were composed of women. In part due to the prevalence of female employees in the healthcare setting, the healthcare industry has moved to address lactation accommodation laws and implement lactation policies at a faster pace than other industries.

Different industries face unique challenges when complying with federal and state workplace lactation laws, and healthcare is no exception. Healthcare workers’ schedules, including breaks and meals, often vary due to the—sometimes urgent—needs of patients, and this can complicate compliance efforts. The U.S. Department of Labor (DOL) has investigated 376 complaints since 2010 for alleged violations of the law regarding expression of milk, and nearly 25 percent of those complaints involved healthcare organizations.

Section 7(r) of the Fair Labor Standards Act (FLSA) requires that employers provide the following for one year after a child’s birth to an employee who needs to express milk: (1) a reasonable break time each time the employee needs to express milk; and (2) a place to express milk. Notably, the place cannot be a bathroom and must be a private area that is “free from intrusion from coworkers and the public.” Employers in all industries are subject to the law, but there is a limited exception for employers with fewer than 50 employees if complying with the law would cause “an undue hardship.” State laws may offer greater protections than federal law in this area.

Many healthcare employers have begun to create policies to ensure the proper support for employees who need to express milk. Some organizations schedule breaks to give breastfeeding employees ample time to pump, or assign a break buddy to cover a patient load while a nursing employee takes a break to express milk. For example, some emergency medical service organizations have accommodated nursing employees, whose normal workspaces are ambulances, by allowing them to express milk at the station while other employees cover for them or to pump in the back of their ambulances. Other employers have worked to create mutually agreeable schedules or assignment changes to provide nursing employees with more flexibility to take breaks during their shifts to express milk.

Creating suitable locations for the expression of milk can be challenging for employers, especially those operating in smaller settings with limited space. Some healthcare entities have dedicated permanent space, particularly in hospitals, for nursing employees, patients, or visitors. Other healthcare organizations have maximized temporary private spaces as the need arises for employees to express milk. These include private offices, conference rooms, or other safe places with at least a chair and a flat space, other than the floor, on which to place a breast pump. Central features of such rooms may include electricity, temperature control, proper ventilation, doors with locks, good lighting, and, possibly, refrigerators, microwaves, clocks, mirrors, and sinks so that nursing employees can express and store milk.

Though implementing an effective lactation accommodation program can at times be a daunting task, a healthcare organization may want to consider the following strategies:

• creating a team to assess the current status of and environment surrounding the lactation accommodation program;
• designating a point person to oversee the program who can listen when employees raise issues and report back to the team;
• identifying resources for the team to review in order to resolve any deficiencies or advance opportunities for improvement;
• creating or updating lactation accommodation policies and procedures;
• publicizing the program; and
• checking in with the team or point person to ensure the program is running smoothly and issues are being addressed quickly.