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Affordable Care Act Supports for Nursing Mothers in the Workplace

gb nursingmothersPublic Health in the National News –  Passage of the Patient Protection and Affordable Care Act (PPACA) in 2010 improved the picture for breastfeeding women in the workforce. PPACA amends Section 7 of the Fair Labor Standards Act (FSLA) of 1938 by adding provisions requiring employers to provide reasonable break times for nursing employees to express milk and that they provide a place, other than a bathroom, shielded from view and free from intrusion in which to express milk (Section 7(f) of the Fair Labor Standards Act – Break Time for Nursing Mothers Provision).

This provision is the first federal law to explicitly require accommodation for mothers who wish to continue breastfeeding while working outside the home (Murtagh & Moulton, 2011).  By using the FSLA as the legislative vehicle for these provisions, Congress made accommodation for breastfeeding mothers an integral part of the US labor laws and thus provided protections for women in states that do not offer legal accommodation for breastfeeding employees.

While passage of the breastfeeding provisions in the PPACA was cause for celebration among breastfeeding advocates, there are still concerns. The provisions apply only to hourly wage workers and not to salaried employees or to certain classes of employees such as school teachers and agricultural workers (Murtagh & Moulton, 2011). The act also applies only to expressing breast milk or pumping and not feeding the child at the breast, a perspective that assumes pumping is the preferred option and insulates employers from developing alternatives that would allow mothers to feed their child at the breast while at work. Small employers with fewer than 50 employees are exempt if they can demonstrate hardship in complying with the law (Murtagh & Moulton, 2011).

The wording of the law is vague and does not provide guidance on what constitutes reasonable break time nor what a place other than a bathroom that is shielded from view and free from intrusion looks like. What constitutes hardship for small employers is also not clearly defined.

As with other vaguely worded legislation that could be interpreted as supporting nursing mothers in the workplace, the courts will become the final arbiter of how the provisions in the PPACA are implemented. The courts’ track record in supporting nursing mothers in the workplace is not good, but breastfeeding advocates hold out hope that the provisions of the PPACA are the start of a new perspective.

Murtagh, L., & Moulton, A. D. (2011). Working mothers, breastfeeding, and the law. Am J Public Health, 101(2), 217-223. doi: 10.2105/ajph.2009.185280

Section 7(f) of the Fair Labor Standards Act – Break Time for Nursing Mothers Provision.   Retrieved July 29, 2012, from

This article was written by Lea Pounds, MBA, instructor in the UNMC COPH Department of Health Promotion, Social and Behavioral Health.

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