Breastfeeding in the Workplace Polices and Maternal Employment Decisions

Recent national policy efforts have been aimed at increasing breastfeeding rates and duration.  In 2011 the Surgeon General issued a call to action to support breastfeeding, citing breastfeeding as a highly effective preventive measure for promoting infant health (US Health and Human Services, 2011).  The Department of Health and Human Services identified increasing the proportion of infants who are breastfed as a target in two of its most recent Healthy People reports (HHS, 2000; 2010). As part of the Patient Protection and Affordable Care Act (ACA) of 2010, employers with 50 or more employees are required to provide reasonable break time for an employee to express breast milk (for one year following birth) and a private place other than a bathroom that may be used to express milk.  The federal requirements do not preempt existing state laws.   Although recent research suggests that breastfeeding in the workplace policies increase breastfeeding initiation and duration (Hawking et al. 2013), the relationship between these policies and maternal employment decisions is not as well understood.  Several studies have found that the sooner the mother returns to work the earlier she stops breast-feeding (Mandal et al. 2012; Mandal et al. 2010; Chatterji & Frick 2005; Roe et al. 1999; Visness & Kenney 1997) but only two consider the possibility that work and breastfeeding decisions are made simultaneously (Roe et al. 1999; Mandal et al. 2012). 

We exploit pre-ACA variation across states to identify the effects of breastfeeding in the workplace policies on employment outcomes.  Prior to the ACA, 24 states had breastfeeding in the workplace laws and more than forty had provisions to allow women to breastfeed in public and private locations.  Data for our analysis come from the Infant Feeding Practices Study, which contains detailed information on (1) breastfeeding attitudes and experiences before, shortly after and up to one-year following delivery and (2) maternal employment status/characteristics both before and after delivery.