1. Scope
2. Terminology
3. Lactation Breaks
4. Commonwealth Government Committment to Breastfeeding Initiatives
5. Equity
6. Benefits of Lactation Breaks
7. Employers
8. The Australian Context
9. ABA'S Record in the area of Breastfeeding and Work.
10. References

1. SCOPE

The Human Rights and Equal Opportunity Commission report into discrimination in pregnancy recommends that breastfeeding be specifically included as a ground of unlawful discrimination (Recommendation 43) and that Australian Governments encourage broad national debate regarding the amended draft text of ILO Convention 103 with a view to ratifying and implementing the resultant Convention (Recommendation 45). ¹

The current Maternity Protection Convention provides a framework for legislation that protects the rights of mothers in the workforce, including maternity leave and nursing breaks. ABA believes that the issue of lactation breaks should continue to be dealt with in ILO Convention 103 as a maternity protection issue.

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2. TERMINOLOGY

ABA has used the term "lactation breaks" throughout this paper. The terms "nursing breaks" and "breaks for lactation purposes" are in use in the Convention and other countries. Whatever terminology is used, it is clear that these breaks are either for breastfeeding or expressing breastmilk to be fed to a baby at a later time.

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3. LACTATION BREAKS

Whilst two thirty-minute breaks per working day would generally be adequate, ABA believes that flexibility is important. The frequency and length of lactation breaks could be adapted to particular needs on the presentation of a medical certificate or other appropriate certification. ABA supports the right of individuals to choose the timing of weaning her child and therefore the length of time for which these breaks are available should not be limited. An employee's need for lactation breaks during her working day is likely to be for only a short time in her overall working life.

Based on the experience of many thousands of women, ABA sees the chief requirements for a woman to successfully combine breastfeeding and work to be:

• flexible lactation breaks
• a private place in which to breastfeed or express breastmilk
• support of the employer and her colleagues

Lactation breaks are the lynch pin for any supportive workplace practices to promote breastfeeding and without them, all else fails. ²

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4. COMMONWEALTH GOVERNMENT COMMITMENT TO BREASTFEEDING INITIATIVES

ABA urges the Government to be mindful of its health policies and objectives as it develops policy related to the Maternity Convention. It makes no sense to set targets for breastfeeding and then develop contradictory workplace relations policy.

The World Health Organisation's (WHO) current infant-feeding recommendation is that infants should be fed breast milk exclusively for around the first six months of life, ^{3, 8 14-17,34} thereafter, infants should begin to receive nutritionally adequate and safe complementary foods, while continuing to breastfeed.^{3, 17-25, 31} The health evidence in favour of continuing to breastfeed in combination with other foods to twelve months and beyond is overwhelming. ^{3, 4, 22, 26-34}

Even women who are eligible for maternity leave will be returning to work before their babies are three months old. In these circumstances women may have to choose between continuing to breastfeed and working if support for maintaining breastfeeding after returning to work is not available. There is little hope of encouraging more Australian women to breastfeed for longer unless working women are enabled to practice breastfeeding.^{5, 35}

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5. EQUITY

The issue of lactation breaks is a particularly female issue. However, it is also an issue of importance to families, as increasingly families struggle to combine work commitments with family needs. In supporting their female employees, employers need to recognise their needs related to pregnancy, birth and lactation.

Commonwealth Government responsibilities under CEDAW and domestic anti-discrimination law are relevant. A woman may make choices whilst pregnant, about returning to work after the birth, based on workplace arrangements. Women return to work after the birth of their baby for diverse reasons including financial need and investment in a career. Many feel they must choose between breastfeeding and returning to work. Women need to see institutional support for breastfeeding and working to feel that this is an option. It is inequitable that only women with significant influence or those who have forward-thinking employers should be able to have access to lactation breaks. For these provisions to be more widely implemented and accessible to Australian women, it is not sufficient to rely on the goodwill of Australian employers. It needs to become part of standard workplace practice.

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6. BENEFITS OF LACTATION BREAKS

The benefits to employers are:

• a simple and cheap way to increase morale and loyalty
• demonstrating a best practice approach by offering family-friendly work provisions
• increasing rates of return after maternity leave thus reducing skills loss and recruitment costs
• reduced absenteeism due to lower rate of illnesses in breastfed babies⁶

The benefits to employees are:

• increased sense of value as an employee
• emotional well-being related to maintaining a physical and emotional link with her baby
• physical well-being due to reduced engorgement and discomfort
• being able to continue her work while also fulfilling her commitment to her baby
• longer breastfeeding period with health benefits for her baby^{7, 28, 29, 36-40}

The benefits to Government and public health are:

• improved infant health related to lower incidence of insulin dependent juvenile diabetes, respiratory infections, gastro-intestinal infections, ear infections, inflammatory bowel disease and childhood lymphoma amongst others ^{4, 28, 36-46}
• improved women's health related to reduced risk for some cancers ^{9,10, 47}
• reduced health care costs ¹¹
• economic benefits ¹²

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7. EMPLOYERS

More than 50 workplaces in Australia have received the Mother Friendly Workplace Award (an initiative of ABA), readily agreeing to provide access to lactation breaks. Peter Reith's Parliament House office and a number of Government departments have received this award. The 1999 Corporate Work and Family Awards highlighted Australian employers who have adopted family-friendly work practices.

If a workplace implements access to lactation breaks there are many creative ways of accommodating the time factor without impacting on the employer's or employee's time. Basically, lactation breaks cost very little to implement. Similarly, other provisions for family-friendly workplaces are also low-cost. An employee who is breastfeeding requires these provisions for a relatively short period in their overall working life.

More than 80 countries world-wide already have provisions in national legislation for lactation breaks including France, Austria and Scandinavian countries.

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8. THE AUSTRALIAN CONTEXT

ABA acknowledges that in the Australian industrial relations context, lactation breaks can be included in workplace agreements. However, in practice, it is very rare for this to happen for the following reasons:

• The vast majority of female workers are within small to medium sized workplaces. Often formalised requirements are needed for change to happen in workplace provisions.
• Women who need lactation breaks may be individuals who feel isolated or powerless in their workplace. They may feel embarrassed or intimidated about raising the issue with their employer.¹³
• The need for the inclusion of lactation breaks in workplace agreements may not be recognised at the time they are made, making it more difficult for change to occur at a later stage.

The inclusion of lactation breaks in the ILO Maternity Convention assists in setting international labour standards and provides impetus for change at a national level. ABA believes that the Government should act on this issue to ensure that Australian women are not disadvantaged. Provisions for lactation breaks are also of particular importance for mothers and babies in less developed countries. They are necessary for the specific purpose of an ILO Convention which sets standards for a wide range of countries.

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9. ABA'S RECORD IN THE AREA OF BREASTFEEDING AND WORK

• Introduced the inaugural Mother Friendly Workplace Awards in 1995
• Established the Breastfeeding and Work Working Group which develops policy and resources in this area
• Collaborated on a joint project with the Department of Industrial Relations which culminated in the Work and Breastfeeding Guide distributed nationally by the Department.
• Provides resources including the Mother Friendly Workplace Information Sheet, Breastfeeding Women & Work booklet, Expressing & Storing Breastmilk booklet, The Carer's Guide to the breastfed baby, "We Can Work It Out" section in the National Newsletter, Working and Breastfeeding Guide (joint ABA & DIR publication), Case studies
• Provides services including telephone and face-to-face counselling, talks to employers, seminars on breastfeeding and work, group discussions, breast pump hire , Lactation Resource Centre providing information and resources to health professionals

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REFERENCES

1. Report of the National Pregnancy and Work Inquiry, Human Rights and Equal Opportunity Commission, 1999.
2. Bar-Yam, Naomi Bromberg. Workplace lactation support, Part 11: Working with the workplace. Journal of Human Lactation 1988 (December); 14:321-325.
3. The World Health Organization's infant-feeding recommendation. Weekly epidemiological record, 1995, 70(17):119-120.
4. American Academy of Paediatrics; Breastfeeding and the Use of Human Milk. Pediatrics Vol. 100 No. 6, December, 1997, pp1035-1039.
5. Scott JA, Binns CW, Aroni RA, Curtin University of Technology, Perth, Latrobe University, Melbourne 1997, Infant feeding practices in Perth and Melbourne - 1993. Report 2: Factors associated with the duration of breast-feeding and women's breast-feeding experiences. National Better Health Promotion Program Grant 120 pages.
6. Cohen R, Mrtek MB, Mrtek RG 1995, Comparison of maternal absenteeism and infant illnesses among breastfeeding and formula feeding women in two corporations. AM J Health Promotion 10(2): 148-153
7. . Hills-Bonczyk SG, Avery MD, Potter S, Duckett LJ 1993 Women's experiences with combining breastfeeding and employment. Journal of Nurse-Midwifery Vol 38 No 5 Sept/Oct 257-266.
8. .Forty-seventh World Health Assembly, May 1994, resolution WHA 47.5 on Infant and young child nutrition.
9. United Kingdom National Case-Control Study Group. Breastfeeding and the risk of breast cancer in young women, British Medical Journal, 307:17-20, 1993.
10. Rosenblatt KA et al. Lactation and the risk of epithelial ovarian cancer, International Journal of Epidemiology, 22 (2): 192-197, 1993.
11. Smith JP & Ingham LH 1997 The economic value of breastfeeding in Australia, 200-222, ABA International Conference Papers, ABA. Oct 23-25
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13. Galtry J 1995, Breastfeeding and paid employment in New Zealand: What role for nurses? Nursing Praxis in New Zealand November, Vol 10 No 3 24-32.
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47. Newcomb PA, Storer BE, Longnecker MP, et al. Lactation and a reduced risk of premenopausal breast cancer. N Engl J Med. 1994;330:81-87.

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