One little-discussed provision in the new health care reform law requires all employers to provide unpaid break time and private space for nursing mothers to pump breast milk at work.
Sen. Jeff Merkley, D-Ore., who sponsored the breast-feeding legislation in the Senate, calls it "a revolution in American culture."
"Essentially, until now there's never been a national discussion, a national sense of, 'Oh, of course this is something we should accommodate,' " Merkley says.
In 2007, as speaker of the Oregon House of Representatives, Merkley championed the state law that served as a model for the federal law. In all, 24 states, the District of Columbia and Puerto Rico have laws on nursing mothers at work. The U.S. law doesn't supersede state laws that offer greater protections, such as paid breaks.
Although the breast-feeding provision took effect when President Obama signed the Patient Protection and Affordable Care Act on March 23, some details haven't been ironed out.
"The whole issue of enforcement is still up in the air," says Joan Younger Meek, an Orlando pediatrician and lactation consultant who chairs the U.S. Breastfeeding Committee, a non-profit advocacy organization. "What will be the recourse for women if they feel they are not being afforded this protection?"
In a "Fact Sheet" that was released this month, the U.S. Department of Labor's Wage and Hour Division provided some general information about the new legislation:
*Employers must provide "reasonable break time" for an employee to express breast milk until her nursing child turns 1. Advocates say nursing mothers need about a half-hour break for every four hours worked.
*Employers must be flexible as far as the timing and length of breaks needed by nursing mothers to express milk.
*Although a bathroom is not a permissible space, employers don't need a dedicated lactation center, as long as a suitable temporary space is available when needed by a nursing mother.
*Companies with fewer than 50 workers don't have to give breast-feeding breaks if they can show that doing so would impose an "undue hardship."
The legislation covers only women who are paid an hourly wage, not a salary, although some state laws cover both.
"Some states put their breast-feeding laws in their family-leave set of regulations," says Alan Quiles, a labor and employment lawyer in Miami. "In that case, the focus is more on having the time as a medical necessity as opposed to just a break."
His colleague Kelly Kolb says, "In our mind, there's no principled reason to treat hourly and exempt (salaried) employees differently with respect to this."
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