Washington State Nutrition & Physical Activity Plan
Nutrition Obj. 3: Priority Recommendation A
Assure that health care settings, child care facilities, and worksite environments support breastfeeding

Most Washington businesses employ women of childbearing age. Though only 13% have a written policy to support breastfeeding, 31% report having a dedicated area that women can use for breastfeeding or pumping milk.

It is easier to breastfeed when healthcare systems, worksites, families, and communities create breastfeeding-friendly

environments. Breastfeeding promotion starts before birth and is supported by hospital practices that encourage breastfeeding over formula feeding unless medically indicated.(6,7) More than 70 percent of mothers with children younger than three years, work full time.(8) A supportive work environment that promotes maternal and child health reduces staff turnover and absenteeism, and improves productivity and loyalty.(6)

Mother and infant


Examples of Activities

Cover breastfeeding-related supplies and services through private and state funded health insurance.

Insurance coverage for lactation services increases the number of women who breastfeed and the length of time they breastfeed.(9) In Washington, Medicaid covers lactation services and electric breast pumps only when medically indicated, not necessarily when returning to work.

Establish hospital and maternity center practices that promote breastfeeding.

Established hospital policies make it easier for new mothers to choose breastfeeding and have a strong impact on long-term breastfeeding success.(3) As recommended in the Blueprint for Action on Breastfeeding(6) and the CDC Guide to Breastfeeding Interventions,(7). the Seattle-King County Breastfeeding Coalition developed model breastfeeding standards for King County hospitals in 1996.(10) These standards are consistent with policies and procedures outlined in the Baby-Friendly Hospital Initiative established by UNICEF and the World Health Organization, an initiative which recognizes hospitals and birth centers that provide an optimal environment for the promotion, protection and support of breastfeeding.(11) Evergreen Hospital Medical Center in Kirkland was the first hospital in the United States to be designated a Baby-Friendly Hospital by this international health program.(12) Other Baby-Friendly hospitals in Washington include Okanogan-Douglas District Hospital in Brewster, St. Mary’s Medical in Walla Walla, and Tacoma General in Tacoma.(13)

In line with the “International Code of Marketing of Breast-milk Substitutes,”(14) the “Ban the Bags” national campaign was started in 2006.(15) The campaign was started to stop formula company marketing in maternity hospitals. Specifically, the campaign advocates against providing formula sample packs and promotional items to new families at discharge. All of Washington’s Baby Friendly hospitals and many other hospitals such as Legacy Salmon Creek Hospital in Vancouver are “bag-free.”
Train health care professionals.

The American Academy of Pediatrics, Health and Human Services Blueprint for Action on Breastfeeding, and the CDC Guide to Breastfeeding Interventions recommend enhanced training for physicians and other health care providers. In 2003, WithinReach, the Breastfeeding Coalition of Washington and Public Health-Seattle & King County’s WIC Program established the Physician Lactation Education Collaborative.(16) The collaborative provides culturally competent, evidence-based research, education, and support to health care providers and encourages them to adopt policies that support breastfeeding.

Develop policies and incentive programs that encourage employers to provide breastfeeding-friendly worksites.

As described in the CDC Guide to Breastfeeding Interventions,7 extended maternity leave supports both breastfeeding initiation and duration rates. In April 2007, Washington became the second state in the nation to ensure paid family leave for all parents caring for a newborn or newly adopted child. The new family leave program described in Senate Bill (SB) 5659 goes into effect October 2009.(17)

For breastfeeding mothers returning to work, a 2001 Washington law “exempts the act of breastfeeding or expressing breast milk from the indecent exposure laws”(18) and encourages employers to accommodate breastfeeding mothers.(19) Several employers in Washington were recognized by the Breastfeeding Coalition of Washington for their leadership and contribution to promoting and supporting breastfeeding as a vital part of the health and development of children and their families. In 2007, the award was presented to Blue Bird, Inc., a co-operative fruit packing company in central Washington that employs approximately 1,600 seasonal employees in their packing houses, orchards, and offices. Blue Bird provides two comfortable private rooms with refrigerators and electric breast pumps, and allows employees to flex their hours to ensure adequate time to express breastmilk during working hours. All Blue Bird employees, including upper management, have received information and training about breastfeeding at work.(16)

Graph: Lactation Room Ammenities - Washington Worksites

Develop policies that require child care facilities to provide quality breastfeeding support.

Child care centers can help increase breastfeeding rates by supporting breastfeeding mothers.(6) Centers can provide safe storage facilities and procedures for using expressed breastmilk. They can respect a mother’s instructions about feedings, and provide a quiet and comfortable place for mothers to breastfeed on-site. The on-site child care facilities at Northwest Hospital and Medical Center (20) in Seattle and ICOS Corporation (21) in Bothell have an "open door policy" to encourage employees to breastfeed or play with their child during work breaks. Child care providers call mothers when their child is hungry and have facilities to hold and thaw breastmilk. The on-site child care facility at Northwest Hospital also has a comfortable sitting area for mothers to nurse or pump.

Establish policies to support breastfeeding friendly communities.

The CDC Guide to Interventions encourages public acceptance of breastfeeding. In 2006, the Moses Lake City Council adopted a resolution encouraging the community to recognize the benefits of breastfeeding and support a breastfeeding mother’s right to breastfeed her baby anywhere. The Moses Lake Breastfeeding Coalition is bringing awareness to the resolution through outreach to local businesses and to WIC and Head Start to reach breastfeeding mothers. The coalition also offers assistance to businesses that want to become more breastfeeding friendly.(22)