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Publication Date



2021 prov rn wa; 2021 prov rn poster; washington; spokane; pshmc


Maternal, Child Health and Neonatal Nursing | Nursing


Background: Breastfeeding is the gold standard for infant nutrition. Many workplace barriers to lactation exist for mothers returning to work after the birth of an infant. In 2010 the Breastfeeding Provisions in the Patient Protection and Affordable Care Act (BP-PPACA) was enacted as the first federal breastfeeding law which outlined specifically break time and a place to pump for businesses with over 50 employees who employed hourly wage workers. There is little known about the satisfaction of hospital employees pumping/lactation experience after the BP-PPACA.

Purpose/Aims: The purpose of this study was to determine the extent to which employed mothers' perceived satisfaction in their breastfeeding experiences after the BP-PPACA. A major aim is to determine the extent to which the health policy allows employed mothers to combine breastfeeding and employment at two Northwestern U.S. hospitals since the 2010 law. Data were from self-reported breastfeeding initiation/duration and pumping experiences.

Methods/Approach: This 43-item survey in REDCap-Research Electronic Data Capture was exploratory and descriptive and sent out to all female employees at 2 hospitals in July 2020. The survey included demographic questions, occupation, as well as five Likert-scale satisfaction questions related to the experience with the BP-PPACA. Results: N=215 returned surveys from one large (over 500-bed) hospital and one medium (100-499 bed) hospital. Employees represented a variety of areas: administrate (non-clinical), clinical pharmacy, food service/dietary (other), phlebotomy/ other lab, EKG/other licensed techs, sterile processing, switchboard/ other communications, however most participants were from nursing. Most responses indicated satisfaction 1) with the BP-PPACA, 2) in their own breastfeeding duration and 3) exclusive use of breastmilk, however there were diverse positive and negative experiences 4) in the actual break time and 5) places to pump.

Conclusions: The BP-PPACA are a start for increasing breastfeeding in the U.S. among employed mothers however other policy considerations include support for PUMP for Mothers Act (S. 3170 and H.R.5592), and future building construction to include lactation spaces. Future research should explore paid maternity leave, on-site daycare/bring baby to work, occupational types, salaried employees, tax deductions for businesses for better workplace accommodations, ideal milk expression times for full milk expression and other satisfaction level research for whom these policies are aiming to support.

Clinical Institute

Women & Children



Conference / Event Name

2021 Providence RN Conference


Virtual Conference

Employed Mothers’ Satisfaction with the Breastfeeding Provisions in the Patient Protection and Affordable Care Act in Two Northwestern U.S. hospitals