Some 94% of US universities that participated in a national survey on lactation spaces have such facilities, according to a 19 March study1. But just 105 of the 684 campuses polled responded to the survey, which sought to determine how many institutions accommodate the physical needs of nursing mothers, and the nature of the facilities provided.
Just over one-quarter — 28% — of the campuses that responded affirmatively say that their campus construction guidelines require lactation spaces.
The authors and some campus planners say that despite the low survey-response rate, the sampling should jump-start a necessary conversation among universities about how to better serve the needs of breastfeeding mothers. “The research is indisputable that breastfeeding improves the lives of individual mothers and infants and results in overall better societal outcomes,” says lead author Diane Spatz, a nurse researcher and lactation specialist at the University of Pennsylvania and Children’s Hospital of Philadelphia.
Authors sent the survey between late 2017 and early 2018 to institutional members of the Society for College and University Planning, based in Ann Arbor, Michigan. Of the 105 anonymized respondents, 99 said that they have at least 1, and up to 50, dedicated lactation rooms on campus. On average, respondents estimated, about three-quarters of staff members and students can access these spaces in 5–7 minutes from wherever they are on campus. But fewer than half of the campuses reported having a public directory of the spaces, and just 13% track their use.
And many US scientist-mothers, particularly early-career researchers such as PhD students and postdocs, report having limited or no access to lactation spaces in which to privately, frequently and sanitarily express breast milk at work.
A biological need
Spatz notes that the American Academy of Pediatrics in Itasca, Illinois, and the World Health Organization in Geneva, Switzerland, recommend that women who are able to breastfeed do so exclusively for the first six months of a baby’s life and then non-exclusively for at least six more months, if possible.
When breastfeeding scientists return to their workplace, they need a 20–40 minute break every 2–3 hours to express milk, for 6–9 months or longer. “Investing in breastfeeding is the right thing to do,” says Spatz. “Unfortunately, as a society, we place all of the onus on the woman” to determine how best to meet a biological need.
Dare Henry-Moss, a consultant for workplace lactation support in Philadelphia, says that lactation is a biological function with requirements that are easily anticipated. “You wouldn’t make a building with no bathrooms,” says Henry-Moss, who conducted the survey with Spatz and colleagues as a master’s student at the University of Pennsylvania. She says that universities should have lactation spaces and policies in place so that women — particularly students and junior staff members — don’t have to individually ask for accommodations.
The US Affordable Care Act, which passed in 2010, mandated that US employers provide adequate breaks and a private space, separate from toilets, for expressing breast milk. However, architects and planners anticipate that it will take at least a decade before compliance and new construction standards kick in. They point to the 1990 Americans with Disabilities Act as an example: that legislation mandated accommodations for people with disabilities in public buildings, but the final construction standards for such accommodations weren’t enforced until 22 years later.
Path to bricks and mortar
Lactation spaces are not required by current federal or state building codes for public buildings. But the survey is prompting campuses to ask how other universities handle these spaces, say planners. “It’s going to take time and continued advocacy before lactation spaces get incorporated into the building code,” says Jeanne Boodley-Buchanan, an architect for Cornell University in Ithaca, New York. Like 28% of survey respondents, Cornell includes lactation spaces in its construction standards — incorporating them into the design of new buildings or major renovations on campus. It’s also one of a handful of US campuses, including 19 of those surveyed, that had sought out a lactation expert to plan those spaces.
More than half of survey respondents reported that most or all of their lactation spaces included one or more of these features: a locking door, electrical outlets, lighting controls, Internet access, counter or table space and wipes or paper towels. Fewer than half, or 40%, reported that most rooms had a sink, or that they post contact information in the space for reporting problems. Fewer than one-quarter said that most rooms had a refrigerator for storing milk, and just ten campuses reported having a hospital-grade pump available for use in at least a few rooms — a feature that can cut by half the time required to express milk.
“We can’t treat every woman as if they are the first to have asked about this,” says Henry-Moss. She notes that campus planners and administrators who have never breastfed a baby also don’t realize that breastfeeding women need support from their institution, because pumping is often an unpleasant chore: “It’s not fun, it doesn’t feel good and it’s not a ‘break’.”
Henry-Moss, D., Lee, J., Benton, K. & Spatz, D. L. Breastfeeding Med. https://doi.org/10.1089/bfm.2018.0198 (2019).