title: Breastfeeding: The Illusion of Choice.
abstract: Breastfeeding is frequently described as a woman's decision, yet this choice is often illusionary owing to suboptimal social and structural supports. Despite passage of the Patient Protection and Affordable Care Act (2010) that requires all qualifying employers to provide mothers "reasonable" break time and a private, non-bathroom space to express breast milk, the majority of women in the United States still do not have access to both accommodations.
  
  
  
  At least three issues may be influencing this suboptimal implementation at workplaces: 1) federal law does not address lactation space functionality and accessibility, 2) federal law only protects a subset of employees, and 3) enforcement of the federal law requires women to file a complaint with the United States Department of Labor.
  
  
  
  To address each of these issues, we recommend the following modifications to current law: 1) additional requirements surrounding lactation space and functionality, 2) mandated coverage of exempt employees, and 3) requirement that employers develop company-specific lactation policies.
  
  
  
  If the goal is to give women a real choice of whether to continue breastfeeding after returning to work, we must provide the proper social and structural supports that will allow for a truly personal decision. No mother should have to choose between breastfeeding her child and earning a paycheck.
authors.affiliation: Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey. Electronic address: DinourL@mail.montclair.edu.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Dinour
authors.affiliation: Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey.
authors.forename: Yeon K
authors.initials: YK
authors.lastname: Bai
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D002755:Choice Behavior; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007878:Legislation as Topic; D009035:Mothers; D016134:Organizational Policy; D058991:Patient Protection and Affordable Care Act; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires; D014481:United States; D014931:Women, Working / Q000523:psychology / Q000706:statistics & numerical data; D017132:Workplace