title: Workplace Lactation Support in Milwaukee County 5 Years After the Affordable Care Act.
abstract: BACKGROUND
  Workplace lactation support has become increasingly important because returning to work is associated with discontinuing breastfeeding and women in the workforce are increasing. Research aim: This study examined workplace lactation support among Milwaukee County businesses 5 years after implementation of the Affordable Care Act's Break Time for Nursing Mothers provision.
  
  
  METHODS
  A cross-sectional survey of Milwaukee County businesses was conducted in the summer of 2015 that inquired about workplace policies, lactation spaces, and other lactation resources offered. Business supports were stratified based on employer sizes: large (> 500 employees), medium (50-499 employees), and small (20-49 employees). A lactation amenity score was calculated for each business based on lactation resources available.
  
  
  RESULTS
  Three hundred surveys were distributed and 71 businesses voluntarily completed the survey. Small employers were excluded from statistical analysis due to fewer responses ( n = 8). Overall, 87.3% ( n = 55) of respondents reported providing access to a multiuser space for lactation and 65.1% ( n = 41) reported providing a designated lactation space. Large employers ( n = 30) were more likely than medium employers ( n = 33) to provide a designated lactation space for breastfeeding or expressing (86.7% vs. 45.5%, p < .001). Large employers' mean amenity score was significantly higher than that of medium employers (3.37 vs. 2.57, p = .014), and they were also more likely to offer additional supports including access to a lactation consultant, classes, and materials (46.7% vs. 12.1%, p < .01).
  
  
  CONCLUSIONS
  Large employers provide more lactation support than medium employers in Milwaukee County. All employers, regardless of size, need to increase additional lactation support for women in the workplace.
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Lennon
authors.affiliation: 1 Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Earnestine
authors.initials: E
authors.lastname: Willis
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000639:trends; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007774:Lactation / Q000523:psychology*; D009111:Local Government; D009035:Mothers / Q000523:psychology; D058991:Patient Protection and Affordable Care Act / Q000639:trends*; D012944:Social Support; D011795:Surveys and Questionnaires; D014922:Wisconsin; D017132:Workplace / Q000523:psychology* / Q000592:standards
keywords: Affordable Care Act; breastfeeding; child health; postpartum; women; workplace