BOSTON — FOR most new mothers who return to work, continuing to feed their babies with breast milk has become a game of hide and seek. Many women sit in supply closets, vacant offices, or even toilet stalls, pumping their milk into bottles or plastic bags to feed their babies later.
Why the secrecy? ``A lot of companies are unaware of this need,'' says Rona Cohen, an assistant clinical professor of maternal child health at UCLA's School of Nursing. And many women feel that they do not have the right to ask their companies to provide a place for them to pump their milk.
According to the National Center for Health Statistics in Hyattsville, Md., more than 50 percent of adult women work outside the home, and 80 percent will become pregnant during their working lives. As the number of women entering the work force continues to increase, some advocates are moving the issue of breast-feeding out of the supply room and into the boardroom.
Ms. Cohen is the national manager of Sanvita, a unique program that helps companies set up lactation programs. Sanvita was launched in 1992 by Medela Inc., a breast-pump manufacturer in McHenry, Ill. Of the 50 percent of mothers who breast-feed their babies, only 12 percent are employed, according to Sanvita. Many women stop breast-feeding after they return to work, Cohen says, anticipating obstacles. Others continue, but never inform their supervisors for fear of being reprimanded or fired. ``When [a company] has a Sanvita program, that company has the stamp of approval toward pregnancy and toward breast-feeding,'' Cohen says.
Some companies set up pump rooms for those employees already breast-feeding, but providing such a room without offering counseling reaches only a small segment of women, Cohen says. ``When you put a pump in a room, the people who tend to use it are those who are already highly committed - that is, your highly educated, highly positioned woman.''
Breast-feeding remains a largely upper-income practice in the United States, Cohen says. The Sanvita program targets women of all incomes and cultures, including blue-collar workers. ``Many of these families have never thought about breast-feeding or the obstacles ... they need more help and more encouragement.''
The Sanvita program includes a lactation specialist who helps set up pump rooms, provides prenatal education for families, promotes the program within the company, and helps recruit participants. About 25 companies in the US use the Sanvita program, including Amoco Oil in Chicago, the Federal National Mortgage Association (Fannie Mae) in Washington, and Southern California Edison.
Sanvita programs, pumps included, cost a company about $450 to $500 per participant, Cohen says. That covers an average of 1 1/2 years of counseling and services for the family, from the beginning of the woman's pregnancy to six to 12 months after the baby is born and still nursing, she says.
To get companies to consider a lactation program, Cohen says they have to be convinced that babies relate to their bottom line. ``Every time you have a formula baby in your company, it's costing you money,'' Cohen says. A number of major medical groups have issued policy statements promoting nursing as the foundation for healthier babies.
According to Sanvita, companies with a lactation program reduced health-care costs by 35.7 percent and absenteeism by 27.3 percent. The program helps companies reduce their turnover rate and enhances employee morale, Cohen says.
Sanvita was modeled after the lactation program at the Los Angeles Department of Water and Power. DWP started the program in 1988 because it wanted to decrease absenteeism, says Beverly King, director of human resources. The No. 1 reason employees are absent from work is to care for a sick child, she says. (It costs DWP about $360 when a $15-an-hour employee is absent one day.) DWP - which has 32 pump sites throughout the department - cites ``substantially reduced'' absenteeism, particularly the first year after a baby's birth. And women on maternity leave at DWP come back to work an average of one month earlier with the lactation program, King says.
Companies without a lactation program say it is because of cost, too little space, and a concern that employees would use pump rooms on company time. But most sites are about the size of a large closet and, with electric pumps, the process can be completed in 10 to 15 minutes three times a day, King says.
In August 1993, AT&T Global Information Solutions in Dayton, Ohio, which already had pump rooms, instituted the Sanvita program. Since then, the number of employees using the pump rooms has tripled, says Lynda Cook, the company's Sanvita consultant. ``[Sanvita] is making an impact on the women who originally did choose to nurse,'' Ms. Cook says. ``They're ... nursing longer than they had intended, and the mothers who had not originally chosen to nurse at all are finding that they are happy with their decision.''