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MUN Breastfeeding Policy

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MUN Breastfeeding Policy Powered By Docstoc
					Report to the Breastfeeding Policy Committee
            Memorial University
                 November 2007




        Janet Murphy Goodridge RN, MN, IBCLC
                  Project Consultant
                                          Table of Contents


Introduction and Background ..................................................................... 3
Benefits for the University in Developing a Breastfeeding Policy………5
Breastfeeding and the Workplace: Key Issues........................................... 6
Environmental Scan ..................................................................................... 7
Summary ...................................................................................................... 10
Proposed Policy Statement ......................................................................... 11
Policy ............................................................................................................ 13
Procedures ................................................................................................... 16
Financial Implications ................................................................................ 16
References .................................................................................................... 17
Appendix A .................................................................................................. 21




                                                                                                                    2
Introduction and Background
The development of a breastfeeding policy arises from questions that have come forward
from faculty in the School of Nursing regarding a student’s request to breastfeed during
lectures. This issue has arisen in the past within the Faculty of Medicine. As a result, the
Faculty of Medicine developed Guidelines for Breastfeeding Infants in Class through “A
Project of the Office of Student Affairs” in conjunction with “Provincial Physician
Recruitment”. Several medical students have returned to their medical studies while
breastfeeding infants. The guidelines were developed to support breastfeeding and to
ensure an environment conducive for learning when infants are present.


Breastfeeding provides unequalled food for the healthy growth and development of
infants and young children. Research studies provide compelling evidence that
breastfeeding improves health outcomes from infancy through to adult life (Feldman &
Frati, 2005; Horta, Bahl, Martines, & Victora, 2007). Breastfeeding contributes to health
through a reduction in the incidence and duration of common illness such as respiratory
tract infections, gastrointestinal infections, and middle-ear infections (American
Academy of Pediatrics, 2005). Furthermore, breastfeeding enhances the emotional,
social, and cognitive development of the infant and child. More current research suggests
that breastfeeding may have long-term health benefits such as lower cholesterol levels,
less obesity, and less Type 2 Diabetes (Horta et al., 2007). The health outcomes are more
pronounced when infants are breastfed for longer and more exclusive periods. Women
also benefit from increased breastfeeding. Breastfeeding offers protection for some
women against breast and ovarian cancers and osteoporosis (Collaborative Group on
Hormonal Factors in Breast Cancer, 2002; Rea, 2004). In addition, there are substantial
cost savings to the health care system in the long term when breastfeeding is promoted
and supported. There are fewer hospital admissions, physician visits, and prescription
medications for common childhood illnesses.


The World Health Organization (WHO) and Health Canada recommend that all women
be enabled to breastfeed their infants exclusively for the first six months, and continue



                                                                                            3
breastfeeding for up to two years and beyond (Health Canada, 2004; WHO, 2003).
Newfoundland and Labrador has the lowest breastfeeding rate in Canada, with only
62.7% of women initiating breastfeeding (Newfoundland and Labrador Provincial
Perinatal Program, 2006). This rate drops to 27.5% at six months, with only 11% of
these infants exclusively breastfeeding (Statistics Canada, 2003). These rates fall well
below national and global recommendations. The Canadian breastfeeding initiation rate
is 85%, with a high of 93 % in British Columbia (Statistics Canada, 2003). Government
family policies play an important role in enabling women to achieve optimal
breastfeeding rates. In Norway, for example, 98% of women initiate breastfeeding, and
75% are still breastfeeding at six months (Yngve & Sjöström, 2001). These rates are a
result of significant government investment through Baby-Friendly practices in hospitals,
extended maternity benefits, and supportive workplace policies.


Memorial University (“the University”) recognizes the importance of breastfeeding for
the mother, child, family, and community at large. The University also acknowledges the
need to support employees and students in order to sustain the breastfeeding relationship
when they return to work or study. A need to return to paid employment is often
identified as a factor in the early cessation of breastfeeding in countries around the world
(Scott, Binns, Oddy & Graham, 2006; Statistics Canada, 2005). Bromberg Bar-Yam
(2004) found that a return to paid employment in the first-year postpartum is a major
deterrent to continued breastfeeding. McKinley and Hyde (2004) reported that for
women employed outside the home, structural variables such as the length of maternity
leave and workplace flexibility, along with personal attitudes about breastfeeding,
predicted duration.


Balancing work and family commitments is an important issue for Canadian families. In
recent years there has been a trend toward more women with young children returning to
the workplace. From a university perspective, female students currently make up 60% of
Memorial’s student population. In light of the substantial evidence that supports
breastfeeding as an important preventive health measure, there is sound rationale for the
development of a university breastfeeding policy. Workplace policies that are supportive



                                                                                            4
of breastfeeding will have a lasting positive impact on mothers, children, and their
families. Furthermore, when organizations have policies that aim to balance work and
family issues, and support pregnant women and breastfeeding mothers, they are more
likely to attract and retain high-quality employees. Workplaces that value women as
mothers, as well as employees, increase workers’ morale, dedication, loyalty, and
productivity (Bromberg Bar-Yam, 2001).

Benefits for the University in Developing a Breastfeeding Policy


              Shows progressive leadership in Canada.
              Enhanced reputation and image as an organization concerned with the
               health and well-being of employees, students and their families.
              Greater loyalty and respect among employees and students for an
               organization that recognizes the importance of breastfeeding.
              Improved relations between the University and its employees and students.
              Relatively low-cost intervention.
              Improved job productivity, satisfaction, and morale of employees and
               students.
              Less absenteeism—parents of breastfed infants are less likely to take time
               off work/school to care for sick children (Ball & Wright, 1999; Cohen,
               Mrtek, & Mrtek, 1995).
              Increased retention of female employees and students who are more likely
               to return to work/study within a supportive environment.
              Easier transition back to work/university following the birth of a child.
              Increased awareness throughout the University of breastfeeding as the
               normal way to feed infants and children.
              Leadership role in promoting positive attitudes towards breastfeeding in
               the younger generation.




                                                                                           5
Breastfeeding and the Workplace: Key Issues


          An increasing number of women are participating in the workforce. A
           significant statistic in recent years has been the rise in employment among
           women with young children.
          Women who are employed outside the home are able to maintain a close
           relationship with their children through continued breastfeeding.
          Combining breastfeeding and work requires considerable commitment.
          Flexible work options such as job-sharing, working from home, and
           flexible start and finish times around core working hours eases the
           transition to the workplace or study setting.
          Fathers play an important role in supporting mothers to continue
           breastfeeding in the work or study environment.
          If a mother is unable to breastfeed or express her milk regularly, her milk
           supply will gradually decrease, often resulting in the early discontinuation
           of breastfeeding.
          Stress, fatigue, and the inability to breastfeed or express milk regularly
           may make new mothers more vulnerable to mastitis.
          Women are guaranteed the right under Human Rights legislation to
           breastfeed their children anytime, anywhere. Issues surrounding
           breastfeeding are included under the broad category of sexual
           discrimination. Employers have a duty to accommodate employees who
           are breastfeeding their children. The duty to accommodate under the law
           varies from case-to-case.
          Breastfeeding is an essential component of the child’s right to the highest
           attainable standard of health (UNICEF, 1989 Article 24 of the Convention
           of the Rights of the Child).
          The International Labour Organization (ILO) Convention 183 and
           Recommendation 191 outline the key elements for workplace protection
           for breastfeeding women: non-discrimination, employment protection,


                                                                                         6
                 maternity leave, and breastfeeding breaks. Convention 183 states that
                 maternity (including breastfeeding) should not constitute a source of
                 discrimination in employment or access to employment. After maternity
                 leave, women employees who are breastfeeding have the right to paid
                 breastfeeding breaks or a reduction of work hours. A breastfeeding break
                 is a period that a mother takes during her workday for breastfeeding or
                 expressing her breastmilk. A time period of 30 minutes is recommended
                 as a reasonable break time (ILO, 2000a, 2000b).1
                The Federal Labour Standards Review Commission has recommended that
                 in the upcoming revisions to Part III of the Canada Labour Code,
                 breastfeeding mothers receive unpaid breastfeeding breaks (Federal
                 Labour Standards Review Commission, 2006).
                A workplace breastfeeding policy must provide provisions for the
                 following key components: time, space, and support (Bromberg Bar-Yam,
                 1998). In addition, individuals are needed within a workplace to ensure
                 that the time, space and support come together for the breastfeeding
                 mother. For example, the human resources department or the manager
                 within a unit/department ensures the flexibility is there for time and space
                 e.g., securing an appropriate room for a mother’s privacy.

Environmental Scan


In response to the large number of women returning to work following the birth of their
children, workplaces in Canada and other countries are striving to be more breastfeeding-
friendly. There is more widespread recognition of the importance of breastfeeding
support programs in the workplace. For example, corporate lactation programs in the
United States provide employees with comprehensive lactation support such as access to
electric breastfeeding pumps, access to the knowledge and skills of a lactation consultant,
support groups, and classes for employees (Centers for Disease Control and Prevention,


1
  ILO Recommendation 191 states, “ where practicable, provision should be made for the establishment of
facilities for nursing under adequate hygienic conditions at or near the workplace” (ILO, 2000b)


                                                                                                          7
2005). These workplace programs are important in the United States where there are
limited maternity leave provisions. The federal governments in both Australia and New
Zealand have demonstrated leadership in this area with excellent resources for women
pertaining to breastfeeding in the workplace (Commonwealth of Australia, 2000;
Government of New Zealand, 2005). The Australian Breastfeeding Association (ABA)
has developed an accreditation process for recognizing breastfeeding-friendly workplaces
(ABA, 2007). However, New Zealand, Australia and the United States have no legislated
provision for breastfeeding breaks in the workplace. European countries such as
Germany, Italy, Bulgaria, The Netherlands, Spain, Portugal, and Bosnia-Herzegovina
have all followed the ILO Maternity Protection Convention and have instituted paid
breastfeeding breaks for the first year after birth. There is a variation of six months to
thirty-six months in the duration of paid breastfeeding breaks in countries throughout the
world. Several countries do not stipulate a specific duration for providing breaks.
Norway, Sweden, and France have legislated provisions for unpaid breastfeeding breaks
(World Alliance for Breastfeeding Action, 2006).


In Canada, there is considerable movement in all regions of the country to establish more
breastfeeding-friendly public spaces, and to make workplaces more accommodating for
breastfeeding mothers (Annapolis Valley Health; City of Toronto, 2001, 2007;
Middlesex-London Health Unit; Saskatoon Health Region, 2004). Canada has not
ratified the ILO Convention on Maternity Protection; therefore, there is no legislated
protection for breastfeeding breaks. Recent evidence suggests that the extended maternity
leave provisions (from six months to one year) implemented in 2001 have significantly
extended breastfeeding duration rates (Statistics Canada, 2007). While this data is
promising, Canada has a long way to go in achieving the WHO standards for
breastfeeding initiation and duration.

The majority of universities across Canada were contacted to determine the existence of a
breastfeeding policy. The results of this scan are included in Appendix A. At this point,
no universities contacted have university-wide breastfeeding policies in place. There was
interest from several universities in sharing the findings of this project. St. Francis
Xavier is currently in the process of developing a policy. Dalhousie University School of


                                                                                             8
Nursing has established a breastfeeding policy. The University of Toronto (U of T) has
designated breastfeeding-friendly spaces throughout campus. These areas are posted on
the U of T Family Care website. The University of Western Ontario has recently
received media attention for the absence of breastfeeding spaces on campus. Nursing
students were instrumental in bringing this issue forward. Three universities in Quebec
(Université du Laval, Université du Québec à Chicoutimi, and Université du Quebec à
Gatineau), offer a special breastfeeding room as a place where students, teachers, or
guests can come to relax and breastfeed. The room includes diaper changing facilities,
comfortable sofas, and a place for older children to play. It also includes up-to-date
breastfeeding pamphlets and other resources, such as information about mother-to-mother
support groups (Louise Dumas, personal communication, May 15, 2007). The
Laurentian Association of Mature and Part-Time Students (LAMPS) in Sudbury Ontario
was recognized by The Sudbury & District Health Unit as an official “Breastfeeding
Friendly” space within the Sudbury & Manitoulin Districts. LAMPS aims to make the
university more accessible for student parents.

Centennial College in Scarborough included breastfeeding as an example of workplace
accommodation in their employee’s accommodation (on the basis of human rights) policy
(Marthanne Robson, personal communication, May 15, 2007). A few of the universities
contacted indicated that although no policy exists, they have accommodated
breastfeeding students and staff on an individual basis through the provision of a private
room assigned for breastfeeding/pumping. They also support mothers to breastfeed
infants during seminars and lectures.


Several universities in Australia (Charles Stuart University, Monash University,
University of Queensland, University of South Queensland, University of New South
Wales, and University of Melbourne) and in New Zealand (Massey University) have
breastfeeding policies. Charles Stuart University helps students balance life and study by
providing a Parents’ Room, a convenient, comfortable place for breastfeeding, in the
campus library. Parents can access hot and cold water, garbage disposal, and spend time
in private. This facility has been recognized by the Australian Breastfeeding Association



                                                                                             9
(ABA) as being among the top-10 baby-care rooms in the country (ABA, 2007). A
University of Adelaide project, under the leadership of Dr. Ellen McIntyre, developed
and distributed 50,000 breastfeeding kits to assist employers in supporting breastfeeding
mothers in the workplace (McIntyre, Pisaniello, Gun, Sanders & Frith, 2002).


The University of Arizona and the University of Michigan have comprehensive lactation
support programs offered through their work/life resource centres (University of Arizona,
2007; University of Michigan, 2007). The University of Arizona website outlines
Individual Instructional/Managerial and Organizational Considerations for Managing
Campus Commitments and Breastfeeding. Similarly, the University of Iowa’s Family
Services Office, part of the Human Resources’ Organizational Effectiveness and Work
Life Services, collaborates with various campus departments to offer support to faculty
and staff who want to breastfeed their babies. The university offers 18 lactation rooms
across campus, many of which are equipped with electric breast pumps. There are also
information classes at the associated Iowa hospitals. Lactation rooms are planned in the
design of all new university buildings (University of Iowa, 2003).

Summary


There is clearly a move worldwide in the development of breastfeeding-friendly
workplace policies. In relation to university policies, there are many examples in
countries outside of Canada. Universities in countries such as the United States offer
extensive lactation support programs due to limited maternity leave provisions.
Presently, while there are no university-wide breastfeeding policies in place in Canadian
universities, there is interest in this topic, especially in regions with breastfeeding rates
below the national average. The extended maternity/paternity leave provisions available
in Canada have minimized the issue of early transition back to work while breastfeeding.
University students, however, are more vulnerable as breastfeeding mothers and parents.
They may be forced, for a variety of reasons, to return to study while breastfeeding and
caring for a very young infant. These circumstances present many challenges that would
be eased with a supportive university policy. Furthermore, the current university



                                                                                                10
population of approximately 60% female students suggests that there is a need for
policies that are supportive of women and families. Finally, the need for supportive
workplace policies in Newfoundland and Labrador is even more relevant given our lower
rates of breastfeeding, and the lack of awareness of the requirements in establishing
workplace breastfeeding support.




Proposed Policy Statement


Supporting and Accommodating Breastfeeding in the University Setting


Sponsor:                      Dr. Doreen Neville, Associate Vice-President (Academic).


Purpose:                      To outline the conditions that apply to supporting and
                              accommodating breastfeeding at Memorial University.



Guiding Principles:           Memorial University recognizes the importance of creating
                              a family-friendly environment for students, employees, and
                              the community at large. An environment that is friendly to
                              and supportive of breastfeeding mothers is an important
                              component of a family-friendly environment. In this regard,
                              the University aims to provide a supportive and flexible
                              environment for breastfeeding employees and students as
                              they transition back to study or work.



Scope:                        All employees, students, and guests of the University in all
                              departments and locations.



                                                                                         11
The policy relates to:
                Human Rights Legislation. The Human Rights Code in Newfoundland and
                 Labrador does not specifically prohibit discrimination based on pregnancy
                 and/or breastfeeding; however, such discrimination is characterized as sex
                 discrimination and is therefore prohibited under section 9.
                International Labour Organization Maternity Protection Convention 183
                 and Recommendation 1912 (not ratified in Canada).
                Canada Labour Code (Recommendation 7.59)3 of Fairness at Work:
                 Federal Labour Standards for the 21St Century (Federal Labour Standards
                 Review Commission, 2006).


Authority:                Office of the Associate Vice-President (Academic) and the
                          Department of Human Resources.




2
  ILO Maternity Protection Convention 183 and Recommendation 191 outline the key elements for
workplace protection for breastfeeding women: non-discrimination, employment protection, maternity
leave and breastfeeding breaks.
3
  Recommendation 7.59 Part III should provide for short breaks during working hours to afford nursing
employees reasonable time off, without pay, to breastfeed a child and /or express milk on the worksite.


                                                                                                          12
Policy


Flexibility is important, as no two women have the same breastfeeding /work experience,
and the needs of breastfeeding mothers and their children change over time. Creative
approaches will be needed to meet the provisions outlined in this policy.


1.0    The University takes all reasonable measures to accommodate employees and
       students who wish to breastfeed or express breastmilk in the workplace, or while
       attending university.


2.0    The University ensures that employees and students are not subject to any
       criticism, harassment, or discrimination for their efforts to continue breastfeeding
       in the workplace or while attending university.


3.0    Quiet breastfeeding infants and young children are welcome in lecture theatres,
       public spaces, seminar rooms etc; however, infants and young children are not
       permitted in laboratories or other settings where potential health and safety issues
       and hazards may be of concern (e.g., science, engineering, nursing, medicine,
       pharmacy laboratories).


4.0    Employees and students must be considerate of the impact of infants and young
       children on the work/study environment of colleagues and fellow students.


5.0    The University provides the following specific facilities and support:


       5.1     Time: Lactation breaks (for mothers who are breastfeeding or expressing
       breastmilk)


              The University is committed to providing flexibility for employees to take
               lactation breaks during their workday. One or more 30-minute unpaid



                                                                                         13
                  breaks in an eight-hour shift, in addition to normal breaks, are
                  recommended.
                 The number of times a woman needs to breastfeed or express milk will be
                  determined by the individual needs of the mother and the age of the baby.
                  A young baby under six months of age would require more frequent
                  breastfeeding or expression of milk during an eight-hour workday. The
                  baby’s needs may change over time, and as the baby gets older the breaks
                  will be fewer.
                 There should be flexibility (timing and frequency) in the arrangements
                  made for lactation breaks. The mother makes these arrangements in
                  consultation with her immediate supervisor or unit head.


         5.2      Space:


                 The University gives consideration to the needs of breastfeeding mothers
                  and families with young children in the design and allocation of all new
                  university buildings, and in the remodeling of existing buildings (e.g.,
                  family-friendly washrooms and access to private space for breastfeeding
                  or care of young children).
                 Breastfeeding and family-friendly spaces are located in central areas
                  throughout the campus as indicated on (insert url here)
                 All breastfeeding women are reasonably accommodated by having access
                  to the following:
                          A clean, hygienic, and private area to breastfeed or express
                           breastmilk4.
                          A comfortable chair to use while breastfeeding or expressing.
                          A table to support breast pump and/or equipment.
                          Washing facilities for hands and equipment.
                          A change table.
4
 This does not imply that a new room must be established. A student or employee lounge, or unused
offices are examples of private spaces that could be used for breastfeeding or expression of breastmilk. A
bathroom is not an appropriate space.


                                                                                                         14
                         Secure storage facilities for breastmilk (refridgerator5/ freezer) and
                          for the storage of breastmilk expression equipment (pump).
                         An electrical outlet for women who use an electric pump.


For students’ breastfeeding:
                Quiet infants and young children in arms are welcome in lecture theatres
                 and seminar rooms.
                Students should attempt to sit in a location where their exit from the room
                 during a lecture or seminar (if the baby becomes fussy) would minimize
                 disruptions to the learning environment.
                During examinations, in cases where the duration of an examination
                 would interfere with breastfeeding routine, students should consult with
                 their course instructor for alternative, appropriate accommodation
                 during the examination if required.


        5.3      Support:


                The University reflects a positive attitude towards breastfeeding women
                 and their families. The University supports an environment that
                 encourages all women to feel at ease breastfeeding their infants and young
                 children throughout the campus.6
                Informing other employees about the workplace policy is important in
                 securing their cooperation for any minor workplace accommodations that
                 need to be made. The attitudes of fellow employees and students are
                 critical in making the breastfeeding mother and child, and her caregiver or
                 partner, welcome in the university setting.
                New employees and students are informed of the University breastfeeding
                 policy during orientation.

5
  A communal fridge is acceptable because breastmilk is considered a food. It should be stored with
appropriate labelling.
6
  There may be areas of the university where infants and young children are not permitted due to
safety/health concerns.


                                                                                                      15
              Pregnant employees are provided written information about the
               University’s breastfeeding policy during their pregnancy.
              There may be situations or environments within the University when
               breastfeeding breaks or private space for breastfeeding may not be
               provided. Other options must be explored with the mother to ensure that
               her needs are met.
              Employees and students who are pregnant or considering pregnancy may
               avail of community resources on breastfeeding at (insert url here St.
               John’s and Corner Brook)

Procedures


1.0    Individuals in charge of venues where there is a safety or health risk to the
       breastfeeding mother and infant are responsible for posting the appropriate notice
       and informing their supervisors of the action.


2.0    A pregnant employee or student should discuss plans for returning to work or
       school with her immediate supervisor or unit head so that practical, appropriate
       accommodations can be arranged.


3.0    The employee and her immediate supervisor or unit head should discuss in
       advance how lactation breaks can be arranged to the satisfaction of the employee
       and the ongoing operations within the unit/department.



Financial Implications


There are minimal costs to the University to implement this policy. There may be costs
in adding change tables or other specific facilities for breastfeeding or expressing milk. It
is important to make use of existing spaces on campus. There will also be costs in
relation to communicating the new policy to the University community.


                                                                                          16
References

American Academy of Pediatrics. (2005). Policy Statement: Breastfeeding and the use of
human milk. Retrieved January 2007 from
http://aappolicy.aappublications.org/cgi/reprint/pediatrics;100/6/1035.pdf

Annapolis Valley District Health Authority Administrative Policy and Procedure:
Breastfeeding and the Workplace.

Australia Breastfeeding Association. (2007). Breastfeeding-Friendly Workplace
Accreditation Information Booklet. Victoria: Author. Retrieved June 4, 2007 from
http://www.breastfeeding.asn.au/bfinfo/mfwp.html1#what

Ball, T. & Wright, A. (1999). Health care costs of formula-feeding in the first year of life.
Pediatrics, 103(4), 870-876.

Bromberg Bar-Yam, N. (2004). Nursing mothers at work: Corporate and maternal
strategies to support lactation in the workplace. Journal of the Association of Research on
Mothering, 692, 127-138.

Bromberg Bar-Yam, N. (2001).What every breastfeeding employee should know.
Breastfeeding Annual International 2001, 72-81.Washington, DC: Platypus Media.

Bromberg Bar-Yam, N. (1998). Workplace lactation support, Part 1: A return-to-work
breastfeeding assessment tool. Journal of Human Lactation, 14(3), 249-254.

Centers for Disease Control and Prevention. (2005). Lactation Support Program.
Retrieved May 6, 2007 from
http://www.cdc.gov/nccdphp/dnpa/hwi/toolkits/lactation/index.htm

City of Toronto. (2007). Breastfeeding in Public Places (DRAFT May 2007). Toronto:
Author.

City of Toronto. (2001). Breastfeeding on City Premises. Toronto: Author.

Cohen, R., Mrtek, M., & Mrtek, R. (1995). Comparison of maternal absenteeism and
infant illness rates among breastfeeding and formula-feeding women in two corporations.
American Journal of Health Promotion, 10(2),148-53.

Collaborative Group on Hormonal Factors in Breast Cancer. (2002). Breast cancer and
breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies
in 30 countries, including 50302 women with breast cancer and 96973 women without
the disease. Lancet, 360 (9328), 187-95. Retrieved June 15 2006 from
www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd



                                                                                          17
Commonwealth of Australia. (2000). Balancing breastfeeding and work. Canberra, ACT:
Author. Retrieved June 13, 2007 from
http://health.gov.au/internet/wcms/publishing.nsf/Content/health-pubhlth-publicat-
document-brfeed-work-booklet-cnt.htm/$FILE/booklet.pdf

Federal Labour Standards Review Commission. (2006). Fairness at Work: Federal
Labour Standards for the 21St Century. Retrieved June 10, 2007 from http://www.fls-
ntf.gc.ca/doc/fin-rpt-e.pdf

Feldman, P. & Frati, F. (2005). Evidence-based benefits of breastfeeding for the
Breastfeeding Committee for Canada: A selected annotated bibliography. Retrieved June
20, 2007 from
http://breastfeedingcanada.ca/pdf/BCC%20Selected%20Annotated%20Bibliography%20
November%202005.pdf

Galtry, J. & Annandale, M. (2003). Guidelines for Supporting Breastfeeding in the
Workplace. Equal Employment Opportunities’ Contestable Fund Project. Retrieved May
2, 2007 from http://www.eeotrust.org.nz/content/docs/breastfeeding_guidelines.doc

Government of New Zealand. (2002). Breastfeeding in the Workplace: An employers
guide to making it work. Department of Labour. Retrieved June 2, 2007 from
http://www.ers.dol.govt.nz

Health Canada. (2004). Exclusive breastfeeding duration – 2004 Health Canada
Recommendation. Retrieved June 12, 2006 from www.hc-sc.gc.ca/fn-
an/nutriton/childenfant/
infant-nourisson/exd_bf_dur_dur_am_excl_e.html.

Horta, B.L., Bahl, R., Martines, J.C., & Victora, C.G. (2007). Evidence on the long-term
effects of breastfeeding: Systematic reviews and meta-analyses. Geneva: World Health
Organization.

International Labour Organization. (2000a). C183 Maternity Protection Convention,
2000. Retrieved June 16, 2007 from http://www.ilo.org/ilolex/cgi-lex/convde.pl?C183

International Labour Organization. (2000b). R191 Maternity Protection
Recommendation, 2000. Retrieved June 16, 2007 from http://www.ilo.org/ilolex/cgi-
lex/convde.pl?R191

McIntyre, E., Pisaniello, D., Gun, R., Sanders, C. & Frith, D. (2002). Balancing
breastfeeding and paid employment: a project targeting employers, women and
workplaces. Health Promotion International, 17(3), 215-222.

McKinley, N. M. & Hyde, J. S. (2004). Personal attitudes or structural factors? A
contextual analysis of breastfeeding duration. Psychology of Women Quarterly, 28, 388-
399.



                                                                                      18
Middlesex-London Health Unit Resource Package Creating a Breastfeeding Friendly
Workplace www.healthunit.com

Newfoundland and Labrador Provincial Perinatal Program. (2006). Neonatal
Breastfeeding Statistics 1986-2005. St. John’s: Author.

Rea, Marina F. (2004). Benefits of breastfeeding and women’s health. Jornal de
Pediatria 80 (5 Suppl.), S142-S146. Retrieved May 16, 2007 from
http://www.scielo.br/pdf/jped/v80n5s0/en_v80n5s0a05.pdf

Saskatoon Health Region. (2004). Royal University Hospital Recognized as a
Breastfeeding Friendly Work Site. Retrieved June 26, 2007 from
http://www.saskatoonhealthregion.ca/news_you_need/media_centre/media/2004/news_0
30804.htm

Scott, J.A., Binns, C.W., Oddy, W.H. & Graham, K. (2006). Predictors of breastfeeding
duration: evidence from a cohort study. Pediatrics, 117, e646-e655. Retrieved June 19,
2007 from http://pediatrics.aappublications.org/cgi/reprint/117/4/e646

Statistics Canada. (2007). Study: Maternal employment, breastfeeding and health. The
Daily. Retrieved June 17, 2007 from
http://www.statcan.ca/Daily/English/070619/d070619d.htm

Statistics Canada. (2005).Breastfeeding practices. Health Reports, 6(2), 23-31. Retrieved
May 18, 2007 from http://www.statcan.ca/english/freepub/82-003-XIE/0020482-003-
XIE.pdf

Statistics Canada. (2003). Breastfeeding practices, females aged 15 to 55 who had a baby
in the previous five years, Canada, provinces, territories and peer groups, 2003. Retrieved
May 15, 2007 from http://www.statcan.ca/english/freepub/82-221-
XIE/2006001/tables/2178_03.htm

UNICEF (1989). Convention on the Rights of the Child. New York: Author.

University of Arizona. (2007). Life &Work Connection website. Lactation Information:
Individual/Managerial and Organizational Considerations for Managing Campus
Commitments and Breastfeeding. Retrieved June 25, 2007 from
http://lifework.arizona.edu/wls/lact/lact_consid.php

University of Iowa. (2003). Got milk? University helps new moms balance breastfeeding
and work. fyi Faculty and Staff News, 41(4), University Relations Publications. Retrieved
June 12, 2007 from
http://www.uiowa.edu/~fyi/issues/issues2003_v41/11072003/index.html




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University of Michigan. (2007). Work/Life Resource Center. Working and Breastfeeding.
Retrieved June 25, 2007 from http://www.hr.umich.edu/worklife/workingbfeed.shtml

World Alliance for Breastfeeding Action. (2006). Status of Maternity Protection by
Country. Retrieved October 15, 2007 from
http://www.waba.org.my/womenwork/MaternityProtectionChart21May2006.pdf

World Health Organization. (2003). Global Strategy for Infant and Young Child Feeding.
Geneva: Author.

Yngve, A. & Sjöström, M. (2001). Breastfeeding in Countries of the European Union and
EFTA: current and proposed recommendations, rationale, prevalence, duration and
trends. Public Health Nutrition , 4(2B), 631-645.




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                                 Appendix A

              Breastfeeding Policies at Canadian Universities

Laurentian University:               no policy; breastfeeding friendly space
                                     designation through Sudbury Health
Brock University:                    no reply
York University:                     Dr. Penny Van Esterik, Anthropology, has
                                     completed considerable work in the area of
                                     workplace policies for breastfeeding. Dr. Van
                                     Esterick used the World Alliance for
                                     Breastfeeding Action, Creating a Mother-
                                     Friendly Workplace resource and applied it to
                                     York University. A list of breastfeeding
                                     spaces on campus was developed along with
                                     change facilities in gender-neutral bathrooms.
                                     Articles about the initiative were included in
                                     the university newspaper
Ryerson University:                  no reply
Lakehead University:                 no reply
Carleton University:                 no policy; rely on Ontario Human Rights
                                     Commission Policy on Pregnancy and
                                     Breastfeeding
University of Ottawa:                no reply
Wilfrid Laurier University:          no policy
McMaster University:                 no policy; one student requested private space
                                     for breastfeeding/ pumping and was
                                     accommodated through Student Health
Trent University:                    no reply
Windsor University:                  no reply
University of Waterloo:              no policy
University of Guelph:                no reply
University of Western Ontario:       no policy; nursing students lobbied for
                                     breastfeeding spaces; general locations
                                     identified on campus; share policy when
                                     developed
University of Toronto:               no policy; breastfeeding-friendly designated
                                     spaces throughout campus (Family Care
                                     Office); U of T voted top-10 Family-Friendly
                                     employer
Queen’s University:                  no reply
University of Winnipeg:              some initial work on a policy but not
                                     completed; share findings
University of Manitoba:              no policy
Brandon University:                  no reply


                                                                                21
University of Saskatchewan:          no policy

University of Regina:                no policy
University of Alberta:               no policy
University of Calgary:               no policy; Women’s Resource Centre is safe
                                     space for breastfeeding and they will be doing
                                     promotion of this in Fall; parents identified
                                     need for change tables in washrooms on
                                     campus
University of Lethbridge:            no policy; share findings
University of Victoria:              no policy
University of British Columbia:      no policy
Simon Fraser University:             no policy; share policy when developed
Dalhousie University:                no university-wide policy; School of Nursing
                                     has a policy; share policy when developed
McGill University:                   no policy
University of New Brunswick:         no policy
Acadia University:                   no policy
St. Francis Xavier:                  breastfeeding policy is currently in
                                     development
Université du Laval:                 no policy; breastfeeding room and resources
Université du Québec à Chicoutimi:   no policy; breastfeeding room and resources;
                                     share policy when developed
Université du Québec à Gatineau:     no policy; breastfeeding room and resources;
                                     share policy when developed
Aurora College:                      no policy
Centennial College:                  no breastfeeding policy but breastfeeding
                                     included in accommodation policy




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