Lactation Support

Johns Hopkins’ registered lactation rooms, located throughout our campuses and office buildings, offer a private space for employees needing to express milk while at work. Our registered rooms are equipped with hospital-grade pumps and other comforts such as vending machines with pump-related items.

Pumps, Accessories & Vending Machines

Personal Pumps through Insurance

The Affordable Care Act (ACA) expanded health plan coverage to include breastfeeding support and supplies. Coverage will vary based on your insurance provider.

Contact your insurance provider to explore the pump options available to you, as well as how to obtain your pump. Typically, a prescription for the personal pump is needed from your Doctor on or after baby’s date of birth, in addition to a copy of your insurance card, and basic demographic information.

• Johns Hopkins Pharmaquip works with all Johns Hopkins insurance providers to distribute a free personal pump through your insurance plan. The Durable Medical Equipment Department can be reached directly at: 410-288-8955. All documents can be faxed to: 410-282-8455. Once the information is received and verified, the personal pump will ship directly to you in 1-3 business days.
• Storkpump is a free resource that also works with all Johns Hopkins insurance providers and navigates the process of obtaining a pump for employees. More information can be found on their website.

Hospital Grade Pumps

We provide hospital-grade pumps in our lactation rooms for use by employees needing to express milk while at work. To use the pumps, you’ll need to provide your own accessory kit. 

A hospital-grade pump is the strongest and most durable pump available for milk expression. It has a more powerful motor than a personal-use pump, so it provides a higher level of suction and more efficient pumping. This effectively stimulates and raises your levels of prolactin and oxytocin, the hormones that increase your milk production and output. While a personal-use pump is intended for use by only one individual, a hospital-grade pump is designed and approved by the FDA to be safe for multiple users.

Medela Symphony  | Ameda Platinum

Rooms can be accessed with a keypad code or with your ID badge, information is provided in your LSP registration confirmation email.

Vending Machine Contents:

• Accessory Kits
• Milk Storage Bottles & Bags
• Accessory Kit Parts
• Chest/Breast Pads
• Quick Clean Wipes

Vending Instructions:

1. Swipe your credit or debit card to unlock the machine door.
2. Select the product(s) you would like. Feel free to read product labels or return the product to its bin/shelf.
3. Remove the product(s) you want to purchase and close the door. Your credit or debit card will only be charged for the products you have removed from the machine before closing the door.
4. Enter your email address to receive a receipt (optional).

Contact Worklife with any questions: worklife@jhu.edu | (410) 516-2000

Continuing to express milk after returning to work or study requires extra planning, patience, and support. The below tips and resources can help to make the transition back to work/study easier and less stressful.

Before Leave

Explore your benefits options.

JHU Benefits & Worklife: (410) 516-2000 | benefits@jhu.edu | worklife@jhu.edu

JHH/JHHS Benefits: (443) 997-5400 | hrsc@jhmi.edu 

Understand the leave options available to you (JHU):

• Read the policies and submit your leave request form on our website.
• Contact Human Resources for more information: HRBusinessServices@jhu.edu | 443-997-2157.

**JHH/JHHS employees, please visit your HR page to learn more about the leave options available to you. 

Consider the possibility of flexible work arrangements.

Talk to your supervisor.

• Number and frequency of breaks (on average 2-3 15 minute breaks in an 8 hour shift)
• Location – if there is not a designated room, can a private space be identified?
• Milk storage – where can you safely store expressed milk? Is there a refrigerator available or do you need to bring your own cooler with ice packs?
• You can also consult your HR representative/administrator to help facilitate the conversation or contact Benefits & Worklife. 

Find a space.

• Explore our list and interactive maps of registered lactation rooms.
• If a registered space is not within close proximity to you, contact your supervisor or HR representative/administrator to explore your options.

Register for our Lactation Support Program

Think about the type of pump you may use.

• • Personal Pump or Hospital-Grade Pump (in our registered rooms)

Sign up for a class or support group.

• • Johns Hopkins Lactation Consultants offer a number of educational classes; Support groups are also available on the East Baltimore and Bayview campuses.

Take a walk! Time yourself walking from your office to the lactation room and back so that you can schedule your time accordingly.

During Leave

Establish a good milk supply. 

• If you have any trouble, contact your pediatrician or a lactation consultant before you go back to work.
• Drink lots of water to help build up your milk supply. It takes a few days to increase your supply, so don’t be discouraged if you don’t get much milk at first.
• Establish backup milk. While practicing using your pump, freeze the milk you pump just in case you run into difficulties at work, the child’s needs change, or you wish to donate to a milk bank.

Obtain your pump.

• The Affordable Care Act created guidelines requiring insurance companies to cover certain preventive services such as breastfeeding support, supplies, and counseling. A personal pump may be available to you, at no cost, through your insurance.
• If you are using one of the registered Lactation Rooms that has a hospital-grade pump, obtain your accessory kit prior to your return to work.
• Practice using your pump to reduce troubleshooting time at work.

Pack your bag.

• Create a list of the items you will need for milk expression when you return to work. Some suggestions include:
  • • Accessory kit and parts (container/bag to store them); Clean bottles with lids or storage bags
    • Cooler for storage
    • Breast/chest pads
    • Hand sanitizer
    • Back-up shirt
    • Healthy snacks and water
    • A photo of your baby or the beneficiary of your milk

Check in with your supervisor to confirm your plans prior to your return and ensure the agreed upon space is ready for use.

Request Lactation Accommodations

Consider setting your return to work date to be a Wednesday or Thursday so you have a short first week to adjust.

After Returning to Work

Additional Resources

• Many area hospitals provide lactation support “warm lines” and other resources. For information regarding the JHH Lactation Warm Lines and other services, including classes and support groups, click here.
  • JHH Lactation: JHHlactation@jhmi.edu | (410) 502-3221
• CDC Proper Storage & Prep of Human Milk & Safe Cleaning Practices
• Maryland Breastfeeding Coalition
• United States Breastfeeding Committee 
• Maryland WIC
• La Leche League of MD-DE-DC
• La Leche League International
• International Lactation Consultant Association
• Office on Women’s Health
• American Academy of Pediatrics
• Nest Collaborative

As a manager or supervisor, you play an important role in an employee’s successful transition from leave to work. A supportive environment includes flexible break times, a clean and private space other than a restroom to express milk and access to information and resources. Employees who continue to express milk after returning to work also need the support of their supervisors, co-workers and others in the workplace.

Creating a Supportive Environment

• Educate yourself on Hopkins’ Family Leave options and the JH policy and local/national laws regarding lactation accommodations.
• Incorporate information from these policies into established department training programs and documents.
• Provide information to ALL employees regarding the resources available to them.
• Promote the policy/program positively as a company health benefit.
• Understand the short and long term benefits a supportive environment has on employees and the employer.

Conversation Tips

Understand your employee’s unspoken concerns: Some employees may feel uncomfortable asking for privacy or breaks to pump because they are concerned that it could jeopardize their opportunities for inclusion or advancement; breaks could be viewed as taking too much time away from work creating a negative attitude from supervisors and/or co-workers; and also because it is a personal topic and decision. 

WHAT CAN YOU DO AS A SUPERVISOR?

1. Educate yourself on the laws and policies in existence regarding lactation accommodations and what is required of you as a supervisor
2. Check in with your employee during the pre- “family leave” planning and upon their return
   • Ask what their plan may be, knowing that it could change
   • Ask what resources they may need
   • Work together to establish a mutually beneficial break schedule
3. Be mindful that each employee’s experience, needs, and plan will be different
4. Pregnancy, childbirth, adoption, surrogacy, and loss are all MAJOR life transitions; understand your employee may be experiencing more stress than usual upon returning to work
   • Consider flexible work options, if possible, to ease some of the transitional difficulties
   • Provide information regarding the benefits, programs, and resources available to them
5. Communicate your support to your employee and their co-workers; it’s important for everyone to know they are in a safe and supportive environment
   • Communicate policy (including lactation accommodations) at new staff orientations and in existing documents and training materials
   • Ensure available benefits, programs, and resources are made known to all employees
6. Respect your employee’s privacy
7. Use inclusive language
   • The LSP will use and promote inclusive language to ensure all in need are able to access the resources available, including:
     • Transgender Individuals
     • Those who have lost a child (during pregnancy, birth)
     • Surrogates
     • Adoptive Parents
     • Cisgender Females

Finding & Designating a Lactation Space

SPACE REQUIREMENTS

• Minimal space is required (can be as small as 4 feet by 5 feet, though the size of an accessible restroom stall, 7 feet by 7 feet, will be more comfortable)
• The room must have the following elements:
  • Chair
  • Table/Shelf Surface (to place pump and other items)
  • At least 1 electrical outlet
  • Plumbing
    • Sink with running hot/cold water does not have to be IN the room, though preferred, but must be in close proximity to the space
  • Refrigerator for milk storage (can be a small dorm-size refrigerator)
  • Must be able to be locked (or otherwise secured) from the inside of the space
  • Cannot be a bathroom or closet (unless a large closet is converted into a new space)
  • Adequate lighting and temperature regulation
  • Trashcan
• These elements are not required, but should be considered when establishing a lactation space:
  • Key pad or card swipe for room access
  • Single or multi-station room
    • If multi-station, hospital curtains are an acceptable and preferred option for privacy between stations
    • If single station, signage for door exterior indicating room is in use (provided by LSP)
  • Options for storage of accessory kits and parts (wall mounted cabinets, etc.)
  • White noise machines to help disguise the sounds of the pump and alleviate any stress, embarrassment, or discomfort if the space is in a busy location
  • Full length mirror
  • Coat hooks/rack
  • Framed photos or posters (LSP can make recommendations on appropriate art and is now working with local artists)
  • Bulletin board for information, announcements, and photo sharing of milk beneficiaries

EXISTING SPACE 

Each of these options must be able to be secured and is designated for lactation use only by signage (provided by LSP) whenever an employee needs to express milk, for as long as they choose to do so; primary function of the space is for lactation and takes precedence over all other uses and functions:

• • Floater/vacant office
  • Unused conference/meeting room
  • Break room
  • Manager’s office
  • Storage room

3 important considerations for a flexible lactation space:

1. 1. Location – close proximity to employee’s work area; near running water; meets basic requirements
   2. Amenities – chair & flat surface, electrical outlet
   3. Privacy – must be able to be locked or secured from the inside

CREATING A NEW SPACE

• Walled off corner of a lounge area (near a restroom/kitchenette) – can build permanent walls
• Supply closets, copy rooms, break rooms
  • • Do you have more than 1 copy or break room? Could they be consolidated into 1 to create a lactation space?
• Renovated restroom
  • • Restrooms are NOT an allowable lactation space, however, can be retrofitted into new space as long as it is completely separated from the restroom area with no toilet in the space (i.e. enclose a portion of the restroom “lounge area” or retrofit a single user restroom by removing the toilet and renovating the space)
• Exam/patient rooms
  • • Health care facilities can use a patient or exam room as a permanent space, which typically already meets the requirements for a lactation room
• New Construction
  • • JHU and JHHS are committed to a plan for all new construction (those in progress and in the future), to include a lactation space meeting all requirement

Additional Resources

Centers for Disease Control & Prevention: Workplace Health Resources for Lactation Support

U.S. Department of Health & Human Services: Supporting Nursing Moms at Work

United States Breastfeeding Committee: Workplace Support in Federal Law

Hopkins Policy

• Johns Hopkins University  Lactation Accommodations Policy

All employees who choose to express milk will be provided reasonable break times to do so throughout the day, each time they need to express milk, for as long as the employee has a need to express milk. The University will also provide a private lactation location, other than a bathroom, for this purpose.

• Johns Hopkins University Family Leave for New Parents

Birth Recovery & Parental Leave is available. The programs offer fully paid time off for full- or part-time faculty, staff, and bargaining unit employees who’ve been employed at JHU for at least a year. Combined, they offer up to 10 weeks of paid leave.

• Johns Hopkins Medicine & Health System Policy 

State & Federal Policy

• Maryland Law: Health – General § 20-801

A mother may breastfeed her child in any public or private location in which the mother and child are authorized to be. A person may not restrict or limit the right of a mother to breastfeed her child. If you experience a situation in which your right to breastfeed is challenged, you can report noncompliance with the Maryland law to the Maryland Attorney General’s Consumer Protection Division.

• Maryland Law: Tax General: Title 11. Sales and use tax: Subtitle 2. Exemptions: 11-211

Maryland was the first state to provide an exemption from sales tax for breastfeeding accessories that may be used by breastfeeding mothers. Exempt items include: breast pumps, breast pump hook-up kits (accessory kits), breast shells, nursing shields, Supplemental Nursing System (SNS), feeding tubes, breast milk storage bags, finger feeders, and purified lanolin.

• Affordable Care Act (ACA) Coverage of Breast Pumps

Made significant progress to support breastfeeding by including new guidelines that require insurance companies to cover certain women’s preventive services such as breastfeeding support, supplies, and counseling.

• PUMP for Nursing Mothers Act

Amends the Fair Labor Standards Act to expand access to breastfeeding accommodations in the workplace, and for other purposes.

• Fair Labor Standards Act

The ACA amended this act by requiring employers to provide reasonable break time and a place other than a restroom that is private and clean for a mother to express milk.

• Friendly Airports for Mothers Act

Requires airports to provide lactation rooms that are accessible to the public.

• Fairness for Breastfeeding Mothers Act

Requires that certain public buildings that are open to the public and contain a public restroom provide a lactation room, other than a bathroom.

WHY IS IT IMPORTANT FOR BUSINESSES TO SUPPORT LACTATION?

• Lower health care costs: chest/breastfed babies are sick less often; the longer an individual is able to chest/breastfeed, the less likely they are to experience breast cancer, type 2 diabetes, and heart disease.
• Lower absenteeism rates: because babies are healthier, parents are less likely to miss work.
• Higher retention rates: research shows that employees who receive lactation support at work are more productive and loyal; they are also more likely to return after their parental leave.

WHY DO EMPLOYEES NEED TIME AND SPACE FOR LACTATION AT WORK?

1. Health Benefits: statistics from the American Academy of Pediatrics have shown that breastfed babies are healthier and in turn have lower health care costs; this leads to less absenteeism for working parents as well.
2. Biological Needs: milk production is a normal, constant, ongoing, biological process. Milk expression must occur on a regular schedule (typically every 3 hours) to keep the supply going. When unable to express milk, it builds up and can be quite painful and also lead to infection.
3. Comfort: a lactation space is necessary because those needing to express milk are able to do so more efficiently when they are relaxed and in a less stressful environment.
4. Privacy: private spaces are necessary because pumping/milk expression is not as discreet as physically chest/breastfeeding the child. In addition, pumps and parts need to be kept clean and expressed milk stored properly.

HOW OFTEN DO EMPLOYEES NEED TO PUMP? HOW LONG IS EACH SESSION?

Typically, an employee will need to pump once every 2-3 hours, so in an 8 hour work period, 2-3 pumping sessions will most likely be needed. Each session can take up to 15 minutes, not including travel time to the room (which is why finding a space in close proximity is extra beneficial to employee and employer). As their child gets older, the frequency for which they need to pump will decrease. Studies show that most employees who express milk at work take just 2-3 breaks for a total time of less than 1 hour per 8 hour workday.

WHY CAN’T EMPLOYEES PUMP IN THE BATHROOM?

Bathrooms are a place to eliminate waste from the body. Human milk is food and should be handled in the same way other food is handled. No one would be willing to prepare food in a bathroom, and that includes human milk.

WHERE IS THE EXPRESSED MILK STORED? I’M CONCERNED ABOUT PEOPLE HAVING ISSUES WITH IT BEING IN OUR SHARED KITCHENETTE REFRIGERATOR.

Human milk is food. The FDA and CDC both state that it can be stored with other food items, however, we understand this is a sensitive topic in the workplace. The easiest workaround is to provide a small dorm-style refrigerator solely for storage of expressed milk. The LSP can provide signage indicating proper human milk storage guidelines and temperature regulation. We advise employees who need to store expressed milk to do so in a small cooler or lunch bag to reduce the chance of spills, etc.

I HAVE AN EMPLOYEE REQUESTING SPACE FOR LACTATION, BUT WE DON’T HAVE ANY ROOM IN OUR BUILDING, WHAT CAN I DO?

A number of alternative options to a permanent lactation space are available. You can convert an empty office or meeting room, consolidate supply closets and retrofit one for lactation. Additionally, you could think about temporary spaces, such as assigning the employee to an office for the duration of their lactation needs; we have a number of lactation spaces already in existence, if it’s not too far from where your employee is, they may be willing to walk to another building or floor.

HOW BIG OF A SPACE IS NEEDED TO CREATE A LACTATION ROOM?

The space can be as small as 4 feet by 5 feet, though the size of an accessible restroom stall, 7 feet by 7 feet, will be more comfortable. These spaces can single- or multi-user spaces; if it is for multiple simultaneous users, privacy is an important consideration and can be easily achieved by using curtains, screens, or partitions to create individual spaces within the room.

I HAVE A ROOM I’D LIKE TO ASSIGN FOR LACTATION, WHAT DO I NEED TO DO?

Great! First step is to contact the LSP – worklife@jhu.edu. From there, we can discuss who the building/facilities contact is and the next steps that need to be taken. If it’s something as simple as converting an empty office into a lactation space, we may not need to involve anyone else. Construction/renovation will obviously take more time and involve more planning.

WHO IS RESPONSIBLE FOR CLEANING/MAINTAINING/STOCKING SUPPLIES IN THE LACTATION ROOM?

Our LSP thrives because of a shared responsibility model. Typically, the department/area that is hosting the lactation room is considered the room “owner”. LSP serves as a back-up if support is needed. Essentially, the “owner” is responsible for making sure the room is on a regular cleaning/maintenance schedule, reporting any issues in the room to the appropriate facilities department, and ordering and stocking the basic supplies needed for the room. The hope is for lactation rooms to be viewed as other common space areas (i.e. bathrooms, breakrooms, kitchenettes), that are monitored and cleaned on a daily basis.

WILL OTHER EMPLOYEES VIEW LACTATION SUPPORT AS SPECIAL TREATMENT?

Working parents needing to take time to express milk are not trying to get out of work, they are trying to balance what is best for their family and their employer. It’s not easy and takes a lot of time, coordination, dedication, planning, and support. Studies show that most lactating employees take 2-3 breaks per workday (normally coinciding with already scheduled breaks), for a total time of less than 1 hour. Those needing to express milk also have a pretty regular schedule, making it easier to work around preplanned lactation breaks. If a colleague needs to cover for someone’s lactation break, it’s not very different from covering for an employee who needs a break for the restroom, to take lunch, or to call home to check on family members.

WHEN SHOULD DISCUSSION ABOUT LACTATION ACCOMMODATIONS TAKE PLACE?

We recommend beginning with an initial conversation prior to an employee going out on leave. A follow-up conversation prior to their return or upon their return will also be beneficial, as plans, needs, and schedules can change.

DOES THE EMPLOYEE NEED TO BE THE BIRTHING PARENT TO RECEIVE A LACTATION ACCOMMODATION?

No. An employee may pump at work regardless of whether they actually gave birth or not. For example, in adoption, parents can induce lactation to feed their  child. Other examples include surrogacy and child loss in which the employee may wish to pump and donate their milk. Not all employees will identify as a “mom” or “female”, therefore, lactation rooms are for any employee needing to express milk.

WHY IS IT IMPORTANT TO USE INCLUSIVE LANGUAGE? 

• Using gender-inclusive language means speaking and writing in a way that does not discriminate against a particular sex, social gender or gender identity, and does not perpetuate gender stereotypes.

(United Nations)

• Referring only to “breastfeeding mothers” excludes families, including, but not limited to, those who chestfeed, bottle feed, don’t identify as a mother, or have experienced infant loss. The impact is particularly problematic when used in legislation and policies as it can literally exclude many families from protections. It’s also important to remember that not all families look alike.

(USBC)

• Gender dysphoria occurs when an individual feels discomfort due to parts of their body that do not match their gender identity. Growth (or re-growth after top surgery) of chest tissue during pregnancy may bring up extreme feelings of gender dysphoria in some individuals, possibly causing anxiety or even depression. Chestfeeding can do the same. For this reason, deciding to chestfeed is a very personal choice. Feelings of gender dysphoria may be triggered or exacerbated when a trans individual is misgendered by others, including health care providers and lactation helpers.

(La Leche League International)

I HAVE CONCERNS ABOUT AN EMPLOYEE’S REQUEST FOR A LACTATION BREAK, HOW DO I GET HELP?

Contact your divisional HR representative or administrator to discuss your concerns and begin working on collaborative next steps with HR and your employee. Space/time must be provided, and there are a number of options available to make this easier for everyone involved.

WHAT RESOURCES ARE AVAILABLE TO EMPLOYEES REGARDING LACTATION?

In addition to the LSP, employees can also speak with a Hopkins Lactation Consultant via email (JHHLactation@jhmi.edu) or through their warm line: 410-502-3221. The Lactation Consultants also host weekly support groups and educational classes. The Office of Benefits & Worklife offers a baby shower (currently virtual) for new, expecting, and adopting parents to hear presentations on leave policies, benefits, lactation support, child care, and an opportunity to visit with Hopkins programs and local vendors to gather more information and resources. On the LSP website, there are additional Hopkins, local, state-wide, national, and global resources listed for reference.

I DIDN’T KNOW WE HAD A LACTATION SUPPORT PROGRAM. IS IT WIDELY-USED?

Yes!  We currently have 52 officially registered rooms across our campuses, with more on the horizon. Also, in November 2019, the JHU LSP was nominated for and won a GOLD Breastfeeding Friendly Workplace Award through the Maryland Breastfeeding Coalition.