Lactation, Breastfeeding & Chestfeeding

Did you know that over 95% of all babies born in Washington state start their lives breastfeeding or chestfeeding?

Breastfeeding and chestfeeding benefits the parent and baby's health while providing a lifetime of health protection for both.

Read more about why breast/chestfeeding is good for you and your baby from the American Academy of Pediatrics

Families come in all shapes and sizes! Women, transgender men, and non-binary people can have babies, and many genders can lactate naturally or with medical assistance.

Some parents feed their baby directly at the breast or on the chest, while some might exclusively pump their milk, utilize donor milk, or supplement non-human milk. There are endless ways to feed a baby, and we celebrate the diversity that makes us stronger together as a community.

Inclusive language makes sure no one is excluded from the birth experience and gives us all our autonomy. Many genders experience birth and lactation in their own unique ways. Including everyone allows all families to reach their infant feeding goals and receive personalized support.

For further reading:

Getting Started

Learning how to nurse your baby is a bonding experience that can have its challenges- especially if this is your first time. There are support systems available to help you along your journey. We're glad you're here!

While the Washington State Department of Health maintains our commitment to using gender-inclusive language, the following resource links may use gendered terms.

Need Help? Get lactation support now

State & Federal Laws

Rule Making Donor Milk Banks

In 2022 the Legislature passed E2SSB 5702, which requires health plans and Medicaid to provide coverage for donor human milk and human milk derived products prescribed for inpatient use. The bill also requires the department to develop minimum standards (RCW 43.70.645) to ensure milk bank safety for human milk and human milk derived products. 

The department finalized the rules which went into effect on September 22, 2023. The rules establish safety standards for ensuring human milk and human milk derived products from milk banks are safe and address provisions as required by statute. Final rules can be found here: Chapter 246-720 WAC.

Access to human milk improves health outcomes for infants, including a reduced risk of infections and sudden infant death syndrome. The legislation and rules seek to provide access to human milk and human milk derived products for the state’s medically fragile infants and to ensure safety of human milk and human milk derived products.  The department’s significant analysis (PDF) provides an overview of this project and the rules that are currently in effect.

For questions, please contact donormilkbankrule@doh.wa.gov

Returning to Work & Lactation Accommodations

Available in: English (PDF) | ;Español - Spanish (PDF) | ኣማርኛ - Amharic ; ;| ; ;العربية – Arabic ; ;| ; ;中文 - Chinese ; (simplified) ; ;| ; ;繁體中文 - Chinese (traditional) ; ;| ;Npe Hom Lus - Hmong | ;हिन्दी – Hindi ; ;| ; ភាសាខ្មែរ - Khmer ; ;| ; ;한국어 – Korean ; | ; Kajin Ṃajōḷ - Marshallese ; ;| ;ਪੰਜਾਬੀ – Punjabi ; ;| ;Igoa o le Gagana – Samoan ; ;| ; Af-soomaali – Somali ; ;| ; ;Русский - Russian (PDF) | Tagalog (PDF) | Українська - ;Ukrainian (PDF) | Tiếng Việt ;- Vietnamese (PDF) ;| ; ;

Your rights to pump and express milk are legally protected

The Revised Code of Washington 43.10.005 & Federal Fair Labor Standards Act Section 7 requires that employers provide breastfeeding employees:

  • A flexible schedule to pump, attend medical appointments, and have reasonable accommodations
  • A convenient private location to express milk that's not a bathroom and a space to safely store milk
  • 2 years of protected reasonable accommodations

If you are an employer or employee in need of guidance on pregnancy and lactation accommodations, reach out to the Washington State Office of the Attorney General for help. (web page available in 18 languages)

Resources for working parents

The Women, Infants, and Children Nutrition Program (WIC)

WIC is a place where working families can get healthy food, lactation support and support navigating returning to work and pumping. WIC is for pregnant people, new and breastfeeding/chestfeeding parents, and children under 5. Almost half of all babies in our state are on WIC.

Find out if you're eligible

There are over 200 WIC clinics across Washington State. To find a WIC clinic near you:

WIC helps improve the health of families through:

  • Nutrition education
  • Breastfeeding support
  • Healthy foods
  • Health screenings and referrals

Ideas on where to pump and creative solutions for employers having trouble finding lactation space.

How much time do employees need to pump?

Employees will need flexible accommodations for pumping because medical accommodations aren't a one size fits all situation. Consider the following factors for time: the average time it takes to pump is between 15-20 minutes, assuming they aren't experiencing maternal or infant challenges which would increase the time for a medical reasonable accommodation. Time for travel, setup and cleanup also needs to be factored in, per the law. This may make an entire pump break 30-40 minutes, assuming the location for pumping is conveniently located.

A person who is nursing will need to express milk as frequently as their own baby eats, which may be every 2-3 hours during the workday. Employers are not required to pay employees for additional time outside the mandatory 10-minute paid breaks but employers are required to give a flexible schedule to accommodate their medical needs.

Need extra time to pump or additional medical leave?

Find out if you qualify for Paid Family & Medical Leave (Available in 16 languages)

Pumps and lactation support are covered by insurance through the Affordable Care Act

Pumps:

Medicaid, WIC, and private insurance cover pumps for a variety of needs. Learn more here (Available in 16 languages)

If you need support around expressing milk, reach out to a trusted health care provider, lactation consultant, WIC, La Leche League or local lactation coalition for help. There are many people to support and help you in your journey! A properly fitting pump that fits your needs can help you reach your infant feeding goals.

Lactation support:

Health insurance plans must provide breastfeeding support, counseling, and equipment for the duration of breastfeeding. These services may be provided before and after birth. Learn more at healthcare.gov.

What does my insurance cover?

To figure out your coverage, call the number on the back of your insurance card and ask the following questions:

  • What breastfeeding-related benefits does my plan offer?
  • Do I need a prescription from my doctor for my pump?
  • Can I request or buy the pump before my baby is born?
  • What types of pumps are covered?
  • Can I get a specific brand of pump?
  • Do I need to buy or rent my breast pump from a certain supplier (i.e., from a specific pharmacy, retailer, or medical supply company)?
  • How will I purchase this pump? (i.e. out of pocket with reimbursement, ask what the steps are for reimbursement)
  • Is rental of an electric pump covered?

Need help finding a lactation consultant or getting peer-to-peer support?
Find a credentialed lactation consultant in your area or visit our Lactation Support resource.

Your milk is food, not a biohazard

Your milk is food, not a biohazard

Many factors can affect how long your milk can be stored safely. Such factors include milk volume, room temperature when milk is expressed, temperature fluctuations in the refrigerator and freezer, and cleanliness of the environment. Learn more about how to safely express and store your milk.

Human milk is not a tissue and cannot spread illness in communal refrigerators. In fact, human milk is full of antiviral and antimicrobial elements that make it the perfect food for your baby. Learn more from the US Department of Labor and the Occupational Safety & Health Administration (OSHA) on the safety of expressed milk.

Additional resources for returning to work while pumping:

Child Care & Expressed Milk

Transitioning to childcare outside of the home may be part of your plan for returning to work or school. In Washington state, there are resources to help you make this transition.

Childcare centers, also known as early learning centers, have policies and resources to support you in continuing to feed your child your expressed milk. Washington law requires our early learning centers to:

  • Have policies on providing, preparing, and storing breast milk
  • A feeding plan that supports the needs of the parent and infant
  • Serve expressed milk for as long as the parent provides it
  • A private space for the parent and baby to nurse

Centers who are part of the Child and Adult Care Food Program (CACFP) can be reimbursed for using expressed milk in addition to infant formula.

Early learning centers who would like to learn more about serving expressed milk can receive STARS credits through our free training module developed in partnership with the University of Washington.

Additional Resources:

Pharmaceuticals, Drugs, Herbs & Vitamins

Covid-19 Vaccine

It is safe to get the COVID-19 vaccine while nursing or pregnant. The protective antibodies made in a person's body from the vaccine can pass through milk to the baby, which gives the baby protection from the virus. The vaccine itself doesn't go into the milk. There has been no evidence correlating risk/harm to the dyad or altering of the milk itself. The risks associated include minor side effects in the parent receiving the vaccine, such as tiredness and soreness at injection site. The COVID-19 vaccine is not a live version of the virus such as the Yellow-fever vaccine, which involves a live, weakened form of the virus, and not recommended for nursing parents. The COVID-19 vaccine uses an mRNA molecule, which is not DNA, and the tiny molecule goes into the muscle cells around the injection site. This mRNA molecule does not pass through into the milk. The body quickly absorbs the vaccine and eliminates it along with other cellular waste once those muscle cells learn how to make COVID-19 antibodies from the mRNA molecule. The vaccine breaks down so quickly in our bodies that it's impossible for it to pass into the milk.

Pregnant and recently pregnant people are more likely to get severely ill with COVID-19; so if a parent is nursing they will especially benefit from the protective properties the vaccine offers.

For more information on the COVID-19 vaccine and nursing, check out our blog from National Breastfeeding Month.

Additional Resources:

Breastfeeding During Emergencies

No clean water? No power? Links to resources for Infant Feeding in Emergencies (LLLI).

Lactation and Infant Feeding-Friendly Environments (LIFE)

The LIFE program, formerly known as the Breastfeeding Friendly Washington program, recognizes and designates health care organizations that work to support, protect and promote lactation and follow maternity care practices that align with the World Health Organization's Ten Steps to Successful Breastfeeding and Baby-Friendly USA.

Hospitals, clinics, and midwife-owned birth centers across the state can apply to be recognized as LIFE accredited—Bronze, Silver, or Gold—depending on the steps they are taking to support breast/chestfeeding.

The Breastfeeding Friendly Washington program was updated to increase clarity of what the program encompasses, to align with the 2021 Baby-Friendly USA program update, and to address disparities.

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