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
- Getting Started
- State & Federal Laws
- Returning to Work & Lactation Accommodations
- Child Care & Expressed Milk
- Medications, Drugs, Herbs & Vitamins
- Vaccines, COVID-19 and Nursing
- Nursing & Infant Feeding During Emergencies
- LIFE Program
- Need Help?
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:
- Academy of Breastfeeding Medicine: Infant Feeding and Lactation-Related Language and Gender (PDF)
- Transgender men and lactation
- Gender spectrum and lactation
- Transgender women and lactation
- Cisgender men and lactation
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.
- Learning how to breastfeed (WIC USDA)
- Apply for WIC
- Common breastfeeding challenges (Women's Health)
- Common questions about breastfeeding and pain (Women's Health)
- Frequently Asked Questions about breastfeeding (CDC)
Need Help? Get lactation support now
State & Federal Laws
- Childcare, "Infant and toddler nutrition and feeding": WAC 110-300-0285
- Childcare, "Breast milk": WAC 110-300-0281
- Infant-Friendly Workplaces: RCW 43.70.640
- Nursing in Public is a Civil Right: RCW 49.60.030
- State Pregnancy and Lactation Accommodations RCW 43.10.005
- Federal Pregnancy and Lactation Accommodations Section 7 of the FLSA
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.
Access to human milk improves health outcomes for infants, including a reduced risk of infections and sudden infant death syndrome. The legislation seeks 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 proposed rule establishes safety standards for ensuring human milk and human milk derived products from milk banks is safe and addresses provisions as required by statute.
Proposal Statement of Inquiry, CR-101 (PDF)
OHSC DM-1.1 Standards for Donor Human Milk Policy Statement (PDF) - This policy statement serves as temporary, interim guidance from the Department for insurance companies while we continue working on draft rules.
Proposed Rule Making, CR 102 (PDF)
Donor Milk Draft language (PDF)
Public comments on the proposed rule are now being accepted. You may submit written comments to the Department by 5:00pm PST on May 16, 2023, using one of the following options:
- The Department of Health online rules comment webpage.
- By email: email@example.com
Public Rules Hearing Registration Information for May 16, 2023, at 1:30 PM PST:
The department is holding a virtual-only public hearing using Zoom.
Register Here for the Public Rules Hearing
After registering, you will receive a confirmation email containing information about joining the hearing.
To request reasonable accommodations, please email: firstname.lastname@example.org . To ensure we are able to provide requested accommodations, please submit requests by May 2nd.
For questions, please contact email@example.com
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)
- Can't find answers to your specific questions? Reach out to firstname.lastname@example.org or call (833) 389-2427 for guidance
- Pregnancy & Lactation Accommodations Complaint Form
- 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.
There are over 200 WIC clinics across Washington State. To find a WIC clinic near you:
- Call the Help Me Grow WA Hotline 1-800-322-2588
- Text "WIC" to 96859
- Visit ParentHelp123's ResourceFinder
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
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.
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:
- National Breastfeeding Helpline 1-800-994-9662 (Available in English and Spanish)
- Business Case for Breastfeeding
- Going Back to Work (WIC)
- Encourage your employer to print door hangers
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.
- Find a childcare center that fits your needs: Child Care Aware WA
- Storing and serving milk: Proper Storage and Preparation of Breast Milk (CDC)
- Low-income childcare: Working Connections Child Care (DCYF)
Pharmaceuticals, Drugs, Herbs & Vitamins
- Tobacco use and breastfeeding (CDC)
- Marijuana use and breastfeeding (CDC)
- Lactation and birth control (Planned Parenthood)
- Bedsider Birth Control for Lactating Parents
An online birth control support network that helps people find the method of birth control that is right for them and learn how to use it consistently and effectively.
- LactMed™ database
includes information on the levels of such substances in breastmilk and infant blood and the possible effects in the nursing infant.
- Vaccine information for people who are lactating (CDC)
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.
- American College of Obstetricians and Gynecologists: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients | ACOG
- Association of 'Women's Health, Obstetric and Neonatal Nurses: AWHONN COVID-19 Practice Guidance - AWHONN
- Nature: COVID vaccines and breastfeeding: what the data say
- World Health Organization: Coronavirus disease (COVID-19): Pregnancy and childbirth
- Centers for Disease Control and Prevention: COVID-19 Vaccines While Pregnant or Breastfeeding
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.
- Learn more about the LIFE program
- Find out if a birthing facility near you is LIFE accredited
- Miscellaneous birth and breastfeeding data (WA Tracking Network)