Supporting

breastfeeding
in the workplace
A guide for employers
and employees
 1

WHY SUPPORT BREASTFEEDING

IN YOUR WORKPLACE

How to use this guide Breastfeeding is the best option

This guide was written to support the practice
of breastfeeding in South African workplaces. It Breastmilk is the best food for babies. promotes brain development and better
contains practical information for employers and It contains nutritional properties that cognitive function.
managers of big, medium and small organisations can prevent illness and death in babies
and young children. Breastmilk provides The unique properties of breastmilk
on how they can create a breastfeeding-friendly
protection later on in life, as breastfed benefit children as they get older and
workplace.
children have lower risks of non- throughout the course of their lives.
This guide is for employees as well – read it from communicable diseases such as childhood Breastfeeding can affect health outcomes
cover to cover and understand your rights. obesity, diabetes, and cardiovascular and school performance, and later, an
diseases. Breastmilk supports and adult’s participation in the economy.1,2

contents page Breastfeeding is protected and supported by

Why support breastfeeding in your workplace 1
the South African government
South Africa’s public health policy protects, should engage their employers to make
Ten steps to becoming a breastfeeding-friendly
3 promotes and supports breastfeeding for arrangements to support breastfeeding.
work environment
all mothers regardless of HIV-status. This
Your workplace breastfeeding policy 8 was reaffirmed in the Tshwane Declaration In 2012, South Africa published national
(2011) by the Minister of Health, Dr Aaron regulations in support of the International
Expressing and storage of breastmilk in the Motsoaledi, conferring South Africa as a Code of Marketing of Breastmilk Substitutes,
10
workplace breastfeeding country in the context of HIV. called Regulations Relating to Foodstuffs for
Infants and Young Children. The regulations are
South African laws protecting pregnant women and HIV-positive mothers can safely designed to remove commercial pressures
14
breastfeeding in the workplace breastfeed their children up to age two from the infant feeding arena, to ensure
years as long as mothers are taking their that all parents receive independent and
Other useful resources 16 anti-retroviral treatment as prescribed.3 objective information, and to ensure that
References 17 South Africa’s Code of Good Practice on the all mothers who wish to breastfeed are
Protection of Employees during Pregnancy and supported to do so.
After the Birth of a Child secures guaranteed
You can read more on South African laws
breastfeeding breaks of 30 minutes
protecting breastfeeding on page 14.
twice per day for breastfeeding or milk
expression each working day for the first
six months of the child’s life. Beyond
six months, breastfeeding women
2 3

STEPS TO BECOMING

More women make up

10 A BREASTFEEDING
FRIENDLY WORKPLACE
the formal workforce
than ever before
The largest increase in the labour
market has been among women,4 Appoint a working group to facilitate breastfeeding
with the majority (4.8 million or 67%)
employed in the formal, non-agriculture
step 1 support in the workplace - where possible under a wellness
programme. The working group should start by developing a
sector. Women make up the majority of written breastfeeding policy to be endorsed by management.
many labour markets including domestic There is a generic example of a breastfeeding policy on page
workers, retail, hospitality, education, and 8. Once complete and signed, the policy should be visible to
nursing. Many of these women are in their What are the benefits all employees.
childbearing years.
of supporting Build awareness among staff and management about the
breastfeeding in step 2 breastfeeding policy and the breastfeeding needs of working
mothers through your human resource department, staff
A breastfeeding the workplace for wellness and training programme, and your labour union.
You can also use all internal communication channels, such
nation is a employers? as newsletters, noticeboards, email, and intranet, to build
healthy and • Breastfeeding can reduce medical
awareness.

productive costs for mother and child. Based

on American data, for every 1,000 Identify an influential breastfeeding advocate from amongst
nation. babies not breastfed, there are an
extra 2,033 doctors visits, 212 days
step 3 your staff to champion the breastfeeding cause in your
workplace and make it a standing item on your staff agenda.
Supporting in hospital and 609 prescriptions.5

breastfeeding • One-day absences to care for sick Identify a suitable and private space for moms to breastfeed

in the workplace
children occur more than twice as
often for mothers of formula-fed
step 4 or express their breastmilk. The space will depend on
your workplace’s needs and demand. Ideally, a dedicated
infants.6 small room for the purposes of breastfeeding or expressing
makes good • A study of multiple companies with breastmilk should be made available. The dedicated
breastfeeding support programmes breastfeeding room should be lockable and private, with
business sense! found an average retention rate of lighting, a comfortable chair, and a plug point if moms are
94%.7 using electric breastmilk pumps. Breastfeeding employees
• Last but not least, staff satisfaction should never be expected to express milk in a toilet. Toilets
and loyalty improve when are unsanitary. They do not provide a place to comfortably
breastfeeding mothers are respected express breastmilk. More information on breastfeeding rooms
and supported in the workplace. is on page 7.
4

PLEASE DO
Allow flexible scheduling of work duties to support
NOT DISTURB
step 5 breastmilk expression during work hours; give new mothers
options for returning to work, such as working from home,
part-time work, and extended maternity leave; consider
providing on-site or near-site child care; and consider
offering professional lactation management services and
support through staff wellness programmes.

If possible, allocate a dedicated fridge for expressed

step 6 breastmilk, as well as a dedicated hand basin. If this is not
possible, employees can use personal cooler bags in the
communal fridge and wet wipes.

It would be advisable to keep record/register of how many

step 7 staff use the breastfeeding room and other services to
evaluate their effectiveness, as well as the need to create
more demand.

Report on and celebrate the establishment of your

step 8 breastfeeding room in your staff newsletter or your intranet.
Celebrate World Breastfeeding Week annually during August 1-7
each year (http://worldbreastfeedingweek.org).

Evaluate the breastfeeding policy and amend when

step 9 necessary. This can be done through your company’s
employee wellness survey.

Photocopy the signs on the following pages and stick

10
COME BACK IN
step them up in a prominent place to show that you are a
breastfeeding friendly workplace and to show where the
breastfeeding room is.

MINUTES
 7

SETTING UP YOUR
BREASTFEEDING ROOM

The breastfeeding room can be as basic or advanced as desired based on your

company resources and staff needs. You can start with a very small room with the basic
requirements and expand according to the need.

BASIC INTERMEDIATE ADVANCED

REQUIREMENTS REQUIREMENTS REQUIREMENTS

• Clean room that is • Clean room that • Clean room that is lockable
lockable and private is lockable and and private
• Electrical outlet private • Electrical outlet
• Comfortable chair • Electrical outlet • Comfortable chair/couch
• Disinfectant • Comfortable chair/ • Disinfectant wipes
wipes (mothers couch (mothers can provide for
can provide for • Disinfectant themselves)
themselves) wipes (mothers • Room has a washbasin
• Room located near can provide for with clean running water
a source of running themselves) and soap
water • Room has a • Employer-provided small
• Waste bin washbasin with refrigerator for storing milk
• Employee can store clean running water • Waste bin
milk in a public and soap • Printed educational

BREASTFEEDING
refrigerator or • Employer-provided resources obtained from
personal cooler small refrigerator a reputable source (refer to
• Printed educational for storing milk page 16)
resources obtained • Waste bin • Employer-provided TV and

FRIENDLY
from a reputable • Printed educational DVD for mothers to watch
source resources obtained breastfeeding DVD on milk
(refer to page 16) from a reputable expression
source (refer to page

WORKPLACE
• Employer-provided radio to
16) play relaxing music
• Attractive wall • Storage lockers for
hangings, floral essential items
arrangement, etc. • Desk or table top space
• Attractive wall hangings,
floral arrangement, etc.
Adapted from National Business Group on Health by Center for Prevention and Health Services. Investing in
Workplace Breastfeeding Programs and Policies (An Employers Toolkit)
8 9

TEMPLATE OF A WORKPLACE
BREASTFEEDING POLICY 3. Employees can request and be granted reasonable time-off to breastfeed her baby or for expressing
breastmilk.
4. Such time-off will not be regarded as vacation leave, but a record must be kept as part of the regular
attendance management system of the institution.
5. Arrangements should be made for employees to have breaks of 30 minutes twice per day for
Breastfeeding friendly workplaces need a breastfeeding policy endorsed by management.
breastfeeding or milk expression each working day for the first six months of the child’s life, over and
Use the breastfeeding policy template below as is, or as a guide to develop something
above normal breaks. Beyond six months, breastfeeding women should engage their employers to
suitable for your workplace’s needs. In either instance, remember to circulate the
make arrangements to support breastfeeding.
complete and signed policy widely amongst staff using all internal communication
6. Operational requirements must be considered at all times as discussed by the employee and supervisor.
channels available: email, noticeboards, intranet, newsletters, workers unions, wellness
programmes, etc. 7. In cases where abuse of time is suspected, the employer may investigate and take action according
to company policy.
Workplace breastfeeding policy for [insert Business / Company / Workplace Name]
Space and facilities
Background It is recognised that bathroom facilities are not appropriate for women to breastfeed or express breastmilk.
(insert workplace name) recognises that breastmilk is the recommended The following will be provided for breastfeeding and/or expressing of breastmilk:
ideal, most healthful, natural and economic food for healthy growth and development of infants and young • A clean, comfortable and private space at or near the workplace
children. Our policy is to support the needs of breastfeeding mothers when they return to work.
• Appropriate signage (i.e.: “ROOM IN USE”) to ensure privacy
(insert workplace name) therefore promotes and supports breastfeeding • Comfortable chair with supportive arms - for breastfeeding
and the expression of breastmilk by employees who are breastfeeding. • Small table and chair for expressing breastmilk
• In case that an electrical breast pump is used, accessible electrical outlets will be needed.
Purpose • Baby changing station or table with a means to hygienically clean area
To provide a guideline to supervisors and managers with regard to employees who choose to breastfeed or • Proximity to washing facilities with a clean, safe water source for hand washing and rinsing out breast
express breastmilk for their babies. pump equipment
• A small refrigerator or space in a refrigerator for safe storage of breastmilk. Alternatively, the
Scope
employee can provide her own cooler bag with ice packs for the storage of breastmilk.
The provisions contained in this policy are applicable to employees who return from maternity leave as well
as new appointees who are breastfeeding at the time of appointment. Breastfeeding women will provide their own containers for the expression and storage of breastmilk in the
refrigerator. The breastmilk containers will be clearly labelled by the mother with a name and date.
Legislative framework
• Constitution of the Republic of South Africa, No 108 of 1996 Promotion and communication of policy
• Labour Relations Act, No 66 of 1995 as amended This policy will be communicated to all staff of (insert workplace name) and will be
• Basic Conditions of Employment Act, No 75 of 1997 reiterated to female employees commencing maternity leave. The policy will also be included in the new
• Employee Equity Act, No 55 of 1998 employee’s orientation programme.
• Code of Good Practice on the Protection of Employees during pregnancy and after the birth of a Further information
child as per the regulation Gazette No 6342 of 1998, issued in terms of the Basic Conditions of
Employment Act of 1997 For further information or assistance in relation to this policy please contact:
(insert name and contact details of contact person)
Arrangements
1. On return from maternity leave, the employee will inform the direct supervisor that she is breastfeeding. Authority [Approved by]
2. The supervisor, in conjunction with the manager, will ensure that reasonable provision is made within
the workplace to accommodate female employees who request to breastfeed or express breastmilk. [Date approved] [Last reviewed]
10 11

EXPRESSING AND STORAGE

OF BREASTMILK IN THE
WORKPLACE

Many mothers are choosing to continue As you apply the pressure the breast have been expressed and
breastfeeding after they return to work 8 pads of the thumb and finger move feel soft. This should take about
by direct feeding when they are with their Direct feeding toward each other pushing in and 20-30 minutes.
baby, and expressing breastmilk for when before and after not pulling towards the nipple. Find
Do not feel discouraged about
they are away from their baby. Direct a good rhythm of compression and 10
feeding before and after work, during the work, during relax similar to your baby’s suck the amount that you are able to
express. It may only be a few drops
night, and weekends is a great way to help the night, and pattern.
when you start but it will increase
keep breastmilk supply going and to bond
with your baby. weekends is a great 9
Alternate between breasts every as you become comfortable and
few minutes (about 5 times per skilled in hand expressing.
At work, there are two ways that a mother way to help keep breast), rotate your fingers around
can express breastmilk: hand expression, breastmilk supply the nipple so that all areas of your
which is a great skill to know, and using a
manual or electric breast pump. going and to bond
with your baby.
How to express
by hand
When you are ready to start, place
1
Wash your hands and 5 your thumb on the top of your
have a clean collection
container with wide breast and your fingers below the
mouth ready to collect breast about 4 cm from the nipple
your milk. on the areola (darker ring around
your nipple).
Before you start, spend some time
2 Apply steady pressure into the
gently massaging your breasts with 6 breast toward the chest wall,
your hands. You can use a warm
cloth to add some heat which can repeat a few times. If no milk
help. comes out move your finger closer
or further away from the nipple and
Make yourself comfortable in an repeat the pressure.
3 upright position while leaning
You may find these resources on hand expression of breastmilk useful
Apply a steady pressure towards https://globalhealthmedia.org/videos/breastfeeding/
forward slightly. 7 the chest wall and not the nipple. https://youtu.be/6ZViuYKX5LU
Hold the container near your breast Your milk will be in the breast and https://100percentbreastfed.co.za/
4 under nipple and areola. not in the nipple.
12 13

Building up Below are some storage tips for freezing

expressed breastmilk:
Preparing breastmilk DO NOT boil your
breastmilk or
breastmilk supplies • Name and date the breastmilk before it is fed to use a microwave
container with the date on which you to heat it; this
A good time to start your frozen expressed expressed it. Use the breastmilk your baby can damage
breastmilk reserve is around one to two with the earliest date first (apply the the nutritional
months before you go back to work. This Breastmilk can be defrosted in the fridge
first in, first out rule). properties
is long enough to get over the anxiety of the day before you need to use it. You
• Freeze your breastmilk in the can warm up the expressed breastmilk
going back to work, to learn the skill of
amounts that you will most likely to room temperature by standing it in a
expressing breastmilk at home, and get a
need. If baby drinks 50 ml a feed, container of warm water.
good amount of breastmilk stored. Some
store in 50 ml amounts or in the full
mothers expect to express lots of milk but Most breastmilk will separate if it has By following the guidelines below, you will
amount for the day.
this may be difficult because you are still stood for a time. If this happens gently be able to express your breastmilk and
feeding your baby and then expressing • Only add breastmilk to breastmilk of
the same temperature. For example, mix the breastmilk by slowly shaking leave it for your baby while you are at work.
for extra milk afterwards – that’s why it’s up your container. DO NOT boil your Make sure that the person looking after
good to get a head start. warm milk from your breast should
be allowed to cool down in the fridge breastmilk or use a microwave to heat it; your baby knows how much breastmilk to
before it is mixed with breastmilk this can damage the nutritional properties give at each feed and how to feed your
that has been in the fridge. of your breastmilk and also burn your breastmilk to your baby.
baby’s mouth.
Storage guidelines for expressed breastmilk
for full term healthy babies at home: Expressed breastmilk guidelines for feeding
MILK DEEP FREEZER FRIDGE 40C INSULATED ROOM BABY’S AGE AVERAGE MILK PER FEED AVERAGE MILK INTAKE PER DAY
STORAGE/ FREEZE SECTION OF COOLER TEMPERATURE First week (after day 4) 30-60 ml 300-600 ml
HANDLING -180C FRIDGE WITH WITH ICE 250C
Weeks 2 & 3 60-90 ml 450-750 ml
SEPARATE PACKS 150C
DOOR Months 1-6 90-150 ml 750-1040 ml
Fresh 6 to 12 3 months 3 days 24 hours 4 hours optimal; Adapted from Nancy Mohrbacher, IBCLC
months optimal; up up to 8 hours
to 6 days acceptable under After six months, when your baby is starting to eat solids, his or her breastmilk intake
acceptable clean conditions will begin to decrease. However, you should continue to breastfeed because breastmilk
will still contribute significantly to your baby’s nutritional needs.
Frozen, Do not Do not 24 hours Do not store 4 hours
BABY’S AGE AVERAGE MILK PER FEED AVERAGE MILK INTAKE PER DAY
thawed in refreeze refreeze
fridge 7 to 11 months 120 – 150 ml 800 - 900 ml
12 to 24 months 100 – 120 ml 400 - 550 ml
Thawed, Do not Do not 4 hours Do not store Until feeding ends
warmed, not refreeze refreeze
fed
Warmed, fed Discard Discard Discard Discard Until feeding ends
14 15

SOUTH AFRICAN LAWS PROTECTING

PREGNANT WOMEN AND
BREASTFEEDING IN THE WORKPLACE

The South African Code of Good Practice on

the Protection of Employees during Pregnancy
Promotion of Equality and Prevention of Unfair
Discrimination Act (No. 4 of 2000) protect
By creating
and after the Birth of a Child which forms
part of the Basic Conditions of Employment
women against dismissal during their
maternity leave; deem dismissals for
a supportive
Act (No. 75 of 1997 as amended), stipulates
that arrangements should be made for
pregnancy or reasons related to pregnancy
as automatically unfair; and expressly
environment for
employees who are breastfeeding to have
breaks of 30 minutes twice per day for
prohibit any form of discrimination on the
grounds of pregnancy.
breastfeeding
breastfeeding or milk expression each
Code of Good Practice on the Protection of
mothers in the
working day for the first six months of the
child’s life. Employees During Pregnancy and After the Birth
of a Child as per the regulation Gazette
workplace, you
The Basic Conditions of Employment Act (No. No 6342 of 1998, issued in terms of the are complying with
75 of 1997 as amended) offers women Basic Conditions of Employment Act of 1997 (the
four months’ maternity leave, six weeks Code) guarantees breastfeeding breaks. legislation and
of which must be taken after the birth South Africa has adopted the Code which
of the baby. Paid maternity leave is not provides that arrangements should be promoting the health
obligatory. made to enable women who are returning
to work to have breaks of 30 minutes and wellbeing of
Unemployment insurance in the form
of a maternity benefit can be claimed
twice per day for breastfeeding or milk
expression each working day for the first your employees and
if contributions have been made by the
mother to the Unemployment Insurance
six months of the child’s life. The Code
was developed and adopted in terms of
their babies.
Fund (UIF) in the months preceding her section 87(1)(b) of the Basic Conditions
pregnancy. The benefit can be claimed for of Employment Act, with the objective of
a maximum of 121 days of up to an amount providing “guidelines for employers and
of 60 percent of the contributor’s salary. employees concerning the protection of
However, a sliding scale is adopted, and the health of women against potential
women earning at the higher end of the hazards in their work environment during
scale may claim significantly less than 60 pregnancy, after the birth of a child and
percent. The highest earning women may while breastfeeding”.
claim a maximum of only 38 percent of
their salary. The code of good practice can be found
on the Department of Labour website.
The Basic Conditions of Employment Act, the
Labour Relations Act (No. 66 of 1995), and the
16 17

OTHER USEFUL RESOURCES REFERENCES

Breastfeeding resources WHO. 2003. Global strategy for infant and young Ortiz J, McGilligan K, Kelly P. Duration of breast milk
1 7

child feeding: World Health Organization. www.who.org/ expression among working mothers enrolled in an
• South African Department of Health - http://www.health.gov.za/ nutrition Accessed 28 June 2018 employer-sponsored lactation program. Pediatric
Nursing. 2004;30(2):111-119
• The South African Breastmilk Reserve (SABR) is the Department of Health’s 2
Victora, C.G., Bahl, R., Barros, A.J., França, G.V., Horton,
largest milk bank partner. They can help you find out if there is a milk bank near S., Krasevec, J., Murch, S., Sankar, M.J., Walker, N. & 8
https://www.cdc.gov/breastfeeding/pdf/BF_guide_2.
you, which you can donate to, or access - https://www.sabr.org.za Rollins, N.C. 2016. Breastfeeding in the 21st century: pdf Accessed 29 June 2018
epidemiology, mechanisms, and lifelong effect. The
• The Human Milk Bank Association of South Africa (HMBASA) is an NGO that 9
Jones & Tully, 2006, Best Practice for Expressing,
Lancet, 387(10017):475-490.
coordinates milk banks in South Africa - https://hmbasa.org.za Storing and Handling Human Milk in Hospitals, Homes
• International Baby Food Action Network (IBFAN) aims to improve the health and
3
Dept. of Health (2017). IYCF policy 2013 amendment, and Child Care Settings
well-being of babies and young children, their mothers and their families through Nutrition Directorate, 7 June 2017
the protection, promotion and support of breastfeeding - www.ibfan.org 4
Dept. of Labour http://www.labour.gov.za/DOL/
• World Health Organisation - www.who.int/topics/breastfeeding/en/ downloads/documents/useful-documents/labour-
market-research-and -statistics/Labour%20Market%20
• UNICEF - https://www.unicef.org/nutrition/index_24824.html Research%20%20Women%20in%20the%20South%20
• World Breastfeeding Week - http://worldbreastfeedingweek.org African%20Labour%20Market%201995%20-%202005.
pdf Accessed 25 June 2018
• 100% breastfed campaign - https://100percentbreastfed.co.za/
5
Ball TM, Wright AL. (1999). Health care costs
of formula-feeding in the first year of life.
Pediatrics,103(4):870-876
Resources for pregnant women and 6
Cohen R, Mrtek MB, Mrtek RG (1995). Comparison of
caregivers of babies and young children maternal absenteeism and infant illness rates among
breastfeeding and formula-feeding women in two
• Sign up for to MomConnect a free SMS and Whatsapp stage-based messaging corporations. American Journal of Health Promotion,
service from the National Department of Health. Dial *134*550# from your 10(2),148-153.
cellphone to register.
• Look out for the How to Raise a Happy and Healthy Child booklet in your home language
in your state clinic or hospital, as well as other Side-by-Side materials.
HEALTH SERVICES
Your local clinic
Your doctor
AIDS Helpline 0800 012 322
Depression/Mental Health 0800 12 13 14/011 262 6396, sms
helplines 31393
Emergency ambulance 10177
From a mobile: 112
Poison information centre 0861 555 777
MomConnect *134*550#
BIRTH REGISTRATION AND IDENTITY DOCUMENTS
Home Affairs Toll Free helpline 0800 601 190
CHILD PROTECTION AND SAFETY
Police emergency number 10111
Childline toll free 0800 055 555 / 0800 123 321
GRANTS
SASSA Toll Free helpline 0800 601 011 / 0800 600 160
GrantEnquiries@sassa.gov.za
CHILD CARE AND EDUCATION
Your local ECD centre, creche, preschool, child minder

Let’s work together side by side to

encourage mothers to breastfeed
anytime and anywhere.