Illustration: Rebecca Zisser/HuffPost; Photos: Getty

After a Walmart employee wrapped up her maternity leave in 2015, she walked into her Carson City, Nevada, store with an electric breast pump in tow. She was intent on breastfeeding her new baby. Walmart was legally obligated to help her do it by providing a private space and enough breaks so she could pump breast milk. But the slow-moving disaster that unfolded over her first weeks back illustrated the many challenges breastfeeding moms like her still face on the job. At first, management told her she would have to pump in the store’s fitting rooms, but there was no outlet for her to plug in her electric pump. She asked if she could use an extension cord and was told it would be a tripping hazard. So she wound up pumping in the store’s employee training room. The law states the space must be “free from intrusion,” but she later said managers and co-workers walked in on her several times when her breasts were exposed ― sometimes even holding group meetings in her presence. Managers told her she could use a space next to the electrical server room, but it was dirty and a sign on the door warned of danger from high voltage. Management’s next best solution was to provide her with a manual pump to use in the fitting room. But her body had grown accustomed to the electric pump, and her milk production dropped off sharply when she started using the manual one. The lack of milk left her baby hungry. Her colleagues saw her crying at work and pooled money to buy her the baby formula she apparently couldn’t afford. The formula initially made the child sick, forcing the mother to buy a special version for sensitive babies. She was eligible for financial assistance for formula under Nevada’s Women, Infants and Children program for low-income families ― but she was told she needed to turn in the free electric pump she had received through the same public program. (A WIC spokesperson says that a mother would be asked to return a breast pump she’s no longer using, but that benefits could not be withheld if she didn’t.) SUBSCRIBE AND FOLLOW BUSINESS Get the top stories emailed every day. Newsletters may offer personalized content or advertisements. Privacy Policy Newsletter Please enter a valid email address Thank you for signing up! You should receive an email to confirm your subscription shortly. There was a problem processing your signup; please try again later Twitter

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Flipboard Walmart finally did install an electrical outlet so the employee could use her electric pump, but it took more than two months ― a third of the time doctors recommend a mother breastfeed her baby exclusively. And by then it was too late. She’d given up on breastfeeding and started feeding the baby solely formula. The Walmart worker’s story was among 376 investigations that HuffPost obtained from the federal government through public records requests. The Labor Department is responsible for enforcing the “nursing mothers” provision of the Affordable Care Act, better known as Obamacare, which requires employers like Walmart to accommodate workers who want to pump breast milk. HuffPost sought any cases involving a potential violation of that law and received investigations from across the country, stretching from 2010 to 2018. The agency redacted names and identifying characteristics of workers in the files, but they provide insight into the kinds of problems new moms face while pumping on the job. The American Academy of Pediatrics has promoted breastfeeding as the healthiest start for both infants and their mothers. The share of infants who are breastfed increased from 73.8% to 83.2% between 2004 and 2015, as more doctors in the U.S. encourage mothers to feed their babies exclusively breast milk for six months and continue nursing for a year or more. But the reality is that the United States does not guarantee paid leave by law, and many mothers end up going back to work in less than two weeks. For those who want to breastfeed, that means most have to pump ― every 2-3 hours throughout the workday, and for as long as it takes to fully empty their breasts, which can take 15-30 minutes. The Labor Department records make clear that many companies still break a law meant to protect a mother’s right to pump at work, including companies that tout themselves as mother-friendly. Employers broke the law in 255 of the cases HuffPost obtained, or 68%. In slightly more than half the cases, employers violated the requirement that they provide adequate space for pumping. In roughly a third, they violated the requirement that they provide sufficient break time. In nearly one out of every five cases, employers ran afoul of both provisions. A complaint from a worker prompted the vast majority of the investigations.

The hurdles to pumping at work took a financial, emotional and physical toll on many of the women. HuffPost identified five cases in which workers developed mastitis, a painful inflammation that can come with swelling, a burning sensation, fever and chills. Mastitis can result from skipping pumping sessions and milk backing up in the breast. In one example, a worker at a pancake house developed an infection but worried she would lose her job if she spoke up ― a fear common in many of the cases. Employers illegally retaliated against workers for asserting their rights in 22 cases, including the Walmart case in Carson City. The woman in that complaint said she lost her lunch breaks after she started pumping; she also said she was told to clock out when she needed to pump, even though another nursing mother was allowed to do so on the clock. In the end, Walmart agreed to pay the woman $217 in back wages. The investigator handling that case noted that the ordeal not only cost the family money but left the baby in pain due to the switch to formula. The investigator wrote that “equitable relief” should require Walmart to reimburse the woman for the formula she paid for out of pocket, since she “would not have had to purchase formula to begin with” had Walmart accommodated her as the law required. Randy Hargrove, a Walmart spokesperson, said the company has a corporate-wide policy in place meant to assure employees can pump. “This incident took place more than four years ago and our associate received all of her entitled backpay,” Hargrove said. “We welcome nursing mothers to breastfeed in our store, and we have processes in place to help ensure that our stores are accommodating to them, whether it’s our customers or associates. We take compliance with the law seriously and if there’s a misstep, we want to know about it so we can address it right away.” While many other cases were not so egregious, they shared similar themes, particularly in low-wage fields like retail and food service where workers struggle to find a clean, private space for pumping. Many of them are sent to restrooms ― in some cases, even public ones ― despite the fact that the law explicitly says restrooms are unacceptable because they’re unsanitary. Other women were told to pump in their manager’s office or a meeting room without locks, where they were walked in on repeatedly. Many had to pump in view of security cameras. In two separate cases, restaurant workers were instructed to pump behind the bread racks, leaving them partly visible to colleagues and customers. Those who do find an appropriate space often don’t receive the time they need to fully empty their breasts. A McDonald’s worker was yelled at and ordered to return to work before she was done pumping. A Family Dollar worker asked for more time to pump and got demoted to part-time. A spa employee was required to sign a piece of paper agreeing that she wouldn’t take any more breaks. Her inability to pump caused her to leak milk from her breasts while she worked.

‘A Constant Struggle’ The nursing mothers law was one of the few pieces of the Affordable Care Act that both Democrats and Republicans could agree on. Pro-life conservatives who otherwise denounced former President Barack Obama’s 2010 landmark health care law joined their liberal colleagues in supporting the breastfeeding provisions. The thinking was simple: If a mother wants to breastfeed, she should still be able to work for a living. The law states that for up to a year after the child’s birth, an employer must provide the worker with a space to pump that’s shielded from view and “reasonable break time” to pump ― although what’s reasonable is not defined and can vary from one woman to the next. The employer doesn’t have to pay the worker for that time unless it is break time the worker is normally paid for. Employers with fewer than 50 workers can be exempted from the law if they can show it would be an “undue hardship.” An analysis of Labor Department filings shows that the number of nursing mother cases has generally been rising, perhaps because more women have become aware of their rights under the law and are filing complaints. Among the cases released to HuffPost, only 42 were investigated in 2011, the year after the law was enacted. More than 70 were investigated in 2017. The most common industry for worker complaints was retail, which accounted for more than one out of every five investigations. The cases revealed violations by a litany of household names: BestBuy, JCPenney, Dollar General, Lowes, Toys R Us, Costco and Kroger, among others. Walmart had the most violations of any private company, with six, but it is also the largest private-sector employer in the U.S., with 1.5 million workers. Research has shown that babies in low-income homes are less likely to be breastfed. The investigations help explain why. Not only do low-wage women typically have to return to work sooner after having a child, many of them also have a difficult time getting breaks from their employers to pump. A worker at a Family Dollar store in Scranton, Pennsylvania, asked for only one pumping break each day, but couldn’t get it from her managers. She “spent the majority of her time working alone and there was no coverage from co-workers to provide her an opportunity to take a break,” the investigator wrote. When she did get a break, she had to pump in a stock room where both a vendor and a co-worker walked in on her. A Family Dollar spokesperson declined to comment on the case, citing privacy reasons. An employee at a Jared Vault jewelry store in Oklahoma City wasn’t given a private space to pump, so she often clocked out and drove home when she needed to do it. The arrangement was not only inconvenient but cost her wages. Another woman who worked at a cosmetics shop in a Miami mall was told to use the public restroom, where the lack of privacy and heavy foot traffic made it difficult. The aggravation of dealing with her boss and the mall’s management over the issue discouraged her from breastfeeding. “Little by little [she] pumped less and less,” until eventually she gave up, the case file states. The woman filed a complaint against the employer “to avoid this from happening to anyone else in the future.” Restaurants made up more than 10% of the cases, including small eateries and large chains like McDonald’s, Subway, Olive Garden, Cracker Barrel and Buffalo Wild Wings. An Outback Steakhouse was cited in 2017 for failing to provide a worker with a space safe from the view of co-workers. The investigator found that the restaurant’s parent company, Bloomin’ Brands, did not have a clear corporate-wide policy for pumping at work, even after the law had been in place for roughly seven years. The company did not respond when asked if that had changed.

In many restaurant cases, workers who asked for time to pump were told there was no one to cover for them. Managers at IHOP diners broke the law in two separate cases by denying servers breaks. One worker at an IHOP in Oklahoma said her general manager declined her requests for even a few minutes to pump, telling her curtly, “not right now,” or “later.” She eventually developed mastitis. A worker at an IHOP in Arkansas told her boss she would need to pump for 15 minutes roughly every two hours once she returned to work after having her baby. Over the next 20 days, she received just two breaks and was told to pump behind a bread rack. Her bosses told her nobody could cover for her, especially on the weekends. She quickly gave up on breastfeeding. An IHOP spokesperson said the two locations that broke the law were run by franchisees. The breastfeeding protections apply only to employees who are covered by the Fair Labor Standards Act ― the same workers with overtime protections ― while excluding managers, professional employees and whole other categories of workers. That means it is predominantly hourly employees who get the protections; women who earn a regular salary above $23,660 and perform certain job duties are exempt from the law. Many white-collar women face the same hurdles to pumping as retail workers, but their struggles wouldn’t be found in the Labor Department’s investigations. While the cases skewed toward low-wage jobs, the field with the second-most complaints after retail was hospitals and healthcare facilities, which accounted for 62 of the 376 cases. Nurses may be more familiar with the law and willing to file complaints, but they also have just as hard a time getting breaks as many retail workers. Even hospitals with “baby-friendly” designations due to their breastfeeding services failed to provide their own employees with the time needed to pump. An investigator found that nurses at a Bellevue, Washington, hospital couldn’t find time to pump “due to the nature of the business.” One employee there ended up with a breast infection. A time study performed at a Michigan hospital revealed that nurses spent the bulk of their 15-minute breaks traveling to and from the lactation room, which was on another floor, leaving them with only five minutes to actually pump. One hospital worker called pumping at work a “constant struggle.” Nursing homes and home care settings accounted for another 19 cases. More than 40 cases involved government workers, and the U.S. Postal Service had the most violations of any public-sector employer, with eight. The agency has a workforce of half a million employees, many with union protections that other workers do not enjoy ― perhaps making them more comfortable raising grievances over pumping. One postal worker in Southern California wasn’t given enough breaks and had to sneak pumping sessions in the bathroom. Her breasts apparently hurt so badly that she pumped breast milk into the toilet to relieve the pressure. Lack of a clean, available space also led her to pump while seated on the locker room floor. Her supervisor gave her a seven-day suspension for taking too many breaks. The Labor Department concluded the discipline amounted to illegal retaliation. The Postal Service removed it from the employee’s record.

A Postal Service spokesperson said the agency does not comment on individual personnel matters, but “we take seriously our obligation to follow Department of Labor guidance” on the nursing mothers law. Public-sector workers appear again and again in the reports. A supervisor at Detroit’s Water and Sewerage Department instructed a female employee who worked out in the field to pump in a McDonald’s bathroom. A field employee with the Indiana Department of Transportation couldn’t get adequate time to pump from her bosses and was eventually fired, allegedly for being absent without permission. After an investigation, the Labor Department brokered her reinstatement. The worker was owed more than $26,000 in backpay. At a government contractor in Oklahoma, one worker said she endured the indignity of having her female manager stand outside the nursing room and time her while she pumped. The manager threatened to discipline her if she didn’t stop pumping after four months, even though the employee stayed late to make up for her pumping time. She eventually suffered from mastitis. According to the case file, her boss asked her why she was still breastfeeding if she had an infection. In many cases, middle managers apparently ignored breastfeeding policies that were already in place. Some readily admitted they did not know the law; others understood their obligations but didn’t want to take the extra steps necessary to accommodate a worker. Sometimes an employer made what seemed to be a good-faith effort to help employees pump but still failed to comply with the law. In one example, the Boeing Company had established a lactation program at its production facility in Everett, Washington, where mothers could sign onto the company’s internal website and reserve a room to pump. Each room came equipped with a lock, a chair and a refrigerator to store milk. The problem workers encountered was high demand ― 20 women were all trying to use a limited number of nursing spaces. The worker who filed the complaint said she wasn’t able to pump when she needed to. A Boeing spokesperson said the company nearly doubled the capacity for pumping mothers at the facility after the complaint. Because some workers have a long way to travel to the lactation rooms, the company is launching a pilot program in which mobile nursing pod will come to them. The company also added a benefit that allows breastfeeding moms on travel for work to mail their breast milk home at company cost. Other employers seemed less humbled when an investigator came knocking. A worker at the furniture manufacturer Polywood, in Syracuse, Indiana, reported that she was told to pump only during scheduled 15-minute breaks and her lunch, a routine that didn’t give her enough time, and to do so in the women’s bathroom. When a Labor Department investigator explained the law to management, Polywood’s representatives admitted they had failed to meet the requirements. One company official asked the investigator if an employer is really “at the mercy of any nursing mother.” A Polywood manager did not respond to requests for comment.

‘A Hostile Environment’ In reality, the violations investigators turned up probably reflect only a small fraction of the times women are prevented from pumping at work. One problem, experts say, is the vast number of workers excluded from the protections because they aren’t covered by the law. Some states have passed their own, more expansive laws, covering workers who are carved out of the federal statute. But there are still large gaps. The Center for WorkLife Law, a research group at the University of California’s Hastings College of Law, estimates that 27.6 million women of child-bearing age aren’t legally guaranteed time and space to pump at work. If any of those women filed a complaint, there is little that federal investigators could do about it. Another problem is how relatively little the women who are protected have to gain by initiating an investigation. Workers generally can’t expect anonymity when reporting their employers ― everyone knows who the new mom is ― which can be an invitation to retaliation. Women have to weigh their desire to breastfeed against their relationship with their boss, hope for a promotion, or even their job itself. Many women only reported their employers after they had left their jobs. That was the case with an employee at a Sunglass Hut in Indiana who had trouble getting breaks and pumping at the mall. The investigator wrote that she filed a complaint because “she simply wants to educate the employer.” There is usually no financial incentive to filing a complaint, though a company can be required to provide backpay if it fired a worker or cut her hours due to pumping, or withheld pay for normally paid breaks. That was the case with a Wawa convenience store in Bethlehem, Pa., which had to reinstate and pay nearly $5,000 to one breastfeeding mom who’d been terminated. But most workers are rarely owed anything but an accommodation under the federal law. Liz Morris, the deputy director of the Center for WorkLife Law, said she would like to see the law amended to allow for damages so that firms that break the law face greater consequences. “There may be no financial implications for the employer if they completely ignore the law,” Morris said. “In my opinion, it’s the biggest problem.” Some women who’ve been prevented from pumping at work have chosen to pursue lawsuits under Title VII of the Civil Rights Act, which prohibits discrimination based on race, color, religion, sex and national origin. The statute itself does not explicitly say anything about pumping, but federal appeals courts in recent years have ruled that discrimination due to breastfeeding is a violation of that law. A lawsuit can lead to a big settlement or jury verdict, unlike a complaint filed under the nursing mothers provision. But the accommodations required under Title VII are not nearly as clear and straightforward.