More than half of working mothers lack proper breaks and facilities to pump breast milk at work — even though it's required by federal law for large employers — according to the first national look at breast-feeding support in the workplace since the Affordable Care Act took effect.

The new study by the University of Minnesota surveyed more than 1,000 working mothers who gave birth in 2011 and 2012 and found that 60 percent lacked the required breaks or secluded spaces.

Given the well-documented health benefits for breast-fed babies, "it's a shame when the reason that women decide they can't is because it's too hard at work," said Katy Kozhimannil, the lead researcher. "That shouldn't be the case anymore."

Workplace support is important, she said, as women with adequate breaks and space for pumping breast milk were more than twice as likely to rely exclusively on breast-feeding their babies for six months. That is the minimum duration recommended by the American Academy of Pediatrics for the infant health benefits.

Emily Whebbe, a Twin Cities lactation consultant, said relaxation can help maximize milk production, but that isn't possible if women need to pump in a bathroom stall or hunker down in a cubicle and hope nobody peeks over the wall.

"A couple weeks after returning to work, it's wrecking their supply because they don't have the break time or don't want to ask their bosses to create space because it's embarrassing," she said. Many women quit as a result and feed formula to their babies, she said.

Federal requirements contained in the Affordable Care Act took effect in 2010, but apply only to businesses with 50 or more workers and to "nonexempt" employees — generally those who are not in management ranks.

Minnesota has had a comparable law since 1998, and it applies to all businesses and workers. The state's rules were toughened in 2014 to clarify that private space for pumping breast milk couldn't be in a bathroom and must be secluded and near an electrical outlet.

Flexibility helps

The emphasis on breast-feeding wasn't as strong seven years ago, when Kristin McKelvey gave birth to her first child. She was taking college courses part-time and gave up because there was no place for pumping milk at the pet hospital where she worked.

Now McKelvey is an administrative assistant in the midwifery department at Hennepin County Medical Center, and receives so much support for breast-feeding her second child that co-workers sometimes make her take breaks to pump.

"I had come in to work in tears one day because my supply was almost gone," she said, "and they told me exactly what to do, and I got it back up."

Kozhimannil said she was surprised by the number of women lacking the required facilities, but attributed it to the difficulty of renovating offices, factories, restaurants or other workplaces.

"I wouldn't want to assume that it's just angry employers who hate Obamacare," said Kozhimannil. "I think it's just a tough problem."

The study, published in the journal Women's Health Issues, found that lower-income women had less access to breaks and space for pumping.

Whebbe said she tries to take the burden off clients, who sometimes fear retribution if they complain to their employer. She has written notes to employers explaining the laws or indicating the number of times new mothers should pump milk.

Flexibility on the part of the employee can help — " 'I won't take a lunch, but I'll take three breaks' " she said.

Federal and state laws require employers only to make "reasonable" efforts to accommodate working mothers. But Minnesota last year gave women recourse if they run into problems, requiring the state Department of Labor and Industry to investigate their complaints within 10 days.

Six investigations so far have resulted in workable solutions for mothers. In one instance, a factory line worker was fired when a pumping break lasted 30 minutes instead of the usual 15. She was rehired after the state looked into her case.

"Employers really want to figure out ways to comply with this law," said Jessica Looman, the department's deputy commissioner.

McKelvey, 28, is two-thirds of the way toward her goal of breast-feeding her second child for one year. The cost savings and bonding with her daughter have been significant, and she doesn't think they would have happened without workplace support.

"I never thought I would make it this far," she said, "put it that way."

Jeremy Olson • 612-673-7744