JOINT BASE LEWIS-MCCHORD, Wash. -- Madigan Army Medical Center has two new policies that protect, promote and support breastfeeding. Commander's Policy #3W: Employee Lactation Support Program Work Plan Policy, signed April 21, addresses the needs and support mechanisms for employees. Clinical Policy #90: Infant Feeding, signed March 30, outlines how Madigan plans to support breastfeeding patients in the clinical setting.

Dorothy Strobl-Lucas, a registered nurse and lactation consultant at Madigan, explained the change the commander's policy brings. "Prior to having the policy," she said, "there was no basis of support for allowing the time or space for lactation efforts by staff. As a healthcare facility, we should be promoting evidence-based care. This does that."

The commander's policy expands and localizes Army Directive 2015-43 (Revised Breastfeeding and Lactation Support Policy). This directive is based upon higher level guidance that originated with changes made by the Affordable Care Act to the Fair Labor Standards Act in 2010.

"Maintaining lactation is associated with a lot of health benefits," said Strobl-Lucas. "There's so much research out there that shows the benefits to a mom and baby."

The Office of Women's Health, which is a part of the U.S. Department of Health and Human Services, has information on all aspects of women's health, including a webpage dedicated to breastfeeding that can be found at

The research presented on the site shows that breastfeeding reduces a long list of illnesses for both baby and mother. Strobl-Lucas explained, "We know that it's your best public health program for setting people up for optimal health for their lifespan."

According to the Department of Health and Human Services, the workplace benefits of a breastfeeding and lactation support program are improved readiness through reduced absenteeism, reduced cost of insurance claims for sick children and mothers, reduced loss of institutional knowledge and turnover, and increased morale. Both locally and nationally, the benefits of breastfeeding are clear.

Beyond requiring the provision of appropriate time and space to breastfeed or pump, the commander's policy puts forth education and support group resources available to staff, offers guidance on establishing a lactation room and lists the lactation stations currently positioned around the medical center. The policy also includes a sample work plan contract for an employee and their employer to use to work out an amendable schedule. This is not mandatory, but having a written agreement to guide time and space allowances for breastfeeding is encouraged.

The Army Public Health Center has a breastfeeding resource webpage within its Women's Health Portal that includes everything from policy and guidance to getting a free breast pump from Tricare to healthy eating tips. It can be found at:

Clinical Policy #90: Infant Feeding addresses how Madigan strives to provide breastfeeding support for patients. This policy includes guidance on pertinent topics to include staff and provider lactation training, safe formula feeding guidelines, breastmilk storage guidelines, proper breast pump cleaning, medically acceptable indications for supplementation, contraindications for breastfeeding, and the mother's right to breastfeed in public, including while in uniform.

Madigan is ahead of other military treatment facilities with its support programs. There is the "MOMS Breastfeeding Support Group" for anyone interested and the "Breastfeeding Buddies" group for active duty Service Members. "There is no other MTF that has Breastfeeding Buddies; we're the only one that has it," said Robyn Roche-Paull, a lactation consultant who co-facilitates the group.

Natural though breastfeeding may be, that does not mean it is automatic or that it does not require learning and building skills. "Only 15 percent of our patients come to class. People don't know how hard breastfeeding can be in the beginning and how much support is needed," said Strobl-Lucas.

Both policies mention education offered. Classes include a basics of breastfeeding and assistance for the working mother. Call the main phone number on the mother/baby floor at 253-968-3044 for more information.

Other facilities already know this number well as they see Madigan as a model of care for breastfeeding support. "When we lead, others follow. We do have other MTFs that call us," said Maria Walden, a lactation consultant. "We hear from them all the time; they know they can call us and get best practice advice and guidance."

Ensuring quality education for providers and all staff in patient care is a vital key to supporting breastfeeding in the clinical setting. It is more than an online course or a classroom presentation on breastfeeding. It means pairing with a lactation consultant to develop both skills and comfort in working with patients. As Strobl-Lucas described it, "Translating knowledge to the bedside takes time."

Patients appreciate that time spent with them at their bedside developing their skills.

"As a first-time mom, not having a clue what I was doing, it was really nice to have people that could answer my questions immediately and show, from when he first came out even, what to do and what to expect," said Janelle Williams, the mom to 2-day-old Colton. "Just the education was really helpful."

Building on the approval of these polices, the lactation team of five full-time consultants has a number of goals in the works. One plan is to open a lactation clinic to offer walk-in support because, as Walden said, "When moms need help, they need it right away." Also, an education specialist to coordinate and ensure that training is supported could help expand support efforts into every area of the medical center.

"It really does take a village, and the village is all of us," said Walden.