PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 43 Review Article Mangla M, et al. Improving Breastfeeding Rates in Working Mothers the provision of lactation and nursing rooms where women can safely express and store breast milk hygienically and comfortably. Worldwide about 60% of working women are employed in the informal economy, a sector that is not regulated or protected by government laws. In India, this proportion is much more significant, reaching up to 90%.6 Most women are employed in agriculture or small establishments or are street vendors, waste pickers, construction workers, home-based workers, or domestic workers. This population of mothers does not benefit from the formal employment-related provisions that are known to improve infant and young child feeding practices. Furthermore, there are no regulations for protecting the rights of contractual workers. The infant and young child feeding guidelines, drafted by the Indian Academy of Pediatrics in 201610 also says that all efforts should be taken to remove hurdles impeding breastfeeding in public places and that special areas/rooms should be identified or constructed in places such as bus stands, railway stations, and airports. India should adopt laws from countries like the United States of America, where laws such as the Friendly Airports for Mothers Act 2017 (FAMA) mandates the building of lactation and nursing rooms that are accessible, hygienic, and open to the public.11 Mothers@Work is a national initiative in Bangladesh to help ensure that the children of working mothers get adequate nutrition during the early years of life. Infrastructure and logistics India does not have good infrastructure and laws to support breastfeeding in public places. Breastfeeding in public places is still considered a stigma, and as a result, women choose not to breastfeed and offer substitutes to the baby instead. Although some public places such as malls and airports have come up with lactation and nursing rooms, these are still far-fetched ideas in most other public places such as railway stations, bus stops, hospitals, marketplaces, and temples. A woman should feel as comfortable breastfeeding in public places as she feels within the confines of her house. Table. A Summary of State Legislation in India That Promotes Breastfeeding Maharashtra The Maharashtra Factories Rules, 1963 Crèches for workers’ children, accompanied with washrooms and an adequate milk supply (at least 300 mL for each child/day). The entire facility must be under the charge of an adequate number of trained women qualified as per standards. Maharashtra Beedi and Cigar Workers (Conditions of Employment) Rules, 1968 Female workers with children < 6 years, in establishments with more than 50 workers, are entitled to well-lit and ventilated designated room(s) for maternal activities. Employees should be provided with breaks at regular intervals for breastfeeding. The Maharashtra Shops and Establishments (Regulation of Employment and Conditions of Service) Act, 2017 Every establishment with > 50 workers should have a suitable room as a crèche for the use of workers’ children. A group of establishments can also create common crèches if they are within a radius of one kilometer. Uttar Pradesh Section 70, UP Factories Rules, 1950 At least half a pint of clean, pure milk should be provided free of cost for each child every day. The mother for such a child should be allowed two intervals of at least half an hour in her daily work to feed the child. For children who do not require milk, an adequate supply of wholesome refreshments should be provided. Rajasthan Section 6 of the Rajasthan Maternity Benefit Rules, 1967 Employer to give reasonable and adequate nursing breaks (At least two of 15 minutes each) An extra break for travel to and from the place or crèche where the woman leaves the children while on duty (not less than 5 minutes or exceed 15 minutes). Section 28 of the Rajasthan Shops And Commercial Establishments Act, 1958 A break of half an hour twice a day for nursing, during her working hours, in addition to regular intervals for rest Tamil Nadu Tamil Nadu Handloom Workers (Conditions of Employment and Miscellaneous Provisions) Act, 1981; Tamil Nadu Beedi Industrial Premises (Regulation of Conditions of Work) Act, 1958 Female workers with children under the age of 6 years, in establishments with more than 50 workers, are entitled to a designated room(s) for maternal activities. Breaks for employees at regular intervals for breastfeeding.
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