What is the Family and Medical Leave Act (FMLA) and How Can You Use It?

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As most of you already know,  the United States does not have a nationally mandated leave policy that covers time off.  Employers can have a wide variety of leave policies, some more generous than others.

Acknowledging this, in 1993 President Bill Clinton included the Family and Medical Leave Act (FMLA) in his agenda to support parents in the workforce.

FMLA covers pregnancy and birth, adoption, foster care placement, serious personal or family illness, and family military leave.

In order to be eligible for FMLA leave, an employee must have been at the business at least 12 months, and worked at least 1,250 hours over the past 12 months, and work at a location where the company employs 50 or more employees within 75 miles. FMLA covers both public- and private-sector employees,

FMLA-eligible employees can  take up  to 12 weeks of unpaid leave a year.

In general, your rights under FMLA are as follows:

  • the same group health insurance benefits, including employer contributions to premiums, that would exist if the employee were not on leave.
  • restoration to the same position upon return to work. If the same position is unavailable, the employer must provide the worker with a position that is substantially equal in pay, benefits, and responsibility.
  • protection of employee benefits while on leave. An employee is entitled to reinstatement of all benefits to which the employee was entitled before going on leave.
  • protection of the employee to not have their rights under the act interfered with or denied by an employer.
  • protection of the employee from retaliation by an employer for exercising rights under the act.
  • intermittent FMLA leave for his or her own serious health condition, or the serious health condition of a family member. This includes occasional leave for doctors’ appointments for a chronic condition, treatment (e.g., physical therapy, psychological counseling, chemotherapy), or temporary periods of incapacity (e.g., severe morning sickness, asthma attack).

However, if you are in the top 10% of earners at your place of employment, your employer may be able to claim that denying the employee their position is “necessary to prevent substantial and grievous economic injury to the operations of the employer.” 

Some states have expanded the FMLA coverage, extending the definition of a family member to include domestic partners, step-parents, grandparents, parents-in-law, among others. It’s worth it to check on your state to get specifics.

Returning to Work

For many new parents, the return to work after the birth of your baby can elicit anxiety and stress. There are so many decisions to make, childcare situations to consider, and schedules to keep, and through it all you  want to be able to enjoy both work and family life.

As a lactation consultant in a hospital setting, I usually dispensed a few pieces of advice to every family. The one I usually stressed was the introduction of the bottle. When breastfeeding is going well, often parents want to delay introduction of the bottle as long as possible. While I love that idea, the fact remains that babies who breastfeed well, love breastfeeding, sometimes to the exclusion of anything else. That makes the return to work even tougher than it has to be.

I remember, with my first baby, who only took enough from the bottle so as not to starve, I would have my mother bring my disconsolate baby to the train station, where I would nurse her in the car to finally calm her down. Needless to say, this was stressful for me, my baby AND my mother!

I usually advise, if you know your baby will need to  take a bottle,, don’t wait longer than 2-3 weeks to introduce a  bottle. (I used to say 4-6 weeks, but sometimes even that can be long enough for a baby to resist the bottle, so I’ve shortened the time frame.) Usually one bottle a day is enough to keep the baby in the habit of taking a bottle, while still mainly breastfeeding, until it’s time go back to work. This is also a nice opportunity for dads to help with feedings!

Which brings me to my second point… if you’re planning to pump while at work, a fast, quiet, efficient and effective double electric pump is crucial. In my earlier post on  the Affordable Care Act (ACA), I detailed the current benefits accorded to post-partum mothers, which include a pump.

Medela Symphony hospital-grade pump with attachments

Some mothers get advice from other mothers that they should rent a hospital-grade pump, either Medela or Ameda, because that is the strongest, best pump on the market. And they are the best! However, that does not mean you need the best. For many people, a Honda Accord is perfectly serviceable for their needs; they don’t need a BMW.

The downside is hospital-grade pumps are expensive, usually about $50-75 a month to rent and prohibitively expensive to own for a single user, and often not covered by insurance unless your insurance company deems it medically necessary. They are also very heavy, held in a hard plastic case, and not really designed for transporting back and forth every day.

I usually recommend, unless you have a low milk supply or a history of low milk supply, your baby is not gaining well or you are supplementing with formula, or your baby was premature or spent some time in the NICU, start with your ACA pump and see how that works for you. If not, you can always buy a better pump or rent a hospital grade pump here or here.

A side note, if you find the milk expressed by your pump is not as much as expected and/or it is painful to pump, you should check in with a lactation

An Ameda standard flange

consultant to see if the flanges fit correctly. You can find a nearby lactation consultant here.

In terms of retail pumps to purchase, generally speaking Medela, Ameda and Spectra are very well-received. These are also called single-user pumps because they are designed for one mother only. Read reviews before purchasing, but remember, for frequent pumping, you definitely want to have a double electric pump.

One thing to mention, hospital-grade, or rental, pumps have a barrier against cross-contamination and designed to be used by more than one person. It should be wiped down thoroughly after each use, and each user needs her own set of tubing, bottles, flanges and connecting parts. These cannot be shared.

Some breastfeeding-friendly businesses purchase one or two hospital grade pumps for a lactation room for all pumping mothers in the company to use. They just need to have their own pumping attachments to use with it. Maybe you can persuade your company to invest in a hospital-grade pump!

Here are a few other resources that you might find helpful:

  • Lawyer and mother Lori Mihalich-Levin has a website called Mindful Return, where you can find a blog and e-courses about returning to work after childbirth.
  • Idealistmom.com has a good checklist to follow, especially useful for mothers who are choosing to continue breastfeeding after returning to work.
  • Parents magazine
  • What to Expect