Infants at Work: A Pediatric Clinic’s Approach to Workplace Breastfeeding Support

Background

Breastfeeding offers well-established health benefits for both mothers and infants (Figueiredo et al., 2021; McGowan & Bland, 2023; North et al., 2022; Tucker & O’Malley, 2022). Yet only 25% of U.S. infants meet the Center for Disease Control’s (CDC) recommendation for exclusive breastfeeding during the first 6 months of life (Centers for Disease Control and Prevention [CDC], 2020). In response, global and national organizations increasingly call on employers to improve lactation support in the workplace (United Nations International Children’s Emergency Fund [UNICEF], 2020). Current strategies often include lactation spaces, scheduled pumping breaks, and organizational policies (Chang et al., 2021; Hernández-Cordero et al., 2022). While these accommodations represent important progress, they typically require mothers to separate from their infants during the workday and rely on breast pumps to maintain milk supply, both of which can create logistical, emotional, and physiological challenges (Snyder, Hulse, et al., 2021; Snyder, Worlton, et al., 2021). Despite growing attention to workplace lactation accommodations, little empirical research has examined policies that allow infants on site to support direct breastfeeding, and existing studies have largely been exploratory or formative in nature (DeMaria et al., 2021; Stoltenburg, 2018). Thus, there is limited documentation of how IAW policies are implemented and experienced in clinical or professional settings. As a result, there is a gap in practical and implementation-focused knowledge regarding the feasibility and organizational impact associated with integrating infants into the workplace. This paper highlights a pediatric clinic that has successfully implemented an IAW policy over the past decade. Unlike traditional accommodations that separate work and caregiving, this model intentionally integrates them. The purpose of this paper is to describe the policy, share qualitative insights from semistructured interviews with mothers and clinical staff (n = 5), and explore practical considerations for replication and adaptation. These interviews were overseen by a university-affiliated Institutional Review Board (0745-24-EX).

Clinical Innovation

Policy Overview

The IAW policy at this pediatric clinic allows employees to bring their infants to work starting at 6 weeks postpartum and continuing until the child reaches 12 months of age, provided the infant can be safely integrated into the workplace environment. Employees are automatically offered this opportunity upon notifying the pediatrician (clinic owner) of their pregnancy. At that time, employees are asked to indicate the duration for which they intend to use the policy. All employee roles are eligible to participate, including physician assistants, nurses, medical assistants, and administrative associates. Policy components can be seen in Table 1.

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Table 1.

IAW Policy Components.

Policy Statement	Rationale	Implementation Details
1. All clinic employees are eligible to participate in the Infant at Work policy. Infants may attend the clinic beginning at six (6) weeks postpartum through twelve (12) months of age, contingent upon safe and feasible integration into the workplace environment.	Supports early postpartum bonding, maternal well-being, and child development (Modak et al., 2023).	Participation discussed upon pregnancy notification; employee indicates anticipated duration of child in the workplace to supervisor prior to childbirth.
2. Upon notification of pregnancy, the clinic owner will proactively offer participation in the Infant at Work policy and initiate a discussion regarding anticipated duration and expectations for participation.	Offering the policy proactively can reduce reliance on parents to self-advocate for accommodations and reduce potential stigma for flexibility (Chung, 2020; Taylor & Wallace, 2012).	Leadership initiates offer during pregnancy disclosure conversation.
3. Prior to an infant’s first day in the clinic, the team will engage in a structured discussion to clarify workflow expectations, address potential concerns, and establish communication and conflict resolution procedures.	Promotes transparency, buy-in, and conflict prevention.	Team meeting to clarify workflow adjustments and communication norms.
4. Breastfeeding is permitted on demand during natural workflow breaks and does not require use of a designated lactation space.	Promotes direct breastfeeding, milk supply maintenance, and normalization (Roghair, 2024).	Mothers may breastfeed at desk or in shared space without restriction. Private space available upon request and may include empty patient room or break room.
5. Participating employees are responsible for providing necessary infant equipment (e.g., bassinet, swing, toys, feeding supplies). Equipment may be stored onsite for the duration of participation, provided it does not interfere with clinic operations or safety standards.	Facilitates safe, comfortable infant presence without major structural changes.	Equipment kept in office during participation period. Equipment kept away from general patient population.
6. Infants shall not be involved in direct patient care. The participating parent retains primary responsibility for the infant during the workday. Coworker assistance is voluntary and provided at their discretion.	Protects patient safety and maintains professional standards while clarifying caregiving accountability.	During breastfeeding or infant care needs, staff coordinate temporary coverage of patient-facing responsibilities to maintain workflow continuity. Participation in infant support is optional, and team members retain autonomy in determining daily task adjustments.
7. Infants with mild illness (e.g., runny nose, cough) may attend the clinic; however, attendance in cases of contagious conditions (e.g., vomiting) is subject to clinical discretion by the pediatrician to ensure patient and staff safety.	Balances infection control with flexibility for parents.	Attendance at discretion of clinic owner.
8. If participation in the Infant at Work policy becomes unfeasible due to workflow, safety, or operational concerns, the clinic owner reserves the discretion to modify or terminate participation.	Protects clinic workflow and patient care standards.	Final discretion held by pediatrician/clinic owner; however, feedback can be sought from all employees.
9. Sustained implementation of this policy requires an organizational culture that prioritizes trust, flexibility, mutual respect, and clear, open communication among staff and leadership.	Supports emotional well-being and minimizes stigma.	Staff are able to bring feedback to their supervisor at any time and any manner.
10. The clinic owner informally monitors organizational outcomes, including staff retention and absenteeism related to childcare and team dynamics to assess the ongoing feasibility and effectiveness of the policy.	Ensures leadership oversight and evaluation of employee-level impact.	The clinic owner may engage in informal conversations with staff to determine how the policy is going.

Perspective of the Employer

From the employer’s perspective, the policy has not negatively affected staff retention or workplace dynamics. Over the past decade, no employees have left the clinic due to participation in the policy, and any workflow or interpersonal concerns were addressed collaboratively through open communication. Anecdotally, the employer reports that the policy has also contributed to continuity of staffing during the postpartum period, reduced unexpected absences related to childcare disruptions, and supported earlier and more confident returns to work. Informally, the clinic has observed high employee satisfaction, sustained productivity, and strengthened team cohesion, as staff describe a shared sense of support and mutual investment in one another’s well-being. These factors suggest that, in this setting, the policy has functioned not only as a family-supportive benefit but also as a strategy that reinforces workforce stability and organizational culture.

Looking Ahead: Sustainability and Research

While this case highlights positive maternal and organizational experiences, the perspectives of patients were not formally evaluated. Future research should include patient or family perceptions of infant presence in clinical environments to provide a more comprehensive understanding of policy feasibility. Although no formal complaints or documented disruptions occurred in this setting, systematic evaluation would strengthen confidence in broader implementation.

From an employer's perspective, future research could more rigorously evaluate organizational outcomes such as staff retention, absenteeism, sick leave utilization, recruitment advantages, and workplace morale. While this clinic experienced stable retention and collaborative resolution of operational concerns, formal evaluation metrics would provide stronger evidence for scalability.

Finally, areas for refinement include developing clearer written guidelines, establishing formal feedback mechanisms for staff, and identifying objective indicators of workflow impact. Such measures could enhance transparency and sustainability as IAW models are considered in other professional contexts.

Conclusion

At the heart of implementation success for this policy is a strong, preexisting culture of trust, flexibility, and mutual support. As one staff member put it, “If you’re going to implement a policy like this, you have to have the right support, or it won’t work.” This paper illustrates how a pediatric clinic successfully implemented an IAW policy to support breastfeeding mothers, resulting in improved breastfeeding outcomes, emotional well-being, and work-life balance. A family-oriented culture, normalization of breastfeeding, and flexible workflows were key to the policy’s success. For organizations considering a similar approach, three elements are critical: (1) fostering a supportive workplace culture through leadership engagement and staff training, (2) creating a lactation-friendly environment where breastfeeding is accepted and accommodated without barriers, and (3) planning for workflow adjustments by clearly defining roles, establishing backup care guidelines, and maintaining open communication. These strategies can help ensure that infant-inclusive policies are both sustainable and beneficial to families and organizations alike.