Nominate a MT Mother-Friendly to Support Breastfeeding Worksite

Designate a Worksite

Please complete survey to:

1. Request support in setting-up worksite lactation accommodations or;

2. Nominate a Montana Mother-Friendly to Support Breastfeeding Worksite.

We will contact the worksite/nominator to discuss the simple next steps.

Question Title

* 1. Name of worksite:

Question Title

* 2. Worksite Contact Information:

Worksite Name:

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 3. Nominator Information:

Name of individual nominating worksite:

Position/Relation to worksite:

Email:

Question Title

* 4. I would like more information on how to set up lactation support accommodations at my worksite.

Yes, We have limited lactation accommodations at our worksite and we would like information on how to set it up.

No, we have lactation accommodations in place and I am nominating a worksite for Mother-Friendly Recognition (See below).

Question Title

* 5. I am nominating a worksite that provides lactation accommodations. The worksite provides:

1. Developed & implemented a lactation accommodation policy addressing space and time to pump?

2. Provided employees a private, accessible area, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, for either expressing breastmilk or breastfeeding?

3. Provided work schedule and work pattern flexibility to, at a minimum, accommodate a reasonable break time for an employee to express breastmilk/breastfeed for her child for one year or longer after the child’s birth?

2. Communicated worksite lactation accommodation program with employees?

Question Title

* 6. Please provide any additional on how the nominated worksite provides lactation accommodations and/or breastfeeding support? (Please give specific examples).

For more information on the Montana Mother-Friendly Worksite to Support Breastfeeding Initiative go to the Montana Nutrition & Physical Activity Program (NAPA) or contact TMiller6@mt.gov