Most of us have heard the expression "Breast is best" when it comes to breast-feeding and the health of an infant, but financially savvy business owners might be able to add "for business" to that slogan.

U.S. Department of Labor Statistics data show that 46 percent of workers in this country are women, and it's clear that the role of working mothers is increasing. In 1960, less than one of every five mothers worked; now, seven of every 10 mothers are employed.

Women also are going back to work sooner after having babies. Of those who return, one-third will return within three months of having a child, and two-thirds within six months, says the Centers for Disease Control and Prevention.

The current economic crisis makes it more important than ever for employers to maximize worker productivity, minimize health-care costs, and heighten employee loyalty. A key part of that involves meeting the unique needs of mothers, one of which is breast-feeding.

For a lot of women, returning to work makes breast-feeding too difficult, and many decide to stop breast-feeding or choose not to breast-feed for that reason. Most women who stop breast-feeding after returning to work say that they do so due to a lack of flexibility for milk expression, having no place to pump or store breast milk, and concerns about support from employers and colleagues.

So, how does breast-feeding impact the bottom line for employers? For starters, women who feed with formula instead of breast milk miss more work. A federal health-agency review found that breast-fed babies have less risk of developing a variety of ailments, such as lower respiratory tract infections, asthma, diabetes, and childhood leukemia.

Breastfeeding also can have a positive impact on the health of the mother. Women who breast-feed are less likely to get breast and ovarian cancer, infectious illnesses, diabetes, and Crohn's disease. Also, research suggests that breast-feeding is associated with decreased levels of stress and depression following childbirth. In short, women and babies generally are healthier with breast-feeding, which means less work missed for illness and caretaking.

Women whose needs aren't met in the workplace might choose to not return to work after childbirth, or might opt to find a job that accommodates their needs. For many women, one of those needs is the ability to continue breast-feeding. When employees don't return to work, it impacts employers financially. Given the cost of advertising for and training new employees, it makes the most sense for employers to strive hard to retain employees.

Women who breast-feed seem to be healthier in both the short and long term. Nursing women report fewer visits to the physician, fewer gastrointestinal symptoms, and fewer cardiac symptoms than mothers who don't breast-feed.

The guilt women experience when there is conflict between home and work responsibilities has been linked to decreased productivity as well as decreased family functioning. For example, fatigue and reduced concentration at work due to anxiousness and the time spent caring for a sick baby can diminish productivity.

So, what can employers do to accommodate breast-feeding by employees? One way is to provide private rooms for milk expression. They needn't be extravagant, but should include a comfortable chair, adequate lighting and ventilation, a sink for washing hands and pump equipment, and a refrigerator. It also is beneficial to have a hospital-strength dual pump available. Such pumps can reduce expression time to about 15 minutes, compared with 25 minutes using a home-version pump. A bathroom isn't a suitable place to express milk.

Another important accommodation is to allow for flexible breaks. Women need to express milk at least every three hours for about 15 minutes. Long periods between expressions can be very uncomfortable for lactating women.

Employers also can provide opportunities for prenatal and postnatal education. Lactation interventions, a term used for programs designed to encourage breast-feeding, are most effective when they begin in the prenatal period and extend throughout the postnatal period.

Interventions that are conducted by trained instructors and that include both education and support are most effective. For group education to be effective, it needs to be interactive, such as by holding seminars at which participants can practice techniques and thereby increase their confidence in breast-feeding. Local community health organizations often provide these classes. Community Health Education and Resources (CHER), of Spokane, offers a monthly course titled "Breastfeeding Basics" in which participants learn strategies to overcome typical breast-feeding barriers.

The most effective programs include peer and professional support, and creating an overall environment in which breast-feeding is encouraged is essential.

Lactation options for working mothers can include bringing their infant to work, pumping at work, traveling back and forth to home, working from home, and working part time. The Spokane Regional Health District has an employment policy under which women in certain positions can bring their infants to work for the first few months after they are born.

Jennifer Hansen, a Health District employee who recently brought her infant to work for 20 weeks, says, "Though it was challenging to balance work and mothering duties at times, bringing my daughter to work with me allowed me to return to work earlier. The opportunity to strongly bond with my daughter was priceless. "

Finding an arrangement that suits the needs of the employer and employee might increase employee loyalty and productivity. Hansen says, "I feel really loyal to my employer because they allowed me flexibility. I felt like I needed to give 110 percent because I was given such a wonderful opportunity."

For information on starting a lactation support program, visit www.cdc.gov. Information on the monthly Breastfeeding Basics class can be found on CHER's Web site at www.cherspokane.org.