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New Jersey Breastfeeding-Friendly Worksite Recognition Program
Workplace Mailing Address
Point of Contact Name
Point of Contact email
Point of Contact phone
Number of Employees
Select all supportive practices that apply
All lactating employees are allowed reasonable breaks to express milk or to nurse their children [REQUIRED]
All lactating employees have access to a private space for expressing milk or nursing their child. The space is not a bathroom. The space is lockable and shielded from view. The space has an electrical outlet. [REQUIRED]
The lactation support (a place to pump and break time) is verbally communicated to all current and future employees
A working sink near to the breastfeeding location where mothers can clean pumping equipment and wash hands
A written policy to support workplace lactation is provided to employees (sample policy is available on the NJBC website and feedback/review of your draft policy can be provided if you contact NJBC at
Access to a refrigerator for milk storage
Offer a flexible return to work policy(part-time, flex-time, job sharing, telecommunicating)
A comfortable chair in the lactation space
Small table or shelf in the lactation space
Lactation support information (i.e. ZipMilk.org) is available in the lactation space
Your application will not be considered complete until you have sent a photo image of your lactation space to
Will be sending
Does the NJBC have permission to publish your workplace location and photos of your lactation space on our website, once your submission has been approved?
I certify that the above criteria listed in this application for worksite recognition have been in effect for at least 6 months.
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