Tag: PUMP Act

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Lactation Support in the Workplace: New and Improved Protections Guest Post by Donna Walls

Universal pumping icon by Fiona Jardine

When the PUMP Act was signed into law in late 2022, after I did my happy dance, I made sure to share the wonderful news with several of my friends. One of my pals shared my enthusiasm and then urged that advocates make sure that moms actually know about their rights. Years ago, when she worked in a daycare, she noticed that  so many of the moms she interacted with didn’t realize that they had any lactation rights (which were less than, but still existent). That’s what guest blogger Donna Walls’s mission is this week, to amplify the progress we’re making around lactation support in the workplace. Please enjoy and pass along her piece: Lactation Support in the Workplace: New and Improved Protections. 

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There have been great victories for lactation advocates and families but, unfortunately, we are not hearing much about them outside of the “inner circle”. It’s time we start talking about these important legislative victories!

Source: United States Breastfeeding Committee (USBC)

I am privileged to be a part of the United States Breastfeeding Committee’s (USBC) Workplace Support Constellation. The Workplace Support Constellation works to address the barriers to breastfeeding for lactating workers, with a specific focus on reducing disparities and inequities. The Constellation works together to advance the following priority strategies:

  • Increase understanding of employer responsibilities and employee rights under federal and state law through an education campaign emphasizing existing implementation resources.
  • Identify gaps in the current laws and work to expand protections for all employees. [Retrieved from: https://www.usbreastfeeding.org/ws-constellation.html] 

We work to support mothers returning to work or school in any way needed; practically, legally and educationally. While there is always work to be done, I am happy to report that much progress has been made. 

First, let’s impart a little history of lactation support in the workplace. In 2010, the US Department of Labor Wage and Hour Division amended Section 7 of the Fair Labor Standards Act (FLSA) to require employers to provide breastfeeding mothers with reasonable break time and a place (other than a bathroom) to express breast milk. This amendment became effective on March 23, 2010, when the Patient Protection and Affordable Care Act (ACA) was signed into law.

Over a decade later, the PUMP (Providing Urgent Maternal Protections) Act for Nursing Mothers was passed providing expanded protections, including legal recourse for those who have been denied these rights by their employer. 

Watch the PUMP Act Briefing here. 

Though the updated legislation filled many gaps, unfortunately, certain employees of airlines, railroads, and motorcoach carriers are exempt from nursing employee protections under the FLSA. However, employees who are not covered,  may be entitled to break and/or space protections under State or local laws.

More good news came in the summer of 2023 when the Pregnant Workers Fairness Act  (PWFA), through The Equal Employment Opportunity Commission, went into effect.

According to the government website, “Generally, PWFA  requires an employer to provide a ‘reasonable accommodation’ to a qualified employee’s or applicant’s known limitations related to, affected by, or arising out of pregnancy, childbirth, or related medical conditions, unless the accommodation will cause the employer an ‘undue hardship’.  Reasonable accommodations may include extra breaks, flexible scheduling, being able to sit down or drink water, uniform changes, taking time off work or limiting exposure to hazardous chemicals.

Photo by João Paulo de Souza Oliveira: https://www.pexels.com/photo/gray-scale-photo-of-a-pregnant-woman-3737150/

The PWFA applies to all businesses private and public sector, including state and local governments federal agencies with more than 15 employees. 

Protections also include accommodations related to infertility, miscarriage, pregnancy loss, and abortion, childbirth and recovery, postpartum depression and lactation and conditions like mastitis, low milk supply and plugged ducts.  

Employers must:

  • make a reasonable accommodation for the known limitations of an employee
  • not deny a job or employment opportunities to a qualified employee based on the person’s need for a reasonable accommodation
  • not require an employee to take leave if another reasonable accommodation can be provided that would let the employee keep working
  • not punish or retaliate against an employee or applicant for requesting or using a reasonable accommodation
  • not coerce individuals who are exercising their rights or helping others exercise their rights under PWFA

Check out https://pregnantatwork.org/ for more detailed information. 

If employees are being denied these accommodations, they can file their complaints through the Equal Employment Opportunity Commission. Click here for more. A Better Balance also offers a  free and confidential legal helpline to help individuals understand their  rights in the workplace. The helpline number is 1-833-NEED-ABB (1-833-633-3222) or there is an online form available. 

You can also check  out https://pregnantatwork.org/ for more detailed information. 

One of the most recent victories are the new protections finalized under Title IX. 

Title IX prohibits discrimination on the basis of sex and pregnancy-related conditions and parental status. This includes sexual orientation of the parent, biological or adoptive parents, foster or stepparent, legal guardian or custodial parent, actively seeking legal guardianship, custody or visitation, adoption of a child under 18 years of age or a disabled person over 18 who is not capable of self-care.

Protections have expanded to include students, trainees and employees of schools K-12,

college, university, vocational school, other academic institution or government-funded training

programs. Exemptions may be granted to religious institutions if not discriminating violates their religious beliefs. More information on exemptions can be found here. 

For clarification and help with implementing these protections, the Workplace Lactation Accommodations: Employer Toolkit will be published soon through the USBC Workplace Support Constellation.

Example of a lactation space. Read more about this one here: https://www.ourmilkyway.org/colorado-pediatric-office-becomes-breastfeeding-friendly-employer/

Until then, here is a brief summation of the protections:

  • What is a “lactation space”?  These may look very different, but all spaces must be a clean, non-bathroom space free from viewing, preferably with a lock or security measure. The space may be multi-use with the provision that the mother expressing her milk is prioritized. Each designated lactation space will contain, at minimum, a chair, table or other flat surface for holding a pump, and electrical outlets (not required but strongly recommended). A sink or access to water for hand and equipment cleaning is also strongly recommended. A general guideline for establishing the number of lactation spaces needed is about six spaces per 1,000 female employees. Examples may be an exam room, conference room, office or clean, uncluttered storage room or closet.       

 

  • What is a “lactation break”? Time will be provided for employees to express milk as often as needed (as determined by the employee) during the workday and will

Include time to set up, express milk and clean up. Employees are expected to inform their supervisor of the expected schedule as soon as possible, and it is the responsibility of the supervisor to obtain any required coverage. Employees’ needs may change over time and they may request changes in this schedule as needed. Salaried employees will not find changes in their pay as a result of pumping breaks, but hourly employees’ lactation breaks will be unpaid except when they choose to work while pumping; are pumping during a break that is normally paid; are using paid time off. A general guideline is that the employee may need about 20 to 30 minutes, every two to three hours but this may vary depending on the child’s age and individual needs.

 

  • What about milk storage? The law requires a place to store milk safely but does not

Make any specific considerations. Human milk is not considered a safety concern and can be stored in any employer provided refrigerator or cold storage. All milk should bel labeled with the employee’s name and date expressed. The Center for Disease Control and Prevention provides milk storage guidelines here. 

Much work has been done, and we are now presented with the opportunity for all lactation advocates to help spread the word. Provide this information in your breastfeeding classes, share on all of your social media sites and talk with pregnant women whenever possible, including local childbirth education classes and postpartum support groups.

Check with the Human Resources Department in your workplace to make sure they are aware and can implement the needed protections. Find parallel advocacy fields– Adolescent Nutrition, Climate Change, Digital Health, Early Marriage/Pregnancies, Emergency Settings/Humanitarian Crises, Economics, Newborn and Child Health, Pediatrics, Sexual and Reproductive Health, Social and Behavioral Change, Women’s Health–  lactation and breastfeeding are almost always relevant somehow! Let’s celebrate these major strides. 

 

Other relevant resources

Pregnant Scholar toolkit on student legal protections

USBC list of local partners 

Sample outreach letter from lactation support orgs to local schools/colleges: https://thepregnantscholar.org/wp-content/uploads/Lactation-Support-Org-Letter.docx 

WorkLife Law’s Free Legal Helpline for pregnant, postpartum and lactating students and workers: (415)703-8276 and hotline@worklifelaw.org

HHS Employer guide to supporting nursing parents at work

Breastfeed LA accommodation ideas in different spaces, guides for employees/students and employers 

University of Northern Colorado Campus Lactation Toolkit (note, contains outdated legal information) 

Title IX BreastfeedLA website with reports on lactation and education

Lactation accommodation while incarcerated 



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Boston Public School teacher works to extend support to other lactating educators

Porshai Z. is a third grade teacher in the Boston Public School system, currently on maternity leave with her three-month-old son who cooed during our phone call on an early October morning.

Photo courtesy of Porshai Z.

“I absolutely love it,” Porshai says of teaching. “My [students] are at the most tender age where they’re still aiming to please adults, but they have a little sass and personality.” 

After the birth of her first son, Porshai returned to work just four months postpartum, and she says it’s one of her biggest regrets. For one, it took away from her role as a teacher. She found herself pumping in a bathroom,  stressing each and every time she needed to leave her full-of-personality third graders. Returning to work so soon after the birth of her baby also took away from the joy of feeding her first son, Porshai shares. 

Though Porshai poured herself into research about unmedicated birth and how to breastfeed as soon as she became pregnant, she found herself unprepared for the physical demand of feeding her little human. There was one evening in particular where she felt enticed to open the commercial milk formula package sent by the formula company, but she ultimately persevered. 

“I don’t know what quieted that voice,” Porshai reflects. Perhaps it was the investment she made learning and preparing for this relationship and her realization even through the challenge: “Wow, this is really special.”  

This time, Porshai will remain at home with her new baby for a year. Simultaneously, she is completing the Lactation Counselor Training Course (LCTC). Porshai earned one of the most recent rounds of the Accessing the Milky Way Scholarships. 

“I have really been enjoying [the course],” Porshai shares. “ There is so much I wish I knew the first time I was nursing.” 

She says she appreciates that the course grounds breastfeeding as a public health issue and that she was surprised to learn about the composition of human milk. Learning about milk’s dynamic nature has allowed her to better understand her own infant’s behavior. More generally, she was fascinated to consider how our society has adopted nesting caregiving behavior though we are truly carriers.  

“This is mind-blowing,” she says. “So many more women need to hear that.” 

As a highschooler, Porshai was always fascinated by reproductive health. She’d watch documentaries on birth and her favorite science museum exhibit was one that depicted the stages of life. It wasn’t until later that she became aware of the option to become a lactation care provider. 

Through Boston Medical Center’s Curbside Care for Moms and Babies, a mobile unit that provides “comprehensive mother-infant dyadic care during the first six weeks of life”– Porshai met her first duo of Certified Lactation Counselors (CLCs). 

“I really do think the power of that training is what allowed me to continue [breastfeeding]  in the first place,” Porshai reflects. 

This wrap-around care was particularly influential as it ‘met her where she was at.’ 

Porshai goes on to say, “I hope to work in that way as well. I hope to be that visibility.” 

More specifically, Porshai says she has been thinking a lot about how elementary education is a female-dominated industry; with many friends and colleagues growing their families, Porshai hopes to be a resource and support for them as they learn to feed their babies. She plans to create a network of breastfeeding mothers within the Boston Public Schools so that there is a designated space for parents navigating infant feeding and the unique challenges of teaching. 

In addition, Porshai is considering becoming a postpartum nurse. 

“[The LCTC] could very well be the thing that catapults me to go back to school.” 

For more on teaching and lactation, check out this article. The PUMP Act now extends federal lactation rights and protections to all employees in K-12 schools.

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Educator and leadership team member shares breastfeeding experiences, supports lactating colleagues

When the PUMP Act was signed into law last year, it expanded the legal rights of some 9 million more lactating individuals, including teachers, who had been previously excluded from the 2010 Break Time for Nursing Mothers law as it only applied to hourly workers.

But even with the revamped legislation, teachers are in a unique position.

In Jill Inderstrodt’s I Study Breastfeeding Behavior. Here’s Why Nursing Teachers Have It So Tough, she explains: “…The bill’s prescriptions are often at odds with the day-to-day logistics of jobs.”

Inderstrodt goes on, “In many cases, teachers have to choose between finding coverage for their classroom or forgoing pumping. With one or two pumping sessions per day, this could mean finding coverage 40 times a month.”

Stacy Synold is an educator and part of the leadership team at a small, private school in the Midwest. She breastfed all three of her biological children, now 25, 22, and 19, beyond their second birthdays.

“I never thought I would breastfeed as long as I did but I followed their lead and found it to be supportive of my parenting choices,” Synold shares.

She continues, “Breastfeeding was so important for my kids, who all had asthma and allergy issues.  I shudder to think of what their health may have been without nursing. What started as a nutritional imperative for me became some of the most treasured [moments] in my life.  Given that I nursed toddlers and even a near preschooler, they were all very verbal and verbally loving about breastfeeding, and I remember all the little names and words they had for breastfeeding.”

There was “sie-sie” for nursies and “noonies” and “nonnies”.

“One time… my son said, ‘I give hugs to the nurse and hugs to the other nurse,” in reference to breastfeeding, Synold remembers.

As it sometimes is, weaning was a momentous event for Synold’s family. When her daughter was about to turn three, she hosted a weaning party.

“We had pink cupcakes and the whole family celebrated.  She had stopped nursing except for once every few weeks so we decided to support her into her next phase.  We gave her a baby doll to nurse if she wanted to and that was her favorite doll for a long time.”

Besides feeding her own children, Synold pumped her milk for the adopted newborn of a local woman who endured the death of her biological baby a year earlier.

“She had high hopes of relactating, but I very much wanted to help her in the short-term,” Synold says.  For eight weeks, she pumped on a three to four hour schedule.

“It was almost like having a newborn again, and my 18-month-old daughter loved my increased production,” Synold remembers. “I would do it all again to see the smile on that mom’s face each time I delivered the milk!”

Synold served as a La Leche League Leader for nearly a decade under the mentorship of Kay Batt, who has been a LLL leader since 1967.  Batt invited Synold to an evening meeting which turned out to be a meeting with an emphasis of supporting mothers and families who worked outside the home.

“She helped me become a better mom and shared so much knowledge, especially about how to support the unique needs of working families who breastfeed,” Synold reflects.

Since breastfeeding her own babies, Synold has witnessed a shift in infant feeding culture.

She cites being appreciative of the laws passed in protection of breastfeeding and the increase in designated places for mothers to breastfeed in public.

“I wasn’t bashful, but my children were easily distracted and needed a quiet place to nurse],” she begins. “I was kicked out of a restaurant in Mayfair Mall once in 2001 for breastfeeding at the table.  Apparently, men and boys ate there…who knew! I said to the woman who was kicking me out when she stated about men and boys, ‘I know, I am feeding a little boy right now!’”

Because of the nature of her work outside of the home while she was breastfeeding, Synold didn’t find herself in the position of needing workplace accommodations. For instance, as a nanny at one point, she says she was easily able to nurse her son without special accommodation. In a different position, her daughter was two, so she was able to withstand longer stretches without emptying her breasts. Her toddler  would then nurse throughout the night as they coslept.

In her recent leadership roles, Synold facilitates safe lactation spaces for her colleagues.

“I always have a comfy area in my office, I offer flexible schedules and plentiful breaks if needed, and seek better locations,” Synold explains.  “One year, I had seven teachers give birth and my office was the only office with a lock.  I ended up out of my office most of that year, so we gave a locking large closet a makeover for pumping.  I did realize I sometimes needed an office!”

Like Inderstrodt concludes, “If we are going to recruit and retain our teaching workforce under such circumstances, teachers need all the accommodations we can give them. That means that legislation such as the PUMP Act must be accompanied by scheduling accommodations at both the school and district levels so that the legislation for lactating mothers transcends paper.” Even before it was signed into law, Synold has exemplified this support.

#WBW2023​
#WABA ​
#breastfeeding​​
#SDGs​
#worldbreastfeedingweek2023 ​
#WarmChain ​
#buildingbackbetter ​
#EmpoweringParentsCampaign
#EnablingBreastfeeding
#MakingADifference
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‘Full pandemic mama’ becomes full spectrum doula

Allysa Singer was, as she describes, a “full pandemic mama.” Singer became pregnant with her first child in the winter of 2019. As she became aware of the threats and the consequences of COVID-19, she started researching her options and her rights in the delivery room she’d find herself in August 2020.

What started as personal preparation– How many support people would she be allowed? Would she be allowed a support person at all? What restrictions would she encounter? How could she advocate for herself? What were her options?–  propelled her into a world of birth support and autonomy advocacy.

“I was just dumbfounded by the disparities that exist in maternal health,” Singer begins.

In 2020, Alabama, where Singer and her family live, had the third-highest Maternal Mortality Rate in the nation, at 36.4 per 100,000 live births.

BIPOC families suffer from massive disparities in maternal and infant deaths. In a recent piece, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison is quoted: “It’s not race, it’s racism…The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

Still, unlike so many of her peers, Singer reports having had an amazing birth experience.

Inundated by birth horror stories, she decided to change care at 27 weeks in hopes that she would be better supported in her choices at a different institution.

Here, she was allowed a doula and support person to accompany her during her birth.

“Not a lot of women had that luxury,” Singer comments.

Knowing well that birth support is a right and not a luxury, she started her own doula practice in December 2021. 

Singer shares that she experienced severe postpartum depression, but she was able to divert and ultimately reshape this energy into her doula work.

“My doula training was the lifeboat that saved me from drowning in my PPD,” she says.

And now her practice, Faith to Fruition, has become the lifeboat for many of the birthing people Singer supports.

She shares: “I don’t believe that a birther’s desire to have more children should be dictated by their birthing experience. I have heard so many stories from people who had one kid but say, ‘I would never do this again because my experience was so traumatic.’ One of my biggest missions and goals is to support birthers to feel empowered in their process; not as bystanders of their process.”

Singer also holds a full time position as an industrial psychologist where she channels her advocacy work, pushing for organizational change and understanding of proper maternal support.

In fact, as part of a public speaking course for a training curriculum, Singer presented on why it’s important to support breastfeeding. She reports that her audience of roughly 25 was engaged, especially as she pointed out the absurdities of infant feeding culture in our country: How would you feel if I asked you to eat your meal in the bathroom? How would you like to eat with a blanket tossed over your head? for instance.

Singer also points out the “insanely amazing public health outcomes” breastfeeding affords.

If 90 percent of U.S. babies were exclusively breastfed for six months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). [Bartick, Reinhold, 2010]

“Not only is there a personal investment, there is a public investment and value to understanding the larger implications,” Singer comments. “As a taxpayer, [breastfeeding] impacts you; as someone who utilizes our healthcare system, [breastfeeding] impacts you.”

With the recent passing of the PUMP Act and the Pregnant Workers Fairness Act coming soon, Singer says “We still have a long way to go.”

Organizational policy doesn’t support motherhood; instead it fuels detached parenting which goes against nature, Singer goes on.

“Mothers feel the brunt of that more than ever,” she says.  “[We aren’t] supported to be able to care for our children the way that we want to.”

Singer says she sees it as her mission as an organizational psychologist to encourage change that supports parenthood, so that women don’t feel threatened to care for their children the way that they want to. This means ensuring that women are provided with ample space to pump their milk while away from their babies and empowering them to approach HR when there aren’t appropriate accommodations.

“Outside forces shouldn’t be able to dictate how you care for and feed your child. The end of one’s breastfeeding journey should be a personal decision.”

She continues, “It’s amazing that legislation is catching up. The thing that I fear with any law, there are still people behind those laws that have to enforce them and carry them out. Education and garnishing an understanding of what this looks like is a key component to implementation. The people behind those policies have to make them successful, but this is  moving things into a very good direction, and I hope that more changes to legislation follow suit, especially with paid parental leave. It’s a catalyst for change; I am hopeful but cautiously optimistic.”

Singer says she owes her personal success continuing to breastfeed her two-and-a-half year old to Chocolate Milk Mommies, where she now serves as a board member.

Through Chocolate Milk Mommies, Singer started a subcommittee to focus on education for individuals within the breastfeeder’s support system.

“The people in the village need to be supportive. When you don’t know better, you can’t do better,” she explains.

Singer recently completed the Lactation Counselor Training Course (LCTC) as part of Chocolate Milk Mommies’ mission to best support their constituents and as a way to benefit her doula clients with more well-rounded support.

“I really loved the training because I already thought that our bodies are amazing, but learning more science was great. I would text my friends the ‘Boobie Fact of the Day’,” Singer shares. “[The science] allows me to really appreciate my journey that much more and how impactful I’m being with my daughter.”

You can follow Singer’s work here and here.

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USBC Deputy Director Amelia Psmythe Seger’s ‘The Four Pillars of Infant Nutrition Security in the United States’

Our headlines are overloaded with tragedy, perversion, inequities, the unthinkable yet preventable.

Journalist Mary Pilon says in Throughline’s Do Not Pass Go episode “It’s a shame to waste a crisis. A crisis can also be a moment when you look at things and make changes and improvements.”   

And so, from that vantage point, we are honored to be republishing United States Breastfeeding Committee Amelia Psmythe Seger’s piece The Four Pillars of Infant Nutrition Security in the United States originally published here last month. 

“We will get through this because we must. Together we must ensure we build an infant nutrition security system worthy of parent’s trust,” she writes. 

In celebration of World Breastfeeding Week and National Breastfeeding Month on the horizon, there’s no better time than now to take action.  #TogetherWeDoGreatThings

 

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The Four Pillars of Infant Nutrition Security in the United States by Amelia Psmythe Seger, Deputy Director USBC

Throughout its 22-year history, the U.S. Breastfeeding Committee has been working towards the policy, systems, and environmental changes that build a landscape of breastfeeding support.
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The catastrophic infant formula shortage demonstrates the value of this work and the need to build a robust infrastructure for infant nutrition security in the U.S. that holds all families in care.

This infrastructure includes four pillars: Parents, Programs, Policies, and a Plan for emergencies.

Parents:

Parents are critical stakeholders in infant nutrition security. The Parents pillar includes people of all races, genders, caregiving roles, routes to parenthood, immigration status, religious or political views, and infant feeding methods. Everyone who loves and cares for a young child belongs. Welcome.

Parents deserve the full support of a robust national infant nutrition security infrastructure. Without it, many are forced onto painful and difficult paths of infant feeding and care. The U.S. needs equitable programs, policies, and a plan for emergencies that centers on the most impacted.Parents and caregivers whose infants rely on formula are the highest priority right now. They need help finding formula, advice on switching between formulas, reassurance that reliable supplies are on the way, and an answer to the question: what should I feed my baby if I cannot find formula?  With appropriate caution, the American Academy of Pediatrics (AAP) published an article on what to feed babies of different ages and situations in an extreme emergency (such as this). Babies under six months should truly only consume human milk or infant formula. In considering very short-term alternatives, the stakes are so high that a physician should monitor the baby.

Parents who are breastfeeding or feeding human milk are in anguish right now, too. Many are feeling pressure to share their milk without acknowledgment of how hard this society has made it to establish and maintain milk supply. Few families have access to lactation support providers, paid family leave, and workplace accommodations to pump breast milk during the workday. In this context, many turn to formula as their backup plan, and it is very scary for them to see that their safety net is in tatters. To answer questions related to human milk, the Academy of Breastfeeding Medicine (ABM) published a guide. This ABM guide addresses pregnancy, low milk supply, re-lactation, options for donation or safe milk sharing, and healthcare guidance and training.
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Additional burdens or blame should never be placed on the families and caregivers whose hands are literally full of babies and toddlers. When capacity allows, however, the collective potential power of parents is significant. Consider if parents insisted on being at the table with the commercial milk formula industry, playing a role in ensuring industry quality, safety, and ethics. They are key stakeholders, after all, so this should be encouraged. Parents could also insist the U.S. enhance our nonprofit milk banking system to ensure an affordable, plentiful donor milk supply for medically fragile infants and those whose parents cannot or do not wish to breastfeed. This would diversify the infant food supply and provide parents with more options.

Programs:

Federal programmatic funding needs to be expanded considering setbacks caused by the pandemic, including the current infant formula shortage.

Federal funding supports quality improvement investments to implement maternity care best practices in hospitals, especially while recovering from pandemic-induced breakdowns in those settings.

Expansion of this funding supports state and community efforts to advance care coordination and strengthen lactation support through policy, systems, and environmental change interventions to reduce or eliminate breastfeeding disparities along the fault lines of income and race.

Federal investments enhance and deepen partnerships to integrate infant feeding and lactation support services into emergency response systems and food security programs during acute disasters and prolonged public health crises.
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This funding supports critical national monitoring and public reporting activities, including annual analysis of the National Immunization Survey (NIS), administration of the bi-annual Maternity Practices in Infant Nutrition and Care (mPINC) Survey, bi-annual production of the National Breastfeeding Report Card, and administration of the longitudinal Infant Feeding Practices Study. All of which is especially needed in light of recent updates to the Dietary Guidelines for Americans, which, for the first time, provides nutritional guidance for infants and toddlers.

Policies:

Due to major policy gaps, families face obstacles that make it difficult or impossible to start or continue breastfeeding. Policymakers must choose to prioritize the policies and investments for infant food security so that we never find ourselves in this situation again.

Critically needed policy solutions are waiting for Congressional action:

  • Establish a national paid family and medical leave program. The FAMILY Act (S. 248/H.R. 804) would ensure that families have time to recover from childbirth and establish a strong breastfeeding relationship before returning to work.
  • Ensure all breastfeeding workers have time and space to pump during the workday. The Providing Urgent Maternal Protections (PUMP) Act (S. 1658/H.R. 3110) would close gaps in the Break Time for Nursing Mothers Law, giving 9 million more workers time and space to pump. Contact your legislators about the PUMP Act!
  • Invest in the CDC Hospitals Promoting Breastfeeding program by increasing funding to $20M in FY2023. This funding helps families start and continue breastfeeding through maternity care practice improvements and community and workplace support programs.
  • Create a formal plan for infant and young child feeding in emergencies. The DEMAND Act (S. 3601/H.R. 6555) would ensure the Federal Emergency Management Agency can better support access to lactation support and supplies during disasters. Contact your legislators about the DEMAND Act!

Additional areas for policy development

The U.S. has not regulated the marketing practices of the commercial milk formula industry, unlike 70% of the world, which has implemented at least some part of the WHO’s International Code of Marketing of Breast-Milk Substitutes. In the absence of regulation, these marketing practices are predatory.
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Diversify the nation’s production of infant formula. Plainly it is a mistake to allow 42% of the infant formula in this country to be produced not only by one company but by one factory of that company. Infant formula companies are part of an infant food security system, but we don’t have to be so dependent on that industry.Enhance the national network of nonprofit donor milk banks. Support innovative partnerships across existing structures, taking a cue from a national model such as what exists in Brazil. Consider: Red Cross has the infrastructure to support donor screening; WIC offices or community health clinics could be donor drop-off sites; more hospitals could provide space and equipment for donor milk processing and distribution, as some have done. Models exist to create an affordable and plentiful alternative to commercial milk formula when a parent’s own milk is not available.

Plan:

All nations should have a robust plan for infant and young child feeding in emergencies that includes three phases: preparedness, response, and resiliency. The USBC-Affiliated Infant & Young Child Feeding Constellation has published a Joint Statement on Infant & Young Child Feeding in Emergencies (IYCF-E) in the U.S. context.
Emergency preparedness includes building a lactation support provider directory and a system to track the inventory of national resources such as infant formula.Emergency response for infants, young children, and their families must include priority shelter, trauma-informed care, lactation support providers in every community; access to breast pumps, and milk storage and cleaning supplies; non-branded infant formula, clean water, bottles, and cleaning supplies.
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Emergency resilience includes trauma-informed care that centers on the needs of communities that have been historically undersupported, and disproportionately impacted in emergencies.

Every system is perfectly designed to get the results it gets. The insufficient system we’ve had, led to this crisis. It was predictable, and thus it was preventable.
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Now that there’s a mass mobilization of activity – from neighbors driving many miles to find spare formula tins, to the President invoking the defense production act – we must collectively build the resiliency to support a community during a flood, a region during a power outage, or a nation during a pandemic and supply chain crisis. We will get through this because we must. Together we must ensure we build an infant nutrition security system worthy of parent’s trust.
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