Download docx - aagar.weebly.com€¦ · Web viewLegislative Action Paper. Dr. Erin Comartin . Adrienne Agar. Oakland University . Adrienne Agar. 44095 Trent Drive . Clinton Township, MI, 48038

Running head: LEGISLATIVE ACTION PAPER

Legislative Action Paper

Dr. Erin Comartin

Adrienne Agar

Oakland University

LEGISLATIVE ACTION PAPER 2

Adrienne Agar44095 Trent Drive Clinton Township, MI, 48038

March 21, 2014

The Honorable Randy RichardvilleMajority Senate Leader Randy RichardvilleP.O. Box 30036Lansing, MI 48909-7536

Dear Senator Richardville:

My name is Adrienne Agar and I reside in Clinton Township, MI. I am currently a junior in the Social Work Program at Oakland University. I am writing to you to concerning “Bill No. 0464” which aims to amend the “Elliot – Larsen civil rights act”, 1976 PA 453, to prohibit discriminatory acts against woman who breastfeed.

According to the American Public Health Association, breastfeeding promotes a wide array of health benefits for infants such as it improves cognitive advances, heightens and strengthens the immune system, and reduces the risks for obesity. These studies show that mothers who breastfeed also receive health benefits such as a quicker weight loss post-pregnancy and lowered risks for obtaining breast or ovarian cancers. Here in the United States, nearly 69% of adults are overweight or obese and breast cancer stands as the most prevalent cancer among women. Considering these statistics, I believe the protective health benefits of breastfeeding are reason alone to recognize the importance of this bill.

However, while it seems that breastfeeding, a biological attribute developed by most women during pregnancy, should simply be an organic right for women, seemingly this is not the case. When is the last time you can recall observing a mother breast feeding her child in public? Yet, if you can recall an instance, can you also recall the looks of people around her? Unfortunately, discrimination against mothers who breastfeed in public plays a definite role in our society today. It is my firm belief that a natural ability which provides survival, growth, and life should be accepted, protected and promoted, never frowned upon or discriminated against.

While the state of Michigan does have a law to prevent the application of public nudity to breast feeding mothers, we are one of six states in this country to still have no laws that specifically allow a woman to breastfeed in public. Michigan also has no protection laws for breast feeding mothers in the workplace. Finally, as indirectly noted, we have no laws to prevent discriminatory acts against women who breastfeed their children in public.

Please do whatever is in your authority to aid the progress of this bill and give breastfeeding mothers the support they undoubtedly deserve. Many other states have already passed various laws concerning breastfeeding to support and protect women. It would truly be a loss for the


state of Michigan to not recognize a woman’s natural right to freely and unashamedly breastfeed her child.

As a recommendation for this bill, I feel that a mandated promotion supporting anti-discriminatory practices against women who breastfeed should be placed in all public facilities. While a written law prohibiting discrimination acts against women who breastfeed their child is a great place to start, I believe the best way to change an outlook or action is through awareness. By placing promotions in plain view of all public establishments, individuals may become more aware of their bias towards other, will then be less likely to engage in unlawful discrimination, and may now consider possible benefits to breastfeeding practices.

As your constitute, I urge your support for SB No. 0464 of 2013 to protect the civil rights of women who breastfeed their children. Thank you for your consideration and I look forward to hearing from you soon.

Sincerely,

Adrienne Agar44095 Trent DriveClinton Township, MI, 48038(586) 265 - [email protected]


Adrienne Agar44095 Trent Drive Clinton Township, MI, 48038

March 21, 2014

The Honorable Tory RoccaSenator Tory RoccaP.O. Box 30036Lansing, MI 48909-7536

Dear Senator Rocca:

My name is Adrienne Agar and I reside in Clinton Township, MI. I am currently a junior in the Social Work Program at Oakland University. I am writing to you to concerning “Bill No. 0464” which aims to amend the “Elliot – Larsen civil rights act”, 1976 PA 453, to prohibit discriminatory acts against woman who breastfeed.

According to the American Public Health Association, breastfeeding promotes a wide array of health benefits for infants such as it improves cognitive advances, heightens and strengthens the immune system, and reduces the risks for obesity. These studies show that mothers who breastfeed also receive health benefits such as a quicker weight loss post-pregnancy and lowered risks for obtaining breast or ovarian cancers. Here in the United States, nearly 69% of adults are overweight or obese and breast cancer stands as the most prevalent cancer among women. Considering these statistics, I believe the protective health benefits of breastfeeding are reason alone to recognize the importance of this bill.

However, while it seems that breastfeeding, a biological attribute developed by most women during pregnancy, should simply be an organic right for women, seemingly this is not the case. When is the last time you can recall observing a mother breast feeding her child in public? Yet, if you can recall an instance, can you also recall the looks of people around her? Unfortunately, discrimination against mothers who breastfeed in public plays a definite role in our society today. It is my firm belief that a natural ability which provides survival, growth, and life should be accepted, protected and promoted, never frowned upon or discriminated against.

While the state of Michigan does have a law to prevent the application of public nudity to breast feeding mothers, we are one of six states in this country to still have no laws that specifically allow a woman to breastfeed in public. Michigan also has no protection laws for breast feeding mothers in the workplace. Finally, as indirectly noted, we have no laws to prevent discriminatory acts against women who breastfeed their children in public.

Please do whatever is in your authority to aid the progress of this bill and give breastfeeding mothers the support they undoubtedly deserve. Many other states have already passed various laws concerning breastfeeding to support and protect women. It would truly be a loss for the state of Michigan to not recognize a woman’s natural right to freely and unashamedly breastfeed her child.


As a recommendation for this bill, I feel that a mandated promotion supporting anti-discriminatory practices against women who breastfeed should be placed in all public facilities. While a written law prohibiting discrimination acts against women who breastfeed their child is a great place to start, I believe the best way to change an outlook or action is through awareness. By placing promotions in plain view of all public establishments, individuals may become more aware of their bias towards other, will then be less likely to engage in unlawful discrimination, and may now consider possible benefits to breastfeeding practices.

As your constitute, I urge your support for SB No. 0464 of 2013 to protect the civil rights of women who breastfeed their children. Thank you for your consideration and I look forward to hearing from you soon.

Sincerely,

Adrienne Agar44095 Trent DriveClinton Township, MI, 48038(586) 265 - [email protected]


Legislative and Article Summary

The Legislation

The legislation I chose for the this assignment was SB No. 0464, which is bill to amend

1976 PA 453 by adding the prohibition of discriminatory acts against women who breastfeed

their children. This bill entails the prevention of refusal of goods, services, and accommodations

to women who breastfeed in public establishments. This bill also includes the exclusion of

making a woman’s attendance feel unwelcome and disagreeable due to the fact that she is

breastfeeding her child.

Reasoning for Legislation Choice

I chose this legislation for both personal and objective reasons. Firstly I chose this bill

because I have had a personal family experience of being discriminated against for breastfeeding

in public. I can distinctly remember a time when my mother was breastfeeding my younger

brother at a local restaurant, completely covered, and my family and I received non approving

looks from both customers and employees. Interestingly enough most of the discrimination came

from other women. After researching this topic of breast feeding I realized Michigan did not

have any distinct laws to protect women who breastfeed their children in public. Not only does

breastfeeding provide many important health benefits, but considering this is a natural ability

most women possess, I feel it should simply never be a factor for judgment.

Reasoning for Article Choice


I chose to use the “Breast Cancer” article from Centers for disease control and

Prevention for my letter because it had many important statistics concerning breast cancer in the

United States. These statics were important because breastfeeding has been proven to in some

cases lessen a woman’s risk for this cancer. I chose to use the “Breastfeeding Laws” article from

Breastfeeding State Laws because this laid out the demographics for the topic of breastfeeding

laws and where Michigan lies on this spectrum. I chose to use the “Working mothers,

breastfeeding, and the law” article from the American Journal of Public Health because it

provided the very important health benefits found in breastfeeding for both the mother and the

child. I chose to use the article “Overweight and Obesity in the U.S” from the Food Research

Action Center Overweight and Obesity in the US Comments because it presented the social

problem of obesity here in America. These statistics then backed up the importance of

breastfeeding since it has been known to lessen the risks for obesity. Lastly I chose the “Senate

Bill No. 464” summary from the Michigan Legislative Website because it was the piece of

legislation I used for my letter and provided the official information regarding the bill.


References

Breast Cancer. (2013, October 23). Centers for Disease Control and Prevention. Retrieved

March 25, 2014, from http://www.cdc.gov/cancer/breast/statistics/

Breastfeeding Laws. (n.d.). Breastfeeding State Laws. Retrieved March 25, 2014, from

http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx

Murtagh, L., & Moulton, A. D. (n.d.). Working mothers, breastfeeding, and the law. American

Journal of Public Health. Retrieved March 25, 2014, from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020209/

Overweight and Obesity in the U.S. « Food Research & Action Center. (n.d.). Food Research

Action Center Overweight and Obesity in the US Comments. Retrieved March 25, 2014,

from http://frac.org/initiatives/hunger-and-obesity/obesity-in-the-us/

Poway mother says school district discriminated against her for breastfeeding her baby. (2013,

September 18). YouTube. Retrieved March 25, 2014, from

http://www.youtube.com/watch?v=lpP35gSVvg4

Senate Bill No. 464. (n.d.). Michigan Legislative Website. Retrieved March 18, 2014, from

http://www.legislature.mi.gov/%28S%28ip2nva553jbysvuukpkrhtqp%29%29/

mileg.aspx?page=getObject&objectName=2013-SB-0464



SENATE BILL No. 464

September 10, 2013, Introduced by Senators WARREN, HUNTER, HANSEN, HOPGOOD, ANANICH, ANDERSON, GREGORY and HOOD and referred to the Committee on Government Operations.

A bill to amend 1976 PA 453, entitled

"Elliott-Larsen civil rights act,"

by amending the title and section 302 (MCL 37.2302), the title as


amended by 1992 PA 258.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

TITLE

An act to define civil rights; to prohibit discriminatory

practices, policies, and customs in the exercise of those rights

based upon religion, race, color, national origin, age, sex,

height, weight, familial status, or marital status, OR

BREASTFEEDING; to preserve the confidentiality of records regarding

arrest, detention, or other disposition in which a conviction does

not result; to prescribe the powers and duties of the civil rights

commission and the department of civil rights; to provide remedies


and penalties; to provide for fees; and to repeal certain acts and parts of acts.

Sec. 302. Except where permitted by law, a person shall not:

(a) Deny an individual the full and equal enjoyment of the

goods, services, facilities, privileges, advantages, or

accommodations of a place of public accommodation or public service

TO AN INDIVIDUAL because of religion, race, color, national origin,

age, sex, or marital status OR TO A WOMAN BECAUSE SHE IS

BREASTFEEDING A CHILD.

(b) Print, circulate, post, mail, or otherwise cause to be

published a statement, advertisement, notice, or sign which THAT

indicates that the full and equal enjoyment of the goods, services,

facilities, privileges, advantages, or accommodations of a place of


public accommodation or public service will be refused, withheld

from, or denied an individual because of religion, race, color,

national origin, age, sex, or marital status , or REFUSED, WITHHELD

FROM, OR DENIED A WOMAN BECAUSE SHE IS BREASTFEEDING A CHILD; that

an individual's patronage of or presence at a place of public

accommodation is objectionable, unwelcome, unacceptable, or

undesirable because of religion, race, color, national origin, age,

sex, or marital status; OR THAT A WOMAN'S PATRONAGE OF OR PRESENCE

AT A PLACE OF PUBLIC ACCOMMODATION IS OBJECTIONABLE, UNWELCOME,

UNACCEPTABLE, OR UNDESIRABLE BECAUSE SHE IS BREASTFEEDING A CHILD.

http://www.legislature.mi.gov/%28S%28ip2nva553jbysvuukpkrhtqp%29%29/mileg.aspx?page=getObject&objectName=2013-SB-0464

http://www.legislature.mi.gov/(S(ip2nva553jbysvuukpkrhtqp))/mileg.aspx?page=getObject&objectName=2013-SB-0464

http://www.legislature.mi.gov/(S(ip2nva553jbysvuukpkrhtqp))/mileg.aspx?page=getObject&objectName=2013-SB-0464


http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx

Breastfeeding LawsTable of Content

Federal Health Reform and Nursing Mothers State Breastfeeding Laws Resources

NCSL Contact

Health Program

Updated August 2011

Health professionals and public health officials promote breastfeeding to improve infant health. Both mothers and children benefit from breast milk. Breast milk contains antibodies that protect infants from bacteria and viruses. Breastfed children have fewer ear, respiratory and urinary tract infections and have diarrhea less often. Infants who are exclusively breastfed tend to need fewer health care visits, prescriptions and hospitalizations resulting in a lower total medical care cost


compared to never-breastfed infants. Breastfeeding also provides long-term preventative effects for the mother, including an earlier return to pre-pregnancy weight and a reduced risk of pre-menopausal breast cancer and osteoporosis. According to the Centers for Disease Control and Prevention, approximately 75 percent of mothers start breastfeeding immediately after birth, but less than 15 percent of those moms are breastfeeding exclusively six months later. As a part of the Healthy People 2020 initiative, the national goal is to increase the proportion of mothers who breastfeed their babies in the early postpartum period to 81.9 percent by the year 2020.

Federal Health Reform and Nursing Mothers

President Obama signed the Affordable Care Act (ACA) on March 30, 2010. (See the combined full text of Public Laws 111-148 and 111-152 here.) Among many provisions, Section 4207 of the law amends the Fair Labor Standards Act (FLSA) of 1938 (29 U.S. Code 207) to require an employer to provide reasonable break time for an employee to express breast milk for her nursing child for one year after the child's birth each time such employee has need to express milk. The employer is not required to compensate an employee receiving reasonable break time for any work time spent for such purpose. The employer must also provide a place, other than a bathroom, for the employee to express breast milk. If these requirements impose undue hardship, an employer that employs fewer than 50 employees is not subject to these requirements. The federal requirements shall not preempt a state law that provides greater protections to employees.

For more information:

Fact Sheet on Break Time for Nursing Mothers under the FLSA , U.S. Department of Labor

Break Time for Nursing Mothers , U.S. Department of Labor Frequently Asked Questions – Break Time for Nursing Mothers , U.S. Department of

Labor Reasonable Break Time for Nursing Mothers: Request for Information from the public ,

Federal Register Notices, Vol. 75, No. 244, December 21, 2010

In addition, the ACA requires new private health insurance plans, including those available in the new health insurance marketplaces, to provide coverage for specified women’s preventive health services with no cost sharing (e.g., copayment, coinsurance, or deductible). Breastfeeding support, supplies and lactation counseling are one of these specified preventive services.

For more information:

Preventive Services Covered Under the Affordable Care Act , NCSL webpage Women's Preventive Services Guidelines , Health Services and Resources Administration,

U.S. Department of Health and Human Services Affordable Care Act Rules on Expanding Access to Preventive Services for Women ,

HHS.gov/HealthCare, U.S. Department of Health and Human Services

State Breastfeeding Laws


Forty-five states, the District of Columbia and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location. (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Washington, Wisconsin and Wyoming.)

Twenty-eight states, the District of Columbia and the Virgin Islands exempt breastfeeding from public indecency laws. (Alaska, Arizona, Arkansas, Florida, Illinois, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nevada, New Hampshire, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virginia, Washington, Wisconsin and Wyoming.)

Twenty-four states, the District of Columbia and Puerto Rico have laws related to breastfeeding in the workplace. (Arkansas, California, Colorado, Connecticut, Georgia, Hawaii, Illinois, Indiana, Maine, Minnesota, Mississippi, Montana, New Mexico, New York, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Vermont, Virginia, Washington and Wyoming.)

Fifteen states and Puerto Rico exempt breastfeeding mothers from jury duty or allow jury service to be postponed. (California, Connecticut, Idaho, Illinois, Iowa, Kansas, Kentucky, Michigan, Mississippi, Montana, Nebraska, Oklahoma, Oregon, South Dakota and Virginia.)

Five states and Puerto Rico have implemented or encouraged the development of a breastfeeding awareness education campaign. (California, Illinois, Minnesota, Missouri and Vermont.)

Several states have unique laws related to breastfeeding. For instance,

Virginia allows women to breastfeed on any land or property owned by the state. Puerto Rico requires shopping malls, airports, public service government centers and other select locations to have accessible areas designed for breastfeeding and diaper changing that are not bathrooms.

At least two states have laws related to child care facilities and breastfeeding. Louisiana prohibits any child care facility from discriminating against breastfed babies. Mississippi requires licensed child care facilities to provide breastfeeding mothers with a sanitary place that is not a toilet stall to breastfeed their children or express milk, to provide a refrigerator to store expressed milk, to train staff in the safe and proper storage and handling of human milk, and to display breastfeeding promotion information to the clients of the facility.

California requires the Department of Public Health to develop a training course of hospital policies and recommendations that promote exclusive breastfeeding and specify staff for whom this model training is appropriate. The recommendation is targeted at hospitals with patients who ranked in the lowest 25 percent of the state for exclusive breastfeeding rates.


Maryland exempts the sale of tangible personal property that is manufactured for the purpose of initiating, supporting or sustaining breastfeeding from the sales and use tax. Louisiana also prohibits state sales or use tax from being applied to any consumer purchases of breastfeeding items.

California , New York and Texas have laws related to the procurement, processing, distribution or use of human milk.

New York created a Breastfeeding Mothers Bill of Rights, which is required to be posted in maternal health care facilities. New York also created a law that allows a child under one year of age to accompany the mother to a correctional facility if the mother is breastfeeding at the time she is committed.

States Summary of Statutes

Alabama Ala. Code § 22-1-13 allows a mother to breastfeed her child in any public or private location. (2006 Ala. Acts, Act 526; HB 351)

Alaska

Alaska Stat. § 29.25.080 and § 01.10.060 (1998) prohibit a municipality from enacting an ordinance that prohibits or restricts a woman breastfeeding a child in a public or private location where the woman and child are otherwise authorized to be. The law clarifies that lewd conduct, lewd touching, immoral conduct, indecent conduct, and similar terms do not include the act of a woman breastfeeding a child in a public or private location where the woman and child are otherwise authorized to be. (SB 297)

Arizona

Ariz. Rev. Stat. Ann § 13-1402 specifies that indecent exposure does not include an act of breastfeeding by a mother.

Ariz. Rev. Stat. Ann § 41-1443 (2006) entitles a mother to breastfeed in any public place or place of public accommodation where the mother is otherwise lawfully present.

Arkansas

Ark. Stat. Ann. § 5-14-112 (2007) defines indecent exposure and specifies that a woman is not committing indecent exposure for breastfeeding a child in a public place or any place where other individuals are present. (2007 Ark. Acts, Act 680; HB 2411)Ark. Stat. Ann. § 11-5-116 (2009) requires an employer to provide reasonable unpaid break time each day to an employee who needs to express breast milk for her child and requires an employer to make a reasonable effort to provide a private, secure and sanitary room or other location other than a toilet stall where an employee can express her breast milk. (2009 Ark. Acts, Act 621, HB 1552)Ark. Stat. Ann. § 20-27-2001 (2007) allows a woman to breastfeed a child in a public place or any place where other individuals are present. (2007 Ark. Acts, Act 680; HB 2411)

California Cal. Civil Code § 43.3 (1997) allows a mother to breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and the child are otherwise authorized to be present. (AB 157)Cal. Code of Civil Procedure § 210.5 (2000) requires the Judicial Court to adopt a standardized jury summons for use, which must include a specific reference to the rules for breastfeeding mothers. 2000 Cal. Stats., Chap. 266 (AB 1814)


created the law and directs the Judicial Council to adopt a rule of court to allow the mother of a breastfed child to postpone jury duty for a period of up to one year and that after one year, jury duty may be further postponed upon written request by the mother. See California Rules of Court, Trial Court Rules, Rule 2.1006.

Cal. Government Code § 12926 states it is unlawful to engage in specified discriminatory practices in employment or housing accommodations on the basis of sex. The law provides that, for purposes of the act, the term sex also includes breastfeeding or medical conditions related to breastfeeding. (2012 Cal. Stats., Chap. 701; AB 2386)Cal. Health and Safety Code § 1647 (1999) declares that the procurement, processing, distribution or use of human milk for the purpose of human consumption is considered to be a rendition of a service rather than a sale of human milk. (1999 Cal. Stats., Chap. 87; AB 532)Cal. Health and Safety Code § 1648 requires a hospital that collects, processes, stores or distributes human milk collection from a mother exclusively for her own child to comply with the standards for collection, processing, storage or distribution of human milk by the Human Milk Banking Association of North America unless the department of health approves alternate standards. No screening tests are required to be performed on human milk collected from a mother exclusively for her own child.Cal. Health and Safety Code § 123360 et seq. and § 1257.9 require the Department of Public Health to include in its public service campaign the promotion of mothers breastfeeding their infants. The department shall also develop a training course of hospital policies and recommendations that promote exclusive breastfeeding and specify staff for whom this model training is appropriate. The recommendation is targeted at hospitals with exclusive patient breastfeeding rates ranked in the lowest twenty-five percent of the state. To the extent that funding is available, the law requires the Department of Public Health to expand the breastfeeding peer counseling preogram at local agency California WIC sites. The law also requires all general acute care hospital and hospitals providing maternity care to make available a breastfeeding consultant or provide information to the mother about where to receive breastfeeding information. (2007 Chapter 460, SB 22)Cal. Labor Code § 1030 et seq. (2001) provides that employers need to allow a break and provide a room for a mother who desires to express milk in private.Cal. Assembly Concurrent Resolution 155 (1998) encourages the state and employers to support and encourage the practice of breastfeeding by striving to accommodate the needs of employees, and by ensuring that employees are provided with adequate facilities for breastfeeding and expressing milk for their children. The resolution memorializes the governor to declare by executive order that all state employees be provided with adequate facilities for breast feeding and expressing milk.

Colorado Colo. Rev. Stat. § 25-6-301 and § 25-6-302 (2004) recognize the benefits of breastfeeding and encourage mothers to breastfeed. The law also allows a


mother to breastfeed in any place she has a right to be. (SB 88)Colo. Rev. Stat. § 8-13.5-101 et seq. (2008) require an employer to provide reasonable break time for an employee to express breast milk for her nursing child for up to two years after the child's birth. The employer must make reasonable efforts to provide a place, other than a toilet stall, for the employee to express breast milk in privacy. The law also requires the Department of Labor and Employment to provide, on its website, information and links to other websites where employers can access information regarding methods to accommodate nursing mothers in the workplace. (2008 Colo., Sess. Laws, Chap. 106, HB 1276)

Connecticut

Conn. Gen. Stat. § 31-40w (2001) requires employers to provide a reasonable amount of time each day to an employee who needs to express breast milk for her infant child and to provide accommodations where an employee can express her milk in private. (HF 5656)Conn. Gen. Stat. § 46a-64 (1997) prohibits places of public accommodation, resort or amusement from restricting or limiting the right of a mother to breastfeed her child. (1997 Conn. Acts, P.A. 210 )Conn. Gen. Stat. Ann. § 53-34b provides that no person may restrict or limit the right of a mother to breastfeed her child.

2012 Conn. Acts, P.A. 51 requires the judicial branch to maintain a web site with information for prospective jurors about jury services, including, but not limited to, information for breastfeeding women regarding their ability to postpone jury duty. The website must also include contact information for prospective jurors, including breastfeeding women, to request reasonable accommodation be made. The jury administrator must also provide training to staff on discrete issues and policies for breastfeeding women who have been summoned for jury service. (2012 SB 194)

DelawareDel. Code Ann. tit. 31 § 310 (1997) entitles a mother to breastfeed her child in any location of a place of public accommodation wherein the mother is otherwise permitted. (Vol. 71 Del. Laws, Chap. 10; 1997 HB 31)

District of Columbia

D.C. Code Ann. § 2-1402.81 et seq. amend the Human Rights Act of 1977 to include breastfeeding as part of the definition of discrimination on the basis of sex, to ensure a woman's right to breastfeed her child in any location, public or private, where she has the right to be with her child. The law provides that breastfeeding is not a violation of indecent exposure laws. The law also specifies that an employer shall provide reasonable daily unpaid break periods, as required by the employee, so that the employee may express breast milk for her child. These break periods shall run concurrently with any break periods that may already be provided to the employee. Requires that an employer make reasonable efforts to provide a sanitary room or other location, other than a bathroom or toilet stall, where an employee can express her breast milk in privacy and security. The location may include a childcare facility in close proximity to the employee's work location. (2007 D.C. Stat., Chap. 17-58; B 133)


Florida

Fla. Stat. § 383.015 (1993) allows a mother to breastfeed in any public or private location. (HB 231)Fla. Stat. § 383.016 (1994) authorizes a facility lawfully providing maternity services or newborn infant care to use the designation "baby-friendly" on its promotional materials. The facility must be in compliance with at least eighty percent of the requirements developed by the Department of Health in accordance with UNICEF and World Health Organization baby-friendly hospital initiatives. (SB 1668)Fla. Stat. § 800.02 et seq. and § 827.071 exclude breastfeeding from various sexual offenses, such as lewdness, indecent exposure and sexual conduct. Fla. Stat. § 847.0135 (5) (d) (2008) excludes a mother breastfeeding her baby from the offense of lewd or lascivious exhibition using a computer. (2008 Fla. Laws, Chap. 172, SB 1442)

Georgia

Ga. Code § 31-1-9 (1999) states that the breastfeeding of a baby is an important and basic act of nurture which should be encouraged in the interests of maternal and child health and allows a mother to breastfeed her baby in any location where the mother and baby are otherwise authorized to be. (1999 SB 29, Act 304; 2002 SB 221) Ga. Code § 34-1-6 (1999) allows employers to provide daily unpaid break time for a mother to express breast milk for her infant child. Employers are also required to make a reasonable effort to provide a private location, other than a toilet stall, in close proximity to the workplace for this activity. The employer is not required to provide break time if to do so would unduly disrupt the workplace operations.

Hawaii

Hawaii Rev. Stat. § 367-3 (1999) requires the Hawaii Civil Rights Commission to collect, assemble and publish data concerning instances of discrimination involving breastfeeding or expressing breast milk in the workplace. The law prohibits employers to forbid an employee from expressing breast milk during any meal period or other break period. (HB 266)Hawaii Rev. Stat. § 378-2 provides that it is unlawful discriminatory practice for any employer or labor organization to refuse to hire or employ, bar or discharge from employment, withhold pay from, demote or penalize a lactating employee because an employee breastfeeds or expresses milk at the workplace. (2000 Hawaii Sess. Laws, Act 227; HB 2774)Hawaii Rev. Stat. § 489.21 and § 489-22 provide that it is a discriminatory practice to deny, or attempt to deny, the full and equal enjoyment of the goods, services, facilities, privileges, advantages, and accommodation of a place of public accommodations to a woman because she is breastfeeding a child. The law allows a private cause of action for any person who is injured by a discriminatory practice under this act. 2010 House Concurrent Resolution 158 urges the Department of Human Services and the Department of Health to develop a program to encourage breastfeeding among mothers who receive assistance from Medicaid.

Idaho Idaho Code § 2-212 (2002) provides that a person who is not disqualified for jury service under § 2-209 may have jury service postponed by the court or the


jury commissioner only upon a showing of undue hardship, extreme inconvenience, or public necessity, or upon a showing that the juror is a mother breastfeeding her child. (2002 HB 497)

Illinois

Ill. Rev. Stat. ch. 20 § 2310/442 (1997) allows the Department of Public Health to conduct an information campaign for the general public to promote breastfeeding of infants by their mothers. The law allows the department to include the information in a brochure for free distribution to the general public. (Ill. Laws, P.A. 90-244)Ill. Rev. Stat. ch. 705 § 305/10.3 amends the Jury Act; provides that any mother nursing her child shall, upon her request, be excused from jury duty. (Ill. Laws, P.A. 094-0391 , 2005 SB 517)Ill. Rev. Stat. ch. 720 § 5/11-9 (1995) clarifies that breastfeeding of infants is not an act of public indecency. (SB 190)Ill. Rev. Stat. ch. 740 § 137 (2004) creates the Right to Breastfeed Act. The law provides that a mother may breastfeed her baby in any location, public or private, where the mother is otherwise authorized to be; a mother who breastfeeds in a place of worship shall follow the appropriate norms within that place of worship. (SB 3211)Ill. Rev. Stat. ch. 820 § 260 (2001) creates the Nursing Mothers in the Workplace Act. Requires that employers provide reasonable unpaid break time each day to employees who need to express breast milk. The law also requires employers to make reasonable efforts to provide a room or other location, other than a toilet stall, where an employee can express her milk in privacy. (SB 542)2011 Ill. Senate Resolution 170 recognizes the unique health, economic, and societal benefits that breastfeeding provides to babies, mothers, families and the community and resolves the state of Illinois to work to ensure that barriers to initiation and continuation of breastfeeding are removed and that a women's right to breastfeed is upheld.

Indiana

Ind. Code § 16-35-6 allows a woman to breastfeed her child anywhere the law allows her to be. (HB 1510)Ind. Code § 5-10-6-2 and § 22-2-14-2 (2008) provide that state and political subdivisions shall provide for reasonable paid breaks for an employee to express breast milk for her infant, make reasonable efforts to provide a room or other location, other than a toilet stall, where the employee can express breast milk in private and make reasonable efforts to provide for a refrigerator to keep breast milk that has been expressed. The law also provides that employers with more than 25 employees must provide a private location, other than a toilet stall, where an employee can express the employee's breast milk in private and if possible to provide a refrigerator for storing breast milk that has been expressed. (2008 Ind. Acts, P.L. 13, SB 219)

Iowa Iowa Code § 135.30A (2002) a woman may breastfeed the woman's own child in any public place where the woman's presence is otherwise authorized.Iowa Code § 607A.5 (1994) allows a woman to be excused from jury service if she submits written documentation verifying, to the court's satisfaction, that she is the mother of a breastfed child and is responsible for the daily care of the


child.

Kansas

Kan. Stat. Ann. § 43-158 allows a mother breastfeeding her child to be excused from jury service and allows jury service to be postponed until the mother is no longer breastfeeding the child. (2006 HB 2284)Kan. Stat. Ann. § 65-1,248 provides that it is the public policy of Kansas that a mother's choice to breastfeed should be supported and encouraged to the greatest extent possible and that a mother may breastfeed in any place she has a right to be.

Kentucky

Ky. Rev. Stat. § 29A.100 (2007) directs judges at all levels of the court to excuse women who are breastfeeding or expressing breast milk from jury service until the child is no longer nursing. (SB 111)Ky. Rev. Stat. § 211-755 (2006) permits a mother to breastfeed her baby or express breast milk in any public or private location. Requires that breastfeeding may not be considered an act of public indecency, indecent exposure, sexual conduct, lewd touching or obscenity. Prohibits a municipality from enacting an ordinance that prohibits or restricts breastfeeding in a public or private place. (2006 SB 106)

Louisiana

La. Rev. Stat. Ann. § 46. 1409 B 5 prohibits any child care facility from discriminating against breastfed babies. (HB 233)La. Rev. Stat. Ann. § 51. 2247.1 (2001) states that a mother may breastfeed her baby in any place of public accommodation, resort, or amusement, and clarifies that breastfeeding is not a violation of law, including obscenity laws. (2001 HB 377)La. House Concurrent Resolution 35 (2002) establishes a joint study of requiring insurance coverage for outpatient lactation support for new mothers.2008 La. Senate Resolution 110 requests the Department of Health & Hospitals to study and/or consider a provision of providing non-emergency transportation for new mothers to allow them to visit the hospital and bring their breast milk for their babies.

2011 La. Acts, P.A. 269 requires specified state-owned buildings, educational institutions, and office buildings that meet specified criteria to provide suitable areas for breastfeeding and lactation. (2011 HB 313)

2011 La. Acts, P.A. 331 provides that the state sales or use tax shall not apply to consumer purchases of breastfeeding items, including breast pumps and accessories, replacement parts, storage bags and accessories, and nursing bras. (2011 SB 82)

Maine Me. Rev. Stat. Ann. tit. 5, § 4634 (2001) amends the Maine Human Rights Act to declare that a mother has the right to breastfeed her baby in any location, whether public or private, as long as she is otherwise authorized to be in that location. (Me. Laws, Chap. 206; LD 1396)Me. Rev. Stat. Ann. tit. 26, § 604 (2009) requires an employer to provide adequate unpaid or paid break time to express breast milk for up to 3 years following childbirth. The employer must make reasonable efforts to provide a


clean place, other than a bathroom, where an employee may express breast milk in privacy. The employer may not discriminate against an employee who chooses to express breast milk in the workplace. (2009 Me. Laws, Chap. 84, HB 280)

Maryland

Md. Health-General Code Ann. § 20-801 (2003) permits a woman to breastfeed her infant in any public or private place and prohibits anyone from restricting or limiting this right. (SB 223)Md. Tax-General Code Ann. § 11-211 exempts the sale of tangible personal property that is manufactured for the purpose of initiating, supporting or sustaining breastfeeding from the sales and use tax.

Massachusetts

Mass. Gen. Laws Ann. ch. 111 § 221 (2008) allows a mother to breastfeed her child in any public place or establishment or place which is open to and accepts or solicits the patronage of the general public and where the mother and her child may otherwise lawfully be present. The law also specifies that the act of a mother breastfeeding her child shall not be considered lewd, indecent, immoral or unlawful conduct and provides for a civil action by a mother subjected to a violation of this law. (2008 Mass. Acts, Chap. 466, SB 2438)

Michigan

Mich. Comp. Laws § 41.181, § 67.1aa and § 117.4i et seq. (1994) state that public nudity laws do not apply to a woman breastfeeding a child.

2012 Mich. Pub. Acts, Act 69 provides an exemption for nursing mothers from jury service for the period during which she is nursing her child. A mother may be exempt upon making the request if she provides a letter from a physician, lactation consultant, or a certified nurse midwife verifying that she is a nursing mother. (HB 4691)

Minnesota

Minn. Stat. Ann. § 145.894 directs the state commissioner of health to develop and implement a public education program promoting the provisions of the Maternal and Child Nutrition Act. The education programs must include a campaign to promote breastfeeding.Minn. Stat. § 145.905 provides that a mother may breastfeed in any location, public or private, where the mother and child are authorized to be, irrespective of whether the nipple of the mother's breast is uncovered during or incidental to the breastfeeding.Minn. Stat. § 181.939 (1998) requires employers to provide daily unpaid break time for a mother to express breast milk for her infant child. Employers are also required to make a reasonable effort to provide a private location, other than a toilet stall, in close proximity to the workplace for this activity. (SB 2751) Minn. Stat. Ann. § 617.23 (1998) specifies that breastfeeding does not constitute indecent exposure.

Mississippi Miss. Code Ann. § 13-5-23 (2006) provides that breastfeeding mothers may be excused from serving as jurors. (SB 2419)Miss. Code Ann. § 17-25-7/9 (2006) prohibits any ordinance restricting a woman's right to breastfeed and provides that a mother may breastfeed her child in any location she is otherwise authorized to be. (SB 2419)Miss. Code Ann. § 43-20-31 (2006) requires licensed child care facilities


to provide breastfeeding mothers with a sanitary place that is not a toilet stall to breastfeed their children or express milk, to provide a refrigerator to store expressed milk, to train staff in the safe and proper storage and handling of human milk, and to display breastfeeding promotion information to the clients of the facility.Miss. Code Ann. Ch. 1 § 71-1-55 (2006) prohibits against discrimination towards breastfeeding mothers who use lawful break time to express milk.Miss. Code Ann. § 97-29-31 and § 97-35-7et seq. (2006) specifies that a woman breastfeeding may not be considered an act of indecent exposure, disorderly conduct, or disturbance of the public space.

Missouri

Mo. Rev. Stat. § 191.915 (1999) requires hospitals and ambulatory surgical centers to provide new mothers with a breastfeeding consultation or information on breastfeeding, the benefits to the child and information on local breastfeeding support groups. The law requires physicians who provide obstetrical or gynecological consultation to inform patients about the postnatal benefits of breastfeeding. The law requires the Department of Health to provide and distribute written information on breastfeeding and the health benefits to the child. (SB 8)Mo. Rev. Stat. § 191.918 (1999) allows a mother, with as much discretion as possible, to breastfeed her child in any public or private location.

Montana

Mont. Code Ann. § 39-2-215 et seq. specifies that employers must not discriminate against breastfeeding mothers and must encourage and accommodate breastfeeding. Requires employers to provide daily unpaid break time for a mother to express breast milk for her infant child and facilities for storage of the expressed milk. Employers are also required to make a reasonable effort to provide a private location, other than a toilet stall, in close proximity to the work place for this activity.Mont. Code Ann. § 50-19-501 (1999) states that the breastfeeding of a child in any location, public or private, where the mother otherwise has a right to be is legal and cannot be considered a nuisance, indecent exposure, sexual conduct, or obscenity. (SB 398)Mont. Code Ann. § 3-15-313 (2009) specifies that the court may excuse a person from jury service upon finding that it would entail undue hardship for the person; an excuse may be granted if the prospective juror is a breastfeeding mother. (2009 Mont. Laws, Chap. 167, HB 372)

Nebraska

Neb. Rev. Stat. §25-1601-4 (2003) states that a nursing mother is excused from jury duty until she is no longer breastfeeding and that the nursing mother must file a qualification form supported by a certificate from her physician requesting exemption. (LB 19)2011 Neb. Laws, L.B. 197 specifies that a mother may breastfeed her child in any public or private location where the mother is otherwise authorized to be.

Nevada Nev. Rev. Stat. § 201.210, and § 201.220 (1995) state that the breastfeeding of a child is not considered a violation of indecent exposure or open or gross lewdness laws. (SB 317)


Nev. Rev. Stat. § 201.232 (1995) states that a mother may breastfeed her child in any location, private or public, where the mother is otherwise authorized to be. (SB 317)

New Hampshire

N.H. Rev. Stat. Ann. § 132:10-d (1999) state that breastfeeding does not constitute indecent exposure and that limiting or restricting a mother's right to breastfeed is discriminatory. (HB 441)

New Jersey

N.J. Rev. Stat. § 26:4B-4/5 (1997) entitles a mother to breastfeed her baby in any location of a place of public accommodation, resort or amusement wherein the mother is otherwise permitted. Failure to comply with the law may result in a fine.

New Mexico

N.M. Stat. Ann. § 28-20-1 (1999) permits a mother to breastfeed her child in any public or private location where she is otherwise authorized to be. (SB 545)N.M. Stat. Ann. § 28-20-2 (2007) requires employers to provide a clean, private place, not a bathroom, for employees who are breastfeeding to pump. Also requires that the employee be given breaks to express milk, but does not require that she be paid for this time.2009 N.M. House Memorial 58 requests the governor's women's health advisory council to convene a task force to study the needs of breastfeeding student-mothers and make recommendations for breastfeeding accommodations in school environments.

New York

N.Y. Civil Rights Law § 79-e (1994) permits a mother to breastfeed her child in any public or private location. (SB 3999)N.Y. Correction Law § 611 allows a mother of a nursing child to be accompanied by her child if she is committed to a correctional facility at the time she is breastfeeding. This law also permits a child born to a committed mother to return with the mother to the correctional facility. The child may remain with the mother until one year of age if the woman is physically capable of caring for the child. (2009 N.Y. Laws, Chap. 411; SB 1290) N.Y. Labor Law § 206-c (2007) states that employers must allow breastfeeding mothers reasonable, unpaid break times to express milk and make a reasonable attempt to provide a private location for her to do so. Prohibits discrimination against breastfeeding mothers.N.Y. Penal Law § 245.01 et seq. excludes breastfeeding of infants from exposure offenses.N.Y. Public Health Law § 2505 provides that the Maternal and Child Health commissioner has the power to adopt regulations and guidelines including, but not limited to donor standards, methods of collection, and standards for storage and distribution of human breast milk.N.Y. Public Health Law § 2505-a creates the Breastfeeding Mothers Bill of Rights and requires it to be posted in a public place in each maternal health care facility. The commissioner must also make the Breastfeeding Mothers Bill of Rights available on the health department's website so that health care facilities and providers may include such rights in a maternity information leaflet. (2009 N.Y. Laws, Chap. 292; AB 789)


North CarolinaN.C. Gen. Stat. § 14-190.9 (1993) states that a woman is allowed to breastfeed in any public or private location, and that she is not in violation of indecent exposure laws. (HB 1143)

North Dakota

N.D. Cent. Code § 12.1-20-12.1 was amended in 2009 by Senate Bill 2344 to exempt the act of a woman discreetly breastfeeding her child from indecent exposure laws.N.D. Cent. Code § 23-12-16 allows a woman to breastfeed her child in any location, public or private, where the woman and child are otherwise authorized to be. (2009 SB 2344)N.D. Cent. Code § 23-12-17 provides that an employer may use the designation “infant friendly” on its promotional materials if the employer adopts specified workplace breastfeeding policies, including scheduling breaks and permitting work patterns that provide time for expression of breast milk; providing a convenient, sanity, safe and private location other than a restroom for expressing breast milk; and a refrigerator in the workplace for the temporary storage of breast milk. The law also directs to the state department of health to establish guidelines for employers concerning workplace breastfeeding and infant friendly designations. (2009 SB 2344)

OhioOhio Rev. Code Ann. § 3781.55 (2005) provides that a mother is entitled to breastfeed her baby in any location of a place of public accommodation wherein the mother is otherwise permitted. (SB 41)

Oklahoma

Okla. Stat. tit. 38, § 28 (2004) exempts mothers who are breastfeeding a baby from jury duty, upon their request. (2004 HB 2102)Okla. Stat. tit. 40, § 435 (2006) requires that an employer provide reasonable unpaid break time each day to an employee who needs to breastfeed or express breast milk for her child. The law requires the Department of Health to issue periodic reports on breastfeeding rates, complaints received and benefits reported by both working breastfeeding mothers and employers. (HB 2358)Okla. Stat. tit. 63, § 1-234 (2004) allow a mother to breastfeed her child in any location that she is authorized to be and exempts her from the crimes and punishments listed in the penal code of the state of Oklahoma. (HB 2102)

Oregon

Or. Rev. Stat. § 10.050 (1999) excuses a woman from acting as a juror if the woman is breastfeeding a child. A request from the woman must be made in writing. (SB 1304)

Or. Rev. Stat. § 109.001 (1999) allows a woman to breastfeed in a public place. (SB 744)Or. Rev. Stat. § 653.075, § 653.077 and § 653.256 (2007) allow women to have unpaid 30-minute breaks during each four-hour shift to breastfeed or pump. Allows certain exemptions for employers. (HB 2372)

PennsylvaniaPa. Cons. Stat. tit. 35 § 636.1 et seq. (2007) allows mothers to breastfeed in public without penalty. Breastfeeding may not be considered a nuisance, obscenity or indecent exposure under this law. (SB 34)

Puerto Rico 1 L.P.R.A. § 5165 declares August as "Breastfeeding Awareness Month" and the first week of August as "World Breastfeeding Week" in Puerto Rico.


3 L.P.R.A. § 1466 and 29 L.P.R.A. § 478a et seq. provide that breastfeeding mothers have the opportunity to breastfeed their babies for half an hour within the full-time working day for a maximum duration of 12 months.23 L.P.R.A. § 43-1 directs the Regulations and Permits Administration to adopt regulations, which shall provide that in shopping malls, airports, ports and public service government centers there shall be accessible areas designed for breastfeeding and diaper changing that are not bathrooms.34 L.P.R.A. § 1735h states that any woman breastfeeding her child under 24 months old and who presents a medical attestation to such fact is exempt from serving as a juror. (2003 SB 397)

Rhode Island

R.I. Gen. Laws § 11-45-2 (1998) specifies that indecent exposure-disorderly conduct laws do not apply to breastfeeding in public. (1998 HB 8103, SB 2319; 2008 R.I. Pub Laws, Chap. 183, SB 2916)R.I. Gen. Laws § 23-13.2-1 (2003) specifies that an employer may provide reasonable unpaid break time each day to an employee who needs to breastfeed or express breast milk for her infant child. The law requires the department of health to issue periodic reports on breastfeeding rates, complaints received and benefits reported by both working breastfeeding mothers and employers, and provides definitions. (2003 HB 5507, SB 151; 2008 R.I. Pub. Laws, Chap. 475 , HB 7906)R.I. Gen. Laws § 23-13.5-1 and § 23-13.5-2 (2008) allow a woman to feed her child by bottle or breast in any place open to the public and would allow her a private cause of action for denial of this right. (2008 R.I. Pub. Laws, Chap. 223 and Chap. 308, HB 7467 and SB 2283)

South CarolinaS.C. Code Ann. § 63-5-40 (2005) provides that a woman may breastfeed her child in any location where the mother is authorized to be and that the act of breastfeeding is not considered indecent exposure. (2008 HB 4747)

South Dakota

S.D. Codified Laws Ann. § 22-22-24.1 and § 22-24A-2 (2002) exempt mothers who are breastfeeding from indecency laws.

2012 S.D. Sess. Laws, Chap. 114 provides for an exemption from jury duty for a mother who is breastfeeding a baby younger than one year. A written notice requesting an exemption must be submitted to the clerk of court within ten days of receiving the summons for jury duty. (HB 1177)

Tennessee Tenn. Code Ann. § 68-58-101 et seq. (2006, 2011) permits a mother to breastfeed in any location, public or private, that the mother is authorized to be, and prohibits local governments from criminalizing or restricting breastfeeding. Specifies that the act of breastfeeding shall not be considered public indecency as defined by § 39-13-511; or nudity, obscene, or sexual conduct as defined in § 39-17-901. Tenn. Code Ann. § 68-58-101 et seq. and § 39-13-511(d) were amended in 2011 by Tenn. Pub. Acts, Chap. 91 (SB 83) to remove a provision permitting mothers to breastfeed only infants 12 months or younger in any location. (2006 Tenn. Law, Chap. 617; HB 3582)Tenn. Code Ann. § 50-1-305 (1999) requires employers to provide daily unpaid break time for a mother to express breast milk for her infant child. Employers


are also required to make a reasonable effort to provide a private location, other than a toilet stall, in close proximity to the workplace for this activity. (1999 Tenn. Law, Chap. 161; SB 1856)

Texas

Tex. Health Code Ann. § 161.071 (2001) requires the Department of Health to establish minimum guidelines for the procurement, processing, distribution, or use of human milk by donor milk banks. (HB 391)Tex. Health Code Ann. § 165.002 (1995) authorizes a woman to breastfeed her child in any location.Tex. Health Code Ann. § 165.003 et seq. provides for the use of a "mother-friendly" designation for businesses who have policies supporting worksite breastfeeding. (HB 340) The law provides for a worksite breastfeeding demonstration project and requires the Department of Health to develop recommendations supporting worksite breastfeeding. (HB 359)

U.S. Virgin Islands

14 V.I.C. § 1022 specifies that a woman breastfeeding a child in any public or private location where the woman's presence is otherwise authorized does not under any circumstance constitute obscene or indecent conduct.

Utah

Utah Code Ann. § 17-15-25 (1995) states that city and county governing bodies may not inhibit a woman's right to breastfeed in public.Utah Code Ann. § 76-10-1229.5 (1995) states that a breastfeeding woman is not in violation of any obscene or indecent exposure laws. (HB 262)

Vermont

Vt. Stat. Ann. tit. 9, § 4502 (j) (2002) and 2002 Vt. Acts, Act 117 state that breastfeeding should be encouraged in the interest of enhancing maternal, child and family health. The law provides that a mother may breastfeed her child in any place of public accommodation in which the mother and child would otherwise have a legal right to be. The law directs the human rights commission to develop and distribute materials that provide information regarding a woman's legal right to breastfeed her child in a place of public accommodation. (SB 156)Vt. Stat. Ann. tit. 21, § 305 (2008) requires employers to provide reasonable time throughout the day for nursing mothers to express breast milk for three years after the birth of a child. Also requires employers to make a reasonable accommodation to provide appropriate private space that is not a bathroom stall, and prohibits discrimination against an employee who exercises rights provided under this act. (2008 Vt. Acts, Act 144, HB 641)2008 Vt. Acts, Act 203 directs the commissioner of health to convene a healthy worksites work group to identify priorities and develop recommendations to enhance collaborative learning and interactive sharing of best practices in worksite wellness and employee health management. The work group shall examine best practices in Vermont and other states, including strategies to spread the adoption of workplace policies and practices that support breastfeeding for mothers. The commissioner is required to make recommendations in a report on healthy living initiatives to the legislature by January 15, 2009. (HB 887)

Virginia Va. Code § 2.2-1147.1 (2002) guarantees a woman the right to breastfeed her child on any property owned, leased or controlled by the state. The bill also


stipulates that childbirth and related medical conditions specified in the Virginia Human Rights Act include activities of lactation, including breastfeeding and expression of milk by a mother for her child. (HB 1264)Va. Code Ann. § 8.01-341.1 (2005) provides that a mother who is breastfeeding a child may be exempted from jury duty upon her request. The mother need not be "necessarily and personally responsible for a child or children 16 years of age or younger requiring continuous care during normal court hours." (2005 Chap. 195, HB 2708 )Va. Code Ann. § 18.2-387 (1994) exempts mothers engaged in breastfeeding from indecent exposure laws.Va. House Joint Resolution 145 (2002) encourages employers to recognize the benefits of breastfeeding and to provide unpaid break time and appropriate space for employees to breastfeed or express milk.

Washington

Wash. Rev. Code § 9A.88.010 (2001) states that the act of breastfeeding or expressing breast milk is not indecent exposure. (HB 1590)Wash. Rev. Code § 43.70.640 (2001) allows any employer, governmental and private, to use the designation of "infant-friendly" on its promotional materials if the employer follows certain requirements. (2001 Wash. Laws, Chap. 88)Wash. Rev. Code § 49.60.30(g) provides that it is the right of a mother to breastfeed her child in any place of public resort, accommodations, assemblage or amusement. (2009 Wash. Laws, Chap. 164, HB 1596)Wash. Rev. Code § 49.60.215 states that it is an unfair practice for any person to discriminate against a mother breastfeeding her child in any place of public resort, accommodations, assemblage or amusement. (2009 Wash. Laws, Chap. 164, HB 1596)

Wisconsin

Wis. Stat. § 944.17(3), § 944.20(2) and § 948.10(2)(b) (1995) provide that breastfeeding mothers are not in violation of criminal statutes of indecent or obscene exposure. (AB 154)2009 Wis. Laws, Act 148 provides that a mother may breastfeed her child in any public or private location where the mother and child are otherwise authorized to be. The law specifies that in such a location, no person may prohibit a mother from breastfeeding her child, direct a mother to move to a different location to breastfeed her child, direct a mother to cover her child or breast while breastfeeding, or otherwise restrict a mother from breastfeeding her child. (2009 AB 57)

Wyoming

Wyo. House Joint Resolution 5 (2003) encourages breastfeeding and recognizes the importance of breastfeeding to maternal and child health. The resolution also commends employers, both in the public and private sectors, who provide accommodations for breastfeeding mothers.Wyo. Stat. § 6-4-201 (2007) exempts breastfeeding mothers from public indecency laws and gives breastfeeding women the right to nurse anyplace that they otherwise have a right to be. (HB 105)

Sources: National Conference of State Legislatures and StateNet


Note: List may not be comprehensive, but is representative of state laws that exist. NCSL appreciates additions and corrections.

Resources

Got Milk?NCSL State Legislatures magazine, October/November 2011

Breastfeeding Saves Lives and MoneyNCSL postcard, July 2010

The Economic Benefits of BreastfeedingNCSL LegisBrief, January 2010

The Benefits of BreastfeedingNCSL State Legislatures magazine, April 2005

American Academy of Pediatrics (AAP) : Breastfeeding

American Academy of Family Physicians: Promoting and Supporting Breastfeeding

Center for Disease Control and Prevention: Breastfeeding Topics Breastfeeding Report Card, 2013 Online Data from the Infant Feeding Practices Study II The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies, 2013

Le Leche League International

March of Dimes: Breastfeeding

Investing in Workplace Breastfeeding Programs and Policies: An Employer's ToolkitNational Business Group on Health, June 2009

Health Resources and Services Administration, U.S. Department of Health and Human Services

Office on Women's Health, U.S. Department of Health and Human Services

Breastfeeding

The Business Case for Breastfeeding

HHS Blueprint for Action on Breastfeeding


Business Case for Breastfeeding, Maternal and Child Health Bureau

The Surgeon General's Call to Action to Support Breastfeeding, 2011 (Executive Summary)Office of the Surgeon General, U.S. Department of Health and Human Services: Breastfeeding

Women, Infants, and Children (WIC): Breastfeeding Promotion and Support in WIC U.S. Department of Agriculture, Food and Nutrition Service

This site is made possible by project, UC4MC21528, from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, U.S. Department of Health and Human Services.

Am J Public Health. 2011 February; 101(2): 217–223.

doi: 10.2105/AJPH.2009.185280Copyright/License ► Request permission to reuse

TABLE 1Selected Benefits of Breastfeeding

Health Benefits to Child Health Benefits to Mother Economic Benefits

Improved cognitive developmentDecreased postpartum bleeding

Higher employee productivity and lower absenteeism

Bolstered immune systemDecreased menstrual blood loss

Increased employment retention by working mothers who breastfeed

Reduced incidence and severity of such conditions as bacterial meningitis, diarrhea, and urinary tract infections

Increased child spacing

Family cost savings by avoiding purchase of infant formula

Reduced risk of diabetes, lymphoma, Earlier return to Decreased health care costs of $3.6

http://www.mchb.hrsa.gov/


Health Benefits to Child Health Benefits to Mother Economic Benefits

leukemia, hypercholesterolemia, and asthma

prepregnancy weight

billion if breastfeeding rates were raised to Healthy People 2010 goals, resulting in savings to public and private insurers

Decreased risk of overweightDecreased risk of breast and ovarian cancers

Source. Gartner et al.1; Harder et al.2; Dietz and Hunter3; US Department of Health and Human Services4; Ball and Wright5; Bartick and Reinhold6; Healthy People 2010 Midcourse Review.10


Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

Am J Public Health. 2011 February; 101(2): 217–223. doi: 10.2105/AJPH.2009.185280PMCID: PMC3020209

Working Mothers, Breastfeeding, and the LawLindsey Murtagh, JD, MPH and Anthony D. Moulton, PhDAuthor information ► Article notes ► Copyright and License information ►This article has been cited by other articles in PMC.Go to:

AbstractWorkplace barriers contribute to low rates of breastfeeding. Research shows that supportive state laws correlate with higher rates, yet by 2009, only 23 states had adopted any laws to encourage breastfeeding in the workplace.

Federal law provided virtually no protection to working mothers until the 2010 enactment of the “reasonable break time” provision of the Patient Protection and Affordable Care Act. This provision nonetheless leaves many working mothers uncovered, requires break time only to pump for (not feed) children younger than 1 year, and exempts small employers that demonstrate hardship.



Public health professionals should explore ways to improve legal support for all working mothers wishing to breastfeed. Researchers should identify the laws that are most effective and assist policymakers in translating them into policy.

Breastfeeding yields important immediate and long-term health benefits for infants and their mothers, including positive impacts on children's cognitive development and their health as adults.1–3 Breastfeeding is associated with higher productivity and lower absenteeism for breastfeeding mothers and has additional benefits for society (Table 1).4–6 The American Academy of Pediatrics recommends exclusive breastfeeding through 6 months postpartum and continued breastfeeding until the infant is aged at least 12 months.1 Among other organizations, the World Health Organization, the US Surgeon General's Office, and the American Academy of Family Physicians recommend comparable or longer durations of breastfeeding.7–9

TABLE 1Selected Benefits of Breastfeeding

Healthy People 2010 established 5 US breastfeeding goals, none of which have been achieved (Table 2).10 Of the mothers of children born in 2006, 73.9% initiated breastfeeding, which is close to the Healthy People 2010 goal of 75%. However, only 43.4% continued breastfeeding for at least 6 months postpartum, only 33.1% continued exclusive breastfeeding at 3 months, and only 13.6% continued exclusive breastfeeding for at least 6 months postpartum.11 Many states' breastfeeding rates for these mothers were small fractions of the Healthy People 2010 goals. Breastfeeding rates are low in certain minority groups (especially African Americans, American Indians, and Alaska Natives) and among low-income, less-educated, and younger women, directly implicating health equity issues.12

TABLE 2US Breastfeeding Goals and Rates

In 2003, the World Health Organization and UNICEF recommended “enacting imaginative legislation protecting the breastfeeding rights of working women and establishing means for its enforcement” by all governments.7(p14) An analysis of national, aggregate data in the United

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020209/table/tbl1/



States found a general association between states' adoption of laws supporting breastfeeding (not limited to workplace laws) and initiation of breastfeeding and breastfeeding at 6 months.13 Here we review federal and state laws relevant to breastfeeding in the workplace, identify gaps and limitations in those laws, and recommend actions to improve the use of law for achieving higher rates of breastfeeding.

Go to:

WORK AND BREASTFEEDINGEmployment of mothers outside the home, especially full-time employment, has a negative influence on duration of breastfeeding.14–18 (Employment appears to have a less deleterious effect on initiation of breastfeeding.) Among mothers of infants in their first year, 35.5% work full time and 16.1% work part time outside the home; for mothers of children aged 12 to 24 months, the rates are 40% and 17%, respectively.19 Therefore, improving the ability of mothers to breastfeed or to express and store milk in the workplace would likely contribute to higher US breastfeeding rates.

Why work outside the home shortens breastfeeding duration is not completely clear, but factors related to the time surrounding return to work appear critical. One study of women at high risk for not breastfeeding found that those who made plans to return to full-time work during the month before actually doing so had 1.34 times the odds of terminating breastfeeding as mothers who, during the same month, did not plan to return to work. In the month she returns to work, a mother has 2.18 times the odds of quitting breastfeeding as do her nonworking counterparts; in the first month after she starts work, her odds of terminating breastfeeding are 1.32 times that of her nonworking counterparts. However, in the second month after returning to work, her odds of terminating breastfeeding do not differ significantly from those of a woman not working in the same month postpartum.16 Thus, if employment conditions encourage women to initiate and continue breastfeeding through the first 2 months of work, they may be more likely to extend breastfeeding duration as recommended through at least the first year.

Women frequently attribute early weaning to unsupportive work environments.20 Lack of privacy and adequate time to express breastmilk are cited as barriers.21 Other impediments include employers' perception that the presence of infants in the workplace reduces mothers' productivity, regulations and other rules that bar children from the workplace, and a lack of child care close to the workplace.21 Fein et al. compared strategies women use to continue breastfeeding while working and found that breastfeeding an infant directly during working hours was associated with the longest duration, and pumping milk during working hours was the second most successful strategy; neither breastfeeding nor pumping during work hours was associated with the shortest duration.22

Women's experience of workplace-related barriers to breastfeeding varies by occupation. Professional women have significantly greater success in breastfeeding than do women in such occupations as retail sales, administrative support, and construction trades.14,16,17 Professional women typically have more autonomy, enabling greater privacy to breastfeed and greater freedom to accommodate the timing demands of lactation. They also may have greater access to


employer-sponsored lactation programs than do nonprofessional women, even in the same company.23 Another study found that women in food and health service occupations did not differ greatly in breastfeeding from professional women; these women likely had flexibility in arranging their work schedules.16

Attempts to encourage breastfeeding in the workplace sort into 3 types: employers' voluntary initiatives, support services offered by nonprofit and other private entities, and government encouragement and requirements. Evidence suggests employers may reap net economic benefits by enabling women to combine work with breastfeeding. The US Department of Health and Human Services' Business Case for Breastfeeding reports that in addition to improving retention of experienced employees, breastfeeding leads to lower health care spending, decreased absenteeism, increased productivity, improved morale, and positive company image.4 A study of a corporate lactation program voluntarily offered by 5 employers found it successful in enabling women to express milk in the workplace.20 These corporations felt offering a lactation benefit was important as a recruitment tool and in retaining female employees. Although such approaches can help, the persistence of low US breastfeeding rates calls for active exploration of additional approaches, including supportive laws that can reach a broader class of employees than do voluntary efforts.

Federal Laws

Working women desiring to breastfeed have sought legal protection in the US Constitution and in 3 federal statutes, but without success. The Patient Protection and Affordable Care Act of 2010, however, includes a provision that promises substantially more support.

US Constitution.

In 1981, the US Court of Appeals, Fifth Circuit, found that the Constitution protects a woman's liberty interest in breastfeeding her child.24 The court likened the decision to breastfeed to the protected liberties found in “individual decisions respecting marriage, procreation, contraception, abortion, and family relationships.”24(p786) The court held that a public employer's interference with a woman's decision to breastfeed must “further sufficiently important state interests, and [be] closely tailored to effectuate only those interests.”24(p787) The initial promise of the ruling, however, did not materialize. In the subsequent procedural history of the case, the trial court upheld the school board regulations that made it impossible for the plaintiff employee to continue breastfeeding during her breaks, even though she had breastfed on-site for 3 months without incident.25 Other judicial circuits have not addressed the question, leaving the Fifth Circuit's ruling an anomaly.

Civil Rights Act and Pregnancy Discrimination Act.

Title VII of the Civil Rights Act of 1964 prohibits employers from discriminating on the basis of gender, but despite breastfeeding's inherent connection to gender, Title VII has not helped breastfeeding mothers. The Supreme Court initially found that Title VII did not even protect women from discrimination on the basis of pregnancy.26 The Pregnancy Discrimination Act (1978) amended Title VII to protect against discrimination “because of or on the basis of


pregnancy, childbirth, or related medical conditions.”27 Arguably, breastfeeding can be considered a related medical condition. However, federal courts, as summarized in Derungs v Wal-Mart Stores, Inc, have repeatedly found that the Pregnancy Discrimination Act's protection does not extend to discrimination based on breastfeeding.28

Americans With Disabilities Act.

Plaintiffs have sought protection for breastfeeding under the Americans with Disabilities Act by having breastfeeding classified as a disability. Title I of the act prohibits employers from discriminating against an individual with a disability “who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires.”29 If breastfeeding were classified as a disability, accommodative steps could include providing flexible break time or a location to express milk. However, lactation is a normal condition associated with pregnancy, and courts have consistently held that the disabilities act is almost always inapplicable to pregnancy-related conditions30–35 and have explicitly held it is inapplicable to lactation in Martinez v NBC, Inc.36

Family Medical Leave Act.

By requiring employers to offer leave to new mothers, the Family Medical Leave Act (FMLA) provided working women with perhaps the most significant federal support for breastfeeding before 2010. This act permits eligible employees to take a total of 12 workweeks of leave during any 12-month period for “the birth of a son or daughter of the employee and in order to care for such son or daughter.”37 Because longer maternity leave is associated with longer duration of breastfeeding,14,38 FMLA leave may facilitate increased breastfeeding duration, but it falls short in 4 critical ways.

First, as of 2000 (the most recent data available), only 56.3% of privately employed women with children aged 18 months or younger were entitled to FMLA leave time.39 The act applies only to employees who have worked for at least 12 months and for a minimum of 1250 hours and to employers of at least 50 employees who reside within 75 miles of the place of work.40 It also excludes federal employees in specified categories.39

Second, women who are least likely to be covered by the FMLA are also unlikely to breastfeed. Eligible employees have significantly higher family incomes and educational attainment and are more likely to be older, non-Hispanic White, and married,41 characteristics associated with increased likelihood of exclusive breastfeeding.12

Third, many eligible employees cannot make practical use of FMLA leave because it is unpaid. Because breastfeeding correlates with income,12 the mothers least able to afford unpaid leave are those most in need of support to breastfeed.

Fourth, the FLMA does not assist mothers in balancing work and breastfeeding. Absent an express employer–employee agreement, a mother may take FMLA leave only as continuous leave.42 This inflexibility bars a mother from using FMLA leave to reduce her hours or take


flexible breaks for breastfeeding, actions that could facilitate longer duration of breastfeeding for some working mothers.

State Laws

To identify state laws supportive of breastfeeding in the workplace, we searched Westlaw databases of the statutes of all 50 states, the District of Columbia, and Puerto Rico, with the words “breastfeed,” “breast milk,” or “lactate” (or variations of “breastfeed” and “lactate”) and a word beginning with the stem “employ.” To verify inclusiveness, we compared our results with a list of breastfeeding statutes maintained by the National Conference of State Legislatures. Our searches identified all but 2 on that list; those 2 were enacted in 2009 and were not included in Westlaw at the time of our search.

We found that 23 states, the District of Columbia, and Puerto Rico had enacted 28 statutes containing a total of 51 provisions relevant to breastfeeding in the workplace (Table 3). Of these provisions, 21 focus on break times for breastfeeding or expressing milk, 19 focus on private locations for breastfeeding activities (2 location provisions for Indiana: 1 for private and 1 for public employers), 8 prohibit breastfeeding-related employment discrimination, and 3 encourage employers to provide “infant-friendly” or “mother-friendly” workplaces.

TABLE 3Provisions of Statutes Relating to Breastfeeding in the Workplace Adopted by 23 States, the District of Columbia, and Puerto Rico

Break time provisions.

Lactating mothers must breastfeed their infants or express milk regularly to maintain a supply of milk adequate to continue breastfeeding. For working women, pumping and breastfeeding during work are associated with longer duration of breastfeeding.22 Laws ensuring that women have the time and freedom to pump or breastfeed in the workplace thus can be beneficial.

Break time may be especially helpful for mothers paid by the hour, since salaried employees are more likely already to have the autonomy to take breaks to breastfeed or express milk. Employees who cannot afford reductions in pay, however, may be unable to take advantage of such breaks. Indiana is the only jurisdiction requiring public employers to compensate employees for breastfeeding breaks they take in addition to standard breaks.

The strongest break time laws (15) require employers to provide break time, although 12 of those exempt employers that show a significant degree of burden. Three states have weaker provisions



mandating that women be allowed to pump but not requiring breastfeeding break time. (Two of those states do not require any breaks.) The 3 weakest statutes merely state that employers may offer breaks for women to express or breastfeed, imposing no break time obligations on employers.

Variations in the 21 break time statutes may influence their relative effectiveness:

Three apply to both breastfeeding and pumping; 18 apply only to pumping. Three exempt small employers (defined in different terms). Although less limiting than

FMLA exemptions, these statutes may leave many employed mothers unprotected. The Indiana and Montana laws only apply to public employers.

Laws that require breastfeeding break time likely are especially valuable in states that do not require employers to provide rest or meal breaks.

Location and facilities provisions.

Having to express milk in a toilet stall is a barrier to continued breastfeeding after a return to work and can lead to premature weaning.43 Sixteen of the 18 state location and facilities laws are virtually identical, requiring that an employer provide a location for breastfeeding activities and that it (1) not be a toilet stall, and in some cases also not be a bathroom (with 1 exception); (2) be private; and (3) be close to the workspace (with 3 exceptions; Indiana's law also applies only to public employers). Some jurisdictions also require that the space be clean (5) and secure (3). The remaining 2 location and facilities statutes state only that employers may provide a location in which women can express milk in private.

Providing women with pumping equipment increases breastfeeding duration after they return to work.20 No states require employers to provide lactating employees with such equipment. Employers may have an incentive to do so, however, because high-grade breast pumps reduce expressing time. Indiana requires public and private employers above a certain size to provide employees with access to a refrigerator or other cold storage space in which to store expressed breastmilk.

Employment discrimination provisions.

Eight jurisdictions prohibit employment discrimination based on expression of milk and, in some cases, on breastfeeding in the workplace. Six states and the District of Columbia broadly prohibit employers from discriminating on the basis of breastfeeding activities or breastfeeding status. Virginia's much more limited law only prohibits employers with more than 5 and fewer than 15 employees from discharging an employee because of lactation status.

Infant- or mother-friendly workplace designations.

Three states limit their statutory approaches to workplace breastfeeding to authorizing employers to designate their workplaces as mother friendly (Texas) or infant friendly (North Dakota, Washington) if they adopt policies supporting flexible work schedules, locations for


breastfeeding, access to a water supply (e.g., a sink), and access to hygienic storage for breastmilk.

Information on implementation of the North Dakota statute, which became effective August 1, 2009, was not available at the time of our research. Lack of funding has muted the impact of the Texas (J. Stagg, MSN, RN, personal communication, October 2009) and Washington44 laws by preventing issuance of procedures to implement the program.

These laws assume that employers want a mother- or infant-friendly reputation because it attracts or retains women employees or for other reasons. To influence national rates of breastfeeding among working mothers, however, large proportions of employers must have that desire. Although employers may benefit from breastfeeding, research suggests that a small minority see value in promoting breastfeeding.45

In the absence of federal legal protection, 23 states, the District of Columbia, and Puerto Rico had enacted laws by late 2009 that (1) target specific barriers such as lack of adequate time to pump and lack of access to a private place to pump, (2) prohibit employers from discriminating against breastfeeding employees, or (3) attempt more generally to create incentives for employers to establish work environments supportive of breastfeeding. These laws vary greatly across states and include provisions that likely dilute their effectiveness. Only 12 states' laws appear to have enforcement provisions.

A New Legal Landscape in 2010

Set against this backdrop of minimal federal legal protection and highly variable legal protection across the states, section 4207 of the Patient Protection and Affordable Care Act of 2010 (PL 111–148) changed the relevant legal landscape in important and beneficial ways.46 The act requires all employers to provide, on an employee's request, “reasonable break time” for her to express milk for (but not to breastfeed) a child aged up to 1 year and a private location other than a bathroom for that purpose. Employers need not pay wages for such breaks. Employers of fewer than 50 employees that demonstrate hardship in complying with the law may be exempted.

Section 4207 amends the Fair Labor Standards Act of 1938, which sets national minimum wage and overtime rules. It applies only to employees covered by the act's overtime provisions, as detailed in Section 213.47 The protections apply to employees who work for hourly wages. They do not apply to salaried employees, many of whom typically have better breastfeeding accommodations. Nor do they apply to certain other classes of employees, such as administrative employees, elementary and secondary school teachers, and many agricultural workers.

Section 4207 is significant for 2 principal reasons. First, from the public health perspective, it is likely to improve eligible mothers' ability to express milk, which means that their children are likely to enjoy better health, the central goal of breastfeeding, as a result. Second, from the legal perspective, Section 4207 is the first federal law to require accommodation for mothers who wish to continue breastfeeding while working outside the home. Congress's decision to use the Fair Labor Standards Act as the legislative vehicle makes breastfeeding accommodation an integral part of the nation's labor laws. Further, by mandating a nationally uniform floor,


Congress holds that all eligible mothers should have at least a minimum level of accommodation, including workers in the many states that offer no legal accommodation at all. Women in states with more protective worksite breastfeeding laws will benefit from their states' added protection.

As with most laws, the impact of Section 4207 will depend on many factors. These factors include the provisions of the implementing Department of Labor regulations, education and technical assistance to employers, and enforcement of the law. Employer compliance will be important, as will provision of information to eligible women by state and local agencies, advocacy groups, and nonprofit organizations.

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RECOMMENDATIONSThe workplace poses serious impediments to continued breastfeeding by mothers who return to work postpartum. Yet federal law before 2010 offered those mothers little support, and only 23 states, the District of Columbia, and Puerto Rico had adopted related statutes, some of them essentially symbolic or hortatory in nature. A majority of states have no laws supportive of breastfeeding by working mothers.

With more than one third of all mothers of children younger than 2 years working full time outside the home, the United States is more likely to improve its low breastfeeding rates if it seeks the help of legislation. Congress took an important step in that direction with enactment of the Fair Labor Standards Act's reasonable break time provision. Although Congress could have preempted stronger existing and future state laws, it chose not to. The resulting new legal landscape presents public health professionals with an array of policy options to consider in moving toward the goal of accommodating the lactation (feeding as well as breastmilk expression) needs of all working mothers.

Options to maximize the benefit of the new federal law include informing eligible mothers and employers about it and advocating for resources needed to implement and enforce it. State law–oriented options could include identifying classes of mothers who are ineligible for Section 4207 and state accommodation, identifying facilities and services (such as lactation rooms and pumping equipment) that contribute to longer breastfeeding duration, and developing state or municipal laws to address those gaps and needs.

The issue of discrimination against mothers who wish to breastfeed in the workplace requires a different legal approach. The broad body of discrimination law indicates that breastfeeding antidiscrimination laws may offer the greatest deterrent to overt employer retaliation when intent to discriminate can be most easily proven in court. Such laws may have less impact on subtle forms of discrimination or systemic barriers if intent cannot be proven. Policymakers should consider adopting both accommodation laws and antidiscrimination laws, as some states already do.

Another need is for applied research. We located no evaluations of the impact state (or other) breastfeeding laws have on the duration of breastfeeding or the mechanisms through which they


operate. A 2007 review identified no randomized or quasi-randomized clinical trials evaluating any type of workplace breastfeeding intervention, including legal interventions.48 We also are unaware of empirical studies of the effect of laws on such important, related elements as women's perception of support for breastfeeding in the workplace and employers' perception of the benefits they may realize from employees' continued breastfeeding.

Although the effectiveness of these laws in prolonging breastfeeding has not been ascertained, they appropriately target an activity—employment outside the home—that research shows is negatively correlated with duration. Research is needed to determine the effectiveness of these laws. The results should be disseminated nationally to federal, state, tribal, and local policymakers for their use in eliminating or reducing employment-related barriers to breastfeeding.

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AcknowledgmentsWe acknowledge helpful suggestions on earlier drafts of the article by Laurence Grummer-Strawn, PhD, and Meredith Reynolds, PhD, Centers for Disease Control and Prevention (CDC); Michelle Mello, JD, PhD, Harvard School of Public Health; Sharona Hoffman, JD, Case Western Reserve University School of Law; and Judith Monroe, MD, Indiana State Health Department. We also acknowledge useful suggestions and research assistance from Lindsay Culp, MPH, CDC.

Note: The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Go to:

Human Participant ProtectionNo protocol approval was required because no human participants were involved in this research.

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4. US Dept of Health and Human Services The business case for breastfeeding. Available at: http://www.womenshealth.gov/breastfeeding/programs/business-case/index.cfm. Accessed February 4, 2010.5. Ball TM, Wright AL. Health care costs of formula-feeding in the first year of life. Pediatrics. 1999;103(4 pt 2):870–876. [PubMed]6. Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048–e1056. [PubMed]7. World Health Organization/UNICEF Global strategy for infant and young children feeding. 2003. Available at: http://www.who.int/child_adolescent_health/documents/9241562218/en. Accessed February 4, 2010.8. Galson SK. The 25th anniversary of the Surgeon General's Workshop on Breastfeeding and Human Lactation: the status of breastfeeding today. Public Health Rep. 2009;124(3):356–358. [PMC free article] [PubMed]9. American Academy of Family Physicians Breastfeeding, family physicians supporting (position paper). Available at: http://www.aafp.org/online/en/home/policy/policies/b/breastfeedingpositionpaper.html. Accessed February 4, 2010.10. Healthy People 2010 Midcourse Review. Washington DC: US Dept of Health and Human Services; 2006. Also available at: http://web.health.gov/healthypeople/document. Accessed October 6, 2010.11. Centers for Disease Control and Prevention Breastfeeding report card—United States, 2009. Available at: http://www.cdc.gov/BREASTFEEDING/DATA/report_card.htm. Accessed February 4, 2010.12. Centers for Disease Control and Prevention Breastfeeding among U.S. children born 1999–2006, CDC National Immunization Survey. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm. Accessed September 22, 2009.13. Kogan MD, Singh GK, Dee DL, Belanoff C, Grummer-Strawn LM. Multivariate analysis of state variation in breastfeeding rates in the United States. Am J Public Health. 2008;98(10):1872–1880. [PMC free article] [PubMed]14. Calnen G. Paid maternity leave and its impact on breastfeeding in the United States: an historic, economic, political and social perspective. Breastfeed Med. 2007;2(1):34–44. [PubMed]15. Fein SB, Roe B. The effect of work status on initiation and duration of breast-feeding. Am J Public Health. 1998;88(7):1042–1046. [PMC free article] [PubMed]16. Kimbro RT. On-the-job moms: work and breastfeeding initiation and duration for a sample of low-income women. Matern Child Health J. 2006;10(1):19–26. [PubMed]17. Kurinij N, Shiono PH, Ezrine SF, Rhoads GG. Does maternal employment affect breast-feeding? Am J Public Health. 1989;79(9):1247–1250. [PMC free article] [PubMed]18. Ryan AS, Zhou W, Arensberg MB. The effect of employment status on breastfeeding in the United States. Womens Health Issues. 2006;16(5):243–251. [PubMed]19. Bureau of Labor Statistics, US Dept of Labor Employment characteristics of families in 2008. Available at: http://www.bls.gov/news.release/pdf/famee.pdf. Accessed October 16, 2009.20. Ortiz J, McGilligan K, Kelly P. Duration of breast milk expression among working mothers enrolled in an employer-sponsored lactation program. Pediatr Nurs. 2004;30(2):111–119. [PubMed]21. Raju TNK. Continued barriers for breast-feeding in public and the workplace. J Pediatr. 2006;148(5):677–679. [PubMed]


22. Fein SB, Mandal B, Roe BE. Success of strategies for combining employment and breastfeeding. Pediatrics. 2008;122(Suppl 2):S56–S62. [PubMed]23. Hansen L. A comprehensive framework for accommodating nursing mothers in the workplace. Rutgers Law Rev. 2007;59(4):885–916.24. Dike v School Board of Orange County, Florida, 650 F2d 783 (5th Cir 1981)25. Shdaimah CS. Why breastfeeding is (also) a legal issue. Hastings Womens Law J. 1999;10(2):409–443.26. Gen Elec Co v Gilbert, 429 US 125 (1976)27. 42 USCA §§ 2000e(k), 2000e-2(a) (2009)28. Derungs v Wal-Mart Stores, Inc, 374 F3d 428 (6th Cir 2004)29. 42 USCA §§ 12111(8) (2009)30. Kucharski v Cort Furniture Rental, 536 FSupp2d 196 (DConn 2007)31. Minott v Port Authority of NY and NJ, 116 FSupp2d 513 (SDNY 2000)32. Conley v United Parcel Service, 88 FSupp2d 16 (EDNY 2000)33. Gabriel v City of Chicago, 9 FSupp2d 974 (NDIll 1998)34. Gudenkauf v Stauffer Communications, Inc, 922 FSupp 465 (DKan 1996)35. Villarreal v JE Merit Constructors, Inc, 895 FSupp 149 (SDTex 1995)36. Martinez v NBC, Inc, 49 FSupp 2d 305 (SDNY 1999)37. 29 USCA §§2612(a)(1)(A) (2009)38. Roe B, Whittington LA, Fein SB, Teisl MF. Is there competition between breast-feeding and maternal employment? Demography. 1999;36(2):157–171. [PubMed]39. Waldfogel J. Family and medical leave: evidence from the 2000 surveys. Mon Labor Rev. 2001;124(9):17–23.40. 29 USCA §2611(2) (2009)41. Galtry J. The impact on breastfeeding of labour market policy and practice in Ireland, Sweden, and the USA. Soc Sci Med. 2003;57(1):167–177. [PubMed]42. Goodman EA. Breastfeeding or bust: the need for legislation to protect a mother's right to express breast milk at work. Cardozo Womens Law J. 2003;10(1):146–174.43. Johnston ML, Esposito N. Barriers and facilitators for breastfeeding among working women in the United States. J Obstet Gynecol Neonatal Nurs. 2007;36(1):9–20. [PubMed]44. Breastfeeding Coalition of Washington. Washington State breastfeeding legislation. Available at: http://www.breastfeedingwa.org/wa_leg. Accessed October 16, 2009.45. Libbus MK, Bullock LF. Breastfeeding and employment: an assessment of employer attitudes. J Hum Lact. 2002;18(3):247–251. [PubMed]46. Patient Protection and Affordable Care Act, Pub L No. 111–148, §4207 (2010)47. 29 USCA §213 (2009)48. Abdulwadud OA, Snow ME. Interventions in the workplace to support breastfeeding for women in employment. Cochrane Database Syst Rev. 2007;(3):CD006177. [PubMed]

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Working Mothers, Breastfeeding, and the Law

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Multivariate analysis of state variation in breastfeeding rates in the United States. [Am J Public Health. 2008]

Paid maternity leave and its impact on breastfeeding in the United States: an historic, economic, political, and social perspective.[Breastfeed Med. 2007]

The effect of employment status on breastfeeding in the United States. [Womens Health Issues. 2006]

On-the-job moms: work and breastfeeding initiation and duration for a sample of low- income women.[Matern Child Health J. 2006]

Duration of breast milk expression among working mothers enrolled in an employer- sponsored lactation program.[Pediatr Nurs. 2004]

Continued barriers for breast-feeding in public and the workplace. [J Pediatr. 2006] Success of strategies for combining employment and breastfeeding. [Pediatrics. 2008]


On-the-job moms: work and breastfeeding initiation and duration for a sample of low- income women.[Matern Child Health J. 2006]

Does maternal employment affect breast-feeding? [Am J Public Health. 1989]



Is there competition between breast-feeding and maternal employment? [Demography. 1999]

The impact on breastfeeding of labour market policy and practice in Ireland, Sweden, and the USA.[Soc Sci Med. 2003]


Success of strategies for combining employment and breastfeeding. [Pediatrics. 2008]

Review Barriers and facilitators for breastfeeding among working women in the United States.[J Obstet Gynecol Neonatal Nurs. 2007]


Breastfeeding and employment: an assessment of employer attitudes. [J Hum Lact. 2002]

Review Interventions in the workplace to support breastfeeding for women in employment.[Cochrane Database Syst Rev. 2007]

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Breast Cancer StatisticsNot counting some kinds of skin cancer, breast cancer in the United States is—

The most common cancer in women, no matter your race or ethnicity. The most common cause of death from cancer among Hispanic women. The second most common cause of death from cancer among white, black, Asian/Pacific

Islander, and American Indian/Alaska Native women.

For more information, visit Cancer Among Women.

In 2010 (the most recent year numbers are available)—

206,966 women and 2,039 men in the United States were diagnosed with breast cancer.*† 40,996 women and 439 men in the United States died from breast cancer.*†

*Incidence counts cover about 97% of the U.S. population; death counts cover about 100% of the U.S. population. Use caution when comparing incidence and death counts.

†Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2010 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2013. Available at: http://www.cdc.gov/uscs.

Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30333, USA800-CDC-INFO (800-232-4636) TTY: (888) 232-6348

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Overweight and Obesity in the U.S.

In the U.S.: 68.5% of adults are overweight or obese; 34.9% are obese. 31.8% of children and adolescents are overweight or obese; 16.9% are obese. 30.4% of low-income preschoolers are overweight or obese. Disparities exist based on race-ethnicity, gender, age, geographic region, and

socioeconomic status.

Obesity rates have more than doubled in adults and children since the 1970’s (National Center for Health Statistics, 2009). While recent estimates suggest that the overall rates of obesity have plateaued or even declined among some groups, obesity is widespread and continues to be a leading public health problem in the U.S. (Ogden et al., 2014; Robert Wood Johnson Foundation, 2012; Wen et al., 2012). Plus, substantial disparities exist based on demographics (e.g., race-ethnicity, gender), geographic region, and socioeconomic status (SES). See the section on the Relationship Between Poverty and Overweight or Obesity for more information on SES disparities.

Adult Overweight and Obesity in the U.S.

More than two-thirds of U.S. adults are overweight or obese (Ogden et al., 2014). In general, rates of overweight and obesity are higher for African-American and Hispanic women than Caucasian women, higher for Hispanic men than Caucasian and African-American men, higher in the South and Midwest, and tend to increase with age (Ogden et al., 2014; Gregg et al., 2009; Sherry et al., 2010). Research also shows that the heaviest Americans have become even heavier the past decade (Beydoun & Wang, 2009).


Racial-Ethnic DisparitiesRecent national data show that 82.0 percent of Black women and 77.2 percent of Hispanic women are overweight or obese compared to 63.2 percent of White women (Ogden et al., 2014). In addition, over half of Black women are obese (versus 37.1 percent of Black men and 32.8 percent of White women) (Ogden et al., 2014). Extreme obesity continues to be higher among women (8.3 percent) than men (4.4 percent), especially among Black women who have more than double the rates of extreme obesity as White and Hispanic women (16.4 percent versus 7.4 percent and 7.6 percent) (Ogden et al., 2014). Rates of overweight or obesity are higher for Hispanic men (78.6 percent) compared to Black men (69.2 percent) and White men (71.4 percent) (Ogden et al., 2014).

The table below highlights these and other selected data on adult overweight and obesity from the National Health and Nutrition Examination Survey (NHANES).

U.S. Prevalence of Adult Overweight and Obesity (NHANES 2011-2012)

Overweight or Obesity

BMI >/=25 kg/m2

Obesity

BMI >/=30 kg/m2

Extreme Obesity

BMI >/=40 kg/m2

All 68.5% 34.9% 6.4%

All Females 65.8% 36.1% 8.3%

White(non-Hispanic)

63.2% 32.8% 7.4%

Black(non-Hispanic)

82.0% 56.6% 16.4%

Hispanic 77.2% 41.4% 7.6%

All Males 71.3% 33.5% 4.4%

White(non-Hispanic)

71.4% 32.4% 3.8%

Black(non-Hispanic)

69.2% 37.1% 6.9%

Hispanic 78.6% 40.1% 3.7%


Source: Ogden C. L., Carroll, M. D., Kit, B.K., & Flegal K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311(8), 806-814.

Childhood Overweight and Obesity in the U.S.

About a quarter of 2-5 year olds and one-third of school-age children (including adolescents) are overweight or obese in the U.S. (Ogden et al., 2014). About 30 percent of low-income preschoolers are overweight or obese (Centers for Disease Control and Prevention, 2011). Overweight and obesity rates tend to be higher and have increased more rapidly over time among African-American and Hispanic children than Caucasian children (Freedman et al., 2006; Ogden et al., 2012; Ogden et al., 2014). The prevalence is also higher among children living in the Southern region of the U.S. (e.g., Mississippi, Tennessee, Kentucky) (Singh et al., 2008).

Racial-Ethnic DisparitiesBased on recent national figures, 29.2 percent of White girls are overweight or obese compared to 36.1 percent of Black and 37.0 percent of Hispanic girls (Ogden et al., 2014). About 40 percent of Hispanic boys are overweight or obese, compared to 34.4 percent and 27.8 percent of Black and White boys, respectively (Ogden et al., 2014). Rates are the highest, and very alarming, for 12-19 year old Hispanic boys (39.6 percent are overweight or obese) and 12-19 year old Black girls (42.5 percent are overweight or obese) (Ogden et al., 2014).

While little national data are available on Native American children, several studies have found substantially higher obesity rates compared to the national average and other racial-ethnic groups (Gordon & Oddo, 2012; Smith et al., 2009; Zephier et al., 2006). For example, obesity rates are twice as high for Native American preschoolers than for White or Asian preschoolers (Anderson & Whitaker, 2009). In addition, while obesity risk tends to rise among adult immigrants as they become more acculturated to the American diet and health behaviors (Singh et al., 2011), there is evidence that children of the least acculturated immigrants have a greater risk of obesity than children of natives or settled immigrants, especially among boys, Whites, and Hispanics (Van Hook et al., 2009).

The following table provides some of the most recent data on childhood overweight and obesity from the National Health and Nutrition Examination Survey (NHANES).

U.S. Prevalence of Childhood Overweight and Obesity (NHANES 2011-2012)

Overweight or Obesity

BMI-for-age >/= 85th percentile

Obesity

BMI-for-age >/=95th percentile

All 31.8% 16.9%

2-5 year olds 22.8% 8.4%


6-11 year olds 34.2% 17.7%

12-19 year olds 34.5% 20.5%

All Females2-19 years old 31.6% 17.2%

White (non-Hispanic) 29.2% 15.6%

Black (non-Hispanic) 36.1% 20.5%

Hispanic 37.0% 20.6%

All Males2-19 years old 32.0% 16.7%

White (non-Hispanic) 27.8% 12.6%

Black (non-Hispanic) 34.4% 19.9%

Hispanic 40.7% 24.1%

Source: Ogden C. L., Carroll, M. D., Kit, B.K., & Flegal K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311(8), 806-814.

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Working Mothers, Breastfeeding, and the LawLindsey Murtagh, Anthony D. MoultonAm J Public Health. 2011 February; 101(2): 217–223. doi: 10.2105/AJPH.2009.185280

http://youtu.be/lpP35gSVvg4

link for Published on Sep 18, 2013

A local mother says the Poway Unified School District discriminated against her for breastfeeding her baby and then punished her 8-year-old son.

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http://youtu.be/lpP35gSVvg4


News & Politics

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