By Carolyn McCoy, MPH
Senior Policy Manager, Health Reform Implementation, AMCHP
Aug. 1-7, 2015 is World Breastfeeding Week. The theme this year is "Let's Make it Work!" Within this theme, there is a call for "concerted global action to support women to combine breastfeeding and work." The opportunity to fulfill this call to action in the United States is better than ever.
The CDC annual report card indicates that in 2013, 77 percent of mothers initiate breastfeeding after the birth of a child. Yet, breastfeeding rates fell to 49 percent nationally after six months. Disparate rates among racial and ethnic groups persist with 55 percent of African-American women initiating breastfeeding. However, while these rates are improving, breastfeeding rates among African-American women remain lower than the rates of other racial or ethnic group in the United States, particularly among those living in the south. Breast milk provides the ideal nutrition for infants. The benefits of breastfeeding for children are well established and include increased immune response, thus lowering instances of ear infections, diarrheal disease, and risk of certain allergies. Breastfeeding also has been shown to reduce the likelihood of obesity in adolescence, and type 1 and type 2 diabetes. Additionally, the skin-to-skin contact and closeness between mother and baby contribute to bonding.
Persistent barriers for women to initiate and continue to exclusively breastfeed include a lack of accommodation to breastfeed or express milk at the workplace; experience or understanding among family and community members of how to best support breastfeeding mothers; opportunities for breastfeeding mothers to communicate and support each other; and up-to-date instruction and information on breastfeeding from health care professionals. Among other community supports for mothers who wish to breastfeed, the Affordable Care Act (ACA) provides an opportunity to lower barriers for breastfeeding mothers returning to work who wish to continue breastfeeding. Under the law, most private health insurance plans (including those available on the new Health Insurance Marketplace) are required to provide coverage for women's preventive health services – including breastfeeding support, supplies and counseling – with no cost sharing (they can no longer charge a patient a copayment, coinsurance or deductible when services are delivered by a network provider). These breastfeeding benefits must be provided in conjunction with each birth. The ACA also amended section 7 of the Fair Labor Standards Act (FLSA) that requires employers provide reasonable breaks for an employee to express breast milk for her nursing child for one year after the birth of the child. In addition, employers are required to provide a place – other than a bathroom – that is shielded from view and free from intrusion from coworkers and the public for nursing mothers to express breast milk during the workday. These requirements, however, do not preempt state laws providing greater protection to employees. Employers with fewer than 50 employees are not subject to FLSA break time requirement if compliance with the provision would impose an undue hardship.
Title V and public health leaders have an opportunity to help inform the populations they serve as well as their partner organizations about these important supports for breastfeeding mothers. An AMCHP issue brief highlights examples of state Title V programs that have partnered with other state-level agencies, and organizations to assist with the implementation of this important law. Many questions remain, however, states are encouraged to reach out to each other as well as AMCHP and the Office of Women's Health for resources and connections to organizations that stand ready to help!
In partnership with the Association of State and Territorial Health Officials (ASTHO), AMCHP hosted a national webinar, "Making room for Moms: Building Lactation Space and Implementing a Model Policy in State Health Departments" on Tuesday, Jul. 21. This webinar highlighted state efforts to implement a model policy to support breastfeeding mothers at work, and included advice and photos on how state health departments developed lactation rooms to support their new moms. Click here to access the webinar recording, slides and other resources shared during this learning event.
How are you working to support breastfeeding in your community? Let us know! Tweet us at @DC_AMCHP using the hashtag #makingroomformoms.