President Trump recently signed into law the Fairness for Breastfeeding Mothers Act. The Act provides that federal buildings that are open to the public must provide a lactation room available for use by both federal employees and any other members of the public who are breastfeeding. The designated lactation room must be separate from a bathroom and deemed hygienic.
This is certainly not groundbreaking legislation, but it follows the trend in supporting the prevalence of lactation space in both public and private property. No family should be forced to feed their child in a filthy bathroom, so I applaud the federal government in its continued effort to support and encourage breastfeeding. Though there is still a long way to go!
Pregnant mothers who are committed to breastfeeding often ask my recommendation for the best book about breastfeeding. My response is always that they should read as many books and articles as they can. But if I had to recommend just one book, it would be The Womanly Art of Breastfeeding. Published by Le Leche League, The Womanly Art of Breastfeeding is a comprehensive breastfeeding guide for the mother from the time she becomes pregnant through weaning their baby or toddler. Le Leche League has done an excellent job revising and updating the book over time to reflect the latest developments in the field. The 8th Edition is the latest edition of the book and is co-written by Diane Wiessinger, Diana West, and Teresa Pitman.
While this is an excellent and comprehensive book, I would not go so far to call it the “breastfeeding bible,” as many refer to it. I do find that the book is lacking in some areas. For example, the book is quite presumptuous that every mother should have a plentiful supply of milk. Many of my clients don’t have a plentiful supply and are discouraged in reading a “bible” that tells them that they should.
Breastfeeding is a unique experience and challenge for every mother, so it is simply impossible to “guide” every mother by generic pages in a book. Read the book and any other sources that you can get your hands on and have time for, but don’t be discouraged if your situation does not match the prototypical situation that the sources discuss. Talk to those that want to see you succeed in your breastfeeding journey and you will find the support and resources you need to succeed.
The Center for Disease Control and Prevention (CDC) monitors statistics to track our country’s progress in reaching certain health goals, including relating to breastfeeding. The CDC recently published its 2018 Breastfeeding Report Card and here are a few statistics that jumped out:
- Among infants born in the United States in 2015, 57.6% were breastfed for at least six (6) months and 35.9% were breastfed for at least one (1) year. Breastfeeding rates in Illinois are below the national average, with only 53% of infants breastfed for six (6) months and only 33.8% being breastfed for at least one (1) year.
- Despite authorities recommending that infants be breastfeed exclusively for the first six (6) months, less than 50% were exclusively breastfeed for three (3) months and only 25% completed the six (6) month minimum recommended period. According to the Report Card, “These rates suggest that mothers may not be getting the support they need from health care providers, family members, and employers to meet their breastfeeding goals.”
- 26.1% of babies born in the United States in 2018 were born at Baby-Friendly facilities, but the number drops to 22.3% for babies born in Illinois.
- Through 2018, only 49% of employers provide a separate onsite lactation room.
- In encouraging news, 5 of the 8 breastfeeding Healthy People 2020 Objectives have already been satisfied:
In 2018, Tammy Duckworth became the first woman to give birth while serving as a United States Senator. Recognizing the importance of being able to do her job and care for her infant, Duckworth then led the charge for the United States Senate to pass a rule to allow lawmakers to breastfeed on the Senate floor. Duckworth became the first woman to cast a vote while breastfeeding her infant daughter, Maile. Duckworth proudly proclaimed: “By ensuring that no senator will be prevented from performing their constitutional responsibilities simply because they have a young child, the Senate is leading by example and sending the important message that working parents everywhere deserve family-friendly workplace policies.”
Other states are following suit. Kansas Governor Laura Kelly was inaugurated January 14, 2019 and has already led Kansas to adopt rules permitting mothers to breastfeed on the Kansas state house floor. Governor Kelly explained, “What I would like to do as we move forward is that in every policy that we make and in every regulation that we pass, that we consider the impact on working families, particularly mothers.”
Most of us do not work as national or state lawmakers, but that does not mean that we don’t have rights as working mothers. Don’t be afraid to challenge the norm at your workplace. If something as steeped in tradition as the US Senate can adopt family-friendly rules, then your workplace can and should as well. Visit the Department of Labor’s webpage for guidance on your rights as a working mother.
In 1991 the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched a global program called the Baby-Friendly Hospital Initiative (BFH). Recognizing the overwhelming evidence-based benefits of breastfeeding, the BFHI is designed to encourage hospitals and other health facilities to provide the optimal level of care for nursing infants and to recognize the facilities that meet these high standards.
In order to obtain the “Baby-Friendly Hospital” designation, the facility must adhere to the following Ten Steps to Successful Breastfeeding:
- Have a written breastfeeding policy that is routinely communicated to all health care staff.
- Train all health care staff in skills necessary to implement this policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers initiate breastfeeding within half an hour of birth.
- Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
- Give newborn infants no food or drink other than breast milk, unless medically indicated.
- Practice rooming-in – that is, allow mothers and infants to remain together – 24 hours a day.
- Encourage breastfeeding on demand.
- Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
The Ten Steps to Successful Breastfeeding have been promoted by several other leading authorities, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Academy of Breastfeeding Medicine, the Centers for Disease Control and Prevention (CDC), and many others. The BFHI assists hospitals in the training and education required for the Ten Steps and then employs a a comprehensive accreditation process to actually earn the accolade.
Rush University Medical Center, after a five-plus year commitment, recently earned the “baby-friendly” designation in February 2017. Rush University joins Advocate Illinois Masonic Medical Center, Advocate Trinity Hospital and Presence St. Joseph Hospital as the only hospitals within the City of Chicago as having the designation. Rush University becomes the seventeenth (17th) baby-friendly hospital across the State of Illinois (designated facilities by state).
Unfortunately there are not currently any baby-friendly hospitals within Chicago’s North Shore. If you will be giving birth at a facility without the designation, it makes it all the more important to educate yourself in advance about breastfeeding.
President Trump and the Republican Congress are working hard to repeal and/or replace the Affordable Care Act (Obamacare). This would obviously be a detrimental blow to the millions of Americans who were finally able to obtain insurance coverage under Obamacare, but it would also be a blow to the many wonderful protections that Obamacare provides to breastfeeding mothers. Those protections generally include:
1) Break Time and Access to Lactation Room. Obamacare amended section 7 of the Fair Labor Standards Act (FLSA) to require that employers with more than 50 employees provide a “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk” and also provide “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.” See 29 U.S.C. 207(r). The importance of employers providing breastfeeding employees with both the time and privacy to express breast milk cannot be overstated. For more information regarding your rights as an employee with respect to breastfeeding, visit the Department of Labor’s website for nursing mothers or reference the Break Time for Nursing Mothers Employee Rights Card.
2) Breast Pumps Covered by Insurer. Under Obamacare, all Marketplace and other health insurance plans (with the exception of those grandfathered in) must cover the cost of either a rental breast pump or a new one for nursing mothers to keep. Plans vary on the type of pump provided (manual or electric) and how long rentals are provided, but the mandate to provide a breast pump is vitally important to nursing mothers, particularly those that could not easily afford pumps, which can be rather expensive.
3) Lactation Support and Counseling. The Affordable Care Act and accompanying laws require health plans to cover “comprehensive prenatal and postnatal lactation support and counseling.” Ensuring pregnant and postpartum mothers the ability to obtain professional lactation support and counseling is critically important to breastfeeding success, which is why I have dedicated my career to lactation support.
Breastfeeding comes with enough challenges. The protections provided under Obamacare were a strong step in the right direction, providing the time, access, equipment, and support to help breastfeeding mothers meet these challenges. These steps forward are all now in jeopardy. I will be following the proposed changes to Obamacare closely and will do my best to keep this blog updated with developments.
The World Health Organization (WHO) and American Academy of Pediatrics (AAP), as well as several other leading professional associations and authorities, recommend that babies be exclusively breastfed for the first six (6) months of their life. That is a big commitment for any mother and family. Statistics show that only 13% of US families reach this mark. Have you considered why WHO and AAP make this recommendation and why it is so important for you to breastfeed your baby?
I strongly recommend that you read, or at least skim, the AAP’s Policy Statement on breastfeeding for an in-depth understanding of the benefits of breastfeeding your baby. Some of the benefits discussed in the Policy Statement include:
- Hospitalizations for lower respiratory tract infections in the first year of a baby’s life are reduced 72% for babies breastfeed exclusively for more than four (4) months.
- Breastfeeding an infant results in a 64% reduction in gastrointestinal tract infections, which reduced risk continues for two (2) months after cessation of breastfeeding.
- Breastfeeding is associated with a 36% reduced risk for sudden infant death syndrome (SIDS).
- Breastfeeding is associated with a 15-30% reduction in both adolescent and adult obesity rates.
- Infants who are exclusively breastfeed for at least three (3) months have a 30% less chance of developing type 1 diabetes mellitus.
This is just a small sample of the quantifiable benefits to breastfed babies. In light of these and other statistics, many leading experts would suggest that you not look at the benefits of breastfeeding, but look at the dangers in not breastfeeding.
Educating yourself, and recognizing the benefits you will be providing to your little bundle of joy, will be all the motivation you need to set high goals for your breastfeeding journey.