Running Head: LAWS 1

Breastfeeding Laws

Samantha Geiger, Nina Hadley, Silva Stout, Emma Howe, and Shelby Koenig

University of North Carolina Wilmington: School of Nursing

Running Head: BREASTFEEDING LAWS 2

Introduction

The benefits of breastfeeding have been discussed for years. provides with essential nutrients and protective antibodies, and it has also been shown to reduce infants’ risks of ear infections, asthma, atopic dermatitis, gastrointestinal infections, respiratory infections, and sudden death syndrome. Breastfeeding can also reduce the ’s risk of breast cancer, ovarian cancer, and type 2 diabetes (Spatz, 2014, pp. 700). The World Health

Organization and the American Academy of recommend that breastfeed exclusively for the first six months of life (Spatz, 2014, pp. 700). Also, the Healthy People 2020 objectives aim to have at least 60.6% of all infants receiving some amount of at six months of age, with at least 25.5% of all infants breastfeeding exclusively at six months of age

(U.S. Department of Health and Human Services, 2011a). The purpose of this paper is to analyze the background of and barriers to breastfeeding, to discuss the laws implemented to support breastfeeding and the effects of these laws, and to describe the nursing implications of breastfeeding. The paper will also explain the methods used to research breastfeeding laws.

Background & Significance

At one point in time, breastfeeding was the only option for mothers to feed their children.

However, in the 1900s, baby formula was created, and the number of women breastfeeding dropped significantly. In her piece, “: Breastfeeding Advocacy in the United States,”

Diane Spatz (2014) notes that, “by 1948, only 38% of infants were receiving exclusively human milk feeds at one week of age, and by 1957, only 21% of infants were exclusively breastfed at the time of hospital discharge after birth” (pp. 700). By the late 1900s, physicians were aware of the nutritional and protective benefits of breastfeeding, and as breastfeeding rates dropped, they recognized a decline in the health of infants. As a result, city governments, doctors, and health Running Head: BREASTFEEDING LAWS 3 officials campaigned for mothers to continue breastfeeding (Wolfe, 2003, p. 2002). However, barriers to breastfeeding, such as embarrassment, lack of social support, and unsupportive work environments for lactating women, continued to contribute to low breastfeeding rates. In an effort to overcome these barriers and increase breastfeeding rates, legislation was developed to support a mother’s need “to breastfeed outside the home whether at work or in public” (Nguyen and Hawkins, 2012, p. 351).

Method

Each group member individually researched via a search engine, public record, or academic resource. Together, the group reviewed the literature, and discussed what information would be relevant for use. The group then came to a consensus on what was most important to the breastfeeding policies in North Carolina. Health Source Plus: Nursing/Academic Edition,

National Conference of State Legislators, EBSCOhost, and North Carolina Office of State

Human Resources were all utilized for research.

Literature Review/Analysis

In 1993, North Carolina passed legislation that established rights for breastfeeding mothers’ to nurse in any public or private location, protecting them from violating indecent exposure laws. While this legislation provided a supportive environment for breastfeeding mothers, there remained a great need for established breastfeeding rights in the workplace.

Many women cite returning to work as a contributing factor for not breastfeeding their children. 66% of mothers return to work three months after giving birth, making it very hard to provide breast milk for their children (Beth, Branch, Holloway, & Sullivan, 2013, p. 2). In fact, research has shown that women who return to work have lower breastfeeding rates 6 months after birth (Brand, Kothari, & Stark, 2011). In order to accommodate working mothers who wish Running Head: BREASTFEEDING LAWS 4 to breastfeed their children and to increase the rate of breastfeeding, North Carolina implemented a policy. The North Carolina Office of State Personnel Lactation Policy became effective July of 2010 and requires employers to provide designated space and time for employees to express breast milk. The designated space must be a private, non-restroom location with a door that locks, and it should have electrical outlets (NC Office of State Human

Resources, 2010, p. 47). Employers are permitted to require the breastfeeding mother to use their paid breaks, however “if time is needed beyond the regularly scheduled paid break times, the agency shall make reasonable efforts to allow employees to use paid leave or unpaid time for this purpose” (NC Office of State Human Resources, 2010, p. 47). The policy is compliant with the

Patient Protection and Affordable Care Act, both of which have nearly identical requirements of employers.

Though information on the development and political support of North Carolina’s

Lactation Policy is lacking, the provision of the Affordable Care Act that allows nursing mother’s break time to express breast milk was widely supported. Republicans and Democrats both agreed on the provision, and it passed unanimously through the Senate (Jamieson, 2014).

Currently, many women in North Carolina are benefitting from the lactation policy. For example,

Keri Stepp, a working mother, reported that the lactation policy allowed her to reach her breastfeeding goals and continue her career (Beth, Branch, Holloway, & Sullivan, 2013, p. 4-5).

Even though these policies are benefitting women and their children, some supporters feel that the enforcement of breastfeeding laws is weak, and they believe there should be stronger penalties when policies are violated (Nguyen and Hawkins, 2012, p. 357). The economic implications of breastfeeding are also great. A study has shown that “if 90% of U.S. families followed guidelines to breastfeed exclusively for six months, the United States would save $13 Running Head: BREASTFEEDING LAWS 5 billion annually from reduced direct medical and indirect costs and the cost of premature death”

(U.S. Department of Health and Human Services, 2011b, p. 3). Clearly, the legislation is supporting working mothers and encouraging them to continue breastfeeding their children.

Discussion

Nurses are in the perfect position to provide mothers with the education they need to successfully breastfeed their children. It is imperative to educate new mothers about breastfeeding laws in order to increase awareness about their workplace rights and breastfeeding in public. Nurses may also teach new mothers about the importance and benefits of breastfeeding, and provide patients with breastfeeding resources. Research has shown that there is a relationship between supportive nursing staff and successful breastfeeding, and that the period immediately after birth is vital for influencing breastfeeding practices. (Davis, Stichler, &

Poeltler, 2012, p. 469). Therefore, it is important for nurses to remain up to date with current research regarding breastfeeding so that they can provide patients with the best care possible and help increase national breastfeeding rates.

Conclusion

Although breastfeeding rates are increasing in the United States, only 45% of mothers are providing infants with some amount of breast milk six months after birth (Castillo, 2013).

Therefore, even with legislation protecting and supporting breastfeeding women, more needs to be done in order to overcome barriers and increase breastfeeding rates. Unfortunately, many women are unaware of their rights and need to be informed of lactation policies. Nurses a major role in providing this education to new mothers and supporting their needs. If the Healthy

People 2020 goals are met, there will be significant health benefits for mothers and children, as well as substantial benefits for the country’s economy. Running Head: BREASTFEEDING LAWS 6

References

Beth, D., Branch, H., Holloway, B., & Sullivan, C. (2013). Eat smart North Carolina: Businesses

leading the way in support of breastfeeding. N.C. Division of Public Health, Nutrition

Services Branch and Community & Clinical Connections for Prevention & Health

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http://www.nutritionnc.com/breastfeeding/PDFS/ESMMBreastfeedingGuideMedRes.pdf

Brand, E., Kothari, C., & Stark, M. A. (2011). Factors related to breastfeeding discontinuation

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Castillo, M. (2013, February 7). CDC: More US mothers are breast-feeding but overall rates still

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North Carolina Office of State Human Resources (2010). State human resources manual: Running Head: BREASTFEEDING LAWS 7

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ding.pdf

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