Breastfeeding Policy in California Supporting Women & Families – Improving Health Equities Breastfeeding policy reforms can improve health equity across the state and in our community. Policy support is needed for breastfeeding women in healthcare offices, hospitals, clinics, worksites and public settings. Put in your logo. We all know that breastfeeding is healthiest for mothers and babies. Breastfeeding reduces acute problems for babies, such as ear infections and respiratory infections, and chronic diseases such as diabetes and asthma, and for mothers breast and ovarian cancers. Our mothers and babies need policies to support their breastfeeding. We need these policies in the hospitals, with Baby Friendly hospitals, in WIC clinics, in the worksite, and in the public settings. Our breastfeeding rates go up when policies support the mothers’ decision to breastfeed.

This slide compares the Healthy People 2010 goals for breastfeeding with some CA hospital BF data. CA mothers surpass the HP2010 goal of 75% initiation of BF. 87% of CA mothers initiate BF in the hospital. But…only 43% of mothers are exclusively BF by hospital discharge. This is a huge drop off in 24-48 hours after birth! The WIC data, this shows the Birth to 12 months rate, which is 13.57% for Exclusive BF. Our WIC mothers are very low for exclusive BF. Over the last few years, and now with the new WIC food package, rates for low-income mothers have increased slightly for initiation, but exclusivity remains low. We know that exclusive BF in the first few weeks, increases the chances a baby will remain BF longer, including, exclusive BF, and of course improves the health of the mother and baby. (2008 hospital bf data was just released on the CDPH/MCAH website. 2009 data will be available in early 2011.)

This graphic shows the drop off in breastfeeding rates at hospital discharge and the continued decline in breastfeeding. If you think of this as a ‘pipeline’, the bf rates quickly become a trickle at hospital discharge. Mothers get BF education prenatally in the medical offices and at WIC. They deliver in the hospitals, but start supplementing. By discharge only 43% of babies are exclusively BFing. (If a mother wants to BF and use formula, we can honor her decision, by making sure for the first few weeks, her baby is exclusively BF. If formula is started too early, BF is often not successful.) With the big drop off in BF rates at hospital discharge, the mothers come back to the WIC clinic not breastfeeding, or using a lot of formula. It is then hard to help them in their desire to BF. Child care settings and worksite are also important, but we need to improve our hospital policies and have more Baby Friendly hospitals in order to have more moms BF when they need child care or are at work. http://www.babyfriendlyusa.org/eng/index.html

Put in your organization’s logo, address, phone and website. Breastfeeding policy is a low-cost, low-tech strategy for improved health outcomes. Health care reform focuses on preventive care which is what breastfeeding is so good for! We need all our hospitals to be Baby Friendly or adopt the CA BF Hospital Model Policies. Health plans and worksites are required to support breastfeeding. Health plans must provide preventive benefits (as designated by the US Preventive Services Task Force recommendations, of which BF is one. So health plans will need to provide lactation consultants and breastpumps and assist mothers with BF problems. http://www.ahrq.gov/clinic/uspstfix.htm The details of this are being worked out now. The worksites must provide for lactation accommodation with a private place to pump (not a bathroom) and reasonable time to do this. CA already has this law and employers all need to provide this support. http://calwic.org/docs/bf/ca_bflaws.doc The WIC food package has been redesigned for improved support for BF. No formula in first 30 days for BF, BF assessment when supplemental formula is requested, follow up when supplementing, all formula more carefully calculated, more foods in BF food package) So the time is now! We can institute local policy to support our mothers and babies to initiate and maintain breastfeeding, ideally exclusive BF for the first 6 months, and continued BF as long as mom and baby desire. The outcome will be a healthier community and all the economic and social benefits, for a minimal investment. Lead into questions and discussion questions listed on Talking Points.