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 77 percent of mothers start breastfeeding immediately after birth, but only about 16 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.
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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.
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State Breastfeeding Laws
- Forty-nine 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, Michigan, 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, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming.)
- Twenty-nine 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, Missouri, 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-seven states, the District of Columbia and Puerto Rico have laws related to breastfeeding in the workplace. (Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Illinois, Indiana, Louisiana, Maine, Minnesota, Mississippi, Montana, New Mexico, New York, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, Washington and Wyoming.)
- Seventeen 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, Missouri, Montana, Nebraska, Oklahoma, Oregon, South Dakota, Utah 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,
- 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. Louisiana's law requires state building to provide suitable areas for breastfeeding and lactation.
- At least three 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. Maryland requires child care centers to promote proper nutrition and developmentally appropriate practices by establishing training and policies promoting breastfeeding.
- 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 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.
The box allows you to conduct a full text search or use the dropdown menu option to select a state.
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.
- Got Milk? | NCSL State Legislatures magazine, October/November 2011
- The Economic Benefits of Breastfeeding | NCSL LegisBrief, January 2010
- The Benefits of Breastfeeding | NCSL 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
- Le Leche League International
- March of Dimes: Breastfeeding
- Investing in Workplace Breastfeeding Programs and Policies: An Employer's Toolkit | National Business Group on Health, June 2009
- Health Resources and Services Administration, U.S. Department of Health and Human Services
- 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
- Women, Infants, and Children (WIC): Breastfeeding Promotion and Support in WIC | U.S. Department of Agriculture, Food and Nutrition Service
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