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 preventive 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, nearly 84% of infants are breastfed to some degree, but only about 25% of infants are breastfed exclusively through six months. As a part of the Healthy People 2030 initiative, two national goals are to increase the proportion of infants who are breastfed exclusively through six months and infants who are breastfed at one year by the year 2030.
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.
Congress passed the Fairness for Breastfeeding Mothers Act of 2019 in July 2019. The law requires certain public buildings to provide a shielded, hygienic space other than a bathroom, that contains a chair, working surface and an electrical outlet for use by members of the public to express milk.
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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
- All fifty states, the District of Columbia, Puerto Rico and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location.
- Thirty-one states, the District of Columbia, Puerto Rico and the Virgin Islands exempt breastfeeding from public indecency laws. (Alaska, Arizona, Arkansas, Florida, Idaho, 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, West Virginia, Wisconsin and Wyoming.)
- Thirty states, the District of Columbia and Puerto Rico have laws related to breastfeeding in the workplace. (Arkansas, California, Colorado, Connecticut, Georgia, Hawaii, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, New Jersey, New Mexico, New York, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia and Washington.)
- Twenty-two states and Puerto Rico exempt breastfeeding mothers from jury duty or allow jury service to be postponed. (California, Colorado, Connecticut, Delaware, Idaho, Illinois, Iowa, Kansas, Kentucky, Michigan, Mississippi, Missouri, Montana, Nebraska, New York, Oklahoma, Oregon, Pennsylvania, South Dakota, Utah and Virginia.)
- Four states and Puerto Rico have implemented or encouraged the development of a breastfeeding awareness education campaign. (California, Illinois, Minnesota and Missouri)
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 requires certain state buildings to provide suitable areas for breastfeeding and lactation and Illinois requires at least one mother’s lactation room in the State Capitol. Illinois also has a Lactation Accommodation in Airports Act.
- At least four 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. Nevada instructs child care facilities to provide an appropriate, private space on the premises of the child care facility where a mother may breastfeed.
- New Jersey exempts breast pumps, breast pump repair and replacement parts and other related items from the sales tax. 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, Connecticut, Illinois, Mississippi, Pennsylvania, New York and Texas have laws related to the procurement, processing, distribution, use or reimbursement 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 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.
- California requires schools operated by a school district or a county office of education, the California School for the Deaf, the California School for the Blind, and charter schools to provide reasonable accommodations to a lactating pupil on a high school campus to express breast milk, breastfeed an infant child, or address other needs related to breastfeeding.
- Illinois requires a public school, including a charter school, to provide reasonable accommodations to a lactating pupil on a school campus to express breast milk, breastfeed an infant child, or address other needs related to breastfeeding. The law provides for grievance procedures.
- Washington law provides midwifery and doula services for incarcerated women, which may include support and assistance during labor and childbirth, prenatal and postpartum education, breastfeeding assistance, parenting education and support in the event that a woman has been or will become separated from her child.
- Arizona, Arkansas, California, Colorado, Massachusetts, Michigan, New Mexico, Virginia and West Virginia require marijuana warnings about potential harms to an unborn child or child following marijuana use during pregnancy or breastfeeding.
- Massachusetts, Minnesota, Missouri, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island and Texas require health insurance plans to provide coverage for assistance and training in breastfeeding.
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A C D F G I K L M N O P R S T U V W
Sources: National Conference of State Legislatures and StateNet
Note: List may not be comprehensive, but is representative of existent state laws. NCSL appreciates additions and corrections.
This webpage is supported by the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1XMC31659-02-00, Supporting State Maternal and Child Health Policy Innovation Program. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government..