State Legislative Efforts on Breastfeeding

May 04, 2017|3:24 p.m.| KT Kramer

On May 6, ASTHO will participate in the March for Babies, in support of the March of Dimes’ work to prevent premature births, birth defects, and infant mortality. The event provides an opportunity to reflect on state and territorial laws and policies to improve the health and well-being of women and children, including policies to support and encourage breastfeeding. Breastfeeding and breast milk are important for premature infants, as they can reduce the rate of necrotizing enterocolitis (NEC), a condition that affects premature and underweight babies. To make it easier for infants at risk of NEC to receive breastmilk, lawmakers introduced bills in New Jersey (A 1470/S 2976) and New York (A 6163/S 61/A 6481/S 4526) requiring Medicaid or insurance companies to cover breastmilk if it is medically necessary. Currently, California, Washington, D.C., Kansas, Missouri, Texas, and Utah require at least Medicaid to cover donor breast milk if medically necessary.

Other bills in Alaska (HB 26), Connecticut (HB 6668/SB 585), Kentucky (SB 113), Puerto Rico (HB 453), South Dakota (HB 1120), Texas (HB 742), and Wisconsin (AB 193/SB 147) would strengthen workplace accommodations for breastfeeding by providing increased oversight and enforcement. Bills introduced in Kentucky (SB 90), Puerto Rico (HB 130), Rhode Island (HB 5809), and Texas (HB 742) set out specific enforcement provisions and fines. For example, the bill in Rhode Island grants the department of health authority to ensure compliance with and enforcement of the state’s existing breastfeeding accommodation provisions and authorizes fines up to $1,000 for noncompliant employers. Allowing enforcement at the state or local level can signal to employers that the state prioritizes breastfeeding and provides women with the option of seeking legal recourse in their states or communities.

State law can also provide greater protections for breastfeeding women than federal law. In Kentucky, SB 113 would extend workplace accommodations for up to three years, whereas federal protections only last one year. In addition, states can require accommodations for groups and locations not covered by federal law. For example, bills in Illinois (HB 2369), Nebraska (LD 427), and Rhode Island (HB 5809) would require schools to provide accommodations to students who are breastfeeding, and two bills vetoed in New Mexico would have allowed courts to release incarcerated pregnant women for up to 18 months after giving birth (SB 277) and required the development and implementation of breastfeeding policies for women in correctional institutions (SB 293). These bills illustrate the ways in which states are identifying innovative and responsive ways to address the unique needs of various individuals and groups.

To learn more about how state public health agencies support the implementation of these policies and programs, check out a recently published ASTHO issue brief on state experiences with worksite lactation accommodations and a webinar on the future of milk banking.