To register: https://www.wakeahec.org/CourseCatalog/CASCE_courseinfo.asp?cr=30417
or copy and paste the address into your web browser.

To print the brochure: https://www.wakeahec.org/coursecatalog/brochures/abc2010nb.pdf

or copy and paste the address into your web browser.

Please forward to colleagues.

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Task Force should consider for the upcoming legislative year.

Send your ideas to:

Elizabeth Hudgins, Executive Director

Child Fatality Task Force

Elizabeth.Hudgins@dhhs.nc.gov

Office: 919-707-5626

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Source: The Atlantic

If you don’t have a small baby, or if your baby is breastfed (and see note at the end of this post), you no doubt are missing the furor over “functional” ingredients that companies have been adding to infant formulas.

DHA (an omega-3 fatty acid) came first. As I discuss in my book What to Eat, infant formula companies could not wait to add it. They knew they could market it on the basis of preliminary evidence associating DHA with visual and cognitive benefits in young infants. Although evidence for long-term benefits is scanty, the companies also knew that they could charge higher prices for formulas containing DHA.

The FDA approved the use of DHA in infant formulas on the grounds that it is safe, but did not require the companies to establish that DHA makes any difference to infant health after the first year. Because of its marketing advantage, virtually all infant formulas now contain DHA. Surprise! They also cost more.

Companies now want to add other ingredients, such as prebiotics, probiotics, lutein, lycopene, and betacarotene, which also can be marketed as healthier and at higher prices.

In response, the Center for Budget and Policy Priorities (CBPP) has issued a report (PDF) on the lack of evidence for the benefits of functional ingredients and the substantial harm they will cause to the economic viability of the WIC program, the USDA’s assistance program for low-income mothers and children.

WIC buys about half the infant formula sold in the United States each year. WIC is not an entitlement program, meaning that the number of participants is limited by available funding (a GAO report explains how this works—click here for a PDF).

The CBPP report says:

As pressure mounts to limit federal discretionary spending, it is critical to ensure that WIC not spend funds on foods with functional ingredients that do not deliver clinically significant benefits. WIC spent approximately $850 million on infant formula last year, and a recent USDA study found that more than ten percent of that spending ($91 million annually) is attributable to higher-priced formulas with functional ingredients. Under current law, the additional cost to WIC of providing foods with these ingredients is likely to grow substantially as such foods proliferate.

As the report explains, formula companies do not have to demonstrate that the added—and more expensive—ingredients do any good:

There is no mechanism within the national WIC program that requires USDA to review the research evidence on the claimed benefits of these functional ingredients or to base decisions about whether to offer foods containing such ingredients on their benefits and the specific needs of WIC participants. Currently, instead, infant formula manufacturers themselves decide whether WIC offers infant formulas with new functional ingredients, while state WIC programs decide whether WIC should offer other foods with such ingredients.

As I keep saying, functional foods (and ingredients) are about marketing, not health. If companies are going to add functional ingredients—and charge higher prices—they need to have some convincing scientific evidence to back up their claims.

Postscript: Laurie True of the California WIC program writes:

Congressman George Miller, chair of the House Education and Labor Committee, is writing the bill that reauthorizes the WIC Program this week. He should include a provision requiring independent scientific review of the efficacy of these “functional ingredients” before USDA allows them in WIC foods and infant formula.

Note: Lori Dorfman sends a Berkeley Media Studies Group issue paper (PDF) on how to advocate for hospitals and workplaces to make it easier for moms to breastfeed.

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Catherine Sullivan and I just participated in the State Breastfeeding Coalitions Teleconference about the free new text service Text4Baby today, June 8^th, from 2:00 – 3:00 PM.

You can see the slides from the presentation posted on the USBC Web site. Please go to www.usbreastfeeding.org and click on “Bi-Monthly Coalitions Teleconferences” in the Quick Links box (bottom right of the USBC home page). You’ll be able to listen to an approximately 30 minute recording of the presentation starting tomorrow. If you have questions, please see the last few slides that have email addresses for you to contact them.

We can all get posters advertising this service from partners@text4baby.org

One exciting fact I learned is that research shows young African American mothers text disproportionately more than other groups – so this may be a very useful tool!

Mary Overfield

Also see additional link
Links to TV Programs

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For those of you who missed the awesome presentation at our conference or those of who did not see this video enough for our lecture “Got Enough Milk? Milk Supply Issues: Pumping, Infertility, Older Mothers, and Adoptive Nursing” by Diane Asbill, RN, IBCLC, Lactation Consultant for the Intensive Care Unit, UNC Hospitals, Chapel Hill, NC.

Here is the link to seeDr. Jane Morton’s video that Diane showed

Hand Expression Video

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“Improving the health of mothers and their children is a primary goal of the Centers for Disease Control and Prevention (CDC). Protecting, promoting, and supporting breastfeeding, with its many known benefits for infants, children, and mothers, is a key strategy toward this goal.”

Please see attached CDC Breastfeeding Report Card

“The 2009 Breastfeeding Report Card shows how breastfeeding is being protected, promoted, and supported in each state using five “outcome” and nine “process” indicators. This allows you to make comparisons across states and indicators and work to increase breastfeeding nationwide.”

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Frequently Asked Questions

With the inclusion of this provision in health care reform legislation, the U.S. joins the rest of the industrialized world in recognizing breastfeeding as the natural outcome of pregnancy, and workplace lactation programs as the natural outcome of a society where the majority of mothers and infants are separated due to work.

What does the Reasonable Break Time for Nursing Mothers law do?

• Section 4207 of the Patient Protection and Affordable Care Act (also known as Health Care Reform), states that employers shall provide breastfeeding employees with “reasonable break time” and a private, non-bathroom place to express breast milk during the workday, up until the child’s first birthday.
• Download the text of Section 4207 only.

What types of employers are covered?

• All employers are covered but those with less than 50 workers do not have to comply if they show that complying with the law would cause “an undue hardship by causing the employer significant difficulty or expense when considered in relation to the size, financial resources, nature, or structure of the employer’s business.”

What types of workers are covered?

• The law is an amendment to our nation’s existing minimum wage and overtime laws, so it covers the workers subject to those laws, so-called “non-exempt workers.” Generally, this means hourly workers (many retail workers, factory workers, restaurant workers, and call center workers, for example) and other employees who work on an hourly basis and who are subject to overtime laws.
• “Exempt” workers are those on a salary (“exempt” from overtime), often in managerial positions. They are not covered by the new federal law. Many of these workers, particularly those employed by large companies, have workplace accommodation as part of company policy. The National Business Group on Health has recently published case studies highlighting several of these.

When does the law take effect?

• The law was effective immediately upon President Obama’s signing of the Patient Protection and Affordable Care Act, however, the rules for enforcement have not yet been put in place. Breastfeeding employees should be assured that the Department of Labor is working swiftly to establish these rules, and should give their employers time to comply once those rules take effect.
• While the Department of Labor works to define terms and processes for enforcement of the law, USBC stands ready to support employers and breastfeeding employees with tools, information, and resources. View resources for employers and managers and resources for breastfeeding employees.

Why is the law necessary?

• The longer a woman breastfeeds her child, the lower her risk of serious diseases such as diabetes, heart disease and breast cancer, and the lower the child’s risk of infections, obesity, diabetes, and other diseases and conditions.
• That’s why medical experts agree with the Department of Health and Human Services in recommending exclusive breastfeeding for six months and continued breastfeeding for the first year of life and beyond.
• Mother-child separation due to work presents a serious challenge to meeting breastfeeding goals when employers do not meet the relatively simple needs of breastfeeding employees: time to regularly express milk (approximately every three hours), in a clean, private space.
• Women now comprise half the U.S. workforce, and are the primary breadwinner in nearly 4 out of 10 American families. The fastest growing segment of the workforce is women with children under age three.
• The Centers for Disease Control and Prevention’s National Immunization Survey indicates that nearly 75% of women initiate breastfeeding, but breastfeeding rates at six months and 12 months drop precipitously.
• Returning to an unsupportive work environment has been identified as a major reason for the avoidance or early abandonment of breastfeeding. Workplace support can bridge this gap and help more women to balance working and breastfeeding.
• While there are increasing numbers of worksite lactation programs, low-wage earners have had less access to this support. A mother’s decision to breastfeed her child should not be predetermined by where a mother works.

Aren’t there state laws that already protect employed breastfeeding mothers?

Currently, 24 U.S. states, Puerto Rico, and the District of Columbia have legislation related to breastfeeding in the workplace. One of the strongest and most detailed was passed in Oregon in 2007. The Oregon law served as a model for the federal provision, introduced into health reform legislation in 2009 by Senator Jeff Merkley (D-OR). A federal law was needed to cover the many states without worksite protection for breastfeeding mothers. The new federal law will provide a minimum level of support in all states, but if an existing state law provides stronger protections, the state law will prevail.

What does an employer stand to gain?

• The Business Case for Breastfeeding, published in 2008 by DHHS, demonstrates an impressive return on investment for employers that provide workplace lactation support, including lower health care costs, absenteeism, and turnover rates. Employees whose companies provide breastfeeding support consistently report improved morale, better satisfaction with their jobs, and higher productivity. As part of The Business Case for Breastfeeding initiative, coalitions in 32 states and territories received training to assist employers in establishing lactation support programs.
• The National Business Group on Health, a nonprofit organization representing large employers on national health policy issues, says that creating a breastfeeding-friendly work environment reduces the risk of long-term health problems for women and children, decreases employee absenteeism, reduces health claims to employers, and increases retention of female employees.
• Research shows that worksite lactation programs are good for business: there has been a steady trend of growth in worksite lactation programs over the last ten years.

What do the time and space requirements in the new law mean?

• The Department of Labor will define terms used in the law, such as “reasonable break time” and “significant difficulty or expense.”
• An example of how the Department of Labor might interpret the law can be found in Oregon’s Rest Breaks for Breast Milk Expression law, which served as the model for the federal law. In Oregon, the Bureau of Labor and Industry Administrative Rules defined the time and space provisions as follows:

What about complaints, enforcements, penalties, and “undue hardship”?

• These are some of the important questions the Department of Labor will be working to answer in the coming months. USBC and Senator Merkley’s office will be closely monitoring and supporting this process.
• There are many resources available with tools to help employers implement the law. Bookmark this page and check back often!

Resources for employers and managers:

Resources for breastfeeding employees:

Source: USBC

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These are the proposed Healthy People 2020 Objectives for breastfeeding

Source: Heathly People 2010

• Increase the proportion of mothers who breastfeed their babiesThe U.S. Breastfeeding Committee (USBC) applauds the retention of this objective. Ever since the health objectives for 1990 were published in 1980, better infant feeding practice has been a national health goal. Improvements are sought in three areas: initiation (more mothers taking up breastfeeding), duration (more babies being breastfed at six and twelve months of age), and quality (higher rates of exclusive breastfeeding). There is ample and increasing evidence that these improvements would bring positive health effects—-short-term and long- term—-for both mother and child, the two partners in the breastfeeding relationship.

• Increase the percentage of employers who have worksite lactation programs.The U.S. Breastfeeding Committee (USBC) welcomes this objective, which addresses the workplace as a key social and physical environment for many mothers. In 2003 more than half the mothers of infants were working for pay. Without worksite lactation support, many U.S. mothers begin giving formula or completely wean their babies when they return to work. Some women never even start breastfeeding, knowing that, lacking paid leave, they will have to be back at work in just a few weeks.

• Decrease the percentage of breast-fed newborns who receive formula supplementation within the first 2 days of life. The U.S. Breastfeeding Committee supports the inclusion of this new objective. Formula is seldom medically necessary, yet in some U.S. hospitals, a significant number of breastfed babies are reported to receive formula during their hospital stay. Formula permanently changes the gut flora and impacts the immune system. Banked human milk is available and would avoid these outcomes of formula use, but hospitals seldom offer banked human milk for healthy full-term babies.

• Increase the percentage of live births that occur in facilities that provide recommended care for lactating mothers and their babies. The U.S. Breastfeeding Committee (USBC) supports this objective. It is a key to improving both breastfeeding duration and breastfeeding quality. We suggest a slight re-wording: Increase the percentage of births that occur in facilities which provide care for mothers and babies consistent with the WHO/UNICEF “Ten Steps to Successful Breastfeeding.”

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See Amelia Psmythe’s note below with helpful information about the next steps in implementing the law. USBC will be keeping close tabs on this process, and we are collaborating with MomsRising and others to spread the word to moms across the country. We will be issuing a press release shortly, and encourage all state coalitions to either 1) forward our press release to your local media, or 2) use it as a template to write your own release.

I’m attaching the actual language of the provision as a PDF file. It has already received some favorable media attention on NPR.org:

http://www.npr.org/blogs/thetwo-way/2010/03/new_health_laws_workplace_brea.html

Thanks again to everyone for their support and patience while we had to “lay low” to allow this to pass. And please do call or write to Senator Merkley to thank him!”

Best regards,

Megan E. Renner

Executive Director

United States Breastfeeding Committee (USBC)

2025 M Street, NW, Suite 800

Washington, DC  20036

www.usbreastfeeding.org

The mission of the United States Breastfeeding Committee is to improve the Nation’s health by working collaboratively to protect, promote and support breastfeeding. Donate today!

“Good Day, friends!

As I’m sure many of you are aware, US Senator Jeff Merkley’s Reasonable Break Time for Nursing Mothers amendment passed as part of health care reform!  Employer accommodation is now the law of the land.

What courage for a freshman Senator to propose a health care amendment in a contentious climate, see it through a bi-partisan committee, and now guide an implementation process on landmark legislation!  Please take a moment to thank Senator Merkley by calling his office at: 202-224-3753 or use the online form: http://merkley.senate.gov/contact/

I recognize that questions abound regarding the timing, implementation, oversight, complaint process, arbitration and resolution under this provision.  I am writing to assure you that Senator Merkley’s office is in conversation with the US Department of Labor to clarify all of this.  I am in close communication with the Senator and his Portland and DC staff, and I will post to this listserve, and continue to update the BCO website and BCO Facebook page  as new information comes in.

In our state process, where the Bureau of Labor and Industry (BOLI) is the administrator of our law, passage of the law was followed by BOLI drafting Administrative Rules.  These Rules interpreted and clarified the law, even adding a few practical provisions the law had not addressed.  This took several months.  The federal process is not the same, but I believe the US Department of Labor will need to undergo something similar.

I understand and empathize that women (and their advocates and health care providers) want to know what the new rights are.  It is going to be our challenge and opportunity to counsel patience with the next step of the process.

The main message to share with the world is that this is a time of celebration, development and learning.  Creativity and patience will be needed on all sides, but overall — the world is shifting to a paradigm that recognizes breastfeeding is the natural outcome of pregnancy, and workplace accommodation is the natural outcome of a society where the majority of mothers and babies are separated due to work.  For now, we work within the framework of delivering the product of breastmilk to babies while they’re apart from their mothers, in order to facilitate the experience of breastfeeding when they are together. (At least, this is what I told the DC reporter who called at 6am PST, and I’m sticking to it. ?)

When our President said, “this is what change looks like” this is what he is referring to – that change is incremental.  It begins with an imperfect step that through diligence, work and participation, is refined and strengthened.  So it will be with this provision.

Trust that more information will follow, and it will be good.

Best,
Amelia

--

Amelia Psmythe, Director

Breastfeeding Coalition of Oregon

Mail:   Community Health Partnership:

        Oregon's Public Health Institute

        315 SW Fifth Ave, Suite 202

        Portland, OR 97204-5502

Email:  Amelia@BreastfeedingOR.org

Web:    www.breastfeedingOR.org

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