Breastfeeding moms face barriers in US

By Charnicia Huggins

NEW YORK (Reuters Health) - The World Health Organization recommends that infants be fed breastmilk for the first six months of life, yet women who adhere to this recommendation may be subject to arrest for "public indecency" if they breastfeed in public in some parts of the United States.

Some women may discontinue breastfeeding early due to workplace-related barriers. "We need to do a better job of educating the public that to breastfeed the baby in NOT indecent, whether at workplace or in the public," Dr. Tonse N. K. Raju, of the National Institute of Child Health and Human Development, in Bethesda, Maryland, told Reuters Health.

Raju's commentary on barriers for breast-feeding in public and the workplace appears in this month's issue of The Journal of Pediatrics.

His interest in the topic was sparked when he was informed that a fellow employee in another office could not bring her child to work because the building code did not permit children. Also, he said, a colleague of his was breastfeeding in a South Carolina airport, when "someone told her could be arrested."

However, as of May 2, 2006, the governor of South Carolina approved an amendment that grants women the right to breastfeed their child in public, and exempts breastfeeding from indecent exposure statutes in that state, according to the Web site of La Leche League International, a non-governmental organization (NGO) that promotes breastfeeding.

"I think things are changing, which is good," Raju said, "but there needs to be more public awareness."

States including Arizona, Mississippi and Massachusetts, have no laws to promote breastfeeding, protect a woman's right to breastfeed, or exempt breastfeeding women from being arrested for public indecency. On the other hand, most states have laws that address a mother's right to breastfeed in public. California, Minnesota, and Oklahoma also exempt breastfeeding women from jury duty and a few states have also developed breastfeeding education programs.

Some states, including Connecticut, Georgia and Illinois, also have laws that address breast-feeding in the workplace, but in some cases, these laws are not mandatory for employers, according to Raju's report. Research has shown that many women stop breastfeeding when they return to work, which poses a challenge to the goal of US Healthy People 2010 of increasing the proportion of women who breastfeed for six months to 50 percent.

Women in low-wage jobs, in particular, face various barriers to breastfeeding or expressing breast milk in the workplace, including the perception that infants at work may affect their job performance, a lack of privacy, and the lack of affordable day care at or near the workplace.

In Raju's opinion, however, "the most important barrier is one of mindset. I think the public at large may still be under the illusion that breastfeeding is 'old fashioned,'" he added.

Breastmilk continues to be the best form of nutrition for infants, however. Studies have shown that it may lower their rates of gastrointestinal and respiratory infections, ear infections and obesity, and that it may be associated with higher IQ scores as well.

Breastfeeding is also beneficial for mothers. Reports show that breastfeeding may decrease the rates of depression, breast and ovarian cancer, and enhance bonding between mothers and their infants.

The benefits of breastfeeding also extend to employers and society at large, Raju notes. For example, a child's improved health may reduce employee absenteeism and lower employer's health insurance costs.

"The benefits from breastfeeding are so many, that it may be to the advantage of the employers and the employees to consider developing means to accommodate women who desire to breastfeed their babies at work," suggests Raju.

"People at all levels can become proactive in promoting more women to breastfeed their babies, as long as they can, and as long as is recommended," he added.

SOURCE: The Journal of Pediatrics, May 2006