Marina Mejia California State University San Bernardino HSCI 455 Term Paper Professor Alexander F Taylor MPH

April !5 !"#!

Marina Mejia "4$!5$#! HSCI 455% Term Paper Breastfeedin& and P'(li) Healt* +a, C'rrent P'(li)$-nvironmental Healt*%.elated Cons'mer Iss'es Breastfeedin& in p'(li) *as (een an on&oin& so)io)'lt'ral iss'e in t*e United States/ 0*et*er a mot*er s*o'ld n'rse 1(reastfeed2 in p'(li) or not is a )onstant ar&'ment (et,een individ'als/ Ho,ever t*e real iss'e *ere is not ,*et*er t*at is appropriate or not ('t rat*er if t*e la)3 of s')* implies a P'(li) Healt* iss'e for (ot* t*e mot*er and t*e (a(y and in fa)t it does/ Unfort'nately (reastfeedin& is not en)o'ra&ed often data from t*e Center for 4isease Control points o't t*at only 45/46 of ne,(orns in !""7 ,ere (reastfeedin& 'ntil six mont*s of a&e and a smaller per)enta&e #5/7 ,ere ex)l'sively (reastfeedin& 'ntil t*at a&e/ Moreover *ospitals are not very reso'r)ef'l to n'rsin& mot*ers8 t*e avera&e &radin& for Ba(y%Friendly *ospital in t*e United States ,as 75 o't of #"" 1C4C !"#"2/ Also many parents are )*oosin& infant form'las in a mis)on)eption of t*e a)t'al (enefits of it and are i&norin& t*e *a9ard t*at t*ese impose on t*e )*ild/ A resear)* fo'nd t*at s*orter d'ration of (reastfeedin& and t*e early introd')tion of infant form'la in a )*ild )an )ontri('te to t*e ris3 of type #dia(etes ast*ma atopi) dermatitis and ot*er disease 1M):iel !"#"2/ And poli)ies t*at are in effe)t at t*e Federal and State levels are not (ein& enfor)ed *en)e ,e *ave an iss'e t*at mi&*t (e )ontri('tin& to many of o'r )'rrent *ealt* )on)erns s')* *as dia(etes ast*ma infe)tions and even o(esity/ And t*at is only for t*e )*ild8 t*e mot*er also

in)reases *er ris3 of (reast )an)er ovarian )an)er osteoporosis stress and anxiety to mention j'st a fe, 1:ort*)ott !"#!2/ -xistin& +a,s Poli)ies .'les And .e&'lations At T*e Federal State .e&ional And +o)al +evels/ In #;;; Con&ress,oman Carolyn Maloney introd')ed t*e .i&*t to Breastfeed A)t and alt*o'&* it did not pass t*ere is a version of t*is t*at *as (een in)l'ded in t*e Treas'ry%Postal and t*e Interior Appropriations (ill/ T*is la, si&ned on Septem(er !; #;;; as part of t*e Treas'ry%Postal Appropriations (ill states t*at any ,oman )an (reastfeed *er )*ild at any Federal ('ildin& or on Federal property 1U/S/ !"#"2/ Also Se)tion 4!"< of t*e Patient Prote)tion and Afforda(le Care A)t also 3no,n as Healt* Care .eform and ,*i)* ,as si&ned (y President =(ama in !"#" amended t*e Fair +a(or Standards so t*at employers provide private non%(at*room pla)e for n'rsin& mot*ers for one year after t*e )*ild>s (irt* 1U/S/ !"#"2/ Here in t*e state of California t*ere are la,s t*at prote)t n'rsin& mot*ers/ T*e California Healt* and Safety Code re?'ires for t*e 4epartment of P'(li) Healt* to develop a trainin& )o'rse of re)ommendations and *ospital poli)ies to promote ex)l'sive (reastfeedin& ('t it is only re?'ired to )ertain *ospitals 1Cal Code #!557"2/ Also t*e California +a(or Code indi)ates t*at employers need to provide a room for a n'rsin& mot*er ,*o desires to express mil3 in private in ot*er ,ords provide a p'mpin& room 1Cal Code #"5"2/ Moreover n'rsin& mot*ers are allo,ed to (e exempt from j'ry d'ty if t*ey )*oose so/ At t*e lo)al level t*ere are pro&rams t*at allo, for ,omen to learn *o, to (reastfeed s')* as t*e San Bernardino 0omen C*ildren and Infant 10IC28 *o,ever little promotion is done/

Major Proposals For C*an&e In)l'din& T*e :at're =f +e&al Interventions And Identify T*eir Proponents And =pponents T*ere *as already (een passa&e of la,s to prote)t t*e ri&*ts of ,or3in& mot*ers ,*o are n'rsin& and also for t*ose mot*ers t*at desire to (reastfeed in p'(li) federal or private lo)ations/ T*e 4ivision of :'trition P*ysi)al A)tivity and =(esity 14:PA=2 of t*e Center for 4isease )ontrol *as an ann'al Breastfeedin& .eport Card ,*ere t*ey report t*e advan)ements t*at are (ein& made and t*e statisti)s on *o, *ospitals are (ein& )*an&ed into more Ba(y%Friendly environments/ B't ,*ere t*e )*an&e really needs to (e made is in t*e ,ay t*at t*ose la,s are (ein& implemented and enfor)ed/ T*e Federal &overnment made a step (y indi)atin& t*at (reastfeedin& in federal property is allo,ed8 *o,ever t*ere is not a spe)ifi) san)tion for t*ose ,*o violate t*is ri&*t/ Many ,*o are not a,are of t*is are dis)o'ra&in& (reastfeedin& and t*erefore )ontri('tin& to t*e in)rease in t*e ris3 of disease and t*at is ,*ere it (e)omes not j'st a so)ial )on)ern ('t a p'(li) *ealt* iss'e/ People ,*ose personal opinion fall 'nder t*e opposition *ave 's'ally a so)ial prej'di)e t*at ar&'es t*at (reastfeedin& as a mot*er%to%)*ild (ondin& experien)e is to (e done so in a private lo)ation/ At t*e state level t*ere needs to (e a more spe)ifi) &'ideline for t*e re?'irement of p'mpin& stations at ,or3/ Fe, states re?'ire employers to *ave p'mpin& stations for n'rsin& mot*ers and even t*en it only needs to (e implemented if )ertain a n'm(er of ,or3ers are (ein& employed (y t*e )ompany/ =pponents to t*is ar&'e t*at it ,ill )reate an 'nfair treatment of employees and n'rsin& mot*ers ,ill *ave preferred treatment/ Also t*ere is a )on)ern ,it* t*e ris3 of infe)tion t*at p'mpin& may )a'se parti)'larly t*e

transmission of HI@ not only t*ro'&* (reast feedin& ('t also if t*ere is a mis'se or if t*ere is s*arin& of p'mpin& ma)*ines 1:ort*)ott !"#!2/ T*ere are many )oalitions and or&ani9ations t*at *ave (een esta(lis*ed ,it* t*e p'rpose of in)reasin& t*e rates of (reastfeedin& and ex)l'sive (reastfeedin& amon& Ameri)an ,omen/ +a +e)*e +ea&'e in t*e U/S/ and t*e Breastfeedin& Coalition are j'st a )o'ple of or&ani9ations t*at promote t*is/ Also t*e 0orld Healt* =r&ani9ation 10H=2 *as stated t*at ex)l'sive (reastfeedin& is re)ommended 'p to 7 mont*s of a&e and t*en to )ontin'e (reastfeedin& ,it* )omplementary foods 'p to t,o years of a&e/ B't t*ere is too little t*at is done ,*en t*ere are j'st re)ommendations/ T*e P'(li) Healt* 4epartment needs to (e (a)3ed 'p some*o, so t*at t*e )'rrent statisti)s )an (e improved/ STU4-:T>S .-C=MM-:4ATI=: F=. ACTI=:1S2 P'(li) Healt* needs to ta3e a leadin& role in t*e promotion and prote)tion of (reastfeedin& in t*e United States and in)l'de (reastfeedin& s'pport as a standard of )are/ Moreover t*ere needs to (e (etter promotion of pro&rams to train and inform not only *ospitals ('t also ot*er p'(li) *ealt* a&en)ies at t*e lo)al level so t*at t*ey are a(le to effe)tively provide t*ose servi)es to mot*ers and )*ildren/ Also t*e California +a(or Code s*o'ld implement a se)tion t*at addresses t*e iss'e of n'rsin& mot*ers in t*e ,or3in& pla)e and re?'ire for any a&en)y )ompany or state instit'tion to provide a p'mpin& room for ,or3in& mot*ers and in s')* )ase st'dent mot*ers ,*i)* ,o'ld allo, t*em to t*en provide (etter n'trition to t*eir )*ildren at literally no )ost/ P'(li) Healt* a&en)ies need to raise a,areness of s')* iss'e and also inform of t*e advanta&es of (reastfeedin& so t*at on)e t*e pop'lation is informed t*ey are more

,illin& to p't press're on t*e passa&e of a la,/ T*e California Code of .e&'lations needs to also address t*e iss'e of ,omen (reastfeedin& in p'(li) pla)es as t*ere is no spe)ifi) san)tion for people ,*o violate t*e ri&*ts of n'rsin& mot*ers/ T*e California Healt* and Safety Code s*o'ld ,or3 )losely ,it* lo)al p'(li) *ealt* pra)titioners to &rant t*em t*e a't*ority to intervene and improve t*e implementation of n'rsin&$(reastfeedin& pro&rams s')* as t*ose (y t*e 0IC a&en)ies/ And as t*e S'r&eon Aeneral Call to A)tion to S'pport Breastfeedin& !"## did ,e as a pop'lation need to (e s'pportive of mot*ers and t*eir de)ision to (reastfeed t*eir )*ildren and (e more informed of t*e many *a9ards t*at )ome from feedin& )*ildren ,it* infant form'la/ IMPACT =F .-C=MM-:4-4 ACTI=:S =: TH- PUB+IC>S H-A+TH Most of o'r )'rrent *ealt* )on)erns for )*ildren and ad'lts evolve aro'nd some of t*e ris3s implied from not (reastfeedin& appropriately/ .esent findin&s from resear)* *ave s*o,n t*at )*ildren ,*o are ex)l'sively (reastfed for t*e first six mont*s are less li3ely to experien)e respiratory or ear infe)tions t*an t*ose ,*o *ave a )om(ination of (reast mil3 and ot*er so'r)es of food s')* as infant form'la 1Het9ner !"";2/ Anot*er resear)* fo'nd t*at (reastfeedin& sli&*tly *elps in t*e red')tion of )*ild o(esity ris3 1Armstron& !""!2/ =t*er (enefits for t*e )*ildren are red')ed ris3s of aller&ies ast*ma and )*roni) disease and t*e )o&nitive stim'lation t*at (enefits t*e development of t*e )*ild 1:ort*)ott !"#!2/ Amon& t*e (enefits for t*e mot*er resear)* *as s*o,n t*at t*e lon&er yo' (reastfeed t*e ris3s of (reast )an)er type ! dia(etes )ardiovas)'lar disease ovarian )an)ers postpart'm depression and r*e'matoid art*ritist*ese are red')ed 1Aodfrey !"#"2/ :'rsin& may even delay menstr'al period ,*i)* 's'ally

*appens (e)a'se of t*e lo, estro&en levels8 and t*is of )o'rse does not impede ov'lation in t*e mot*er 1:ort*)ott !"#!2/ More importantly promotion of (reastfeedin& )o'ld save a(o't ;"" lives a year and (illions of dollars8 t*is only if ;" per)ent of ,omen ,ere to (reastfeed t*eir (a(ies for t*e first six mont*s of life 1Areen(er& !"#!2/ So ,e need to )reate )ons)ien)e of t*ese iss'es and start a)tin& promotin& *ealt* improvin& o'r standard of livin&/

BIB+I=A.APHB Armstron& C'lie C/ DBreastfeedin& and +o,erin& t*e .is3 of C*ild*ood =(esityE Lancet the ;5!! 1!""!2F 55;/ GC4C :ational Imm'ni9ation S'rvey/G Centers for Disease Control and Prevention/ Centers for 4isease Control and Prevention #; Apr/ !"#"/ 0e(/ !5 Apr/ !"#!/ H*ttpF$$,,,/)d)/&ov$(reastfeedin&$fa?$index/*tmI/ Cal +a(/ Code J #"5" 10est Ann/ !"##2 Print/ Cal/ Healt* and Safety Code J #!55" 10est Ann/ !"##2 Print/ Cal/ Healt* and Safety Code J #!5</; 10est Ann/ !"##2 Print/ Aodfrey C. and .A +a,ren)e/ GTo,ard =ptimal Healt*F T*e Maternal Benefits of Breastfeedin&//// .'t* A/ +a,ren)e M/4/G Journal of Women's Health (1540999 ! #;/; 1!"#"2F #5;</ Areen(er& Sally/ GBreastfeedin& a P'(li) Healt* Iss'e/G "CL's #avv$ Consumer %lo&/ !5 Apr/ !"#"/ 0e(/ !! Apr/ !"#!/ H*ttpF$$savvy)ons'mer/,ordpress/)om$!"#"$"4$#!$(reastfeedin&%a%p'(li)%*ealt*% iss'e$I/ Het9ner :ina M/ P*ilipsen .a)*el .a99a +i9a(et* Malone and Ceanne Broo3s%A'nn/ GAsso)iations Amon& Feedin& Be*aviors 4'rin& Infan)y and C*ild Illness at T,o Bears/G 'aternal ( Child Health Journal #5/7 1!"";2F <;5/ M):iel M- MH +a((o3 and S0 A(ra*ams/ G0*at Are t*e .is3s Asso)iated ,it* Form'la Feedin&K a .e%analysis and .evie,/G %irth) *ssues in Perinatal Care 5</# 1!"#"2F 5"/

:ort*)ott Farra*/ DBreastfeedin& in P'(li)/E Introd')tion to P'(li) Healt* !<#/ California State University San Bernardino/ #7 Mar)* !"#!/ United States/ Con&/ H/./ Patient Prote)tion and Afforda(le Care A)t of !"#"/ 1ena)ted2 ###t* Con&/ H/./ 55;" Print/