Senate Bill S1107A

                                 BILL NUMBER:  S1107A              REVISED 05/27/09

 TITLE OF BILL :
An act to amend the public health law, in relation to breastfeeding
mothers' bill of rights


 PURPOSE :
To provide support for breast feeding as the best modality to achieve
infants' immediate and long term health outcomes.

 SUMMARY OF PROVISIONS :
The Breastfeeding Mothers' Bill of Rights will codify the New York
Codes Rules and Regulations, Best Hospital Practices and major
components of the World Health Organization's Baby Friendly Guidelines
as they pertain to the breast feeding of newborns and infants. Section
1. A new section is added 2505-a 1. Which is a declaration of public
policy that it is every woman's right to be informed about the
benefits of breast feeding and have an environment which is conducive
to what all pediatricians agree to be the safest and healthiest choice
for newborn and infant feeding. The section also defines 'maternal
health care provider' and maternal health care facility'

2505-a 2. Requires the Commissioner to make available on the Health
Department's website for use by maternal health care facilities and
providers the "Breast feeding Mothers' Bill of Rights" in the top six
              

languages spoken in the state, other than English.

2505-a 3. Contains the "Breast feeding Mothers' Bill of Rights" and
limits those rights only in cases where your health or the health of
your baby requires it.

2505-a 4. Requires the Commissioner to make regulations necessary to
implement this section.

Section 2. Effective Date.

 JUSTIFICATION :
The Breastfeeding Mothers' Bill of Rights is the work of a team of
pediatricians, WIC personnel, New York City Department of Health staff
and lactation specialists. It represents their expertise and
experience in the health delivery system and the need for providing
support for breastfeeding as the best modality to achieve infants'
immediate and long term health outcomes. A public posting in maternal
healthcare facilities nurseries, maternity floors and post delivery
recovery rooms of these rights and like distribution will encourage
and support breast feeding as the optimum standard for newborn and
infant feeding.

Fewer medical problems and hospital stays for breast fed infants
translate to lower health care costs and workplace absenteeism. A 2001
U.S.  Department of Agriculture analysis estimated that at least $3.6
billion could be saved nationally if only 50% of mothers breastfed
their infants until they were at least six months old. A family's
budget can also be stretched when a mother breastfeeds. Barring
limited costs for accessories, breastfeeding is free while mothers can
be expected to spend as much as $700 or more for the first year of
formula feeding.

CDC research performed in 2001 has shown that women who receive the
most post delivery breastfeeding support are eight times more likely
to continue breast feeding for at least six weeks compared to women
whose experience was less favorable.

National statistics show that 70% of mothers breast feed after
discharge from the hospital. That number drops precipitously at six
months of infant life to 14.4% for Caucasian mothers who are still
exclusively breastfeeding their infants, 15.7% for Hispanic mothers
and 8.6% for African American mothers. These statistics from the
Center for Disease Control's (CDC) 2004 National Immunization Survey
show that while there is a significant drop for all races, African
American mothers report the lowest breastfeeding percentages after
leaving the hospital. A number of reasons contribute to these low
statistics such as:

- the lack of support for breastfeeding during the mother's in-patient
delivery stay
- lack of access to accurate educational materials
- the mother's age and education
- an immediate economic need to return to a work environment that is
not conducive to breastfeeding or pumping
- distribution of commercially produced educational materials and gift
formula packets

Numerous studies and reports published over the last several decades
by the CDC, FDA and American Academy of Pediatrics have concluded that
breast fed infants have fewer hospital stays and suffer fewer ear and
gastrointestinal infections, rashes, food allergies, diarrhea and are
at lower risk for sudden infant death syndrome, asthma and obesity
than bottle-fed babies. This is especially true when exclusive
breastfeeding is continued from six months until the child is one year
old as antibodies contained in the mother's milk contribute to
lowering the risk factors for these medical problems and infections.
The American College of Obstetricians and Gynecologists supports
extended breast feeding because it has a long range benefit of
reducing the risk of ovarian and breast cancers.  Additional benefits
to mothers are a lower risk of adult-onset diabetes and osteoporosis.
Even the International Formula Council, a trade association has
stated, "Breastfeeding is the preferred and recommended method of
infant feeding."

The Federal government's Healthy people 2010 initiative has set a goal
of increasing rates of breast feeding mothers to 75% upon birth and
50% until six months of age. While New York State currently has Civil
Rights Laws, Corrections Laws and a Penal Law protecting breast
feeding behavior once a mother has taken her infant home from the
hospital, there is no legislation ensuring that women receive
appropriate, culturally sensitive information and support about
breastfeeding during and immediately following their delivery.
Providing women with early pre and post delivery support for
successful breastfeeding will contribute to achieving our public
health goals for the year 2010.

" BREASTFEEDING MOTHERS' BILL OF RIGHTS "

Choosing the way you will feed your new baby is one of the important
decisions you will make in preparing for your infant's arrival.
Doctors agree that for most women breastfeeding is the safest and most
healthy choice. It is your right to be informed about the benefits of
breast feeding and have your healthcare provider and maternal health
provider encourage and support breastfeeding. A woman has the right to
make her own choice about breastfeeding. Whether you choose to breast
feed or not you have the following basic rights. These rights are
yours regardless of your race, creed, national origin, sexual
orientation or who is paying for your healthcare.

1)  BEFORE YOU DELIVER :

If you attend prenatal childbirth education classes provided by the
maternal health care facility and all hospital clinics and diagnostic
and treatment centers providing prenatal services in accordance with
article 28 of the public health law you must receive the Breastfeeding
Mothers' Bill of Rights. Each maternal health care facility shall
provide the maternity information leaflet, including the breastfeeding
mothers' bill of rights, in accordance with section twenty-eight
hundred three-i of this chapter to each patient or to the appointed
personal representative at the time of prebooking or time of admission
to a maternal health care facility. Each maternal health care provider
shall give a copy of the breastfeeding mothers' bill of rights to each
patient at or prior to the medically appropriate time.

You have the right to receive complete information about the benefits
of breast feeding for yourself and your baby. This will help you make
an informed choice on how to feed your baby.

* The nutritional, medical and psychological benefits of breast
feeding;
* The steps necessary to prepare yourself for breastfeeding;
* An explanation of some of the problems you may encounter and how to
avoid or solve them.

2)  IN THE MATERNAL HEALTHCARE FACILITY :

* You have the right to have your baby stay with you right after birth
whether you deliver vaginally or by cesarean section. You have the
right to begin breastfeeding within one hour after birth.
* You have the right to have someone trained in breastfeeding give you
information and help you when you need it.
* You have the right to have your baby not receive any bottle feeding
or pacifiers.
* You have the right to know about and refuse any drugs that may dry
up your milk.
* You have the right to have your baby with you 24 hours a day.
* You have the right to breast feed your baby at any time day or
night.
* You have the right to know if your doctor or your baby's
pediatrician is advising against breast feeding before any feeding
decisions are made.
* You have the right to have a sign on your baby's crib clearly
stating that your baby is breastfeeding and that no bottle feeding of
any type is to be offered.
* You have the right to receive full information about how you are
doing with breastfeeding and get help on how to improve.
* You have the right to breastfeed your baby in the neonatal intensive
care unit. If nursing is not possible, every attempt will be made to
have your baby receive your pumped or expressed milk.
* If you, or your baby, are re-hospitalized in a maternal care
facility after the initial delivery stay, the hospital will make every
effort to continue to support breastfeeding to provide hospital grade
electric pumps and rooming-in facilities.
* You have the right to have help from someone specially trained in
breast feeding support and expressing breast milk if your baby has
special needs.
* You have the right to have a family member or friend receive breast
feeding information from a staff member if you request it.

3)  WHEN YOU LEAVE THE MATERNAL HEALTHCARE FACILITY :

* You have the right to printed breastfeeding information free of
commercial material.
* You have the right, unless specifically requested by you, and
available at the facility, to be discharged from the facility without
discharge packs containing infant formula, or formula coupons unless
ordered by your baby's health provider.
* You have the right to get information about breastfeeding resources
in your community including information on availability of breast
feeding consultants, support groups and breast pumps.

* You have the right to have the facility give you information to help
choose a medical provider for your baby and understand the importance
of a follow-up appointment.
* You have the right to receive information about safely collecting
and storing your breast milk.
* You have the right to breast feed your baby in any location, public
or private, where you are otherwise authorized to be. Complaints can
be directed to the New York State Division of Human Rights.

All the above are your rights. If the maternal healthcare facility
does not honor these rights you can seek help by contacting the New
York State Department of Health or by contacting the hospital
complaint hotline via email.

The Commissioner shall make regulations reasonably necessary to
implement this section.

 FISCAL IMPLICATIONS :
Limited due to translation costs.

 EFFECTIVE DATE :
This act shall take effect on the first day of May next succeeding the
date on which it shall have become law; provided, however, that
effective immediately, the addition, amendment and/or repeal of any
rule or regulation necessary for the implementation of this act on its
effective date are authorized and directed to be made and completed on
or before such effective date.