Lindsey MurtaghPublic Health Law Program

Centers for Disease Control and PreventionSummer 2008

JD/MPH Candidate

The content of this presentation was prepared

by Lindsey Murtagh in her capacity as an

intern with the CDC Public Health Law

Program, summer 2008. It does not represent

any policy of the Centers for Disease Control

and Prevention. This presentation should not

be considered to be legal advice; always

consult your legal counsel for legal advice.

OutlinePublic health implicationsOverarching legal considerationsResearch objectivesEarly findingsAdditional research directions

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Breastfeeding: a public health priorityBenefits to Infant: Benefits to Mother: Nutritious Increases exposure to

protective antibodies Decreases risk of ear infections,

respiratory infections, urinary tract infections and decreased frequency of diarrhea

Decreases risk of overweight

Decreases risk of breast and ovarian cancers

Facilitates post-pregnancy weight loss

Reduces risk of osteoporosis Offers economic benefits Provides opportunities to bond

with infant

Decreases health care costs Increases work productivity Decreases waste

Benefits to Society:

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Breastfeeding: A Public Health IssueEver Breastfed

Breastfed at 6 months

Breastfed at 12 months

HP 2010 Target 75% 50% 25%

U.S. Average 74.2% 43.1% 21.4%

U.S. Range (by state)

47.9% - 90.3% 21.8% - 62.1% 7.5% - 38.9%

White 76.8% 43.2% 21.9%

Black/Afri-Am 61.4% 29.3% 13.4%

Hispanic/Latino 80.6% 45.1% 24.1%

Asian 83.6% 51.8% 29.1%

2005 Data from: www.cdc.gov/breastfeeding/data/NIS_data

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Applicable (or not) Federal and International LawsTitle VII, Civil Rights Act

Does not protect women who are breastfeedingPregnancy Discrimination Act (PDA)

Extends Title VII protection to discrimination based on pregnancy, childbirth and related medical conditions

BUT Derungs v. Wal-Mart Stores (6th Cir. 2004) held PDA doesn’t apply to breastfeeding

Americans with Disabilities ActDoes not encompass breastfeeding

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Applicable (or not) Federal and International Laws (cont’d)Family Medical Leave Act

Mandates that certain employees be allowed 12-weeks unpaid leave to care for, among others, newborns

Dike v. Orange County School Board (5th Cir. 1981)Held that the decision to breastfeed is a

fundamental rightInternational Code of Marketing of Breastmilk

SubstitutesContains recommendations for regulations to

market breastmilk substitutesU.S. has endorsed Code but taken no action

Research Objectives:To identify express laws that promote or facilitate

breastfeedingTo examine whether a relationship exists

between rates of breastfeeding and the presence of laws focused on breastfeeding

Limits of ResearchResearch will not focus on laws that appropriate

funding for programs supportive of breastfeeding (e.g.-WIC).

Research will focus on laws that expressly mention breastfeeding.

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Express Laws by SettingResearch will examine presence of relevant

state and federal laws in five settings:WorkplaceCommunityChildcareHealthcareIndustry

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Early FindingsCommunity

Breastfeeding moms exempt from jury dutyBreastfeeding permitted in any public or private

locationBreastfeeding exempt from public indecency laws

WorkplaceEmployers required to provide reasonable breaks

for breastfeedingMaternity leave minimum requirements

ChildcareChildcare facilities prohibited from discriminating

based on breastfeeding status10

Early Findings (continued)3 states have no laws directly related to

breastfeeding.Ever Breastfed

Breastfed at 6 months

Breastfed at 12 months

HP 2010 Target 75% 50% 25%

U.S. Average 74.2% 43.1% 21.4%

Massachusetts 78.1% 43.3% 21.7%

North Dakota 68.2% 36.8% 18.4%

West Virginia 57.7% 22.5% 12.0%

2005 Data from: www.cdc.gov/breastfeeding/data/NIS_data

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Early Findings (continued)Oregon has the nation’s highest rates of breastfed

at 6 months (62.1%) and breastfed at 12 months (39.8%)

Oregon Laws:Or. Rev. Stat. § 109.001 (1999) – allows a woman to

breastfeed in a public placeOr. Rev. Stat. § 10.050 (1999) – excuses a woman

from acting as a juror if the woman is breastfeedingOr. Rev. Stat. § 653.075, 653.077, 653.256 (2007) –

allows women to have unpaid 30 minute breaks during each four hour shift to breastfeed or pump. Includes exemptions for certain employers. Provides enforcement mechanisms.

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Additional DirectionsGaps in lawEffectiveness of lawsRecommendations for using law to increase

breastfeedingStrategies for reducing disparities in rates

using lawGlobal comparison of laws (e.g. – Sweden)

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