2023 Impact Report: Breastfeeding Policy Priorities

Cheryl Lebedevitch
National Policy Director

The U.S. Breastfeeding Committee and our network of members, partners, and supporters work diligently to remove the policy, system, and environmental barriers that families face. In 2023, we did many great things together, including achieving forward movement on all five of our policy priorities. 

​We thank you for your continued support and are proud to share this detailed account of our policy efforts this year.

​To kick off the year, the USBC hosted the Welcome Congress Campaign, sending a package of materials, including their state or territory's breastfeeding report to the offices of every Senator and Representative.

This effort was designed to educate legislators about the state of breastfeeding nationally and in their district, the role policymakers play in protecting infant nutrition security, and the five most pressing policy areas in need of attention this congressional session:

• Federal Funding for Breastfeeding
• Infant Nutrition Security
• Access to Lactation Support and Supplies
• Support for Breastfeeding in Workplaces
• Maternity Care Practices

Federal Funding for Breastfeeding

---

Since 2012, Congress has allocated funds to the CDC Hospitals Promoting Breastfeeding program. The Centers for Disease Control and Prevention (CDC) uses these funds to improve maternity care practices, increase access to peer and professional support, ensure continuity of breastfeeding care, increase support for breastfeeding employees, and address disparities in breastfeeding rates. In Fiscal Year (FY) 2023, our collective efforts helped us maintain level funding of $9.75 million for this line item.

• A big thank you to the 121 organizations that signed on to our joint letter and the hundreds of individuals who joined our call for Congress to invest in breastfeeding as a public health imperative in FY23!

While we are grateful for this crucial funding, we know that a much larger investment is needed to meet the needs of today's families. The FY24 federal budget is still under negotiation and the USBC and our network are working hard to demonstrate the importance of this funding.

• Thousands of individuals have used our easy action tools to call on policymakers to invest in breastfeeding and an incredible 194 organizations signed on to this year's organizational sign-on letter.
• Please take a moment to use our easy action tool to contact your Senators and Representative today!

The USBC is monitoring and mobilizing action to support funding for a variety of other federal programs that support lactation, including the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The Senate and House-passed Agriculture Appropriations bills include different overall funding levels for the WIC program, with the Senate bill including $6.3B for WIC and the House bill including only $6B. Both the House and Senate bills include $90M for the WIC Breastfeeding Peer Counselor Program. A recent analysis projects that without significant additional investments, state WIC agencies would be forced to turn away an estimated 600,000 participants.

• Take action with USBC member MomsRising!

Infant Nutrition Security

---

It is critical that the nation takes decisive action to build a robust infrastructure for infant nutrition security in the U.S. that holds all families in care. The USBC is working hard to advocate for policies and programs that expand access to pasteurized donor human milk, reduce predatory marketing practices by formula manufacturers, ensure the safety of commercial milk formulas, and protect infant and young child feeding in emergencies.

• The USBC-affiliated Pasteurized Donor Human Milk (PDHM) Constellation led the bipartisan, bicameral introduction of the Access to Donor Milk Act (S. 2819/H.R. 5486) which would strengthen the national infrastructure for pasteurized donor human milk banks and help protect infant nutrition security.
  • The PDHM Constellation is coordinating a joint letter signed by 220 organizations (and counting!) calling on Congress to prioritize this important legislation, – join the letter today!
  • Amplify these efforts today by calling on your legislators to support the Access to Donor Milk Act with the USBC easy action tool.
  • Share a story about why access to donor milk is important to you.

Infant formula companies utilize intrusive marketing strategies to families, healthcare providers, and policymakers to portray their products as solutions to common infant health issues in ways that systematically undermine breastfeeding and prey on parental concerns. This is especially concerning following the catastrophic infant formula shortage that took place in 2022.

• The National Academies of Sciences, Engineering, and Medicine is completing the "Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States" project to examine and report on characteristics of the U.S. infant formula market, challenges in supply or market competition, differences in infant formula marketed in the United States and infant formula marketed in the European Union, and other related information. The USBC submitted comments raising concerns about the conflict of interest of several appointed members of the committee leading the project, noting the lack of representation from parent advocacy organizations and breastfeeding experts, and providing recommendations of individuals and organizations that should be considered for the committee. 
• The USBC and 1,000 Days developed and delivered an open letter to the offices of all Senators and Representatives on new research highlighting the critical need for strong policies to leverage the value of breastfeeding.

Infant and young child feeding in emergencies is another crucial aspect of infant nutrition security. Infants and children are among the most vulnerable in an emergency, so it is critical that the nation takes steps to ensure that infants are safely fed and supported.

• The USBC submitted and mobilized comments on the draft version of the Federal Emergency Management Agency (FEMA) “Achieving Equitable Recovery: A Post Disaster Guide for Local Officials," noting that infant and young child feeding was absent from the draft guide and urging FEMA to expand efforts to include infant nutrition security. 
• The USBC and the National Association of County and City Health Officials (NACCHO) hosted the Infant and Young Child Feeding in Emergencies: Community Preparedness Systems to Keep Babies Safe webinar featuring an overview of the CDC Infant and Young Child Feeding in Emergencies (IYCF-E) Toolkit as well as current research and experiences with disaster-related factors that influence breastfeeding.

Access to Lactation Support & Supplies

---

Too often, new parents are left without the basic lactation support and supplies they need to start and maintain human milk feeding. The USBC and our network continue to advocate for timely, comprehensive, and culturally appropriate care for all families.

• The USBC-affiliated Lactation Support Providers (LSP) Constellation developed the "Payer Policy Guidance: Innovative Approaches to Coverage Of Breastfeeding Support, Equipment, and Supplies" for health insurers. The document outlines what breastfeeding families need, explains the composition of the lactation workforce, and describes innovative ways to leverage existing payment mechanisms while bolstering community support.  
• In October 2023, the Department of Health and Human Services (HHS) issued a Request for Information (RFI) on the benefits and challenges of requiring insurers to cover the cost of preventive items and services that are available over the counter, including breastfeeding supplies, without cost sharing and without a prescription by a health care provider. To inform the USBC response to this public comment opportunity and help us better understand how the policy landscape is impacting access to lactation supplies, we are connecting with stakeholders and inviting the public to share their experiences with insurer coverage of lactation supplies, including breast pumps, replacement pump parts, and milk storage supplies. Share your story with us today!

Support for Breastfeeding in Workplaces

---

Employment policies in the United States make breastfeeding harder than it needs to be. The United States is one of the only countries in the world without a national paid family and medical leave program, and nearly 1 in 4 employed mothers return to work within two weeks of childbirth.

• This year, the Senate Committee on Finance hosted its first-ever hearing on paid leave and the USBC submitted a letter for the record demonstrating how a national paid family and medical leave program can help the United States increase breastfeeding rates and reduce health disparities. 
• You can urge Congress to establish a national paid leave program by passing the Family and Medical Insurance Leave (FAMILY) Act with the USBC easy action tool!

In the absence of a national paid leave program, many new parents return to work or school before the breastfeeding relationship has been firmly established, only to find themselves fighting for the right to pump breast milk during the work or school day.

• The USBC spent years mobilizing the field to pass the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act and Pregnant Workers Fairness Act (PWFA). These essential bills were signed into law as part of the Fiscal Year 2023 omnibus spending package in December 2022! The USBC teamed up with our coalition partners at a variety of events and celebrations this year to help spread the word about the PUMP Act and PWFA, including at the National Breastfeeding Conference & Convening, the A Better Balance Victory Party, the White House Gender Policy Council event celebrating these new laws, and with two huge digital billboard advertisements in New York City's Times Square during National Breastfeeding Month!
• The PUMP Act protects nearly all workers, but flight crew (pilots and flight attendants) are not covered by the PUMP Act. The USBC worked with policymakers and our coalition partners to introduce the AIR PUMP Act (S.1722/H.R.3576) and include language to support lactating flight crew in the Federal Aviation Administration reauthorization bill (S.1939).
  • Take action with us today to support breastfeeding pilots and flight attendants!
• The U.S. Equal Employment Opportunity Commission (EEOC) released proposed regulations on the Pregnant Workers Fairness Act (PWFA) to define how the law is enforced. The USBC submitted and mobilized extensive comments on the legal considerations, information on common challenges faced by lactating employees, and important public health considerations.
• The USBC is proud to serve on the Coalition for Lactation-Friendly Schools, a group dedicated to expanding lactation support for students. 

Maternity Care Practices

---

The United States is facing a serious maternity care crisis. Maternal mortality is higher than it was in previous generations, with significant and worsening disparities for women and families of color, particularly in Black and Indigenous communities. Supportive, culturally-aligned maternity care practices can play an essential role in reducing maternal mortality and infant morbidity while setting families up for breastfeeding success.

• The Centers for Medicare & Medicaid Services unveiled its Maternity Care Action Plan to support the implementation of the White House Blueprint for Addressing the Maternal Health Crisis, inviting the public to submit comments. The USBC convened stakeholders for a series of Maternity Care Practices Constellation Incubation Conversations to assess the blueprint and action plan and mobilized a strong response from the lactation field to this public comment opportunity.
• The USBC is part of a mighty coalition working to advance a legislative package known as the Black Maternal Health Momnibus. The package of 13 bills addresses the drivers of maternal mortality, morbidity, and disparities in the U.S., including barriers to breastfeeding.
  • Urge your legislators to pass the Black Maternal Health Momnibus with the USBC easy action tool!

Reflecting on 2023 and Looking Ahead to 2024

---

Together, we rose to the invitation to make a big impact in 2023. We showed up when it was time to dig into the details of complicated policies because we knew what it could mean for babies and families. We elevated our concerns and solutions to policymakers. We showed up, even when it was difficult. We still are showing up. And it was all possible thanks to your support and engagement.

We are buoyed by every action you take! Signing on to letters, using our advocacy tools to contact legislators, and urging others to act by posting on social media and talking to people in your networks are all necessary steps to advance the policy agenda we've defined together. We also need financial support to fund our advocacy efforts. Please consider making a donation to the USBC. All contributions, from $25 to $2,500 or more, are valuable, worthy, and appreciated.

We are so grateful to have you with us on this journey and look forward to another big year in 2024. To help us reach new heights, USBC is thrilled to introduce the Breastfeeding Policy Map. The interactive map features federal and state legislation and regulations with the potential to impact infant feeding and/or the lactation field, making it easier to stay informed about policy opportunities, challenges, and emerging trends. Together, we can make lasting change for families.

Warm wishes,

Cheryl Lebedevitch
National Policy Director
U.S. Breastfeeding Committee
​
PS. Want to learn more? Read the 2022 Impact Report.