FY23 Appropriations: What the Senate bills mean for infant feeding

The fiscal year 2023 appropriations process is underway. The Senate Committee on Appropriations released this year's appropriations bills and associated reports.

The Labor, Health and Human Services, Education, and Related Agencies bill includes $9.93 million in funding for the Centers for Disease Control and Prevention's Hospitals Promoting Breastfeeding program. This is $180 thousand above the House bill, but it isn't enough.

We need to do everything we can to protect infant nutrition security. Increasing funding for this line item is an urgent and important step. We hope you'll join us in the call for increased funding via our easy action tool for individuals, and with our organizational sign-on letter. 

The Hospitals Promoting Breastfeeding line item is the top policy priority for the USBC, but it certainly isn't the only provision that impacts infant feeding. Funding relevant to the lactation field is included in several appropriations bills. 

A detailed analysis of funded provisions in these bills can be found on the Federal Appropriations for Breastfeeding webpage, including funding for the Racial and Ethnic Approaches to Community Health program, WIC breastfeeding peer counselor program, and beyond. The webpage traces program funding levels at each step in the federal budget process.   

The Senate appropriations bills and associated reports also include several unfunded directives:
Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Bill Report:

• The Committee encourages the Food and Drug Administration (FDA) to prioritize regulatory actions to address emerging concerns such as toxic elements in baby food and understaffed review capacity to evaluate the safety and nutritional adequacy of infant formula.
• The Committee directs the FDA to address regulation of donor human milk and donor human milk derived products and banks.
• The Committee directs the FDA to submit a report, prepared in coordination with the Department of Agriculture, assessing the risks and resilience of domestic supply chains of infant formula, including specialty formula, and identifying potential solutions to address vulnerabilities. Further, the Committee directs the Department of Health and Human Services Inspector General to conduct a review of the FDA's actions in response to complaints received pertaining to infant formula over the past 3 years, as well as the adequacy and efficacy of the FDA's monitoring efforts for infant formula and related maternal and infant food products.
  
• The Committee is concerned that lead, arsenic, cadmium, and mercury are often present in dangerous quantities in foods intended for consumption by infants and toddlers. The FDA is encouraged to coordinate with the Department of Agriculture to ensure that a wide variety of healthy nutritious foods remain available to participants of Federal nutrition programs.
  

Labor, Health and Human Services, and Education, and Related Agencies Bill Report.

• The Committee supports the National Institutes of Health ongoing longitudinal "Researching COVID to Enhance Recovery" (RECOVER) study and encourages NIH to ensure the study is nationwide, includes diversity of enrollees to account for gender, age, race, ethnicity, geography, comorbidities, and underrepresented populations, including pregnant and lactating women.
  

Financial Services and General Government Bill Report

• The Committee continues the longstanding provision that a woman may breastfeed her child at any location in a Federal building or on Federal property if the woman and her child are otherwise authorized to be present at the location.

Homeland Security Bill Report

• The Committee urges the Federal Emergency Management Agency (FEMA) to ensure access to breastfeeding services and supplies through its Critical Needs Assistance, Other Needs Assistance, and other program, and are listed as eligible items under this program.
• In the aftermath of a disaster, FEMA is also urged to support families with young children by giving them priority consideration for immediate access to a shelter with a space to express breast milk as well as sanitary drinking water, a power supply, and access to a refrigerator for safe storage of food and/or expressed breastmilk.
• The Committee directs FEMA to include clear guidance on supporting access to lactation equipment and breastfeeding support services as part of its efforts to update the Individual Assistance Program and Policy Guide (IAPPG). To accomplish this, FEMA should produce new public-facing materials to educate nursing parents; updated materials and training for disaster relief coordinators, public health workers, and other personnel; and targeted informational resources for relevant disaster response partners such as State emergency management agencies and non-profit organizational partners.
  
• The Committee supports the National policy to discourage the detention or arrest of known pregnant, postpartum, or lactating women. The Committee continues the requirement to provide semiannual reports on the total number of pregnant, postpartum, or lactating women in Immigration and Customs Enforcement (ICE) custody, including detailed justification of the circumstances warranting each pregnant, postpartum, or lactating woman’s continued detention and the time in custody.
  

Military Construction, Veterans Affairs, and Related Agencies Bill Report

• The Committee encourages Veterans Affairs (VA) to enhance its services and access to gender-specific care, including primary care providers, gynecologists, maternity care, and mental health providers, including care related to experiences of military sexual trauma. The VA should also enhance its capacity to support pregnant and postpartum women veterans, including expansion of maternity care and lactation support.
  

State, Foreign Operations, and Related Programs Bill Report

• The Committee directs the United States Agency for International Development Administrator (USAID) to update its nutrition report, including the approximate number of women receiving prenatal vitamins and breastfeeding education and support as a result of U.S. Government assistance.

What's next for the federal budget process? 
Once the House and Senate have each passed their appropriations bills, they must be "conferenced" to work out any differences between the two versions. House-Senate conference committees make final determinations and prepare a Conference Report. The Conference Report is then passed by the House and the Senate and sent to the President to be signed. All appropriations bills must be completed by the end of the fiscal year on September 30, or Congress will have to pass a continuing resolution to keep the government funded at the start of FY 2023 on October 1. 

The USBC will continue to mobilize support for funding that helps human milk feeding families and will be sure to keep you updated at all stages of the federal budget process. We are so grateful for your partnership, engagement, and support. Thank you! 

~ the USBC team