FY24 Appropriations: What the House and Senate Bills Mean for Infant Feeding

The fiscal year 2024 appropriations process is underway. Congress has taken many steps to advance the 12 appropriations bills that set the federal budget, however, there are a range of disagreements that are holding up the process. Follow the status of each of the spending bills in the Congressional Research Service Appropriations Status Table: FY2024.

Funded provisions in these bills can be found on the Federal Appropriations for Breastfeeding webpage. The webpage traces program funding levels at each step in the federal budget process.   

The appropriations bills and associated reports also include a variety of unfunded or one-time directives:

House Report: Department of Homeland Security Appropriations Bill, 2024
The Committee continues to urge the Federal Emergency Management Agency to ensure that breastfeeding mothers impacted by disasters have access to breastfeeding services and supplies through its Critical Needs Assistance, Other Needs Assistance, and other programs. In the aftermath of a disaster, FEMA is directed to work with partners, other federal agencies, and volunteer organizations to ensure that disaster survivors and service providers have information on support available for nursing equipment and supplies.

U.S. Immigration and Customs Enforcement is directed to continue providing semiannual reports on the total number of pregnant, postpartum, and lactating women in ICE custody.

Senate Report: Military Construction, Veterans Affairs, and Related Agencies Appropriation Bill, 2024
The Committee urges the United States Department of Veterans Affairs to prioritize support for pregnant and postpartum women veterans, including expansion of maternity care and lactation support.

House Report: Military Construction, Veterans Affairs, and Related Agencies Appropriation Bill, 2024
The Committee supports the Department of Veterans Affairs maternity healthcare and coordination programs to ensure that veterans can receive high-quality care and robust support during and after pregnancy and encourages the VA to continue to ensure veterans have access to high-quality, well-coordinated care, and robust services and directs VA to continue to implement and fully resource the Protecting Moms Who Served Act.

House Report: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Bill, 2024
The Committee looks forward to receiving the brief requested in House Report 117—392 on efforts to develop consensus standards for pregnancy and lactation registries, including common data elements, so that registry data can be interoperable within and between such registries.

The Committee encourages USDA to ensure that small infant formula manufacturing rural areas are aware of their eligibility for the Business & Industry Loan Guarantees Program and the Food Supply Chain Expansion Loan Program.

The Committee directs the FDA to address the regulation of donor human milk and requests a briefing from the FDA within 90 days of enactment of this Act.
 
Senate Report: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Bill, 2024
Following recommendations by the Task Force on Research Specific to Pregnant Women and Lactating Women, the Committee urges the Department of Agriculture to issue final regulations relating to the inclusion of pregnant women as subjects in clinical research. The agency should consider further guidance about ethical issues to be considered and strategies for designing ethical studies, to inform the inclusion of pregnant women and lactating women in a clinical trial and facilitate their participation.

The Committee directs the Food and Drug Administration to work expeditiously to implement the infant formula provisions of the 2023 Congressional Accountability Act, and directs the FDA to brief the Committee on a semi-annual basis.

The Committee directs the Secretary of Agriculture to ensure that small infant formula manufacturing facilities located in rural areas are aware of their eligibility for the Business and Industry Guaranteed Loan Program.

Financial Services and General Government Appropriations Bills (S. 2309/H.R. 4664)
Notwithstanding any other provision of law, 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.

Senate Report: Legislative Branch Appropriations, 2024
The Committee encourages legislative branch entities to continue to enhance the locations and access to spaces dedicated for the use of nursing mothers. Further, the Committee directs the Architect of the Capitol to retrofit identified spaces, where practical within the historical buildings on the Capitol complex, to better meet the needs of nursing mothers. Dedicated lactation rooms should be provided, subject to the limitations of the physical locations that include access to running water, appropriate temperature-controlled storage, furniture, and equipment for this purpose. The Committee recommends $1M to be utilized to implement recommended enhancements for these lactation spaces.

House Report:  State, Foreign Operations, and Related Programs Appropriations Bill, 2024
The Committee supports effective nutrition interventions, including reducing stunting and wasting, increasing breastfeeding and nutrition supplementation for pregnant women, treating severe malnutrition, and ensuring integration with early childhood development, deworming, and water and sanitation efforts.

As part of the reporting requirements included in the Global Malnutrition Prevention and Treatment Act of 2021, the Administrator of USAID is directed to report to the appropriate congressional committees on the nutrition outcomes achieved over the previous fiscal year, which shall also include: (1) the outcomes, disaggregated by USAID bureau, including nutrition-specific treatment and prevention interventions on a country-by-country basis; (2) the approximate number of additional children treated for severe acute malnutrition and receiving vitamin A as a result of United States assistance; and (3) the approximate number of women receiving prenatal vitamins and breastfeeding education and support as a result of such assistance. The report should be publicly available on the USAID website and track progress towards the global targets on stunting, wasting, anemia, and breastfeeding.

Senate Report: Department of State, Foreign Operations, and Related Programs Appropriations Bill, 2024
The USAID Administrator shall report on USAID nutrition investments within global health, development, and humanitarian programs. Such report shall also include the approximate number of women receiving prenatal vitamins and breastfeeding education and support as a result of U.S. Government assistance.

The Secretary of State shall submit a report on: (1) the number of overseas and domestic facilities that do not meet the government recommendation of one lactation room per 150 desks; (2) the number of overseas facilities that require retrofitting of lactation rooms, including for plumbing, electricity, and refrigeration; (3) the total cost to retrofit existing spaces; and (4) the plan to prioritize this program in fiscal year 2024.