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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