California Passes Groundbreaking Public Health Law Supporting Breastfeeding


Governor Jerry Brown of California approved Senate Bill No. 502, the Hospital Infant Feeding Act on October 6, 2011. This groundbreaking legislation mandates all acute care and specialty hospitals that provide care to mothers provide lactation assistance to facilitate successful breastfeeding.

Breastfeeding is unanimously supported by health care organizations, including the American Academy of Pediatrics and the World Health Organization. In addition to recommendations from the American Academy of Pediatrics and the World Health Organization, the United States Surgeon General advises mothers and babies to breastfeed exclusively for the first six months of life, unless medical contraindications arise.

Unfortunately, many mothers and babies breastfeed for only a very short time, if they breastfeed at all. New mothers and babies face a myriad of barriers to successful breastfeeding, including unsupportive hospital policies and practices. Some of these practices include early and inappropriate supplementation with infant formula.

Healthy People 2020 establishes public health breastfeeding goals for the United States. One of these goals addresses inappropriate supplementation with formula during the typical two day postpartum stay. The Centers for Disease Control and Prevention recommends that only 10 percent or fewer newborn babies should receive supplemental infant formula. Unfortunately, 90 percent of hospitals in California do not follow these recommendations and do not meet this goal.


Early supplementation with formula has been demonstrated to reduce breastfeeding success. The Hospital Infant Feeding Act requires each hospital that provides care to new mothers to post a written infant feeding policy to
address the pros and cons of early formula supplementation.

California’s Hospital Infant Feeding Act calls on all hospitals to provide a policy which supports breastfeeding using guidance from the Baby Friendly Hospital Initiative or the State Department of Public Health’s guidelines known as “Providing Breastfeeding Support: Model Hospital Policy Recommendations.” Both of these guidelines provide evidence-based recommendations to assist women and babies to successfully breastfeed through providing accurate education, consistent information and appropriate interventions.

The Hospital Infant Feeding Act also asks hospitals to provide guidance to women who formula feed, either due to choice or to experiencing a medical contraindication to breastfeeding.

This landmark legislation promotes a statewide dialogue on the importance of breastfeeding and requires hospitals to provide accurate education to new mothers. This Act recognizes that breastfeeding is a public health issue and calls for hospitals to offer medically appropriate interventions and avoid misusing interventions that have been shown to disrupt successful breastfeeding.

The Baby Friendly Hospital Initiative is an international designation that identifies hospitals providing evidence-based breastfeeding support and education. As of October 2011, 34 California hospitals have achieved this designation. This legislation opens the door for many more hospitals to gain this recognition and provide California mothers and infants with optimal breastfeeding care.

Office of Governor Jerry Brown:


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