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Breastfeeding Advocacy &
Information Toolkit
brought to you by Breastfeed Chicago -‐-‐ www.breastfeedchicago.com
Illinois Moms: Know Your Breastfeeding Rights!
Your Public Breastfeeding Rights :
Public Act 093-0942, SB 3211, enacted August 16, 2004
Section 1. Short title. This Act may be cited as the Right to Breastfeed Act.
Section 10. Breastfeeding Location. A mother may breastfeed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether the nipple of the mother's breast is uncovered during or incidental to the breastfeeding; however, a mother considering whether to breastfeed her baby in a place of worship shall comport her behavior with the norms appropriate in that place of worship.
Section 15. Private right of action. A woman who has been denied the right to breastfeed by the owner or manager of a public or private location, other than a private residence or place of worship, may bring an action to enjoin future denials of the right to breastfeed. If the woman prevails in her suit, she shall be awarded reasonable attorney's fees and reasonable expenses of litigation.
Full act available at: http://www.ilga.gov/legislation/publicacts/fulltext.asp?name=093-0942
Also note: breastfeeding is exempt from Illinois public indecency laws as per (720 ILCS 5/11-30) Sec. 11-30. http://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=072000050K11-30
Your Rights as a Nursing Mother in the Workplace:
820 ILCS 260/1 et. esq.2001 ILL. ALS 68; 2001 Ill. Laws 68; 2001 Ill. P.A. 68; 2001 Ill. SB 542
Section 1. Short title. This Act may be cited as the Nursing Mothers in the Workplace Act.
Definitions: "Employer" means an individual, corporation, partnership, labor organization, or unincorporated association, the State, an agency or political subdivision of the State, or any other legal, business, or commercial entity that has more than 5 employees exclusive of the employer's parent, spouse, or child or other members of the employer's immediate family. "Employer" includes an agent of an employer.
Section 10. Break time for nursing mothers. An employer shall provide reasonable unpaid break time each day to an employee who needs to express breast milk for her infant child. The break time must, if possible, run concurrently with any break time already provided to the employee. An employer is not required to provide break time under this Section if to do so would unduly disrupt the employer's operations.
Section 15. Private place for nursing mothers. An employer shall make reasonable efforts to provide a room or other location, in close proximity to the work area, other than a toilet stall, where an employee described in Section 10 can express her milk in privacy.
Full act is available at: http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2429&ChapterID=68
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
Advocate for Yourself: Postpartum Care for the
Nursing Mom
3. The Importance of Self Care Good self-care is essential immediately following the birth of your baby in order to help establish a good start to your breastfeeding relationship. The first 40 days after your baby’s birth is often known as the “babymoon.” During that time, mom’s energy should be mainly focused on rest, recovery and baby care. § Eat healthy! Fortify your recovering body with lots of
fiber and protein-rich foods. Avoid a lot of sugar or saturated fat.
§ Drink to thirst! Stay hydrated with water, tea, or a little juice.
§ Relax! Do at least one thing (a walk, a bath, a chapter of a good book) per day that makes you feel human.
§ Sleep, baby, sleep! “Sleep when the baby sleeps” is the best advice ever! Do it! You’re going to need it!
1. Mother the Mother As a new mom, your first priority is to feed and nurture your baby. Unfortunately, many moms feel they need to continue on with their lives in the same capacity that they did pre-baby. This is the time in your life when it is okay if the laundry piles up, it’s okay to order take-out food, it’s okay to leave the house a mess. Caring for your new baby is more important. In communal cultures, relatives and close friends pitch in to care for the new parents and any other children, so that the parents can focus exclusively on getting to know their baby. In our culture, the mom is often responsible for recruiting and directing her care. Talk with your partner about what you will need after the baby comes and how important it is for you to have their support. Be specific about what they can do. Help them find resources like these: § Breastfeeding: How Can Dad Help?
§ 5 Ways Partners Can Support Breastfeeding Moms
§ Partner’s Support is Important to a Breastfeeding Mom’s Success
4. Communication is Key
Although breastfeeding is the most natural way to feed your baby, it can be very hard in the beginning to make it work, and there is no shame in asking for assistance. KellyMom.com and BreastfeedChicago.com are two great websites to find answers to questions. There are also many incredible professional lactation consultants, peer support moms, and breastfeeding support groups in Chicago where you can find answers to your questions or get practical advice that can be the key to achieving your breastfeeding goals.
Being an advocate for yourself means communicating what you need from your friends and family. Your job is to take care of the baby; their job is to take care of you. Don’t worry, you can return the favor another time. When someone says, “Just let me know what you need!” take that opportunity to let them know! Send a text, a mass email, or a Facebook status update asking for a volunteer to do some grocery shopping, laundry, cooking (by setting up a meal train), older sibling care, or cleaning. People actually LOVE to help, so let them do it! When you have visitors, resist the urge to feel like you have to entertain or host. Ask your partner to help protect you from visitors who stay too long – one hour is more than enough time for them to see you, see the baby, and take out your garbage! If you are having a baby shower, ask that guests chip in to help you hire several hours of a postpartum doula, a cleaning person, or a grocery delivery service.
2. Ask for Help
Advocating for Yourself: Getting to know your birth health care professional
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
Obstetricians are surgeons by training and may not be exposed to the natural birth process during their training. Additionally, most doctors do not receive any training in breastfeeding medicine or support, unless they seek it out themselves. Certified Nurse Midwives are more likely to view birth as a natural process, but it is still important to understand their birth philosophy and breastfeeding experience. We’ve compiled some questions to help you get to your know birth health care professional better. 1. What is your induction/C-section/episiotomy rate? What interventions do you consider routine?
While having a C-section does not preclude a women from breastfeeding, it often makes things more complicated. A woman can ask her doctor for C-section rates and check the hospital at which she plans on delivering. If you do have a c-section, there are many breastfeeding resources on positioning, medications, and recovery while breastfeeding. Though you can breastfeed after almost any intervention, it’s certainly easier if you are feeling awake, empowered, and comfortable. Planning for an intervention-free or low intervention birth can be done with a birth professional like a birth doula.
2. Do you have any education in breastfeeding support? If not, do you have a list of breastfeeding resources if I need help postpartum? Doctors do not routinely receive education about breastfeeding or breastfeeding support. If your practitioner does not have extra education in breastfeeding, it is imperative that they realize this, and refer you to the proper professionals.
3. Are you familiar with Hale’s work on breastfeeding and medication? Will you follow those guidelines? Dr. Hale operates the Infant Risk Center which parents or practitioners can call to get information on medication and breastfeeding. Many doctors mistakenly assume that medicine is unsafe while breastfeeding, when in fact most medications are safe to continue breastfeeding.
4. Skin-to-skin contact is important to me, will you, in the absence of an emergency, allow my baby to have direct skin-to-skin contact immediately after birth? Skin to skin contact is important for full term babies immediately after birth, but crucial for premature infants. Some of the many benefits of skin-to-skin contact include: -‐ Helps stabilize temperature, breathing, and blood sugar of the newborn -‐ Calms and reassures the newborn -‐ Encourages release of oxytocin, increasing milk supply and speeding the production of milk -‐ The baby is more likely to latch on, and latch on well, and be exclusively breastfed
5. Are you willing to delay unnecessary procedures until after my child has had a chance to
breastfeed? Almost all medical procedures can wait for a bit, but this is not necessarily the norm, so make sure your doctor or midwife is aware of your preference.
6. How will you facilitate a long-lasting breastfeeding relationship between my baby and me? Ideally, a practitioner will be encouraging and offer resources to support breastfeeding. He or she should also avoid suggesting formula supplementation or weaning unless absolutely necessary.
One of the most important things about how your practitioner answers these questions is that he or she takes time to explain the answers, and truly listens to your concerns. This speaks volumes about them as a practitioner, and how they will treat you at your birth.
Advocating for Yourself: Talking to your child’s doctor
Little known fact… very few doctors have extensive breastfeeding training. As moms, we need to know just how much our doctors know about breastfeeding, and use that information to make good decisions for our families. Whether you’re interviewing a new doc, or just getting to know your doc a little better, we’ve compiled some questions to get the conversation started.
QUESTION #1: Do you have an IBCLC or LC on staff? What do all those letters at the back of a lactation professional's name really MEAN? If there isn’t a lactation professional on staff, where will your doctor refer you if you are having breastfeeding problems? Do they know about the IBCLC listing on our website?
QUESTION #2: What do you recommend when baby is slow to gain?Is your doctor going to help you trouble-shoot and work with an IBCLC, or are they going to recommend formula?
QUESTION #3: When should baby start solids? What first foods to you recommend? “Food before one is just for fun.” Current recommendations are to hold off on solids until baby is 6 months old or older to make sure that baby gets all the precious nutrients from breastmilk. “Baby-led weaning” is helpful guide for starting solids.
QUESTION #4: When should we finish breastfeeding?There is no right answer for everyone. The American Academy of Pediatrics recommends breastfeeding for at least the first 12 months of life, and as long as mom/baby wish to breastfeed after that. The World Health Organization recommends 2 years and beyond. The point is that your doctor should support you in your breastfeeding relationship for as long as YOU want to breastfeed. By the way, just because you get pregnant doesn’t mean you have to stop.
QUESTION #5: How often does a newborn nurse? Breastfed babies need to nurse at least 8-12 times per day on demand to maintain your milk supply. Beware of a doctor who advocates scheduled feedings for an infant.
QUESTION #6: Do you have children? If so, were they breastfed? Just good to know!
QUESTION #7: Do you use the WHO growth chart to track the growth of breastfed babies?The WHO growth chart is based on breastfed infants, whereas the CDC charts (which most doctors use) are not. Clinicians should be aware that fewer U.S. children will be identified as underweight using the WHO charts, and slower growth among breastfed infants during ages 3--18 months is normal.
QUESTION #8: In what situations would you recommend formula?Trick question! Your doctor should encourage you to seek professional lactation help first.
QUESTION #9: Are you familiar with the Academy of Breastfeeding Medicine, and do you follow their guidelines with your patients?Make your doctor aware of this professional organization.
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
Advocating for Yourself: Talking to your doc about breastfeeding-‐friendly medications
Moms get sick from time to time, and it’s natural for us to be concerned about what we put in our bodies when we are breastfeeding. Unfortunately, many physicians are not knowledgeable about medication safety and breastfeeding. In
the interest of caution they recommend halting breastfeeding while taking any medication. Some physicians use the Physician Desk Reference (PDR) to look medications up. The PDR is written by manufacturers, and manufacturers want to minimize their liability by suggesting not breastfeeding while taking medications, whether or not research supports that recommendation.
Fortunately for all breastfeeding mothers, breastfeeding researchers have provided us with some excellent resources. They look at a number of factors to determine if the medication can enter into the milk: molecule size, where and how the medication binds, half-‐life, ph levels and bioavailability. Find out more about drug transfer to breastmilk here. Talk to your doctor about having these references available to them when recommending medications for breastfeeding moms:
§ Thomas Hale’s Medications and Mothers’ Milk is updated every other year and provides a comprehensive look at medications and effects on mother and baby
§ Thomas Hale’s Clinical Therapy in Breastfeeding Patients looks at clinical conditions and compares possible medications.
§ Thomas Hale’s Infant Risk website has resources for moms and clinicians alike with a hotline number for questions, and apps for Android/iPhone.
§ Frank Nice’s Nonprescription Drug for the Breastfeeding Mother contains guidelines for making decisions about over-‐the-‐counter drugs.
When you are ill, the more information you get, the easier it will be to make a decision that is right for you. Advocate for your needs by:
§ Talking with your doctor about how important it is for you to continue breastfeeding. Some doctors may not understand your commitment to breastfeeding.
§ If your doc recommends stopping breastfeeding, you can ask questions like: o “Where are you looking for information on the safety of this medication?” o “Is this a drug that would be given directly to my child if my child were ill?” o “I’d like to call an IBCLC right now and find out what the recommendations
are for breastfeeding moms in my situation.” § Call an IBCLC, La Leche League leader, Breastfeeding USA counselor, or the Infant
Risk Center to see what the risks are for the medication you’ve been prescribed.
Above all, stay healthy, mama!
Advocating for Yourself: How to breastfeed in public
Thank you to author Rebecca Jackson-‐Artis!
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
Some moms are nervous about breastfeeding in public, but one thing you need to understand is the majority of the public does not care whether you breastfeed or not. The public isn’t even paying attention to you most of the time. With that said, there are two ways to breastfeed in public; 1) discreetly and 2) openly. Openly is self-‐explanatory, and we’re pretty sure you can figure it out on your own. Either way, you are protected by law in Illinois to breastfeed anywhere that you are allowed to be.
Under the discretion category there are four options on how to breastfeed in public: layered NIP, fashion NIP, bib NIP, and traditional NIP. By the way, “NIP” is an acronym for “Nursing In Public.”
Layered NIP
This way of NIP is done by wearing two shirts, a scoop-‐neck tank top under the shirt of your choice. When it is time to nurse your little one you lift up your outer shirt, unhook your nursing bra and pull down your scoop-‐neck tank top, exposing only your areola and nipple. When your baby is breastfeeding no one will see any skin and it will appear you are simply holding your baby close. No mammary tissue is showing, nor is your mid-‐section.
Fashion NIP Wearing a scarf to make a fashion statement can also help to cover up you and your little one while nursing in public. Just throw the scarf over you and your baby when it’s time to breastfeed.
Bib NIP Some moms like to use a breastfeeding cover. You can purchase one at Target, Walmart, Babies R Us or any retail baby product store. When it is time to breastfeed simply throw the nursing bib over you and the baby.
Traditional NIP There are so many different types of nursing tops and dresses. There are even nursing ball gowns. There are ways to even make your bridesmaid dress breastfeeding-‐friendly. So, to NIP traditionally means to don your nursing top or dress and be ready to breastfeed on demand. Many moms find this a convenient option. You can find these items at any maternity/baby store, Walmart, Babies R US or online. Tip: If you’re nervous for your first time breastfeeding in public, try it in front of a mirror a couple times.
We applaud you for breastfeeding our future,
and we honor you every step of the way, at home or in public.
ADVOCATE FOR FUTURE MOMS
If you had a great, really great, or really not so great breastfeeding experience at your child’s birth, and you want to recognize the impact that the hospital staff made on your experience, we’ve started a letter for you. Feel free to change it to fit your experience!
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
Date:
Dear ___________________________,
I am writing to tell you about my experience with your maternity ward. I gave birth to my child, ____________________, in your hospital on _________________________. During my pregnancy, I researched the numerous benefits of breastfeeding for both mother and child, and decided that I would breastfeed my child. I know that the following hospital practices can help a mother-child dyad with establishing a successful breastfeeding relationship: immediate skin-to-skin contact (Anderson, Moore, Hepworth, & Bergman, 2004; Berg & Hung, 2011; WHO, 1998), clinician encouragement of breastfeeding (Lu et al., 2001; Taveras, Braveman, & Escobar, 2003), and the provision of lactation consulting services (Bonuck et al., 2005). Conversely, the following hospital practices may interfere with the establishment of a successful breast-feeding relationship: bottle-feeding and pacifier use in the baby’s first days of life (Aarts et al., 1999; Howard et al., 1999; Howard et al., 2003; Newman, 1990; Righard, 2001; Rocha, Martinez, & Jorge, 2002), health professionals’ encouragement of formula supplementation (Humenick, Hill, & Spiegelberg, 1999), and providing parents with free samples of formula upon discharge (Bergevin et al., 1983; Donnelly et al., 2000; Eastham et al., 2005; Snell et al., 1992).
I believe that your hospital (did a good job, did not contribute, hindered) the establishment of a successful breastfeeding relationship between my child and me in the following ways:
I know that you are working to provide the highest-quality, state-of-the-art care to your patients and their families. I will not recommend your hospital to my friends until your policies include the following simple, empirically based, mother- and child-friendly practices:
1. Provide skin-to-skin contact as soon as possible after birth, for a minimum of one hour 2. Provide lactation support from a certified lactation consultant as soon as possible and as often
as needed to all mothers 3. Do not offer pacifiers or bottles unless a mother specifically asks for them 4. Encourage exclusive breastfeeding; educate mothers about the health benefits of exclusive
breastfeeding 5. Do not encourage formula use or offer formula 6. Do not provide “discharge bags” with formula or formula advertising
Please feel free to contact me at any time to discuss my experience at your hospital. My contact information is as follows:
Sincerely,
Dear _____________,
I am writing on behalf of Breastfeed Chicago!, a local organization dedicated to raising
awareness of the psychological and health benefits of breastfeeding while building community
support for nursing mothers. We hope you will display the attached decal in a window or other
prominent location in your store to show your support for our cause. Please feel free to contact
Katrina Pavlik at [email protected] if you have any questions about our
organization.
Warmly,
© 2012 Breastfeed Chicago – www.breastfeedchicago.com
