BILL ANALYSIS Ó
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 502
S
AUTHOR: Pavley and De León
B
AMENDED: March 24, 2011
HEARING DATE: April 13, 2011
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CONSULTANT:
0
Trueworthy
2
SUBJECT
Hospital Infant Feeding Protection Act
SUMMARY
Establishes the Hospital Infant Feeding Protection Act
which will require all general acute care and special
hospitals that have a perinatal unit to have an
infant-feeding policy and to clearly post that policy.
CHANGES TO EXISTING LAW
Existing law:
Establishes the Maternal Child and Adolescent Health (MCAH)
program, administered by the Department of Public Health
(DPH), which monitors and reports infant feeding data.
Requires DPH to recommend training for general acute care
hospitals and special hospitals that is intended to improve
breast-feeding rates among mothers and infants.
Under MCAH, establishes the program "Birth and Beyond
California" which utilizes quality improvement methods and
training to implement evidence-based policies and practices
that support breastfeeding within the maternity care
setting.
Continued---
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Establishes the Women, Infants and Children program (WIC),
administered by the DPH to provide nutritional food
supplements to low-income pregnant women, low-income
postpartum and lactating women, and low-income infants and
children under five years of age, who have been determined
to be at nutritional risk.
Establishes the "Breastfeeding Peer Counseling Program" at
local agency WIC sites to increase the rate of
breastfeeding for WIC participants.
Establishes the Medi-Cal program, administered by the
Department of Health Care Services (DHCS), which provides
comprehensive health benefits to low-income children, their
parents or caretaker relatives, pregnant women, elderly,
blind or disabled persons, and nursing home residents who
meet specified eligibility criteria.
Covers, as part of the Medi-Cal durable medical equipment
(DME) benefit, the rental or purchase of breast pumps for
pregnant and postpartum women, subject to medical
necessity.
Defines a general acute care hospital as a health facility
having a duly constituted governing body with overall
administrative and professional responsibility and an
organized medical staff that provides 24-hour inpatient
care, including the following basic services: medical,
nursing, surgical, anesthesia, laboratory, radiology,
pharmacy, and dietary services
Defines special hospitals as a health facility having a
duly constituted governing body with overall administrative
and professional responsibility and an organized medical or
dental staff that provides inpatient or outpatient care in
dentistry or maternity.
This bill:
Makes several legislative declarations, including a
declaration that the Baby-Friendly Hospital Initiative
(BFHI) is a global program sponsored by the World Health
Organization (WHO) and the United Nations Children's Fund
(UNICEF) to encourage and recognize hospitals that offer an
optimal level of care for infant feeding.
STAFF ANALYSIS OF SENATE BILL 502 (Pavley and De León)Page
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Establishes the Hospital Infant Feeding Protection Act.
Requires all general acute care hospitals and special
hospitals that have a perinatal unit to have an
infant-feeding policy and to clearly post that policy.
Provides that the infant-feeding policy may include
guidelines provided by the Baby-Friendly Hospital
Initiative or the State Department of Public Health Model
Hospital Policy recommendations.
Requires the infant-feeding policy be routinely
communicated to all perinatal staff.
Requires the infant-feeding policy apply to all infants in
the perinatal unit.
Defines "perinatal unit" to be a maternity or newborn
service of the hospital for the provision of care during
pregnancy, labor, delivery, and postpartum and neonatal
periods with appropriate staff, space, equipment, and
supplies.
Defines "Baby-Friendly Hospitals" to be facilities that
have been awarded accreditation by Baby-Friendly USA, the
national authority for the Baby-Friendly Hospital
Initiative sponsored by the World Health Organization and
the United Nations Children's Fund.
Defines "Model Hospital Policy Recommendations" to be the
most recently updated guidelines approved and published by
DPH entitled, "Providing Breastfeeding Support: Model
Hospital Policy Recommendations."
Would take effect January 1, 2014.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
According to the author, breastfeeding has been shown to
have an impact on obesity throughout the life span, while
also contributing to numerous other positive health
STAFF ANALYSIS OF SENATE BILL 502 (Pavley and De León)Page
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outcomes. The United States Surgeon General and major
health organizations, such as the American Academy of
Pediatrics, recommend exclusive breastfeeding for most
babies for the first six months of life. The author states
that many California hospitals do not have infant feeding
policies in place to help prevent the onset of chronic
health conditions and diseases, as well as later growth and
development problems, such as obesity.
According to the report, One Hospital at a Time, produced
by the California WIC Association and the UC Davis Human
Lactation Center, nearly 90 percent of Californian mothers
enter the hospital intending to breastfeed. Hospital
policies can play a pivotal role in whether they are
successful. The report states that hospital practices can
discourage or prevent mothers from carrying out that
decision by failing to provide skilled support, separating
mothers from their babies, delaying the first feeding, or
routinely providing formula supplementation even for
infants whose mothers intend to breastfeed exclusively.
In an effort to help parents receive the best information
for their baby's early nutrition, the author states that SB
502 would require all general acute care hospitals in
California with a perinatal unit to have an infant feeding
policy. The author contends this is a modest approach that
will help increase the exclusive breastfeeding rates in
California hospitals, while giving the maternity hospitals
a reasonable amount of time to develop their infant feeding
policies and to educate their perinatal unit staff.
Women, Infants and Children (WIC)
WIC is a federally funded health and nutrition program for
women, infants, and children. Participants must meet
income guidelines and be pregnant women, new mothers,
infants or children under age five. In California, 82 WIC
agencies provide services locally to over 1.4 million
women, infants and children each month at over 600 sites
throughout the state.
Since 2004, the California WIC Program has implemented a
Breastfeeding Peer Counseling (BPC) Program to enhance
WIC's breastfeeding management and counseling efforts. In
2004, the USDA allocated $2.15 million to California for
BPC programs. Eight local WIC agencies were authorized for
implementation in October 2004. Seven additional agencies
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received planning grants in February 2005.
In April 2005, the California WIC program received an
additional $2.12 million from USDA and 15 local agencies
received $1.3 million for BPC programs. The remaining funds
were spent on breastfeeding training and materials for
agencies statewide. In 2009, WIC received $12.5 million
from the USDA to further expand the BPC Program.
Surgeon General
On January 20, 2011, Surgeon General Regina M. Benjamin
released The Surgeon General's Call to Action to Support
Breastfeeding which outlines evidence-based steps that all
sectors of a community can take to remove obstacles faced
by women who want to breastfeed their babies. A Call to
Action is the highest directive that a US Surgeon General
can issue, and breastfeeding supporters nationwide applaud
this action.
Baby-Friendly Hospital initiative
Launched in 1991, the Baby-Friendly Hospital Initiative
(BFHI) is a global program sponsored by the WHO and the
UNCF to encourage and recognize hospitals and birthing
centers that offer an optimal level of care for infant
feeding. The BFHI assists hospitals in giving mothers the
information, confidence, and skills needed to successfully
initiate and continue breastfeeding their babies or feeding
formula safely, and gives special recognition to hospitals
that have done so. BFHI focuses on 10 specific policies
designed to reduce barriers to breastfeeding.
According to the report, One Hospital at a Time, produced
by the California WIC Association and the UC Davis Human
Lactation Center, since the implementation of BFHI,
California has seen a rise in the number of baby-friendly
hospitals, growing from 12 in 2006 to 34 in 2010.
Hospitals that have instituted Baby-Friendly practices have
the highest rates of breastfeeding.
Prior legislation
SB 22 (Migden), Chapter 460, Statutes of 2007, requires the
DPH to recommend training for general acute care hospitals
and special hospitals to improve breast-feeding rates among
mothers and infants. Also requires DHCS to streamline and
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simplify existing Medi-Cal program procedures to improve
access to lactation support and breast pumps among Medi-Cal
recipients.
SB 1275 (Ortiz), of 2004 would have required manufacturers
of infant formula that distribute free formula samples in
the maternity unit, nursery, or any other location in a
hospital, to include a single, readable disclaimer notice
stating "The distribution of the formula or the marketing
materials in a hospital setting does not necessarily mean
that the hospital or its health care providers endorse the
company or the product that is being distributed." SB 1275
failed passage in the Assembly Health Committee.
Arguments in support
Supporters contend that many mothers have every intention
of providing their baby the best by having the desire to
breastfeed. However, many hospitals unfortunately do not
provide sufficient training to their staff nor have in
place policies that support their patients desire to
breastfeed successfully.
The California WIC Association, the sponsors of SB 502,
write that this is a modest approach to help increase the
exclusive breastfeeding rates in California hospitals while
giving the maternity hospitals a reasonable amount of time
to develop their infant feeding policies and educate their
perinatal unit staff.
POSITIONS
Support: California Women, Infants and Children (WIC)
Association (sponsor)
Antelope Valley Hospital
Butte County WIC
California Breastfeeding Coalition
California Center for Rural Policy
Community Medical Centers, Inc.
E Center WIC
First 5 LA
Kern County Breastfeeding Coalition
Mono County WIC
Native American Health Center
Orange County Breastfeeding Coalition
Planned Parenthood of Orange and San Bernardino
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Counties WIC
Program
Public Health Foundation Enterprises WIC Program
San Diego County Breastfeeding Coalition
Solano County Health and Social Service WIC
Program
Tulare County Breastfeeding Coalition
20 individuals
Oppose: None on file.
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