BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 502
                                                                  Page  1

          Date of Hearing:   August 17, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

             SB 502 (Pavley and De Leon) - As Amended:  August 15, 2011 

          Policy Committee:                              HealthVote:14 - 5 


          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              

           SUMMARY  

          This bill requires, effective January 1, 2014, that general 
          care, acute care, and specialized hospitals with perinatal units 
          adopt and post an infant-feeding policy either in the perinatal 
          unit or on the hospital's website. In addition, this bill 
          requires that the policy be regularly communicated to the 
          perinatal staff.

           FISCAL EFFECT  

          Any costs associated with this legislation would be minor and 
          absorbable within existing resources.

           COMMENTS  

           1)Rationale . The author states that a growing body of evidence 
            indicates that breastfeeding can affect growth and development 
            in children, while significantly reducing their risk for 
            infections and chronic disease such as diabetes, asthma, and 
            obesity.  The author argues that even though regulations 
            require general acute care hospitals to have a written 
            breastfeeding policy, many do not have those policies in 
            place. According to information gathered by California WIC 
            Association (CWA), 14 out of the 22 lowest performing 
            hospitals, those with the highest formula supplementation 
            rates, do not have a breastfeeding policy.  

            The author states the goal of this bill is to provide 
            hospitals with guidance on infant-feeding policies that 
            address both breastfeeding and proper bottle feeding.  The 
            author contends this bill is a modest approach that will help 








                                                                  SB 502
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            increase the exclusive breastfeeding rates in California 
            hospitals and update current regulations while giving the 
            hospitals a reasonable amount of time to develop their 
            infant-feeding policies and to educate their perinatal unit 
            staff.

           2)Infant-Feeding Policies  . This bill requires hospitals to adopt 
            either a Baby-Friendly Hospital Initiative (BFHI) 
            infant-feeding model policy or the Department of Public 
            Health's (DPH) infant-feeding model policy. 

            BFHI is a global program sponsored by the World Health 
            Orgnization and UNICEF to encourage and recognize hospitals 
            and birthing centers that offer an optimal level of care for 
            infant-feeding. 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 
            adopted BFHI practices and recommendations have the highest 
            rates of breastfeeding in the state.   
            "Model Hospital Policy Recommendations" are the guidelines 
            developed by the Inland Empire Breastfeeding Coalition and 
            approved and provided to hospitals as another resource to 
            improve breastfeeding policies by the DPH.  The official 
            guidelines, which are approved and published by DPH, are 
            entitled, "Providing Breastfeeding Support: Model Hospital 
            Policy Recommendations."  

            Both policies include extensive additional instructions, 
            narrative, references and guidelines to assist hospitals and 
            staff in interpreting and applying these guidelines.  

           3)Health Care Savings Associated with Breastfeeding  . Studies 
            have long shown that there are significant health benefits to 
            exclusively breastfeeding for both the child and the mother.  
            Among the benefits for the child are reduced likelihood of 
            obesity, reduced rates of asthma, type 1 and type 2 diabetes, 
            childhood leukemia, lower respiratory tract diseases and 
            gastrointestinal infections, and a lower risk of Sudden Infant 
            Death Syndrome. For mothers, the health benefits include a 
            lower risk of maternal type 2 diabetes, and lower rates of 
            ovarian and breast cancer. 

            A 2010 University of California study on breastfeeding found 
            that if 90% of all women exclusively breastfed their infants 
            for the first six months it would save $13 billion per year in 








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            health care costs and prevent close to 1,000 deaths annually 
            (95% of them infants). 

           4)Related Legislation  . SB 22 (Migden), Statutes of 2007, 
            requires DPH to recommend training for general acute care 
            hospitals and special hospitals to improve breast-feeding 
            rates among mothers and infants.  Also requires the Department 
            of Health Care Services to streamline and simplify existing 
            Medi-Cal Program procedures to improve access to lactation 
            support and breast pumps among Medi-Cal recipients.

            In 2009, AB 513 (De Leon) required health plans and those 
            health insurers that provide maternity benefits to provide 
            coverage for lactation consultation with an international 
            board-certified lactation consultant and the provision of a 
            breast pump. 

            In his veto message, Gov. Schwarzenegger noted, "I share the 
            author's interest in promoting safer, healthier outcomes for 
            mothers and their children. . . . However, the addition of a 
            new mandate, no matter how small, will only serve to increase 
            the overall cost of health care."  



           Analysis Prepared by  :    Julie Salley-Gray / APPR. / (916) 
          319-2081