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(a) Breastfeeding provides health benefits to babies, as breast milk contains antibodies that protect babies from childhood illnesses including ear infections, respiratory infections, dermatitis, gastrointestinal disorders, asthma, obesity, diabetes, and a reduced risk of Sudden Infant Death Syndrome. The American Academy of Pediatrics recommends that babies be fed exclusively breast milk for the first six months of life and that breastfeeding continue at least until the end of the baby’s first year. For some parents, breast milk is readily available and affordable.
(b) Breastfeeding also provides many health benefits for mothers, including earlier return to pre-pregnancy weight and reduced risk of maternal postpartum depression, and reduced risk later in life of several cancers, type II diabetes, and osteoporosis.
(c) If a mother does not regularly express milk, the mother’s breasts can become full and uncomfortable, which may lead to a decrease in milk supply or infection. Most nursing mothers who return to work are able to sustain their milk supply and avoid discomfort by simply expressing milk at intervals and for lengths of time that suit their bodies.
(d) According to the Centers for Disease Control and Prevention, approximately 79% of new mothers in the United States breastfeed their babies at some point. Despite the benefits to mother and child of breastfeeding, only about 42% of babies are exclusively fed breast milk at three months of age. At six months of age, only about 19% of babies are exclusively fed with breast milk, and only about 49% of babies, in total, are fed some amount of breast milk.
(e) According to the San Francisco Department of Public Health (DPH), the majority of women in San Francisco do not exclusively breastfeed their child during the first six months. Of women who have a live birth, 97% initiate breastfeeding in the hospital, and 80% of mothers exclusively breastfeed in the hospital. Between birth and one month postpartum, 23% of women begin supplementing with infant formula, and 23% who had intended to exclusively breastfeed do so. Between one and three months postpartum, 10% of mothers stop breastfeeding altogether.
(f) There are noticeable disparities in breastfeeding rates in San Francisco among socioeconomic and ethnic groups. Mothers who use Women, Infants, and Children (WIC) services, a federally funded program that provides supplemental foods, health care referrals, and nutrition education to low-income women, experience much lower breastfeeding rates. Between birth and one month postpartum, 27% of mothers participating in WIC are exclusively breastfeeding. And only 16% of mothers participating in WIC are exclusively breastfeeding at six months of age. Caucasian infants whose mothers utilize WIC services are 3.5 times more likely than Asian infants, and 2 times more likely than African American infants, to be exclusively breastfed at one month of age. Hospitals that serve the largest number of low-income women have the lowest rates of breastfeeding initiation.
(g) In the United States, more than one-third of mothers with children under the age of two work full-time outside the home. Employment of mothers outside the home, especially full-time employment, has a negative influence on the period of time mothers breastfeed. Only 25% of employed women who are breastfeeding a child under age one continue to breastfeed the child for at least one month after returning to work. In 2000, only 11% of mothers with a one-year-old child and who worked full-time were still breastfeeding the child, in comparison to 19% of mothers who worked part-time while having a one-year-old child, and 22% of such mothers who were not in the labor force.
(h) There are several barriers to breastfeeding associated with employment. Women may not be aware of their rights to lactation accommodation in the workplace. Many women have fear of discussing breastfeeding with employers, which for San Francisco WIC participants, is one factor associated with early supplementation of formula for breastmilk. In San Francisco, 50% of women who have given birth report back to work within 12 months postpartum, with only 13% reporting leave from their job and only 13% working less than 40 hours per week.
(i) Under the Healthy People 2020 initiative, the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion developed a set of national objectives, which include a goal to increase the proportion of mothers who breastfeed their babies in the early postpartum period to 81.9% by 2020.
(j) An employer with a breastfeeding- friendly environment may have an advantage when recruiting and retaining employees. Breastfeeding may decrease employee absenteeism due to illness of a child, to the extent breastfeeding reduces childhood illnesses. The fewer the childhood illnesses, the fewer sick days mothers and fathers have to take in order to care for sick children.
(k) Federal law requires certain employers to provide nursing mothers with reasonable break time to express milk for one year after the child’s birth and a private space other than a bathroom, that is shielded from view and free from intrusion, to express breast milk. (29 U.S.C. § 207(r).) Similarly, California law requires all employers to provide a reasonable amount of break time and to make a reasonable effort to provide a private space, other than a toilet stall, close to the employee’s work area, to accommodate an employee desiring to express breast milk at work. (Cal. Labor Code § 1030.) Twenty-seven states, the District of Columbia, and Puerto Rico have laws that are supportive of breastfeeding in the workplace. Women employees who have adequate break time and private space to pump milk are more likely to exclusively breastfeed. At six months, employed women who receive breastfeeding accommodations are 2.3 times as likely to exclusively breastfeed and 1.5 times as likely to exclusively breastfeed with each passing month in comparison to women who do not have adequate accommodations.
(l) A work environment that is supportive of a mother’s efforts to breastfeed her child will likely increase the period of the child’s life during which breastfeeding will occur. By creating requirements on employers to facilitate lactation for mothers returning to work, the City will enhance employed mothers’ ability to continue breastfeeding through their child’s first year and beyond.
(m) In recognition of the well-documented health advantages for mother and child of breastfeeding, the purpose of this Article 33I is to provide a supportive work environment to enable employees in the City who are nursing mothers to breastfeed or express milk during working hours. Providing a supportive work environment to these employees will greatly benefit the health and welfare of employees and their families, while reducing burdens on the health care system associated with medical problems in children and mothers caused in part by an absence of or reduction in breastfeeding.
(Added by Ord. 131-17, File No. 170240, App. 6/30/2017, Eff. 7/30/2017, Oper. 1/1/2018)