California
Chapter 1
News Update May 1998
| Spring Meeting in Monterey | Report on National AAP Committee on Medical Liability |
| Honor for David Zlotnick, Past Chapter 1 Chairman | Managed Care Initiative Update |
| Pediatricians - Who are our Colleagues? | Summary of the Board of Directors Meeting |
| Vice President’s Report | 12th Annual California Conference on Childhood Injury Control |
| Chairperson's Report, California District IX | Pictures for the newsletter and website |
| Children with Disabilities Committee (CWDC) | Democrat Representative from New York, Carolyn Maloney’s New Mothers’ Breastfeeding Promotion and Protection Act Draft |
Spring Meeting in Monterey
This year’s Spring meeting will be at the Hyatt Regency in Monterey. This is a wonderful site and facility for a great program. You are encouraged to bring your family for this holiday weekend conference. Many respected speakers will educate you on topics that will be practical in your everyday practice. Program goals are:
Honor for David Zlotnick, Past Chapter 1 Chairman
Lucile Salter Packard Children’s Hospital will honor David Zlotnick during a special Grand Rounds Program on June 5th, 1998 at 8 am in the auditorium. The title is “Interplast: A Pediatrician’s Perspective.” Dr. Zlotnick was an outstanding community pediatrician, loyal Academy member and officer but also devoted himself to various humanitarian causes in underdeveloped countries. He was the first pediatrician to participate in Interplast and also became its President. His dedication in the care of children extended itself to many countries throughout his career. Unfortunately, David no longer practices pediatrics; however he volunteers at the medical school library and still participates in Interplast activities.
Pediatricians - Who are our Colleagues?
By Tom Long
We all agree that there is no going back. The Future of Pediatric Education project considers what we should teach; managed care mandates how we should treat; the baby boomers are looking for alternative treatments. What a contrast these days are to years we spent in medical school, in clinical training and in continuity clinics learning about the sick patients who lay looking up at us.
In conjunction with our District, I recently spent a morning in Sacramento in pursuit of changes in Medi-Cal reimbursement. We lobbied hard to convince the CMA of our need for a substantial increase in the reimbursement of pediatric fees. The CMA has many constituents who also demand attention and hence the CMA is committed to helping them all. The Budget Battle is not yet won. Lucy Crain, the district staff, and our lobbyist work tirelessly on our behalf. We need a stronger network of supporters to assure that the children’s advocacy role that we pediatricians represent is heard. Pediatricians are needed to meet the expectations of the expanded Medi-Cal program and to ensure the success of the Healthy Families Program. We need more allies.
Paul Jewett, our chapter vice president, and I recently traveled to Chico to meet with the pediatricians and to try to promote the development of a rural pediatric committee. With the help of Arnold Gold we had a pleasant dinner, a small CME program and an opportunity to represent the chapter activities. The support of all of our pediatricians is necessary to gain the ear of the politicians and inform them of our minimal budget needs. Many pediatricians outside the Bay Area could play a very important role in our legislative pursuits. We must continue to educate all of our Assembly representatives. You all can contact your State Assembly representative. But we still need more allies.
It occurs to me that there is an area of pediatrics where we should be doing a better job. That sphere of activity is in the schools. The talk of school based clinics makes sense because that is where the children are. There may be better reasons. The role of the schools is changing. Children live much of their early life in school settings – in academics and in extended day care arrangements. In some school settings children eat at least two of their meals there every day. In short, the schools have become “like home,” providing much of the social and moral teaching reserved in the past for home. We may have more in common with educators than we do our colleagues in other medical disciplines.
With this relationship in mind how do we respond to school requests, the kindergarten readiness exam, sports participation physicals, and teachers’ observations about health related concerns or academic failings, academic problems, etc? Are we all well versed in I.E.P. regulations, 504 plans, or the role of Student Study Teams? Each district seems to have its own idiosyncrasies. Many pediatricians are simply so out of touch with school law and school needs as to be intimidated by the educational system. Alienated and burdened are terms that often characterize the relationship of pediatricians and teachers. We can and must do better. How many of us actually interacted with the schools to promote the anti-tobacco message of last year’s Child Health Month? This October our focus will be on alcohol associated problems. Your willingness to participate with teachers would be most welcome. We can provide you with information and presentation kits. School athletic programs, health care screening, nutritional guidance, sex education are but a few more areas in which we could make an impact.
We are winning the battle against pediatric infectious diseases and the few children we admit to the hospital often require the skills of an intensivist or in the case of infants, a neonatologist. Pediatricians must go back to school. We will then understand our patients’ needs better, teachers’ problems will become clearer and we will know the school jargon. Educators need better collaboration with pediatricians to address learning and behavior problems and to advance the development of children with special healthcare needs. Pediatricians need the voice of educators to contend for better access and more comprehensive health care for all children. Recognition as a community resource will enhance our credibility in Sacramento and solidify the coalitions necessary to help our advocacy succeed. This role may be the niche waiting to be filled by tomorrow’s pediatricians.
by Paul Jewett
Tom Long, Beverly Busher, and I were delighted to share an evening with our Chapter Members in Chico last month. It was very inspiring to see pediatricians practicing “the old fashioned way” with an interest in their community and a willingness to go the extra mile to keep up their hospital skills and commitment to quality care. Hats off to them and all of our colleagues in rural practice.
I also wanted to share information about a new state law called The Friedman-Knowles Act that will be taking effect July 1, 1998. This act states that when a denial of coverage is made, there will be a requirement for all health plans to offer patients an external, independent review process under these circumstances. This is recommended if the enrollee (i.e. patient), or a licensed, board-certified or eligible physician in the area of practice appropriate to treat the patient’s condition, has requested a therapy likely to be more beneficial than any available standard therapy. The request must be based on two documents from the medical or scientific literature. In addition, the patient must be judged to have a medical condition with a high probability of causing death within two years from the date of the request for an independent review. The therapy (drug, device, or procedure) must have been a covered service except for the plan’s determination that the proposed therapy is experimental or investigational. An accredited review body must be contracted with and paid by the health plan to perform this review within specific time frames discussed in the law. The law is very detailed and should be consulted for additional information. This is an example of legislation aimed a correcting some of the “abuses of managed care.” Many other states are considering similar legislation. We need to keep abreast of this and all new regulations since our patients may well ask about them.
Following up on our last article, the National AAP Committee on Hospital Care is sponsoring a discussion session at the October AAP meeting in San Francisco on “hospitalists” and inpatient care. I would encourage all of you interested in this topic to attend this session and share your views. It has implications for the future of pediatric training, the role of the general pediatrician in community practice, and the ability to maintain hospital credentials in the future. I would also encourage everyone to read the April supplement to Pediatrics entitled “Pediatric Residency Training in an Era of Managed Care.” Many of the issues discussed are relevant not only to training future pediatricians, but to current practice as well.
I hope to see all of you at our meeting in Monterey and at the AAP meetings in San Francisco.
Chairperson's Report, California District IX
By Lucy Crain
I thought it might be interesting to share some insider information gleaned from my experiences as a frequent visitor to National AAP headquarters in Elk Grove Village, Illinois, where the Board of Directors meets more frequently than I’d realized. Our national AAP Board, on which I’m honored to represent our California constituency, meets 8 to 10 times yearly, and I’ll share more about these meetings in future columns.
Back home in California, state AAP priority issues continue to focus on the Healthy Families project. This project provides expanded access to health insurance for children between 100% and 200% of poverty. It is made possible through a huge federal designation of funds via Title 21 of the Balanced Budget Amendment and major efforts to achieve a substantive increase in Medi-Cal reimbursement rates for pediatric services. The District continues to be well represented in the planning for Healthy Families. Many issues remain unresolved at this time, including options for vaccine carve-out due to the denial of standard VFC benefits. This is because California and several other states chose a combined commercial administration for the program, instead of just expanding Medi-Cal. Presumptive eligibility also remains an unresolved item of some concern.
Thanks to all of you who responded to our urgent survey regarding the rate issue. More than 100 California AAP members clearly voiced what we’ve all heard - Medi-Cal rates for pediatric CPT codes are grossly inadequate and far less than the overhead cost to the pediatrician or family physician providing care for children. These rates have not been adjusted since 1985 and essentially are much the same as they were in 1979. Understandably, many pediatricians strongly feel they simply cannot afford to see Medi-Cal patients when their overhead costs exceed reimbursement for services by as much as 100%, or more in certain locales. Our District AAP Rates Work Group with participation from all 4 chapters has been working at an exhausting pace. We’re working collaboratively with the University Childrens’ Medical Group and a group of other children’s advocacy groups, as well as our politically savvy legislative lobbyist, Erin Aaberg, and District Executive Director, Kris Calvin, MA. Our negotiations with representatives of the Assembly and Senate Budget committees as well as with the CMA are ongoing. I sincerely hope that the intensity of our combined efforts is successful. We all want Healthy Families to succeed. We want to increase access not only to health insurance, but also to quality primary and subspecialty pediatric care. Adjustment of Medi-Cal rates is a crucial component in assuring that this happens for California’s needy children.
Children with Disabilities Committee (CWDC)
By Jan Young, Chair
The Children with Disabilities Committee (CWDC) is monitoring several issues of importance to the AAP. These include, but are not limited to:
Medi-Cal Technical Advisory Committee on OT/PT (TAC): This committee was formed by Medi-Cal to assist them in determining OT/PT needs for children not eligible for the CCS MTU’s. There is AAP representation on this committee and we will continue to have input in the final recommendations made to Medi-Cal. The general recommendation at this time is for Centers of Excellence. CWDC members expressed a number of concerns about the plan but will be involved in having input into the final draft.
Dental access: The CWDC is surveying dental access for disabled children and hopes to be working with the California Dental Association on this project. Alameda County Managed Care Risk Scale: CWDC is watching how things are going in Alameda County with the newly implemented risk scale for determining additional capitation monies to physicians caring for children with disabilities. Data is expected by this summer.
Developmental Centers: The CWDC has representation on the CMA’s task force, which is investigating the Strauss allegations. Developmental Centers will be receiving more monies this next fiscal year and there are no slated closures at present.
Early Start: The State has “bought off” on the ICC Health System recommendations and a draft set of regulations is forthcoming. The CWDC will be involved.
Report on National AAP Committee on Medical Liability
By Jeffrey Berman, Salinas
I have just returned from the Committee on Medical Liability, which met March 6 & 7 in Chicago. There were many issues we discussed.
First, I want to announce to everyone that AB250, the bill that the California Trial Lawyers Association (now known as the Consumer Trial Lawyers of California) has been taken off the docket for this year. AB250 is a bill that would have gutted your MICRA protection, including the $250,000 on pain and suffering. The original bill (which was subsequently changed) required that any child under age 14 years who has been injured would not be subject to the $250,000 protection on pain and suffering.
There were several topics discussed at this COML meeting, three of which I would like to discuss with you – fraud and abuse, suing managed care organizations, and expert witness.
Fraud and Abuse
The federal government has been using an old law to attack doctors for fraud and abuse. Basically, as far as pediatricians are concerned, this means “upcoding.” If you charge a Level IV for what is a “low complex” service instead of a “medium complex” service, you will be subject to fraud and abuse. The fines are $10,000 per incident and return of the difference in payments. Many of you take care of Medi-Cal patients and CHAMPUS patients who may be subject to investigation. The Academy will be developing information for you over the next year to help protect you. The federal government will be looking for “outliers.” Therefore, if you charge too many Level IV’s, they may investigate you.
Suing Managed Care Organizations (MCO’s)
As you know, anyone in the medical community can be sued – nurses, physicians, chiropractors, etc., and MCO medical directors. However, at this point the organizations themselves, especially if they claim ERISA protection, cannot be sued. ERISA is a national law that originally was designed to protect employees from problems with their retirement plans. However, it also gives the right to corporations to self-fund health plans and not be under any rules of the individual states.
There are a large number of physicians who would love to sue managed care organizations for their decisions. I fear the problem with this is that there will be more medical liability suits than there are now. At the present time, malpractice suits in California have leveled off. Any attempt to bring in managed care organizations to be sued would in fact increase the number of medical liability suits. The reason is obvious. The MCO’s are large, deep pockets and there is no $250,000 limit on pain and suffering. In order to sue the MCO, you the individual physician, would likely be a co-defendant. In my opinion, this would be a new, fertile ground for the trial lawyers.
Expert Witness
All across this country there is a hue and cry to do something about expert witnesses, any of which are felt to be “hired guns.” We reviewed several cases along these lines. Some of the expert witnesses’ opinions are “out in left field,” but other were a matter of opinion.
The AMA wants to declare that expert witness testimony is the practice of medicine. Many articles that we reviewed feel expert witnesses should be subject to peer review. The committee had trouble with this concept. Peer review could be interpreted by the courts as infringing on the First Amendment rights of a person to say what they wish. In addition, peer review could lead to what the public would perceive as a conspiracy of silence, and indeed it may coerce physicians who will defend you into not speaking out.
The other problem with declaring expert witness the practice of medicine is it might imply that you would need a medical license in that particular state. Others on the committee, such as myself, feel that as long as the person is licensed in a state, then he would be able to testify in a case. Again, let’s remember that many expert witnesses are for the defense. We are beginning to toy with the idea of asking physicians to notify the state medical board in those instances where the physician felt the egregious testimony was given against him or her. The main disadvantage was the feeling that some states may not have the money or the manpower to investigate an egregious testimony.
I would like to hear from you about your ideas about these three important issues. Please don’t hesitate to call me. My office phone number is (408) 422-6707 and my fax number is (408) 422-0577.
Managed Care Initiative Update
By Anthony T.
Hirsch and Burton F. Willis
Co-Chairs, Managed Care Task Force
With the conclusion of the two-year managed care initiative we wanted to update our membership on some final products of the initiative.
Executive Summary and Slide Presentation
Last fall all of our members received an executive summary of the initiative, a copy of our patient education brochure (to be discussed below), and a cover letter from our District Chair at the time - Len Kutnik. Members of the District Board have begun to present the slide presentation which describes in detail the results of the initiative, to various pediatric medical staffs, and pediatric grand rounds. The presentation has been well received and has certainly elicited many provocative questions related to managed care issues as they affect pediatricians and their patients in California. Members of the Executive Board are available to pediatric medical staffs in the state. If you would like to schedule a grand rounds please call the District Office to set up the presentation.
Patient Education Brochure
As mentioned above the initiative developed a nice patient education brochure to be used in your offices to help educate your patients as to the benefits of having a pediatrician as the best professional to manage and treat their child’s medical needs. The response from the membership has been very positive and well received by our patients. To order the brochures please call Wolf Press at (714) 568-0877.
Future Activities
The Executive Board will be examining ways in which the District can be responsive to the myriad of needs and concerns of our members in the managed care system in California. Each of our four Chapters have active managed care and child health financing committees. We encourage you to contact Beverly Busher at the Chapter office. Your Executive Board is committed to being involved in the managed care issues as they affect our members and our patients in California. Please contact us with your concerns.
Summary of the Board of Directors Meeting March 3, 1998 at the Hyatt Hotel, Burlingame
All Chapter members are encouraged to attend the Annual Business Meeting on Sunday morning May 24th in Monterey. It will provide a forum for Chapter information.
October is Child Health Month. In conjunction with the Fall National AAP meeting in San Francisco this October, Chapter 1 will sponsor a Pediatric Hotline on October 18th in San Ramon.
Members at Large are encouraged to submit regular articles to the newsletter regarding what’s happening in their area. The Board will assign each Member at Large to a particular issue of the newsletter. Articles should be no more than 500 words and should be submitted to either Mika Hiramatsu or Mark Simonian for publication.
Tom Long summarized the retreat and in particular the Internal Objectives listed in the written retreat summary. He emphasized the need for better intra and inter-chapter communication and the recruiting and retention of members.
Everyone was asked to vote for National vice-president-elect and we recognized that the AAP is fortunate to have such excellent candidates for that position.
The following current nominations for national committees are Bill Feaster (Child Health Finance), Richard Powers (Fetus & Newborn), John Bolton (State Government Affairs), Art Ablin (Bioethics), and Bertram Lubin (Committee on Awards for Excellence in Pediatric Practice).
Vice President’s report by Paul Jewett described his Future of Pediatric Education Project (FOPEII) questionnaire response, which has been submitted to the National office.
Dr. Jewett reported on the Membership Committee activities and asked the Board and Committee Chairs to contact those who are not members and see if they were interested in joining the Chapter. He also requested that they fill out a form regarding this personal contact (the form to be developed by Myles Abbott and Paul Jewett). The Board agreed that they would assist with this recruitment project.
The Chapter officers decided to send letters of congratulation to newly appointed emeritus members and ask them to remain active in our chapter.
Majeed Al-Mateen, treasurer, announced that he will be leaving California to move to Tacoma, Washington in July. The Board thanked Dr. Al-Mateen for his excellent work as Chapter Treasurer.
Beverly requested that Chapter 1 purchase a PC format laptop computer in order to be compatible with the PC format of the chapter database, the newsletter and the web site. The Executive Committee will make the selection of a laptop for the Chapter. (Editor’s note: This has been approved and should be available at the Monterey meeting.)
The Chapter 1 Web Page was discussed. Dr. Jewett expressed the concern of the Executive Committee that there needs to be criteria for including physicians who are chapter members on our website. A subcommittee of Mike Harris, Mark Simonian, Bill Feaster and Paul Jewett will convene to establish criteria for the web page.
Barbara Staggers reported on the Committee on Adolescence and stated that this committee has been active in providing policy statements for the Journal of Pediatrics. She also reported that the committee has prepared policy statements on violence. That committee has requested a re-evaluation of the National AAP logo, which is currently the Della Robia. Other items being addressed by the Committee on Adolescence include parenting education for fathers and the dissemination of contraception information. Tom Long thanked Dr. Staggers for her contributions to our CME meetings and her work with the National committee.
Jeff Berman discussed the many legal and ethical issues being addressed by the Committee (His report can be found in this issue.) He provided several examples of issues currently under study, such as the waiving of copayments. Dr. Berman stated that the issues of expert witnesses and telemedicine are also of concern to the committee. He also agreed to do a regular “Question and Answer” column for the Chapter 1 newsletter. Please submitted your questions to Beverly Busher.
Mark Miller reported that he has enjoyed his experience of being on the National Environmental Health Committee and suggested that the Chapter might recruit more members by advertising the possibility of National committee participation.
Several issues are being addressed by the Environmental Health Committee including the effect of exposure to loud, sustained noise in neonatal units, the effect of noise on pregnant women, environmental tobacco smoke, and sun exposure and UV radiation. The committee is working on a revision of the lead statement, and published a brochure for parents - The Environment and Your Child. The EPA will have an office exclusively devoted to children’s issues. The Manual on Pediatric Environmental Health will be published in December or January, and that this manual will be extensive, containing 35 chapters of environmental health information.
Tracy Trotter described the National Committee on Genetics and its many liaisons with other health and genetic interest groups. He described the focus for National subspecialty committees is to assist the general pediatrician in private practice to care for children with problems related to genetic conditions.
Dr. Trotter reported that Thalidomide has been approved by the FDA for use in treating leprosy. Thalidomide has been used successfully to treat severe atopic dermatitis. He expressed the necessity of restricting this drug.
Dr. Trotter also described the committee’s pediatric questionnaire for medical pediatric genetic diseases. He reported that Northern California could be a beta site for this questionnaire. There is concern that written policy statements might become standard of care. Dr. Trotter described several statements, which will be forthcoming from the committee, including Down’s syndrome, maternal PKU, Williams’ syndrome and cord banking.
David Bergman stated he has been a member of the Quality Improvement Committee for six years and chair for two years. He described strong linkage with other committees and organizations. The committee is focusing on developing evidence-based guidelines. He also described the extensive process by which standards of care are established. The Packard Foundation has provided funds to study health care for children and has provided funding to try to improve asthma practices in the office (The committee found significant numbers of practices that were not working within the guidelines for asthma treatment.)
Peter Michael Miller (Early Childhood Adoption & Dependent Care) reported there are eight members and several liaison members to outside organizations. He described the areas of interest for his committee and Healthy Child Care program questionnaires for parents and child care providers and pediatricians. Other topics of interest to this committee include early childhood and early brain development, Head Start and Early Head Start.
Paul Jewett (Committee on Hospital Care) reported that this committee would be sponsoring a meeting during the Fall meeting of National AAP in San Francisco. This will be in the form of a seminar discussion on Pediatric Inpatient Care. He also described the committee’s work in progress on various statements relating to hospital care issues.
Mika Hiramatsu distributed a mock-up of the new Chapter 1 membership brochure and asked everyone to participate in Pediatric Hotline, which is scheduled for Sunday, October 18th, in conjunction with the Annual AAP meeting in San Francisco.
District IX Chair’s Report, Lucy Crain discussed Medi-Cal reimbursement rates and the need to lobby for increased reimbursements for pediatricians in order to ensure that private pediatricians will be able to afford to accept Medi-Cal clients. She announced that District IX will be mailing questionnaires to all pediatricians regarding this issue, and that an immediate response is required for testimony at the end of next week.
The Managed Care Initiative is being retired by the District, but the managed care issue will continue to be addressed at the District level. Dr. Crain reported that the District Violence Task Force continues to meet regularly and is preparing a statement for distribution. She asked the Board to contact the State Budget Committee to document the denial of pediatric care due to lack of proper reimbursement for services.
At the 1998 Annual Chapter Forum Resolutions, it was proposed that the AAP require National members to belong to their local chapter. The Board endorsed this motion.
12th Annual California Conference on Childhood Injury Control
By Janice Yuwiler, Project Director
Date: September 14 - 16, 1998
Location: Radisson Hotel in Sacramento, California
Goal: The conference is designed to update physicians, public health professionals, and injury prevention advocates on current issues and future directions in injury epidemiology, public policy, and injury prevention strategies.
Focus:
Contact: California Center for Childhood Injury Prevention of the Graduate School of Public Health, San Diego State University, 6505 Alvarado Road, Suite 208, San Diego, California 92120, (619) 594-3691.
Sponsor: The conference is conducted in conjunction with the Maternal and Child Health Branch of the California Department of Health Services. Many organizations, including the American Academy of Pediatrics, California District 1X, serve as collaborating agencies for this event.
Please help us update our files. If there have been any changes in your address, please e-mail us at kmjones@pmail.sdsu~edu or contact us at (619) 594-3691.
Pictures for the newsletter and website
Mark M. Simonian requests that if you are a Committee Chairperson or member and have pictures that you would like to share, please send a copy to Beverly Busher so that they might be included in future issues of Chapter publications. He believes that members want to see the face with the name when distance often separates us from speaking in person. The newsletter and website currently show some of the pictures that we have taken. Let’s personalize our publications.
The website is adding new features. We hope to include many informational items accumulated over the years into a historical perspective. Many members have been added with links to their committees, newsletter summaries, and other links. We are interested in hearing from you about topics and features needed in future issues of the newsletter and our Chapter website. Contact Beverly Busher, Mika Hiramatsu, or Mark M. Simonian (see methods on page 2).
Democrat Representative from New York, Carolyn Maloney’s New Mothers’ Breastfeeding Promotion and Protection Act Draft
This bill supports breastfeeding by new mothers and encourages employers to support workplace lactation programs. It is endorsed by the American Academy of Pediatrics, National Association of WIC Directors, International Lactation Consultant Association, La Leche League International, and the National Alliance for Breastfeeding Advocacy (NABA).
Women with infants and toddlers are the fastest growing segment of today’s labor force. At least 50% of women who are employed when they become pregnant return to the labor force by the time their children are 3 months old.
The American Academy of Pediatrics recommends exclusive breastfeeding for at least the first 12 months of a child’s life. AAP recommends that mothers begin breastfeeding within the first hour after delivery and that arrangements are made to provide expressed breast milk if mother and child must separate during the first year.
The United States Surgeon General and the American Academy of Pediatrics agree that breast milk is the best form of nutrition for children during the first months of life.
Although the Pregnancy Discrimination Act was enacted in 1978, prohibiting discrimination based on pregnancy, childbirth, or related medical condition, courts have not interpreted this to include breastfeeding, while the intent of the Congress was to include it.
Women who wish to continue breastfeeding after returning to work have relatively few and simple needs. These are availability of suitable, dependable, efficient breast pumps; a convenient, safe, private, and comfortable location at the worksite; and the ability to pump her breasts two or three times during the work shift.
Many employers have seen positive results in facilitating lactation programs in the workplace, including low absenteeism, high productivity, high company loyalty, high employee morale, and lower health care costs.
Women who can breastfeed in their place of employment benefit their employers because these women have higher morale, higher self-esteem, increased productivity, more company loyalty, and lower health care costs.
Because infant illness is a frequent cause of absenteeism among employed mothers worksite programs that aim to improve infant health may also bring about a reduction in maternal absenteeism. Mothers of formula-fed children missed a day’s work because their children were ill three times more often than breast-fed children.
Breast milk contains all the nutrients a child needs for ideal growth and development. It includes helpful antibodies, proteins and immune cells that can only be found in breast milk. It promotes closeness between mother and child, is easy to digest, and helps guard against juvenile diabetes, lymphomas, Crohn’s disease, celiac disease, and a number of chronic liver diseases. Studies show that children who are not breastfed have higher rates of death, meningitis, childhood leukemia and other cancers, diabetes, respiratory illness, bacterial and viral infections, diarrheal diseases, otitis media, allergies, obesity, and developmental delays.
In 1997, the United States had one of the lowest breastfeeding rates of all industrialized nations – and one of the highest rates of infant mortality.
Breastfeeding may help reduce the mother’s risk of breast and ovarian cancer, and osteoporosis.
Breastfeeding releases a hormone in a woman’s body that causes her uterus to return to its normal size and shape more quickly and another hormone related to breastfeeding acts as a natural tranquilizer.
The bill will:
1. Ensure that Breastfeeding is a protected activity under civil rights law, requiring that women cannot be discriminated against in the workplace for pumping milk, breastfeeding, or related activities.
2. Encourage employers to set up a safe, private, and sanitary environment for women to express milk. Employers can receive a tax credit if they set up a lactation location, purchase or rent lactation or lactation-related equipment, hire a lactation consultant, or otherwise promote a lactation-friendly environment.
3. Grant working women breastmilk breaks of up to one hour per day for up to one year following the birth of a child to breastfeed or express milk. This time could be taken in three 20-minute breaks or two 30-minute breaks.
4. Require the FDA to develop minimum quality standards for breast pumps, to ensure that products on the market are safe and effective.
5. Provide increased funding to WIC’s breastfeeding promotion, education, and support initiative, which now totals approximately $46 million per year, without compromising other WIC objectives.
6. Grant federal employees breastmilk breaks of up to one hour per day for up to one year following the birth of a child to breastfeed or express milk. This time could be taken in three 20-minute breaks or two 30-minute breaks.
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