Breaking Barriers Massachusetts Fails To Support & Protect Breastfeeding Moms By jennifer lerfferts Kerrie Galvin never thought breastfeeding her infant at a family barbecue would cause a stir. But she was wrong. "My mother called me in and said some of the men were uncomfortable,'' said the Holden mother of three. "I was so upset and so taken aback. It was all extended family. I ended up leaving.'' Doctors recommend mothers exclusively breastfeed babies for at least the first six months. And while it is slowly becoming more common and accepted in the United States, nursing mothers continue to face challenges breastfeeding in public, in private homes, and the workplace, experts say. Those obstacles may come in the form of an employer who doesn't accommodate a nursing mother, new federal regulations preventing nursing mothers from carrying breast milk on board airplanes, the formula industry, or a society that doesn't fully understand the health benefits of breastfeeding, mothers and doctors say. "We need a higher public health commitment on a government level to support breastfeeding,'' said Dr. Melissa Bartick, a Cambridge-based internist who is the chairwoman of the Massachusetts Breastfeeding Coalition. "We need health care organizations to divest themselves from the formula companies. We need legislation similar to what is in California that protects a woman's right to return to work and make sure they have the support they need. We need paid maternity leave. We need a culture change. And, we need our society, including our policy decision-makers, to realize this is a huge health care issue and not a lifestyle issue.'' Massachusetts is just one of a handful of states that does not have any laws protecting the rights of breastfeeding mothers. However, that would change under legislation filed by Rep. Paul Frost, a Republican from Auburn and Sen. Susan Fargo, a Democrat from Lincoln. Both lawmakers refiled legislation in January that has failed in the past; but they are hopeful this year will be different. Frost's legislation would make it clear that a woman can breastfeed in public, without fear of being charged with indecent exposure. Fargo's legislation looks to provide more support to mothers in the workplace. Her legislation states that no employer shall prohibit an employee from expressing breast milk during any meal period or break period required by law. It also says that employers shall provide "reasonable unpaid break time each day'' to an employee who needs to express breast milk. The legislation also says that the 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 the employee can express breast milk in privacy. Fargo said she changed the name of her legislation this year and plans to promote the bill in a different way. The legislation is no longer called "an act to protect the rights of working mothers,'' but instead is "an act promoting the public health benefits of nursing.'' Studies have shown babies who are breastfed have fewer illnesses and have lower cancer rates. "It's all about preventative care,'' Fargo said. "Breastfeeding is the most basic, natural cost-effective way to prevent diseases such as obesity, diabetes, cancer and hearth disease. If people care about health care costs caused by chronic illnesses, this is an inexpensive way to counteract that.'' In addition to protecting mothers in the workplace, Fargo hopes the Legislature can protect nursing mothers in public so they aren't harassed like a New Mexico woman last year who was forced to leave an airplane. The breastfeeding mother was on a Delta Airlines plane leaving Burlington International Airport in Vermont, when she was asked by a flight attendant to cover herself with a blanket. But Frost fears it may take an incident like that to prompt Massachusetts lawmakers to act. "I think part of it is that it's not perceived as a problem,'' Frost said. "There aren't police going around arresting women who are breastfeeding in public. It's unfortunate that we tend to react and don't have the foresight to address something before it becomes an issue.'' But instead, it's one of those things that falls through the cracks each year, Frost said. This year alone, lawmakers have filed 6,300 bills. He said not even 10 percent of those will be approved, by the end of the Legislature two-year session. "There hasn't been a catalyst for people to take action and sometimes that's how the Legislature is motivated," he said. Bartick said the power of the formula industry cannot be overlooked. She said many of the leading health organizations take contributions from the pharmaceutical companies that make most formulas. She said a woman's success at breastfeeding depends on many factors including governmental support in the form of legislation, prenatal education about breastfeeding from obstetricians, and support and education in the hospitals after mothers give birth. One major issue in Massachusetts last year involved whether hospitals should be giving out free formula samples in bags. The state's Public Health Council tried to ban the practice in Massachusetts hospitals but the plan was stopped by then-Gov. Mitt Romney. The Massachusetts Breastfeeding Coalition launched a "Ban the Bags'' campaign and in January sent a letter to the 39 hospitals that distribute the bags, urging them to ban the bags. The letter was signed by the Massachusetts chapters of the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, the Association of Women's Health, Obstetric and Neonatal Nurses, and the Massachusetts Breastfeeding Coalition. Eleven of the state's 50 maternity units are bag-free, four of which went bag free since January 2006, even without a state mandate. The current bag-free hospitals are: Boston Medical Center, Brigham and Women's Hospital, Cambridge Birth Center, Cambridge Hospital, Caritas St. Elizabeth's Medical Center of Boston, Franklin Medical Center, Lowell General Hospital, Massachusetts General Hospital, Melrose-Wakefield Hospital, North Shore Birth Center, and Newton Wellesley Hospital. "It's a conflictof interest,'' Bartick said. "The only way to sell more formula is to sell less breastfeeding,'' Studies show that nursing mothers who take home a bag are more likely to start using formula. America accounts for half of the $8 billion a year global formula market. In 2005, 21 states in the United States achieved the national Healthy People 2010 objective of 75 percent of mothers initiating breastfeeding, whereas just fivestates achieved the objective of having 50 percent of mothers breastfeeding their children at 6 months. Those numbers were up from 2004, when 14 states achieved the 75 percent rate of mothers initiating breastfeeding and three states achieved the 50 percent rates of mothers breastfeeding their children at six months. Shoshana Mule from Milbury said the support she received in the hospital after giving birth to her daughter was key. She said the staff was supportive and encouraging. She thinks more mothers would breastfeed, if they had plenty of support and weren't intimidated. "I think the public has a perception that breastfeeding is harder than bottle feeding and I think that's why they give up trying to breastfeed or don't encourage others to do it,'' Mule said. Jennifer Lefferts is a freelance writer from Fitchburg, where she lives with her husband, Jason and their two children, Abigail, 3 and Benjamin, 15 months.