Breastfeeding in Virginia: New law provides protections for nursing mothers but disparities remain

Both a biological process and a powerful bonding experience, mothers and infants have practiced breastfeeding since the birth of humanity. Yet, here in Virginia, breastfeeding in all public spaces became legally protected just  five years ago. Now, as the state observes August as Breastfeeding Awareness Month, health care workers, community advocates and state legislators are working together to make breastfeeding more accessible and sustainable for families.

Dr. Porsche Roberson, an assistant professor of pediatrics at UVA Health who practices in Orange, cites a plethora of benefits of breastfeeding for babies. Mother’s milk strengthens a baby’s budding immune system – “it’s like giving your baby a shot of antibiotics,” – and increases cognitive development. Breastfeeding can also be a plus for moms, as noted by the American Institute for Cancer Research, which found that lactating mothers faced lower risk of breast and ovarian cancer.

The American Academy of Pediatrics recommends babies be fed breast milk exclusively for the first six months of life. But the best way health care workers can support families is by respecting their decisions, says Roberson.

“It’s a very personal choice to breastfeed or not, and it’s up to the families to lead that, not doctors. We should also give [families] the resources they need, whether that’s information about breastfeeding support groups, advising them on what type of formula works best for their baby’s needs, or perhaps referring them to a lactation consultant.”

She stresses to the future pediatricians she teaches that, “our job is to support families in their goals, first of which is to feed their baby. … Whether a family chooses to breastfeed or not, they will be doing the right thing by nourishing their child.”

August is Breastfeeding Awareness Month in Virginia, in accordance with the United States Breastfeeding Committee’s declaration of August as National Breastfeeding Month. Sen. Jennifer McClellan, D- Richmond, has a track record of sponsoring bills dealing with maternal-infant health, and has in recent years lobbied for increased breastfeeding awareness and access. McClellan sponsored the state’s Breastfeeding Awareness Month resolution in 2019, and made history in 2011 when she became the first breastfeeding member of the House of Delegates. The Pregnant Worker Fairness Act, introduced by McClellan in the Senate this year, became law in July.  Del. Jennifer Carroll Foy, D-Prince William, carried the House version. 

“Essentially, this requires employers to make reasonable accommodations for pregnant and nursing mothers in Virginia,” McClellan explains. These types of employer accommodations include, for example, providing a private space to pump breastmilk or nurse – that is not a bathroom. 

“You wouldn’t eat in the bathroom or cook in the bathroom; why would you make mothers feed their children in the bathroom?” says McClellan. The law also prohibits discrimination against breastfeeding workers, specifically banning employers from “taking any adverse action against an employee who requests or uses a reasonable accommodation.” The law also provides guidance to employers on how to accommodate lactating employees. 

While this recent legislation is a major step forward, McClellan says “We still have a lot of work to do to educate policy makers,” recalling when an older, male colleague asked why lactating working moms couldn’t just pump breast milk on their lunch break. McClellan helped him understand that lactating mothers need to pump their milk frequently throughout the day, or risk mastitis – a painful condition when breasts become engorged with milk, resulting in inflammation and infection. The exchange, McClellan says, demonstrated why it is critical that the perspectives and needs of groups directly affected by a law – in this case, nursing mothers – be represented in legislative processes.

“Women who can and would breastfeed, they need institutional and policy support. They need the ability to know they can do what they need to do to provide a healthy meal to their child, even while working.”

Like in maternal health outcomes, Black and Brown families face racial disparities when it comes to breastfeeding. In a recent report, the Centers for Disease Control found that 83 percent of American mothers breastfed their babies at birth; of this number, 85 percent of White mothers nursed their newborns, compared to only 69 percent of Black mothers, the lowest percentage of any group. African American mothers face barriers to breastfeeding that other groups don’t, including “earlier return to work, inadequate receipt of breastfeeding information from providers, and lack of access to professional breastfeeding support,” write the study’s authors. 

The Virginia Breastfeeding Coalition exists to break down these and other barriers to breastfeeding, says Angela Love-Zaranka, chair of the group. The coalition’s statewide network of members include individuals, organizations and state agencies, all advocating for Virginia families to have more equitable opportunity and access to breastfeeding.

“We want to work towards a culture of health and wellness for all, and breastfeeding is a critical part of that. To the mothers and families who choose to breastfeed, we are here [to be] a resource for them, and to do everything we can to ensure they can meet their goals.”

To redress racial disparities, the coalition supports national efforts like Black Breastfeeding Week, starting this Tuesday. In recent years, the coalition worked with VDH’s Virginia Maternity Care Quality Improvement Collaborative to “adopt best practices and evidence-based principles about birth and breastfeeding throughout Virginia,” says Love-Zaranka. “We’ve had meetings to help hospitals integrate these changes, and feel strongly that they are of great benefit to our entire community.”

In addition, the coalition sponsors the Virginia Breastfeeding Friendly Workplace Awards in partnership with the Virginia Department of Health, bestowing bronze, silver and gold honors to companies that enact policies which support breastfeeding workers, above and beyond what the state mandates. Nominations for the 2021 awards run through Aug. 31. 

UPDATE: This post has been updated to add that Del. Jennifer Carroll Foy, D-Prince William, carried the House version of legislation requiring Virginia employers to make reasonable accommodations for pregnant women and nursing mothers.