California

State Score: 61% (23.50 / 38.5)

Rank: 1st

WBTi United States and Territories

2017 Baseline Report

What does WBTi assessment show us?

The World Breastfeeding Trends Initiative (WBTi) aims to stimulate action, not simply to collect information. Having more information is not helpful unless there are strategies in place for translating the information into tools for change and for taking action to improve the situation. The WBTi aims to stimulate research, investigation, ask questions, and find out why optimal infant and young child feeding (IYCF) does or does not occur. It offers an opportunity for comprehensive analysis to stimulate action for change.

To see the full national report for the United States, please visit:
http://www.worldbreastfeedingtrends.org/GenerateReports/report/WBTi-United-States-2016.pdf
To see the full state report for California, please visit: https://www.wbtiusa.org

Optimal IYCF is one of the ways to decrease infant and maternal mortality.

CHARTS/NUMBERS

INDICATOR 1 Is there a statewide policy that protects, promotes, and supports optimal IYCF/breastfeeding and if so, is the policy supported by a government program? Is there a mechanism to coordinate the statewide IYCF committee and a state-employed coordinator for the committee?	Criteria	Results
	1.1) A statewide infant and young child feeding (IYCF)/breastfeeding policy has been officially adopted/approved by the government. (1)	1.00
	1.2) The policy recommends exclusive breastfeeding for the first six months, complementary feeding to be started after six months and continued breastfeeding up to 2 years and beyond. (1)	0.00
	1.3) A statewide plan of action has been developed based on the policy. (2)	2.00
	1.4) The plan is adequately funded. (2)	2.00
	1.5) There is a Statewide Breastfeeding Committee/ IYCF Committee. (1)	1.00
	1.6) The statewide breastfeeding/IYCF committee meets, monitors, and reviews progress on a regular basis. (1.5)	0.50
	1.7) The statewide breastfeeding/IYCF committee links effectively with all other sectors like health, nutrition, information etc. (.5)	0.50
	1.8) There is a state-employed breastfeeding coordinator with a clearly defined role, including regularly communicating statewide policy. (1) (WIC only .5)	0.50
	Total Score	7/10

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org

California

State Score: 61% (23.50 / 38.5)

Rank: 1st

WBTi United States and Territories

2017 Baseline Report


INDICATOR 4 Are there laws or other measures that meet or go beyond the International Labor Organization (ILO) standards for protecting and supporting breastfeeding mothers, including those working mothers in the informal sector?	Criteria	Results
	4.1) Women covered by state legislation are allowed the following weeks of paid maternity leave: any leave less than 14 wks (.5), 14-17 wks (1), 18-25 wks (1.5), or 26 wks or more (2).	1.00
	4.2) Women covered by state legislation are allowed at least one breastfeeding break or reduction of work hours daily: unpaid break (.5) or paid break (1).	0.50
	4.3) State legislation requires private sector employers of women in the state to: give at least 14 wks paid maternity leave (.5) and/or paid nursing breaks (.5)	0.00
	4.4) There is provision in state legislation that provides for worksite accommodation for breastfeeding and/or childcare in work places in the formal sector: space for breastfeeding/breastmilk expression (.5) and/or onsite daycare (.5).	1.00
	4.5) Women in informal/unorganized and agriculture sector are: accorded some protective measures (.5) or accorded the same protection as women working in the formal sector (1).	0.50
	4.6) Information about maternity protection laws, regulations, or policies is made available to workers (.5) and/or there is a system for monitoring compliance and a way for workers to complain if their entitlements are not provided (.5).	0.50
	4.7) Paternity leave is granted in public sector for at least 3 days (.5) and/or in the private sector for at least 3 days (.5).	2
	Total Score	5.5/8.5


INDICATOR 9 Are policies and programs in place to ensure that mothers, infants, and young children will be provided adequate protection for IYCF during emergencies?	Criteria (0-No, 1-Some Degree, 2-Yes)	Results
	9.1) The state has a comprehensive policy on infant and young child feeding that includes infant feeding in emergencies (IFE) and contains all basic elements included in the IFE Operational Guidance. (0,1,2)	0.00
	9.2) Person(s) tasked with responsibility for statewide coordination with all relevant partners such as the Red Cross, FEMA, state EMA, donors, military and NGOs regarding infant and young child feeding in emergency situations have been appointed. (0,1,2)	1.00
	9.3) An emergency preparedness and response plan based on the practical steps listed in the Operational Guidance has been developed and put into effect in most recent emergency situations. (0,1,2)	0.00
	9.4) Resources have been allocated for implementation of the emergency preparedness and response plan. (0,1,2)	2.00
	9.5) Appropriate orientation and training material on infant and young child feeding in emergencies has been integrated and is taking place in pre-service and in-service training for emergency management and relevant health care personnel. (0,1,2).	0.00
	Total Score	3/10


INDICATOR 10 Are monitoring and evaluation systems in place that routinely collect, analyze, and use data to improve IYCF practices?	Criteria (0-No, 1-Some Degree, 2-Yes)	Results
	10.1) Monitoring and evaluation components are built into major infant and young child feeding program activities. (0,1,2)	2.00
	10.2) Data/information on progress made in implementing the IYCF program are used by program managers to guide planning and investments decisions. (0,1,2)	2.00
	10.3) Data on progress made in implementing IYCF program activities routinely collected at statewide levels. (0,1,2)	2.00
	10.4) Data/information related to infant and young child feeding program progress are reported to key decision-makers. (0,1,2)	1.00
	10.5) Monitoring of key infant and young child feeding practices is integrated into the statewide nutritional surveillance system, and/or health information system or statewide health surveys. (0,1,2)	1.00
	Total Score	8/10

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org

California

Sources and Comments

WBTi United States and Territories

2017 Baseline Report

Indicator

1.1

Source(s)

1. http://www.cdph.ca.gov/healthinfo/healthyliving/childfamily/pages/californialawsrelatedtobreastfeeding.aspx

Comment(s)

1. California Department of Public Health/California Department of ? Health Care Services' Promotion, Protection and Support of ? Breastfeeding 2003- Brochure to educate about diet and staying active (Cal. ? Health and Safety Code 123232 ) The department [MCAH] shall ? develop or obtain a brochure to educate pregnant women and new ? parents about the important role of a diet rich in fruits and ? vegetables and staying active in preventing chronic diseases and ? as an important source of nutrients for breastfeeding mothers. ? This section shall be implemented only if, and to the extent ? that, federal or private funding, or both, are available for that? purpose. 2007-Public service campaign (Cal. Health and Safety Code ? 123360) The State Department of Public Health shall include in ? its public service campaign promotion of mothers breastfeeding ? their infants. 2007-Expand breastfeeding peer counseling at local WIC sites ? (Cal. Health and Safety Code 123361) To the extent that ? non-United States Department of Agriculture (USDA) federal funds ? and private grants or donations are made available for this ? purpose, the State Department of Public Health shall expand ? breast-feeding peer counseling program at local agency California? WIC sites. 2007-Medi-Cal to improve access to lactation support and breast ? pumps (Welfare and Institutions Code 14134.55) The department? shall streamline and simplify existing Medi-Cal program ? procedures in order to improve access to lactation supports and ? breast pumps among Medi-Cal recipients. (a) (1) The department shall recommend training for general acute? care hospitals, as defined in subdivision (a) of Section 1250, ? and special hospitals, as defined in subdivision (f) of Section ? 1250, that is intended to improve breast-feeding rates among ? mothers and infants. This recommended training should be designed? for general acute care hospitals that provide maternity care and? have exclusive patient breast-feeding rates in the lowest 25 ? percent, according to the data published yearly by the State ? Department of Public Health, when ranked from highest to lowest ? rates. The training offered shall include a minimum of eight ? hours of training provided to appropriate administrative and ? supervisory staff on hospital policies and recommendations that ? promote exclusive breast-feeding. Hospitals that meet the minimum? criteria for exclusive breast-feeding rates prescribed in the ? most current Healthy People Guidelines of the United States ? Department of Health and Human Services shall be excluded from ? the training requirements recommended by this paragraph. (2) The department shall notify the hospital director or other ? person in charge of a hospital to which paragraph (1) applies, ? that the eight-hour model training course developed pursuant to ? subdivision (b) of Section 123360, is available, upon request, to? the hospital. (b) The recommendations provided for in this section are advisory? only. Nothing in this section shall require a hospital to comply? with the training recommended by this section. Section 1290 ? shall not apply to this section, nor shall meeting the ? recommendations of this section be a condition of licensure.

2. Also laws about breastfeeding in public, break times, jury duty, ? students, etc.

1.2

Source(s)

1. http://www.cdph.ca.gov/programs/BreastFeeding/Pages/default.aspx

Comment(s)

1. "The Breastfeeding Program promotes and supports public health ? and health care efforts to make breastfeeding the normal method ? of infant feeding in California for at least the first year of ? life in order to provide proven benefits to the mother, infant, ? and society. " Not specific enough for exclusivity or duration

1.3

Source(s)

1. http://www.cdph.ca.gov/healthinfo/healthyliving/childfamily/Pages/BreastfeedingProgramFactSheet.aspx

Comment(s)

1. MCAH Breastfeeding Program Fact Sheet "Goals Breastfeeding will be the community norm for infant feeding in ? California for at least the first year of life in order so that ? all infants have the opportunity for optimal growth and ? development and mothers and their babies are protected from many ? diseases now linked with not breastfeeding." "Program Activities Expand the resources available to provide breastfeeding ? promotion, education and support through all Maternal, Child and ? Adolescent (MCAH) Branch programs, such as Black Infant Health, ? Comprehensive Perinatal Services, Adolescent Family Life, ? California Diabetes and Pregnancy Programs and the Regional ? Prenatal Programs of California. Promote the development of healthcare policies, trainings and ? guidelines so that all programs, health care providers and ? hospitals support breastfeeding families. Collaborate with Women, Infant and Children (WIC) Program to ? increase the level of community knowledge about breastfeeding ? utilizing the home visitor and peer education model. Engage experts in the field to provide consultation and ? recommendations to the community. Promote participation by MCAH partners throughout the state in ? local breastfeeding coalitions. Collaborate with Medi-Cal, including its managed care plans, to ? improve access to equipment and support for the breastfeeding ? mother-baby couplet. Maintain a breastfeeding webpage with evidence-based, up-to-date ? resources for health care professionals, government, private ? agencies and the public to increase their knowledge of the ? medical and psychosocial requirements of the breastfeeding ? couplet. Utilize breastfeeding epidemiological information obtained from ? the Newborn Screening Form, Maternal and Infant Health ? Assessment, and the Women's Health Survey to design, implement, ? and evaluate initiatives that provide effective breastfeeding ? interventions and reach individuals with the most need."

1.4

Source(s)

1. http://www.cdph.ca.gov/programs/BreastFeeding/Pages/default.aspx

Comment(s)

1. "Funding is provided by the Federal Title V Maternal and Child ? Health Block Grant." (What is adequate?)

1.5

Source(s)

1. http://californiabreastfeeding.org/about-us/

Comment(s)

1. California Breastfeeding Coalition

1.6

Source(s)

Comment(s)

1. Yes, meets. But does not monitor or review progress. However, the? website is up to date on the progress being made in California. ? Would like to see an agenda....

1.7

Source(s)

1. http://californiabreastfeeding.org/about-us/

Comment(s)

1. "To accomplish our mission, the CBC works to create and ? strengthen collaborative relationships among state and local ? organizations, government agencies, hospitals and health care ? providers, employers and community-based breastfeeding support ? organizations throughout California."

1.8

Source(s)

1. https://www.nwica.org/states/california

Comment(s)

1. WIC breastfeeding coordinator but no state breastfeeding ? coordinator

4.1

Source(s)

1. http://law.justia.com/codes/california/2011/uic/division-1/3300-3306/3303.1

2. https://www.dol.gov/wb/maps/

Comment(s)

1. 6 weeks paid leave for eligible employees (those who have worked ? for an employer for at least 12 months, and who have 1250 hours ? of service during the 12 months prior to the leave)

4.2

Source(s)

1. https://www.dol.gov/wb/maps/

2. https://www.legalmomentum.org/content/california-laws-relating-pregnancy

Comment(s)

1. Employers cannot discriminate against women for breastfeeding or ? breastfeeding-related medical conditions. Cal. Gov't Code 12926, 12940. An employer must provide reasonable unpaid break time to a woman ? to express breast milk, unless doing so would seriously disrupt ? the employer's business. If possible, the break time must occur ? during the employee's ordinary break time. The employer must make? a reasonable effort to provide the mother with a private space ? close to her work area, other than a bathroom, to express breast ? milk. Cal. Labor Code 1030-1033.

3. SCORE SHOULD BE 0.5

4.3.a

Source(s)

1. http://www.ncsl.org/research/labor-and-employment/state-family-and-medical-leave-laws.aspx

2. http://www.nationalpartnership.org/research-library/work-family/paid-leave/state-paid-family-leave-laws.pdf

Comment(s)

4.3.b

Source(s)

1. https://www.dol.gov/wb/maps/

Comment(s)

1. Does not require paid breaks

4.4.a

Source(s)

1. https://www.dol.gov/wb/maps/

2. http://law.justia.com/codes/california/2011/uic/division-1/3300-3306/3303.1

Comment(s)

1. DOL: An employer must provide reasonable unpaid break time to a ? woman to express breast milk, unless doing so would seriously ? disrupt the employer's business. If possible, the break time must? occur during the employee's ordinary break time. The employer ? must make a reasonable effort to provide the mother with a ? private space close to her work area, other than a bathroom, to ? express breast milk. Cal. Labor Code 1030-1033.

4.4.b

Source(s)

1. https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf

Comment(s)

1. Response indicates whether state child care regulations support ? onsite breastfeeding. Data on employer provision of onsite ? daycare was not found.

4.5

Source(s)

1. https://www.dir.ca.gov/dlse/

2. http://www.dir.ca.gov/T8/14300_31.html

Comment(s)

2. Unclear whether maternity protections apply

3. SCORE SHOULD BE 0.5

4.6.a

Source(s)

1. https://www.dir.ca.gov/dlse/

Comment(s)

4.6.b

Source(s)

1. http://www.ct.gov/chro/lib/chro/pdf/chroregs_complaints.pdf

Comment(s)

3. SCORE SHOULD BE 0.5

4.7

Source(s)

1. http://family.findlaw.com/paternity/paternity-leave.html

2. http://www.nationalpartnership.org/research-library/work-family/paid-leave/state-paid-family-leave-laws.pdf

Comment(s)

1. California exceeds federal protections

4.8

Source(s)

1. http://family.findlaw.com/paternity/paternity-leave.html

2. http://www.ncsl.org/research/labor-and-employment/state-family-and-medical-leave-laws.aspx

Comment(s)

1. California law exceeds federal protections.

4.9

Source(s)

1. http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=GOV§ionNum=12945.

2. https://www.legalmomentum.org/content/california-laws-relating-pregnancy#_ftnref2

Comment(s)

1. California requires an employer to grant an employee's request ? for reasonable accommodation when disabled by pregnancy, ? childbirth or a related medical condition. The accommodation may ? include a transfer to a less strenuous or hazardous position if ? the transfer can be reasonably accommodated.[2]

3. SCORE SHOULD BE 0.5

4.10

Source(s)

1. https://www.legalmomentum.org/content/california-laws-relating-pregnancy

Comment(s)

9.1

Source(s)