North Dakota

State Score: 43% (16.50 / 38.5)
Rank: Tied For 9th
 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 North Dakota, 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)
1.00
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)
0.00
1.7) The statewide breastfeeding/IYCF committee links effectively with all other sectors like health, nutrition, information etc. (.5)
0.00
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
5.5/10

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org

North Dakota
State Score: 43% (16.50 / 38.5)
Rank: Tied For 9th
 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).
0.00
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).
0.00
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).
0.00
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).
0.00
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).
0.00
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).
0
Total Score
0/8.5
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   


North Dakota
Sources and Comments    
 WBTi United States and Territories 2017 Baseline Report   
Indicator
1.1
Source(s)
1. http://www.ndhealth.gov/breastfeeding
Comment(s)
1. The North Dakota Department of Health, Division of Nutrition and ? Physical Activity's WIC Program, Healthy Communities Program and ? Maternal and Child Health Nutrition Program work together to ? promote breastfeeding and improve support for breastfeeding in ? all settings.
2. North Dakota has a law protecting the right to breastfeed in ? public (http://www.ndhealth.gov/breastfeeding/?id=64)
1.2
Source(s)
1. http://www.ndhealth.gov/breastfeeding
Comment(s)
1. Initiation, exclusivity and duration are not mentioned in the ? policy
1.3
Source(s)
1. http://www.ndhealth.gov/breastfeeding/image/cache/2013-2018_ND_Breastfeeding_Strategic_Plan.pdf
2. http://www.ndhealth.gov/breastfeeding/?id=66
Comment(s)
1. The North Dakota Breastfeeding coalition has a comprehensive ? action plan with goals to be met by 2020.
1.4
Source(s)
1. http://www.ndhealth.gov/breastfeeding/image/cache/2013-2018_ND_Breastfeeding_Strategic_Plan.pdf
Comment(s)
1. Page 5 of the Strategic Plan deals with infrastructure and ? sustainability. Hard to know if it is "adequate"
1.5
Source(s)
1. http://www.ndhealth.gov/breastfeeding/?id=66
Comment(s)
1. North Dakota Breastfeeding Coalition
1.6
Source(s)
1. http://www.ndhealth.gov/breastfeeding/?id=66
Comment(s)
1. No evidence found
1.7
Source(s)
1. http://www.ndhealth.gov/breastfeeding/?id=66
Comment(s)
1. Seems like that is the plan: "The North Dakota Breastfeeding ? Coalition is comprised of statewide partners working on ? breastfeeding promotion and support efforts across the state. ? Members represent organizations such as health-care systems, WIC,? local public health agencies, Head Start, insurance companies, ? Universities, doulas, members of local breastfeeding coalitions ? and mothers across the state." However, no listing of membership to verify that this is true.
1.8
Source(s)
1. https://www.nwica.org/states/north-dakota
Comment(s)
1. North Dakota has a Nutrition and Breastfeeding coordinator for ? WIC, but not for the state.
4.1
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
Comment(s)
1. No additional protections to federal law.
4.2
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. http://www.legis.nd.gov/cencode/t23c12.pdf?20130605091442
Comment(s)
1. ND Chapter 23-12-16. "Right to breastfeed. If the woman acts in a? discreet and modest manner, a woman may breastfeed her child in ? any location, public or private, where the woman and child are ? otherwise authorized to be."
2. It is unclear whether this extends to a woman's place of ? employment.
3. Federal protections only
4.3.a
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
Comment(s)
1. Only federal protections apply
4.3.b
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
Comment(s)
1.
4.4.a
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. http://www.legis.nd.gov/cencode/t23c12.pdf?20130605091442
Comment(s)
1. ND Chapter 23-12-16. "Right to breastfeed. If the woman acts in a? discreet and modest manner, a woman may breastfeed her child in ? any location, public or private, where the woman and child are ? otherwise authorized to be."
4.4.b
Source(s)
1. https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf
Comment(s)
1. Data on employer provision of onsite daycare was not found.
4.5
Source(s)
1. https://www.dol.gov/wb/maps/
2. http://www.legis.nd.gov/cencode/t14c02-4.pdf
Comment(s)
1. Only federal protections
2. N.D. Cent. Code Ann.  14-02.4-03.
4.6.a
Source(s)
1. https://www.dol.gov/wb/maps/
2. http://www.nd.gov/labor/forms/sfn-14543.html
Comment(s)
1. Pregnancy treated as disability, nothing about BF
2. N.D. Cent. Code Ann.  14-02.4-03.
3. unclear if workers are made aware
4.6.b
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. http://www.nd.gov/labor/forms/sfn-14543.html
Comment(s)
1. Unclear if employers are required to make available
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. Only federal protections
4.8
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. Only federal protections
4.9
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
Comment(s)
1. N.D. Cent. Code Ann.  14-02.4-03.
2. Pregnancy treated as disability, only federal protections for BF
4.10
Source(s)
1. http://www.legis.nd.gov/cencode/t14c02-4.pdf
Comment(s)
1. Unclear whether job protection is included; also unclear whether ? law applies to breastfeeding period.
2. The North Dakota Human Rights Act prohibits employment ? discrimination on the basis of sex, which is defined to include ? pregnancy, childbirth, and disabilities related to pregnancy or ? childbirth. This applies to all employers who employ at least one? person in North Dakota for more than one quarter of each year.
9.1
Source(s)
1. https://www.nd.gov/des/uploads/resources/182/disast-prep-for-spec-needs-children.pdf
2. https://www.nd.gov/des/uploads/resources/186/basicemergencysupplykit.pdf
Comment(s)
1. Disaster Preparedness for Families of Children with Special Needs says "FOR INFANTS AND CHILDREN (two ? week supply) - Formula-ready to eat or with sterile water for mixing* - Diapers* - Bottles* - Powdered milk* - Medications* - Pacifiers*
2. Ensuring a safe and secure homeland for all North Dakotans: "Additional Items to Consider Adding to an Emergency Supply Kit: Ý Prescription medications and glasses Ý Infant formula and diapers
9.2
Source(s)
1. https://www.nd.gov/des/about/
Comment(s)
1. North Dakota Department of Emergency Services - assumng that ? citizens of ND include infant and young children. No mention of ? infant or young child feeding in emergencies.
9.3.a
Source(s)
1. https://www.nd.gov/des/about/
Comment(s)
1. No evidence found
9.3.b
Source(s)
1. https://www.nd.gov/des/about/
Comment(s)
1. No evidence found
9.4
Source(s)
1. http://www.legis.nd.gov/assembly/64-2015/committees/joint/emergency-commission
Comment(s)
1. North Dakota Emergency Commission is well funded.
9.5.a
Source(s)
1. https://www.nd.gov/des/
Comment(s)
1. No evidence found
9.5.b
Source(s)
1. https://www.nd.gov/des/
Comment(s)
1. No evidence found
10.1
Source(s)
1. http://www.ndhealth.gov/wic/
Comment(s)
1. This state has one major infant and young child feeding program, ? Special Supplemental Nutrition Program for Women, Infants and ? Children (WIC). Into the WIC program are built monitoring and ? evaluation components.
10.2
Source(s)
1. http://www.ndhealth.gov/wic/
Comment(s)
1.
10.3
Source(s)
1. http://www.ndhealth.gov/wic/
Comment(s)
1.
10.4
Source(s)
1. https://www.fns.usda.gov/pd/wic-program
Comment(s)
1. All states report program data to UDSA office. USDA is ? considered the key-decision maker. The majority of the ? information reported is program data ie client participation and ? program costs.
10.5
Source(s)
1. https://www.cdc.gov/prams/index.htm
Comment(s)
1.

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org