Puerto Rico

State Score: 31% (12.00 / 38.5)
Rank: Tied For 34th
 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 Puerto Rico, 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)
0.00
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
3.5/10

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org

Puerto Rico
State Score: 31% (12.00 / 38.5)
Rank: Tied For 34th
 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).
0.50
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
0.5/8.5
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)
0.00
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)
0.00
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
0/10
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   


Puerto Rico
Sources and Comments    
 WBTi United States and Territories 2017 Baseline Report   
Indicator
1.1
Source(s)
1. http://breastfeedinglaw.com/state-laws/puerto-rico/
Comment(s)
1. " 3518. Breastfeeding; prohibition of discriminatory practices. (a) Public policy (1) It is hereby confirmed as the public policy of the ? Commonwealth of Puerto Rico, through the Department of Health, ? and in accordance with the public policies established by the ? Department of Health and Human Services of the United States; the? World Health Organization and the United Nations Children's Fund? (UNICEF), the importance of increasing the breastfeeding ? practice. The Surgeon General of the United States recommends ? that newborn children until the age of one (1) year be breastfed,? except if it has been medically contraindicated, to propitiate ? that children achieve an optimal health condition from the time ? of their birth. (2) It has been shown that breast milk provides a better ? nutrition and higher immunity against diseases, is better to ? digest, and may increase the children's IQ. Some sectors of ? society are against the promotion of breastfeeding. Likewise, the? demands of modern life force new mothers who have a busy work ? schedule to choose formula or artificial milk to feed their ? babies. On occasions, some mothers are ashamed and even fear ? social repudiation or criminal accusation if they breastfeed ? their children in public. (3) It is hereby declared that the promotion of family values and? the health of infants demands that our society put a stop to the? vicious cycles of shame and ignorance of men and women regarding? breastfeeding, and in the genuine interest of promoting family ? values, our society shall encourage public acceptance of the most? basic natural act between a mother and her child. This ? Legislature rejects that any mother should feel discriminated for? breastfeeding her child. (b) The right to breastfeed Notwithstanding any contrary precept ? of law, a mother may breastfeed her child in any public or ? private recreational place. (c) Breastfeeding, prohibition of discriminatory practices Any ? direct or indirect act of exclusion, alienation, restriction, ? segregation, limitation, rejection, or any other act or practice ? of differentiation, including denying a person the total ? enjoyment of goods, services, facilities, privileges, advantages,? and accommodations in any public or private place which she ? attends, whether it is visited by the public or used for ? recreation, based on the fact that a mother is breastfeeding her ? child, shall constitute a discriminatory practice prohibited by ?  3518-3518b of this title. (d) Breastfeeding is not a violation of the law A mother ? breastfeeding her child in any place, whether public or private, ? where she is otherwise authorized to be, shall not be deemed as ? indecent exposure, obscene act or other punishable action ? established in similar sections that comprise these conducts in ?  4629 et seq. of Title 33, better known as the "Penal Code of ? the Commonwealth of Puerto Rico", or any legal precept of penal ? or civil nature. (Apr. 23, 2004, No. 95,  1; Sept. 19, 2007, No. 121,  1.)"
1.2
Source(s)
1. http://breastfeedinglaw.com/state-laws/puerto-rico/
Comment(s)
1. Although the law and policy mention up to one year, no mention of? exclusivity or duration to two years and beyond
1.3
Source(s)
1. http://www.salud.gov.pr/Estadisticas-Registros-y-Publicaciones/Publicaciones/Healthy%20People%202020.pdf
Comment(s)
1. 2020 Healthy People Strategic Plan for PR "Support and strengthen the efforts of the State Committee for ? the Promotion of Breastfeeding. " "Educate pregnant and lactating women and the population ? regarding approved legislation that support breastfeeding. Develop and ? submit additional legislative proposals that can support exclusive ? breastfeeding." "Educate pregnant women, women in reproductive age, and the ? population, including parents and grandparents, on the benefits of ? breastfeeding in order to increase the support they provide to mothers who are ? trying to breastfeed their infants." "Promote the adoption of the UNICEF and World Health Organization? (WHO) Baby-Friendly Hospitals Initiative in all local birthing ? hospitals."
1.4
Source(s)
1.
Comment(s)
1. assumed to be funded
1.5
Source(s)
1. http://www.coalicionlactancia.org/
Comment(s)
1. Puerto Rico Breastfeeding Promotion Coalition
1.6
Source(s)
1. http://www.coalicionlactancia.org/index.php/iquienes-somos
Comment(s)
1. No evidence found
1.7
Source(s)
1. http://www.coalicionlactancia.org
Comment(s)
1. No data available
1.8
Source(s)
1.
Comment(s)
1. WIC breastfeeding coordinator, no evidence of state
4.1
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.2
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.3.a
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.3.b
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.4.a
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
2. "Upon returning from maternity leave, women must be given the ? opportunity either to breastfeed their children at an on-site ? child care center or to express milk for an hour each full-time ? working day, which can be divided into two thirty-minute sessions? or three twenty-minute sessions. This applies to all employers ? except small businesses, as defined by the Small Business ? Administration, who only need to provide one half-hour break per ? day, which can be divided into two fifteen-minute sessions. This ? applies to employees with nursing children up to one year of age.? P.R. Laws Ann. tit. 29,  478 et seq.
4.4.b
Source(s)
1. https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf
2. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
Comment(s)
1. "Upon returning from maternity leave, women must be given the ? opportunity either to breastfeed their children at an on-site ? child care center or to express milk for an hour each full-time ? working day, which can be divided into two thirty-minute sessions? or three twenty-minute sessions. This applies to all employers ? except small businesses, as defined by the Small Business ? Administration, who only need to provide one half-hour break per ? day, which can be divided into two fifteen-minute sessions. This ? applies to employees with nursing children up to one year of age.? P.R. Laws Ann. tit. 29,  478 et seq.
2. Appears to be either/or (On-site child care or breaks)
3. verify with Ana Parilla
4.5
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.6.a
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.6.b
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.7
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.8
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.9
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
4.10
Source(s)
1. https://www.dol.gov/wb/state_protection_summary_508_txt.htm
2. https://www.shrm.org/resourcesandtools/legal-and-compliance/state-and-local-updates/pages/overview-puerto-rico-law.aspx
Comment(s)
1. NEED ADDITIONAL HELP
9.1
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No policy found
9.2
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No evidence found
9.3.a
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No evidence found
9.3.b
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No evidence found
9.4
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No evidence found
9.5.a
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No evidence found
9.5.b
Source(s)
1. http://www2.pr.gov/agencias/aemead/Pages/default.aspx
Comment(s)
1. No evidence found
10.1
Source(s)
1. http://www.salud.gov.pr/Dept-de-Salud/Pages/Unidades-Operacionales/Secretaria-Auxiliar-de-Salud-Familiar-y-Servicios-Integrados/Programa-WIC.aspx
Comment(s)
1. Puerto Rico 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.salud.gov.pr/Dept-de-Salud/Pages/Unidades-Operacionales/Secretaria-Auxiliar-de-Salud-Familiar-y-Servicios-Integrados/Programa-WIC.aspx
Comment(s)
1.
10.3
Source(s)
1. http://www.salud.gov.pr/Dept-de-Salud/Pages/Unidades-Operacionales/Secretaria-Auxiliar-de-Salud-Familiar-y-Servicios-Integrados/Programa-WIC.aspx
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. No statewide toddler feeding survey found.

WBTiExpert Panel convened by Healthy Children Project, Inc.

www.centerforbreastfeeding.org