Do We Know More Now Than in 2013?
2025 once seemed so far away
Can we actually do this? Can California’s birth hospitals really comply with the upcoming requirement to adopt a Baby Friendly USA-compliant hospital breastfeeding policy OR equivalent by Jan 1, 2025?
More importantly, will it matter if there isn’t accountability to implement the policy? Having a policy is not the same as abiding by it.
I feel connected to this issue in part because in October 2013, when the bill (SB402) was actually passed that would make this requirement mandatory by Jan 1, 2025, I wrote a blog post about it. I was a much “newer” IBCLC at the time, hands deep in hospital lactation work and just beginning to teach nurses and others. Then our state breastfeeding coalition picked up the article and (with my permission, of course) published it on THEIR website. It’s still there! I was excited as an advocate and as a practitioner of lactation, and I believed that though 2025 felt very far off, it was an important step in making a difference.
Obviously I also feel connected to this for many other reasons, not the least of which is that since 2013, I’ve taught The First 100 Hours strategy. I created it to help hospital staff comply with Baby Friendly or equivalent policies, and I’ve taught it to people working in hospitals as well as aspiring lactation care providers seeking a solid and practical foundation in early lactation care.
I’ve learned so much about how to support bedside nurses and other hospital staff since then, but so many other things have happened in that time. Above all, we learned what a worldwide pandemic can do to a health force. We have seen how fragile the health care system’s “belief” and trust in breastfeeding truly is. We have seen an absolute sea change in how aspiring lactation care providers are being educated and prepared for the IBCLC exam, whether or not they are registered nurses (hint: so much of it is online and virtual, for better or worse.)
Above all, through the years of scientific research since then, we’ve cemented our knowledge of how important breastfeeding and human milk truly are to human health across the lifespan, making this law even more relevant.
Complying with this new requirement, now known as California Health and Safety Code 123367, is a critical step on the journey to improve the environment of lactation care in California.
Meaningful change, however, will stem from ensuring that not only is the policy in place according to the law, but that it is effectively implemented inside every birth hospital.
To be clear, implementation will not look the same or require the same effort and expenditures everywhere. Some hospitals have an expansive lactation staff which can work alongside and teach bedside staff while also accomplishing a lot of the required lactation care. Others have limited, minimal, or no dedicated lactation staff. (One hospital local to me recently hired a lactation consultant for the very first time ever. In 2022. For real. Hundreds of births per month and they have never had a dedicated lactation consultant.)
Some hospitals will find that their staff needs education - though clearly valuable, it’s costly for hospitals to provide necessary training. Others will find that their need for dedicated lactation support has increased as the lactation acuity of their patient population has changed. Nearly all of them will be able to clearly see the critical importance of connecting with community lactation support to ensure continuity of care, especially if they (the hospitals) are unable to provide outpatient, post-discharge lactation care.
Fortunately, our state has an engaged, supportive, effective, and organized breastfeeding coalition which has always and will continue to provide many resources to assist hospitals. We even have an annual Summit that convenes folks from across our large state to discuss and collaboratively address gaps and celebrate victories. We will no doubt rely heavily on them as Jan 1, 2025 approaches and passes.
If you are part of any hospital lactation team, you likely already know what your hospital needs to do (and you’ve probably known for a while and feel like a broken record!). Please make sure your hospital is utilizing ALL of the tools available through the California Breastfeeding Coalition.
If you’re wanting to contribute more from wherever you are or on a more personal or one-to-one level, I’ve got some resources to help as well. Follow me on social media for information about teaching and supporting bedside staff, bringing a focused lens to the earliest days of lactation, advancing your own knowledge, and so much more.
I’m on Instagram and Twitter @IBCLCinCA and on Facebook. I’d love to hear your thoughts on this topic and anything else that’s on your mind in lactation land!