Breastfeeding Legislation & Policy Update - 115th Congressional Session - Published March 2018

 
115th Congressional Session

  Breastfeeding Legislation &
         Policy Update

        Published March 2018
1

                                                               Welcome!
Welcome to the 2018 Breastfeeding Legislation & Policy Update toolkit!

This toolkit will help you take action and effectively communicate with the general public, congressional
staffers, and other stakeholders about legislation and policies that impact breastfeeding families. Each update
includes background information, current status, individual and organizational action opportunities, key
messages, sample social media content, and relevant resources and information.

The toolkit will be periodically updated to reflect the latest action opportunities and Congressional action. To
access the most recent edition, visit www.usbreastfeeding.org/policy-toolkit.

We invite stakeholders to submit additions/edits to the policy toolkit by contacting
advocacy@usbreastfeeding.org. Please share resources or action opportunities from your organization at any
time.

Table of Contents
Health Reform .......................................................................................................................................... 4
Federal Budget ......................................................................................................................................... 7
Children's Health Insurance Program (CHIP) .......................................................................................... 9
Maternal, Infant and Early Childhood Home Visiting (MIECHV) Program........................................... 10
Healthy People 2030 .............................................................................................................................. 11
Supporting Working Moms Act (SWMA) .............................................................................................. 13
Fair Labor Standards Act Overtime Rule Regulations........................................................................... 16
Family and Medical Insurance Leave (FAMILY) Act .............................................................................. 17
Pregnant Workers Fairness Act (PWFA) ................................................................................................ 19
Healthy Families Act .............................................................................................................................. 21
Friendly Airports for Mothers (FAM) Act .............................................................................................. 23
Fairness for Breastfeeding Mothers Act ............................................................................................... 25
Dietary Guidelines for Americans.......................................................................................................... 27

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                                          USBC Resources
Breastfeeding Advocacy HQ
Find the latest news and updates on breastfeeding advocacy in the USBC's Advocacy HQ at
www.usbreastfeeding.org/advocacy

"Landscape of Breastfeeding Support" Photo Gallery
Access photos featuring diverse representations of breastfeeding support in action for educational, advocacy,
and clinical purposes. The photos are free and available for the field for non-profit and non-commercial efforts.
See the Terms of Use at www.usbreastfeeding.org/photo-project for more information and to access the
photo galleries.

State Fact Sheets
Created for a Welcome Congress event in 2017, the state fact sheets feature state-specific data on
breastfeeding rates and support indicators as well as information on funded breastfeeding projects and
activities from the state's breastfeeding coalition. They are a great personalized resource and make great
handouts for policymakers and other stakeholders. Download your state's fact sheet at
www.usbreastfeeding.org/state-fact-sheets

Staying Abreast: Weekly Wire
The USBC publishes the Staying Abreast: Weekly Wire e-newsletter, featuring news briefs from national, state,
and local partners and the week’s top “news clippings” related to breastfeeding. Sign up at
www.usbreastfeeding.org/signup or access the archives at www.usbreastfeeding.org/enews

SGCTA Action Directory
The USBC hosts an Action Directory displaying the work happening on the national, state, and local levels to
implement The Surgeon General's Call to Action to Support Breastfeeding, sorted by sector and action step.
Visit the Action Directory at www.usbreastfeeding.org/action-directory. To have your organization's work
featured in the Action Directory, request an organization website profile at www.usbreastfeeding.org/org-
profile and share about your efforts in the appropriate profile fields. These entries populate public pages on
the site, so that all visitors can easily find and read highlights of related activities from across the country,
sorted by topic.

Breastfeeding Coalition Directory
The USBC maintains a directory of state/territorial, tribal, cultural, and local/community coalitions. Find your
state/local breastfeeding coalition at www.usbreastfeeding.org/coalitions-directory

USBC Webinar Series
The USBC hosts several bi-monthly webinar series: "Power Tools for Coalitions" webinars (odd-numbered
months), CDC-USBC webinars (even-numbered months), and Racial Equity webinars (odd-numbered months).

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Online Learning Communities
The USBC website houses online learning communities on breastfeeding-related topic areas from The Surgeon
General's Call to Action to Support Breastfeeding and beyond. Site users are invited to explore all the Learning
Communities, and join those of greatest interest, to share information and resources and surface
opportunities for collaborative action.

    •    To access the Learning Communities, first request an individual login to the site.
    •    Visit the links on the following page to explore each community, including active discussion forums and
         file sharing libraries on each of its implementation strategies.
    •    To join a specific community, click the "Join Community" button on the community's landing page.

Mothers & Families                                          Research & Surveillance

    •    Mothers Learning Community (1)                         •   Research Learning Community (17, 18)
    •    Families Learning Community (2)                        •   Monitoring & Surveillance Learning
                                                                    Community (19)
Communities
                                                            Public Health Infrastructure
    •    Peer & Professional Support Learning
         Community (3, 11)                                      •   Coalitions Learning Connection (20)
    •    Community-Based Organizations Learning
         Community (4)                                      Other
    •    Promotion Campaigns Learning Community
         (5)                                                    •   Collective Impact Learning Community
    •    Formula Marketing Learning Community                   •   Emergency Preparedness Learning
         (6)                                                        Community
                                                                •   Infant Sleep Practices Learning Community
Health Care                                                     •   Legislative & Policy Advocacy Learning
                                                                    Community
    •    Maternity Care Practices Learning                      •   Media Advocacy Learning Community
         Community (7)                                          •   Racial Equity Learning Community
    •    Continuity of Care Learning Community (8)
    •    Health Professional Education & Training
         Learning Community (9)
    •    Standard of Care Learning Community (10)
    •    Peer & Professional Support Learning
         Community (3, 11)
    •    Donor Milk Learning Community (12)

Employment

    •    Paid Leave Learning Community (13)
    •    Workplace Support Learning Community
         (14)
    •    Babies at Work Learning Community (15)
    •    Child Care Learning Community (16)
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                                          Health Reform
Background
The Patient Protection and Affordable Care Act (ACA) includes three provisions that have a direct impact on
breastfeeding:

    1. Breastfeeding Supports as a Preventive Service
    2. Workplace Breastfeeding Support ("Break Time for Nursing Mothers" provision)
    3. Funding for CDC Breastfeeding Programs via the Prevention & Public Health Fund

Congressional leaders made repealing the ACA a top priority for action in 2017, pursuing repeated repeal
efforts via the legislative mechanism of budget reconciliation beginning in January. In order to qualify for
budget reconciliation, legislative provisions must change spending, revenues, and/or the federal debt limit.
Breastfeeding supports as preventive services and workplace breastfeeding support were not subject to repeal
under this mechanism. The Prevention and Public Health Fund, however, was aggressively targeted for
elimination. In the spring, the House released budget reconciliation legislative recommendations, dubbed the
"American Health Care Act" (H.R. 1628), as the first step in a proposed three-phase process to repeal and
replace the Affordable Care Act. Action then moved to the Senate, where several proposed bills eventually
emerged, though each ultimately failed to achieve sufficient votes for passage. Because of time limitations on
the overarching budget resolution, the ability to use this mechanism to pass a health reform bill expired on
September 30, 2017.

However, efforts to dismantle the ACA continued. The Tax and Job Cuts Act (H.R. 1), passed on December 22,
2017. Beginning in 2019, the tax bill repeals the health reform "individual mandate," a section of the ACA with
tax penalties that encourage individuals to buy health coverage. The Congressional Budget Office projects that
this measure will result in 4 million more people uninsured in 2019 and 13 million by 2027. Therefore, even if
the Preventive Services remain in place for most plans, this loss of health coverage in general will result in
reduced access to them, including breastfeeding support, supplies, and counseling.

Current Status
Drastically reduced funding and support for ACA enrollment outreach, weakened benefit requirements, repeal
of the individual insurance mandate, and new opportunities for insurers to offer skimpier and short term
plans to customers, are creating conditions for divided markets, where healthier people buy lightly regulated
plans that don’t cover much health care, lower earners have access to some form of ACA, and the sicker
middle-class population face escalating costs for insurance with comprehensive benefits. States are beginning
to take action to mitigate the effects of new rulings. This may lead to big variations in health insurance
coverage and action depending on where one lives. Updates on the state of broader issues of health reform
are included in the Federal budget section.

Action Needed
Call on Members of Congress to protect and build on federal policies and investments that support our
Nation's breastfeeding families:
     • Continue and enhance funding—either within or outside the Prevention & Public Health Fund—for the
        Centers for Disease Control & Prevention (CDC) Breastfeeding Support Programs at $15M/year,

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         especially for initiatives to improve maternity care practices and increase access to peer & professional
         support and continuity of breastfeeding care;
    •    Maintain health plan coverage of comprehensive breastfeeding support (including counseling,
         education, and equipment and supplies) as a preventive service without cost-sharing, including both
         the U.S. Preventive Services Task Force and the Women's Preventive Services mechanisms; align
         Medicaid coverage to ensure equitable access to these services for all women and children.

Individual Action Opportunities
    •    USBC Story Collectors—share stories of experiences with:
            o ...the requirement for health plans to cover breastfeeding support, supplies, and counseling as
                a preventive service...maternity care practice quality improvement initiatives that support
                implementation of breastfeeding-friendly practices
            o ...maternity care practice quality improvement initiatives that support implementation of
                breastfeeding-friendly practices
    •    WeTweet: Tweet at your Members of Congress with just a few clicks!
    •    MomsRising Story Collector: Speak up for national programs that boost families
    •    American Public Health Association Action Tool: Oppose cuts to the Prevention and Public Health Fund

Organizational Action Opportunities
    •    Watch for news and action opportunities:
            o Trust for America's Health
            o Coalition on Human Needs
            o Center on Budget and Policy Priorities
            o Prevention Institute

Key Messages
Breastfeeding Saves Dollars & Makes Sense: Protect Breastfeeding Supports within the ACA. Breastfeeding is a
proven primary prevention strategy, building a foundation for life-long health and wellness. The evidence for
the value of breastfeeding to children’s and women’s health is scientific, solid, and continually being
reaffirmed by new research.

A 2016 study of both maternal & pediatric health outcomes and associated costs based on 2012 breastfeeding
rates showed that, if 90% of infants were breastfed according to medical recommendations, 3,340 deaths, $3
billion in medical costs, and $14.2 billion in costs of premature death would be prevented, annually!
Breastfeeding Savings Calculator.

See specific asks above.

Social Media
Hashtags to Use: #ACA (primary hashtag), #MaternityCare, #ACA, #HealthCare, #ProtectOurCare
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

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When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

Sample Messages
If 90% of babies #breastfed, US would save 3k lives and $17B/yr @LegislatorHandle. bit.ly/2cSmzGi

#BreastfeedingIsBipartisan, @LegislatorHandle. Good for families, employers & economy:
usbreastfeeding.org/dollars-sense

.@PublicHealth has created an easy action tool to help you oppose cuts to the Prevention and Public Health
Fund (PPHF). PPHF currently supports CDC Breastfeeding Programs, among other vital programs. Take action
today at http://bit.ly/2DMoCZ6

WHAT WE NEED: Continue and enhance funding for the @CDCgov Breastfeeding Support Programs at
$15M/year. Ask your Members of Congress to take action with just a few clicks at
www.wetweet.org/partners/usbreastfeeding/

For the latest news and updates, visit www.usbreastfeeding.org/health-reform

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                                          Federal Budget
Background

The Senate and House approved and President Trump signed five stop gap measures, or Continuing
Resolutions (CR), to keep the government funded for the 2018 fiscal year. The last CR, approved on February 6
expires on Friday, March 23. Congress needs to pass a final omnibus spending package for the remainder of
fiscal year 2018 by this deadline to avoid another Government shutdown.

On February 12, President Trump released the Administration's FY 2019 Budget, providing a snapshot of his
priorities. Breastfeeding families may be impacted through the proposals to:
    • zero out CDC's Hospitals Promoting Breastfeeding programs;
    • zero out funding for the Racial and Ethnic Approaches to Community Health program;
    • allocate $628 million for the Title V Maternal and Child Health Block Grant, a decrease of $12 million
         from FY 2017. The proposal eliminates or reduces additional maternal-child health programs for a total
         cut of $112 million;
    • fund MIECHV at its current annual funding level of $400 million, but convert this program from
         mandatory funding to discretionary funding to be provided through the annual appropriations
         process;
    • allocate $5.75 billion for WIC to serve all projected participants in FY 2019, with $60 million earmarked
         for breastfeeding peer counseling, and a $10 million cut to program evaluation and monitoring.

The $4.4 trillion budget proposes massive cuts to domestic programs providing basic needs to benefit the poor
and middle class, while substantially increasing spending on defense and immigration enforcement. The
budget proposal would cut CDC program level funding by 19.4 percent relative to the FY 2018 annualized
Continuing Resolution, and 21.2 percent relative to FY 2017. The HHS Budget in Brief, the HHS budget tables,
and the CDC detail chart provide specific details.

The President's budget proposal sets priorities for FY 19 and future years, and will have an impact on
mandatory programs, such as Social Security, Medicare, Medicaid, SNAP, civil service retirement; tax policy;
discretionary program spending, as well as individual program funding.

Current Status
An omnibus bill was expected by March 14 to give Congress time to pass it before the current CR deadline.
However, with several issues, such as provisions to lower health care premiums, immigration and funding for a
border wall, a possible gun control measure, and more still being worked out, it is doubtful if the House will be
able to debate and vote on a spending bill by March 21, which would allow the Senate enough time for debate
and to vote on the final FY2018 Omnibus bill before the March 23 deadline. Congress may have to resort to
another stop gap funding measure to avert a Government shutdown.

Individual Action Opportunities
    •    Watch for news and action opportunities:
            o U.S. Breastfeeding Committee
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             o   Trust for America's Health
             o   National WIC Association

Organizational Action Opportunities
    •    Association of Maternal and Child Health Programs sign-on letter to support funding for the Title V
         Maternal and Child Health Services Block Grant. Deadline: Monday, March 26.
    •    Association of State and Territorial Health Officials 22 by 22 campaign to urge Congress to increase
         overall CDC funding by 22% by 2022

Key Messages
A 2016 study of both maternal & pediatric health outcomes and associated costs based on 2012 breastfeeding
rates showed that, if 90% of infants were breastfed according to medical recommendations, 3,340 deaths, $3
billion in medical costs, and $14.2 billion in costs of premature death would be prevented, annually!
Breastfeeding Savings Calculator.

Social Media
Hashtags to Use: #ACA (primary hashtag), #MaternityCare, #ACA, #HealthCare, #ProtectOurCare
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

Sample Messages
If 90% of babies #breastfed, US would save 3k lives and $17B/yr @LegislatorHandle. bit.ly/2cSmzGi

#BreastfeedingIsBipartisan, @LegislatorHandle. Good for families, employers & economy:
usbreastfeeding.org/dollars-sense

What do we mean when we say “Breastfeeding Saves Dollars & Makes Sense"? Find out here:
http://www.usbreastfeeding.org/dollars-sense

Breastfeeding is a proven primary prevention strategy, building a foundation for life-long health and wellness.
The evidence for the value of breastfeeding to children’s and women’s health is scientific, solid, and
continually being reaffirmed by new research. #intheknow

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

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                Children's Health Insurance Program (CHIP)
Background
The Children's Health Insurance Program (CHIP) provides health coverage to eligible children, covering 8.9
million children in working families who earn too much to qualify for Medicaid but cannot afford or access
private coverage. The program is funded jointly by states and the federal government. Some state CHIP
programs offer coverage to pregnant and postpartum women, which may including breastfeeding support.
Congressional authorization and federal funding for CHIP ended on September 30, 2017. Several bills were
introduced from October through December 2017 to reauthorize CHIP via Continuing Resolutions.

Current Status
The last Continuing Resolution, approved on February 6, included a four-year extension of the Children's
Health Insurance Program (CHIP) and more than $7 billion for community health centers, the primary medical
home for more than 27 million people in 10,400 rural and urban communities across America, which had
expired on September 30, 2017, and had not been funded in Continuing Resolution measures of previous
months.

Equity Lens
With Congress lurching from one Continuing Resolution to the next, timely reauthorization of CHIP did not
occur. In addition, the funding for Community Health Centers that serves CHIP families was also allowed to
expire. This uncertainty around funding and program authorization left families of almost 9 million children
who depend on CHIP without security of continued health coverage.

Key Resources
    •    Families USA CHIP resource page featuring information, a fact sheet, and shareable infographics
    •    Children’s Health Insurance Program (CHIP) Advocacy Toolkit

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

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         Maternal, Infant and Early Childhood Home Visiting
                         (MIECHV) Program
Background:
The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) provides voluntary, evidence-
based home visiting services to at-risk pregnant women and parents with young children until kindergarten
entry. MIECHV grantees must demonstrate improvement for eligible families participating in the program.
Breastfeeding at 6 months is one of six systems outcomes in the maternal and newborn health benchmark
area. Like CHIP, MIECHV authorization expired on September 30.

Current Status
Congress reauthorized the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program at level-
funding of $400 million annually for five years, from FY 2017 to FY 2022 via the Bipartisan Budget Act of 2018,
the February 6 bill that extended the fifth Continuing Resolution of this fiscal year.

Equity Lens
Home visiting programs improve the physical and mental health of participating families by showing families
how to best care for their children and themselves. Home visiting programs help children and families access
quality health care and resources to improve birth outcomes and ensure children born into poverty have a
healthy start.

Key Resources
    •    Home Visiting Coalition Congressional Recess Toolkit
    •    Watch for news and updates:
            o Home Visiting Coalition
            o Association Of Maternal And Child Health Programs

Social Media
Hashtags to Use: #HomeVisitingWorks #MIECHV
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

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                                    Healthy People 2030
Background:
Healthy People provides science-based, 10-year national objectives for improving the health of all Americans.
For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:
    • Encourage collaborations across communities and sectors.
    • Empower individuals toward making informed health decisions.
    • Measure the impact of prevention activities.

Healthy People 2020 includes several breastfeeding objectives in the Maternal, Infant, and Child Health
section:
    • MICH-21 Increase the proportion of infants who are breastfed
              o MICH-21.1 Increase the proportion of infants who are ever breastfed
              o MICH-21.2 Increase the proportion of infants who are breastfed at 6 months
              o MICH-21.3 Increase the proportion of infants who are breastfed at 1 year
              o MICH-21.4 Increase the proportion of infants who are breastfed exclusively through 3 months
              o MICH-21.5 Increase the proportion of infants who are breastfed exclusively through 6 months
    • MICH-22 Increase the proportion of employers that have worksite lactation support programs
    • MICH-23 Reduce the proportion of breastfed newborns who receive formula supplementation within
         the first 2 days of life
    • MICH-24 Increase the proportion of live births that occur in facilities that provide recommended care
         for lactating mothers and their babies

Current Status
Healthy People 2030 Development is now underway. Meeting materials published from the Secretary’s
Advisory Committee for 2030 state that the intention is to reduce the number of objectives by half. The
Secretary's Advisory Committee has announced that they will host up to four (4) regional listening sessions in
2018. Dates and locations have not yet been announced.

Action Needed
The breastfeeding field should prepare to attend regional listening sessions and/or submit comments calling
for the continuation of Healthy People breastfeeding objectives. Discussion of strategy and priorities is
needed. Stay tuned for an announcement of the next Advocacy Networking Call.

Key Messages
Individuals and organizations across the United States are working to meet and exceed the Healthy People
2020 breastfeeding objectives, but the impact of this work extends far beyond these four objectives. The cross-
cutting, collective impact of breastfeeding means that supporting breastfeeding success can create a tidal
wave of progress toward our Nation’s health goals.

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Key Resources
    •    Healthy People:
            o Development of the National Health Promotion and Disease Prevention Objectives for 2030
            o The Secretary's Advisory Committee for 2030: Meeting Information
            o   Public Comment for Healthy People 2030

Social Media

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

Sample message

Healthy People 2020 includes several #breastfeeding objectives in the Maternal, Infant, and Child Health
section: http://bit.ly/2d31iJM. Stay tuned! HP2030 development is underway.

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

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                  Supporting Working Moms Act (SWMA)
Background:
Section 7 of the Fair Labor Standards Act (FLSA) requires employers to provide reasonable break time and a
private, non-bathroom place for most hourly wage-earning workers to express breast milk at work. This
provision is often referred to as the "Break Time for Nursing Mothers" law. Unfortunately, its placement within
existing statute means that only workers who are eligible for overtime under the FLSA are covered.

Note: Some employees have additional workplace breastfeeding protections through state or territorial laws.
Learn more about the laws that impact breastfeeding employees in your state.

The bipartisan Supporting Working Moms Act of 2017 (SWMA) (H.R. 3255/S. 2122) would protect and expand
working moms' right to breastfeed by extending the existing federal law to ensure that executive,
administrative, and professional employees, including elementary and secondary school teachers, have these
same protections.

Current Status
The House version, championed by Representative Carolyn Maloney, was introduced in July 2017 with 11
original co-sponsors. Since then, ten additional co-sponsors have joined. The Senate version, championed by
Senator Merkley, was introduced in November with bipartisan support from nine original co-sponsors. Since
then, one additional co-sponsor has joined.

Senate Cosponsors:
Richard Blumenthal (D-CT)                                  Edward J. Markey (D-MA)
Robert P. Casey, Jr. (D-PA)                                Jeff Merkley (D-OR)
Tammy Baldwin (D-WI)                                       Lisa Murkowski (R-AK)
Kirsten E. Gillibrand (D-NY)                               Elizabeth Warren (D-MA)
Margaret Wood Hassan (D-NH)                                Ron Wyden (D-OR)

House Cosponsors:
Donald S. Beyers Jr. (D-VA-8)                              Michelle Lujan Grisham (D-NM-1)
Tony Cardenas (D-CA-29)                                    James P. McGovern (D-MA-2)
Andre Carson (D-IN-7)                                      Gwen Moore (D-WI-4)
Gerald E. Connolly (D-VA-11)                               Grace F. Napolitano (D-CA-32)
Jim Cooper (D-TN-5)                                        Eleanor Holmes Norton (D-DC-0)
Keith Ellison (D-MN-5)                                     Chellie Pingree (D-ME-1)
Ro Khanna (D-CA-17)                                        Linda T. Sanchez (D-CA-38)
Sander M. Levin (D-MI-9)                                   Janice D. Schakowsky (D-IL-9)
Zoe Lofgren (D-CA-19)                                      Carol Shea-Porter (D-NH-1)
Alan Lowenthal (D-CA-47)                                   Eric Swalwell (D-CA-15)
                                                           Robert A. Brady (D-PA-1)

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Equity Lens
The most vulnerable workers are already covered by the "Break Time for Nursing Mothers" law; SWMA would
ensure a fair and uniform national policy for employees covered by the FLSA, however some categories of
workers will be left unprotected.

Action Needed
SWMA is currently seeking additional cosponsors in both the House and Senate, especially from the Education
and Workforce Committee in the House and the Health, Education, Labor, and Pensions (HELP) Committee in
the Senate.

Individual Action Opportunities
    •    Action Alert: Tell Congress to Support ALL Breastfeeding & Working Moms!
    •    Story Collector: Share stories of experiences with employer implementation of federal "Break Time for
         Nursing Mothers" law
    •    WeTweet: Tweet at your Members of Congress with just a few clicks!

Organizational Action Opportunities
    •    Organizational Sign-on Letter: National, state, and local organizations are invited to complete the sign-
         on form to be added to the letter of support to Representative Maloney and Senator Merkley for
         introducing SWMA

Key Messages
Employment is now the norm for women of childbearing age, yet breastfeeding mothers continue to face
barriers in the workplace, putting them at particular risk for not meeting their breastfeeding goals. While
nearly four out of five U.S. mothers start out breastfeeding, less than half are still breastfeeding at six months
postpartum. The lack of break time and a private place to pump in the workplace remains one of the main
causes for the drop-off in breastfeeding rates.
Social Media
Hashtags to Use: #SWMA (primary hashtag), #WorkingFamilies
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

Sample message if your Senator or Representative is a cosponsor
Thank you for supporting ALL working moms @LegislatorHandle! With your help, we can ensure that every
parent is supported to #breastfeed at work usbreastfeeding.org/swma #SWMA #WorkingMoms

Sample message if your Senator Representative is NOT a cosponsor
Will you support working moms @LegislatorHandle? With your help, we can ensure that every parent is
supported to #breastfeed at work usbreastfeeding.org/swma #SWMA #WorkingMoms

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General sample messages
ALL moms deserve #bfing support @ work. Take action on #SWMA, @LegislatorHandle.
usbreastfeeding.org/swma

The bipartisan Supporting Working Moms Act of 2017 (#SWMA) would protect and expand working moms'
right to breastfeed by extending the existing federal law to ensure that executive, administrative, and
professional employees, including elementary & secondary school teachers.

The most vulnerable workers are already covered by the "Break Time for Nursing Mothers" law; #SWMA would
ensure a fair and uniform national policy for employees covered by the FLSA, however some categories of
workers will be left unprotected. http://www.usbreastfeeding.org/swma

WHAT WE NEED: #SWMA needs additional cosponsors in both the House & Senate, especially from members
of the Education and Workforce Committee in the House and the Health, Education, Labor, and Pensions
(HELP) Committee in the Senate. TWEET THEM: http://www.wetweet.org/partners/usbreastfeeding/

Key Resources
   •    USBC:
            o Online Guide: What You Need to Know About the "Break Time for Nursing Mothers" Law
                     What if your state already has a law?
            o Resource Guide for Breastfeeding Employees and their Employers
   •    Office on Women’s Health:
            o Supporting Nursing Moms at Work: Employer Solutions
            o Business Case for Breastfeeding
   •    Center for WorkLife Law:
            o Pregnant @ Work
            o Guide for doctors on writing work notes for nursing mothers
   •    American Civil Liberties Union:
            o Federal Law and Pregnant, Post-Partum and Breastfeeding Workers
   •    A Better Balance:
            o Babygate

For the latest news and updates, visit www.usbreastfeeding.org/swma

       2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
16

       Fair Labor Standards Act Overtime Rule Regulations
Background:
Following an extensive public comment process, the U.S. Department of Labor issued a Final Rule updating the
Fair Labor Standards Act (FLSA) overtime regulations in May 2016. By increasing the number of employees who
are considered nonexempt (eligible for overtime), the rule would have also expanded the right to workplace
breastfeeding accommodations under the "Break Time for Nursing Mothers" law. Just before it went into
effect, however, a federal judge in Texas granted a preliminary injunction suspending its implementation. The
Department of Justice, on behalf of the Department of Labor, filed a notice to appeal, but in August 2017 the
court ultimately held that the Final Rule is invalid. In July 2017, the Department of Labor released a new
Request for Information to seek feedback from the public related to overtime regulations. Over 140,000
comments were submitted.

Current Status
The Department of Labor released a new Request for Information to seek feedback from the public related to
overtime regulations. Over 140,000 comments were submitted. Stay tuned for updates on further rulemaking
actions.

Social Media
Hashtags to Use: #FLSA #Overtime #WorkingMoms
U.S. Department of Labor: @USDOL

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

General sample message
DYK: Updating #FLSA #Overtime regulations would increase workplace #breastfeeding accommodations?
#WorkingMoms @USDOL

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

     2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
17

           Family and Medical Insurance Leave (FAMILY) Act
Background:
The Family and Medical Leave Act (FMLA) guarantees eligible employees up to 12 weeks of unpaid leave each
year to care for a newborn, a newly adopted child or a seriously ill family member, or to recover from their
own serious health conditions, including pregnancy. However, almost 40 percent of the workforce is not
eligible for leave under the FMLA. The U.S. remains one of the only countries in the world that does not
guarantee paid parental leave, but momentum continues to build in support of a national paid family leave
program. The Family and Medical Insurance Leave (FAMILY) Act (H.R. 947/S. 337) would create a national
insurance program that would support workers and businesses by providing eligible employees with up to 12
weeks of paid leave for their own serious illness or that of a child, parent, or spouse; the birth or adoption of a
child; the injury of a family member in the military; or exigencies arising from a servicemember's deployment.

Current Status
Congresswoman Rosa DeLauro was joined by 112 original cosponsors on the House bill and Senator Kirsten
Gillibrand introduced the companion legislation in the Senate with 26 original cosponsors. The FAMILY Act has
continued to gain support in both Houses of Congress with 154 cosponsors in the House and 32 cosponsors in
the Senate.

Senate Cosponsors | House Cosponsors

Equity Lens
Only 15 percent of workers have access to paid family leave through their employers and 39 percent have paid
personal medical leave through an employer's short-term disability insurance program. Five percent of part-
time workers currently have paid family leave, compared to 18 percent of full-time workers. Ten percent of
employees at smaller businesses (fewer than 50 employees) have paid family leave, compared to 24 percent at
large businesses. The FAMILY Act would apply to workers in ALL companies including younger, part-time,
lower-wage and contingent workers.

Action Needed
The FAMILY Act is currently seeking additional cosponsors in both the House and Senate, especially from the
Senate Finance Committee and the House Ways and Means Subcommittee on Human Resources in the House.

Individual Action Opportunities
    •    Story Collector: Share stories of experiences with paid family leave
    •    MomsRising Action Tool: Tell Congress: We need paid family leave for ALL working families!
    •    1,000 Days Petition: Tell Congress: All Parents Need Paid Time Off To Care For A New Child
    •    Family Values @ Work Action Tool: Let's go beyond FMLA, support the FAMILY Act
    •    9 to 5 Action Tool: Stand for FAMILY with national paid family and medical leave insurance

        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
18

Key Resources
    •    A Better Balance: comparative chart on state paid leave laws
    •    National Partnership for Women & Families: FMLA25 toolkit and social media toolkit to make the case
         for a strong national paid family and medical leave law, like the Family And Medical Insurance Leave
         (FAMILY) Act
    •    Big Cities Health: policy and practice page on paid leave

Social Media Messages
Hashtags to Use: #FAMILYAct #PaidLeave #WorkingMoms #LeadonLeave
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

Sample message if your Senator or Representative is a cosponsor
#PaidLeave has a big impact on #breastfeeding success. Thank you for supporting the #FAMILYAct
@LegislatorHandle! With your help, we can #LeadonLeave

Sample message if your Senator Representative is NOT a cosponsor
#PaidLeave has a big impact on #breastfeeding success. With your help, we can #LeadonLeave.
@LegislatorHandle: pls support the #FAMILYAct

General sample messages

Five percent of part-time workers currently have paid family leave, compared to 18 percent of full-time
workers. #FAMILYAct #Equity #Breastfeeding #LeadonLeave

The #FMLA was a great step toward a family friendly America 20 years ago. It's past time to take the next one:
the #FAMILYAct. #paidleave @LegislatorHandle

Ten percent of employees at smaller businesses (fewer than 50 employees) have paid family leave, compared
to 24 percent at large businesses. #FAMILYAct #Equity #Breastfeeding #LeadonLeave

WHAT WE NEED: The #FAMILYAct needs additional cosponsors in both the House and Senate, especially from
members of the Senate Finance Committee and the House Ways and Means Subcommittee on Human
Resources in the House. Take Action: http://www.wetweet.org/partners/usbreastfeeding/ #Equity
#Breastfeeding

WHAT WE NEED: The #FAMILYAct needs additional cosponsors in both the House and Senate, especially from
members of the Senate Finance Committee and the House Ways and Means Subcommittee on Human
Resources in the House. Take Action: http://bit.ly/2rY98MG @MomsRising #Equity #Breastfeeding
For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
19

                   Pregnant Workers Fairness Act (PWFA)
Background:
The Pregnancy Discrimination Act of 1978 prohibits sex discrimination on the basis of pregnancy, childbirth,
and related medical conditions. In response to court rulings, in 2015, the U.S. Equal Employment Opportunity
Commission released an update of their Enforcement Guidance: Pregnancy Discrimination and Related Issues,
which, for the first time, identified lactation as a pregnancy-related condition. Yet pregnant and postpartum
employees continue to face challenges accessing the workplace accommodations they need.

The Pregnant Workers Fairness Act (PWFA) (H.R. 2417/S. 1101) would protect workers from workplace
discrimination based on pregnancy, childbirth, and related medical conditions by addressing legal ambiguities
and helping ensure that pregnant women are treated fairly on the job. The bill is modeled after the Americans
with Disabilities Act, and would require employers to make reasonable accommodations, such as a minor job
modification, that would allow pregnant workers to continue working and prevent them from being forced out
on leave or out of their jobs. The bill also prohibits employers from denying employment opportunities to
women based on their need for reasonable accommodations related to pregnancy, childbirth, or related
medical conditions.

Current Status
The bill was introduced with bipartisan support in both houses of Congress. The House version, introduced by
Representatives Jerrold Nadler and Mike Coffman, has 113 cosponsors. The Senate version was introduced
by Senators Dean Heller, Bob Casey, and Jeanne Shaheen.

Senate Cosponsors | House Cosponsors

Equity Lens
Hourly-wage workers are often the most at risk for being forced out of a job when asking for pregnancy
accommodations, and PWFA would ensure fair protections for all pregnant workers.

Individual Action Opportunities
    •    MomsRising Action Alert: U.S. Congress: Support the Pregnant Workers Fairness Act!
    •    National Women's Law Center Action Alert: Urge Your Member of Congress to Support the Pregnant
         Workers Fairness Act

Organizational Action Opportunities
    •    Watch for news and action opportunities:
            o National Partnership for Women & Families
            o MomsRising

Key Messages
No one should be forced to choose between a health pregnancy and their job. Simple, cost-effective solutions
can make a big difference for pregnant workers.

        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
20

Social Media Messages
Hashtags to Use: #PWFA #pregnancy #WorkingMoms
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

Sample message if your Senator or Representative is a cosponsor
Thank you for supporting #PWFA @LegislatorHandle! #Pregnant workers need employer & govt support to
succeed

Sample message if your Senator Representative is NOT a cosponsor
Pregnancy should mean reasonable accommodations, not forced to leave your job. Support #PWFA & support
#WorkingMoms @LegislatorHandle

General sample messages
Pregnancy should mean reasonable accommodations, not being forced to leave your job. Support #PWFA &
support #WorkingMoms @LegislatorHandle

Hourly-wage workers are often the most at risk for being forced out of a job when asking for pregnancy
accommodations, and PWFA would ensure fair protections for all pregnant workers. Take Action:
http://bit.ly/2rzEBk6 @MomsRising #PWFA #pregnancy #WorkingMoms

No one should be forced to choose between a healthy pregnancy and their job. Simple, cost-effective solutions
can make a big difference for pregnant workers. Take Action: http://bit.ly/2rzEBk6 @MomsRising #PWFA
#pregnancy #WorkingMoms

The Pregnant Workers Fairness Act (#PWFA) would protect workers from workplace discrimination based on
pregnancy, childbirth, and related medical conditions by addressing legal ambiguities and helping ensure that
pregnant women are treated fairly on the job. www.usbreastfeeding.org/advocacy

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

     2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
21

                                      Healthy Families Act
Background:
Paid sick days make it possible for employees to access preventive services, including breastfeeding support
and counseling, when needed. Yet more than 37 million U.S. workers in the private sector aren't able to earn a
single paid sick day. The Healthy Families Act (HFA) (H.R. 1516/S. 636) would guarantee workers can earn up to
56 hours (seven days) of paid sick time to stay home and get well when they are ill, to care for a sick family
member, to seek routine medical care, or seek assistance related to domestic violence. Workers would earn
one hour of paid sick time for every 30 hours worked. Small employers with fewer than 15 employees would
not be required to provide paid sick days.

Current Status
The House version, introduced by Representative Rosa DeLauro, has 142 cosponsors, and the Senate version,
introduced by Senator Patty Murray, has 36 cosponsors.

Senate Cosponsors | House Cosponsors

Equity Lens
40% of the workforce does not have a single paid sick day, so taking off work for a sick child or parent means
no money earned for that day. A paycheck will be 20% smaller that week—assuming one only works five days
a week. For example, one child's ear infection means at least one trip to the clinic doctor, plus one follow-up
visit as well. This all translates to time missed from work, without pay. Those who don’t have paid sick days are
often those who can least afford lost wages from missed work: eight in ten of the lowest hourly wage workers
have no paid sick days.
Individual Action Opportunities
    •    Family Values at Work Action Alert: Congress, Pass the Healthy Families Act (HFA) Now!
    •    American Public Health Association: Tell Congress to support paid sick leave

Organizational Action Opportunities
    •    Watch for news and action opportunities:
            o National Partnership for Women & Families
            o MomsRising

Key Resources
    •    National Paid Sick Days Coalition: PaidSickDays.org is a project of the National Partnership for Women
         & Families, which convenes the Healthy Families Act coalition

Key Messages
Paid sick days benefit both working parents and their children. Without them, a parent could lost 20% of a
week's paycheck to take a single day to care for their sick child. Lack of access to paid sick days includes access
to preventive care includes breastfeeding support and counseling
        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
22

Social Media
Hashtags to Use: #HealthyFamilies #SickDays #WorkingMoms
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

General sample messages
Paid #SickDays keep everyone healthy. Support #WorkingMoms and support the #HealthyFamilies Act,
@LegislatorHandle

No Paid #SickDays means no access to crucial #breastfeeding support & counseling for #WorkingMoms!
Support the #HealthyFamiliesAct, @LegislatorHandle

40% of the workforce does not have a single #paidsickday, so taking off work for a sick child or parent means
no money earned for that day. A paycheck will be 20% smaller that week—assuming one only works five days
a week. Take Action: http://bit.ly/2poNs8K

#Paidsickdays benefit both working parents and their children. Without them, a parent could lose 20% of a
week's paycheck to take a single day to care for their sick child. Take Action: http://bit.ly/2BGSWQI
#paidsickday #WorkingMoms #HealthyFamiliesAct

The Healthy Families Act (HFA) would guarantee workers can earn up to 56 hours (seven days) of paid sick time
to stay home and get well when they are ill, to care for a sick family member, to seek routine medical care, or
seek assistance related to domestic violence. Take Action: http://bit.ly/2BGSWQI
 #paidsickday #WorkingMoms #HealthyFamiliesAct

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/advocacy

     2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
23

                   Friendly Airports for Mothers (FAM) Act
Background
The bipartisan Friendly Airports for Mothers (FAM) Act (H.R. 2375/S. 110) would require all large and medium
hub airports to provide a private, non-bathroom space in each terminal for mothers to express breast milk. The
space must be accessible to persons with disabilities, available in each terminal building after the security
checkpoint, and include a place to sit, a table or other flat surface, and an electrical outlet. Airports would have
two years to comply and would be able to use Airport Improvement Program funds for the purpose of
complying with the new requirement.

Current Status
In May, Rep. Stephen Knight (CA-25) was joined by 6 original cosponsors on the House bill and Senator Tammy
Duckworth (IL) introduced the Senate version with 2 original cosponsors. The FAM Act has continued to gain
support in both Houses of Congress with 11 cosponsors in the House and 12 cosponsors in the Senate.

The provisions of the FAM Act were also included in the Federal Aviation Administration Reauthorization Act of
2017 (S. 1405), which would reauthorize the Federal Aviation Administration (FAA) and specified FAA programs
through FY2021 and revise requirements for the airport improvement program. Unfortunately, Congress was
unsuccessful in reaching a full reauthorization of the agency. Since FAA authorization was set to expire on
September 30, Congress passed a short term extension through March 28, 2018, to keep the agency operating
while a long term solution is considered. The FAM Act's inclusion in the FAA has been met without opposition.

Senate Cosponsors:
Tammy Duckworth (D-IL)                                        Bernard Sanders (I-VT)
Deb Fischer (R-NE)                                            Amy Klobuchar (D-MN)
Claire McCaskill, (D-MO)                                      Kamala D. Harris (D-CA)
Richard Blumenthal (D-CT)                                     Jeff Merkley (D-OR)
Patrick J. Leahy (D-VT)                                       Christopher A. Coons (D-DE)
Jeanne Shaheen (D-NH)                                         Benjamin L. Cardin (D-MD)

House Cosponsors:
Stephen Knight (CA-25)                                        Norma Torres (CA-35)
Jaime Herrera Beutler (WA-3)                                  Peter Welch (VT-At Large)
Barbara Comstock (VA-10)                                      David E. Price (NC-4)
Susan Brooks (IN-5)                                           Gerald E. Connolly (VA-11)
Cheri Bustos (IL-17)                                          Carol Shea-Porter (NH-1)
Daniel Lipinski (IL-3)                                        Alcee L. Hastings (FL-20)
.
Individual Action Opportunities
    •    USBC Action Alert: Tell Congress Breastfeeding Families Need the FAM Act!
    •    USBC Story Collector: Share stories of experiences with airport lactation accommodations & TSA
         security screenings…

        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
24

    •    USBC Shareable Graphics: Share the campaign on Facebook or Twitter to tell your network to take
         action
    •    WeTweet: Tweet at your Members of Congress with just a few clicks!

Organizational Action Opportunities
    •    USBC Organizational Sign on Letter: National, state, and local organizations are invited to complete the
         sign on form to be added to the thank you letter to Representative Knight and Senator Duckworth for
         introducing the Fam Act

Key Messages
No matter what they're doing or where they are, breastfeeding mothers need to express milk every few hours.
An airport is just one of many environments where women face challenges trying to find a clean, private space
to nurse or pump.

Social Media
Hashtags to Use: #FAMAct #Airports
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

General sample message
92% of airports lack what #BFing #moms need. We need the Friendly Airports for Mothers Act,
@LegislatorHandle. usbreastfeeding.org/fam-act #FAMAct

The #FAMAct is a simple solution to support families while they travel. Let's make #airports #breastfeeding-
friendly! @LegislatorHandle ww.usbreastfeeding.org/fam-act

The bipartisan Friendly Airports for Mothers (FAM) Act would require all large and medium hub airports to
provide a private, non-bathroom space in each terminal for mothers to express breast milk. The space must be
accessible to persons with disabilities, available in each terminal building after the security checkpoint, and
include a place to sit, a table or other flat surface, and an electrical outlet. www.usbreastfeeding.org/fam-act

For the latest news and updates, visit USBC's Advocacy HQ at www.usbreastfeeding.org/fam-act

        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
25

                    Fairness for Breastfeeding Mothers Act
Background
The Fairness for Breastfeeding Mothers Act (H.R. 1174/S. 1497) would require that certain public buildings that
have a public restroom provide a lactation room, other than a bathroom, that is hygienic and is available for
use by a member of the public. A covered public building may be excluded from the requirement if the building
does not contain a lactation room for employees who work in the building and does not have a room that
could be repurposed as a lactation space at a reasonable cost; or if new construction would be required and
the cost is unfeasible.

Current Status
The bill was introduced in the House with bipartisan support by Representative Eleanor Holmes Norton (DC),
who was joined by 2 original cosponsors, with another cosponsor joining later in the month. The bill passed on
the House floor by voice vote in March, becoming the second ever breastfeeding-specific bill to pass the floor
of either house of Congress as a standalone measure. The Senate companion bill was introduced in June by
Senator Steve Daines (MT) with one original cosponsor. Since then, the Senate bill has gained one additional
cosponsor.

Senate Cosponsors:
Steve Daines (R-MT)
Jeff Merkley (D-OR)
Elizabeth Warren (D-MA)

House Cosponsors:
Eleanor Holmes Norton (D-DC-At Large)
Peter A. DeFazio (D-OR-4)
Henry C. "Hank," Jr. Johnson (D-GA-4)
Barbara Comstock (R-VA-10)

Individual Action Opportunities
    •    Story Collector: Share stories of experiences with breastfeeding in public places and spaces...

Social Media
Hashtags to Use: #FBMAct #breastfeeding #NiP
Handles for all U.S. Senators: https://twitter.com/cspan/lists/senators/members
Handles for all U.S. Representatives: https://twitter.com/cspan/lists/u-s-representatives

When using Twitter, be sure to use .@ if you are beginning your tweet with a Twitter handle. There is no need
for a period before the @ sign if a twitter handle is not in the beginning of the tweet.

General sample messages
Buildings open to the public should accommodate everyone, esp. #breastfeeding moms! Support the Fairness
for #Breastfeeding Mothers Act, @LegislatorHandle! #NIP

Support our smallest public citizens! Make all government buildings #breastfeeding-friendly w the Fairness for
Breastfeeding Mothers Act, @LegislatorHandle! #NIP
        2018 Federal Breastfeeding Legislation & Policy Updates | USBreastfeeding.org
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