Breastfeeding bills aim to help children of incarcerated mothers

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COMMENTARY: The New Mexico Legislature is considering two bills that would support the babies of incarcerated women. Both bills either save money for the state and counties, or involve minimal costs.

The New Mexico Breastfeeding Task Force and a number of respected pro-social organizations strongly advocate for the passing of both bills as concrete ways to support the physical and social health of mothers and infants in our state.

SB 277: Alternative Sentencing for Pregnant and Lactating Offenders (Ortiz y Pino)

Women offenders are often appropriate for diversion to alternative incarceration programs, as many have been convicted of non-violent or “victimless” crimes. SB 277 would allow the court to decide to either temporarily release or to place in community custody (eg. house arrest) a pregnant or lactating offender during the most vulnerable months of the fetus/child’s life. This would happen only in cases where the women provided no perceived risk to public safety.

Lissa Knudsen

Courtesy photo

Lissa Knudsen

Alternative sentencing would allow a mother to access appropriate medical care, simplify visiting, make it more possible for her to attend foster care agency conferences and Family Court proceedings, and ultimately ease the reunification process when she is released. Participating in alternative sentencing might even prevent her children from entering or staying in foster care, depending on her personal circumstances. Once her child reaches 18 months of age, the mother would be expected to finish her sentence.

According to a Journal of Criminal Justice article, the adult children of incarcerated mothers are nearly four times as likely to serve time on probation and nearly three times as likely to be convicted of a crime at some point during their lifetime. By allowing mothers and children to form bonds and be housed together, the consequences of mother incarceration are lessened considerably.

SB 277 saves money, too — when inmates with high-risk pregnancies need medical care, the city or county is responsible for the cost. Medicaid cannot pay for services provided while the patient is behind bars, but if they are out on release, Medicaid will pay for the care. Medical care can be costly for high-risk inmate pregnancies, allowing these non-violent women to access medical care outside of corrections reduces overall costs and provides rural counties and cities with significant savings.

The N.M. Association of Counties, the American Congress of Obstetricians & Gynecologists, the N.M. Pediatric Society, New Mexico Academy of Family Physicians, the N.M. Public Health Association, Southwest Women’s Law Center, N.M. Association of Social Workers, New Mexico Voices for Children, Women’s Agenda, PB&J Family Services, Wings for LIFE International, and the Gordon Bernell Charter School all support this bill.

This bill has made it through two committees and was approved by the senate on a 33-6 vote.

SB 293/HB 277: Lactation Policies for Female Inmates (Padilla/Maestas Barnes)

Of course, release or delayed jail time will not be an appropriate option for some female inmates. Considering the proven health and social benefits of breastfeeding to both the mother and the infant, SB 293 (and its mirror bill HB 277) would allow incarcerated mothers who wish to breastfeed or maintain their milk supply the ability to provide their infants with mother’s milk.

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This would be accomplished through the support they need to either express milk for delivery to their infant or, in some cases, to breastfeed their infants during daily visits. If the mother expresses her milk, accommodations would be made for freezing, storing and making the milk available for on-site pick up by the child’s caregiver.

There are several precedents for this type of accommodation, including the California Department of Corrections & Rehabilitation, the Ohio Prison System, Coffee Creek Correctional Facility in Oregon, Travis County Jail in Texas, and the Washington County Jail in New York. All of these provide lactation support programs for the inmates.

Across the country, correctional facilities have provided four types of breastfeeding support (expressed milk can be frozen and distributed to caregiver on a biweekly basis):

  • Pump in cell and daily breastfeeding visit: The benefits to this are less staff time for surveillance, better milk output, and better bonding between mother and child. At the same time, concerns about safety are increased because the mother is given unsupervised access to a pump, which could be repurposed.
  • Pump not in cell and daily breastfeeding visit: This provides more security but results in a more labor-intensive administration of the program and is likely to result in fewer pumping sessions.
  • Pump in cell: This does not allow for actual breastfeeding time between mother and child but does allow a mother who is separated from her child to maintain her milk supply while they are separated.
  • Pump not in cell: This approach provides the highest level of security.

An imprisoned mother’s actions should not condemn her children to lose their rights to the benefits of breastmilk and breastfeeding. When children can’t access the immunity-building and nutritional benefits of breastmilk (as well as the bonding that breastfeeding promotes) because their mothers are in correctional facilities they, too, are sentenced to the lifelong ramifications of imprisonment.

Babies born to incarcerated mothers are more likely to end up incarcerated themselves. However, we know that babies who are breastfed are better able to bond with their mothers, thus reducing child abuse rates and improving other social outcomes. County jail officers have reported that mother inmates in breastfeeding support programs are motivated and have fewer behavioral problems than mothers who are not able to do anything for their off-site child.

The American Congress of Obstetricians & Gynecologists, the N.M. Pediatric Society, New Mexico Academy of Family Physicians, the N.M. Public Health Association, Southwest Women’s Law Center, N.M. Association of Social Workers, New Mexico Voices for Children, N.M. Women’s Agenda, PB&J Family Services, Wings for LIFE International, and the Gordon Bernell Charter School all support this bill.

This bill has made it through four committees and is scheduled to be heard on both the Senate and House floors this week.

In a tough budget year it is understandable that new programs bring up concerns about costs. However, HB 277/SB 293 and SB 277 have the power to lessen costs through reducing recidivism and reducing health-care costs for mother and child. Alternative sentencing will shift costs from municipalities to Medicaid. The lactation policies bill is flexible, allowing for each correctional facility to design a program that best matches its resources and needs. For WIC-eligible children of incarcerated mothers, costs can be as minimal as providing storage bags for the milk. The N.M. Corrections Department has stated that even if the bill does not become statute, it envisions being able to implement a lactation program within its given budget.

Whenever programming is considered for the incarcerated population, safety is a concern. The courts will decide who would be eligible for release (using the criteria of what is in the best interest of public safety). Corrections administrators and medical providers will decide which inmates will be eligible to participate in the lactation support programs. Remember that women offenders are not generally dangerous and mother offenders are even less so. Programs like these provide opportunities for mothers to build self-efficacy and self-esteem, thus improving their outlook and motivation. It also promotes bonding, attachment and reduces child abuse rates.

Although there are safety concerns that may arise regarding the storage and transfer of the expressed milk, breastmilk is food and can be stored like food. Staff will receive training on how to label, store, and deliver expressed milk. These types of procedures are not complicated and are already done in child care facilities, NICUs, and other places that provide expressed human milk to babies.

We know rates of substance abuse are high among women who are incarcerated. The American Academy of Pediatrics, American Congress of Obstetricians & Gynecologists, and Academy of Breastfeeding Medicine all support breastfeeding by women who are enrolled in a supervised methadone (or buprenorphine) maintenance program and have negative screening for HIV infection and illicit drugs. Moreover, breastfeeding has been shown to reduce the symptoms of neonates experiencing neonatal abstinence syndrome as a result of in utero opioid exposure. This is, in fact, the best possible treatment. Medical providers test mothers both at birth (current standard of practice) and throughout the lactation period. This ensures that mother is not using illicit substances while lactating and that breastfeeding continues to be medically recommended.

Human milk should be the standard of nutrition care for babies born to mothers who are incarcerated. SB 277 saves the state both in incarceration costs and in labor and delivery costs. Both bills promote breastfeeding and thus decrease incidences of life-threatening infections and lengthy of hospital stays, improve mother and child bonding, and reduce child abuse rates and health care costs. Ultimately both of these bills help New Mexican babies have the best possible start to their lives regardless of their mother’s crimes.

Lissa Knudsen, New Mexico Breastfeeding Task Force chair, is a PhD Student in the Communication and Journalism Department (focusing on health communication) at the University of New Mexico, and she lives in downtown Albuquerque with her 12-year-old daughter.

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