The New Mexico Breastfeeding Task Force is embarking on a courageous and
treacherous endeavor: we are attempting to make it possible for mother
inmates and their babies to breastfeed, bond, and be together. This
unearths not only sexist beliefs embedded in our society but also classist,
racist, and anti-criminal beliefs/fears as well. This intersection of
identities represents one of the most vulnerable and most vilified
populations in our society.

We need your help in changing the frame and the tone of the conversation
about SB 363: Expectant and Postpartum Prisoners Act.
http://www.nmlegis.gov/lcs/legislation.aspx?Chamber=S&LegType=B&LegNo=363&year=15

Two days ago our local CBS affiliate (KQRE News 13) ran a story about the
bill - with the lead being that a female legislator wants to "cut certain
criminals a break" and that she thinks "judges and prisons should go easy
on pregnant inmates and set them free to have and raise their babies."
http://krqe.com/2015/02/10/lawmaker-looks-at-accommodations-for-pregnant-criminals/

When completing doctoral coursework in Communication Studies, I analyzed
online responses to the Delta Airline nurse-ins in Nov. 2006. The comments
posted about this story on the KQRE News 13 Facebook page (
https://www.facebook.com/krqe.kasa) remind me a lot of those - accusations
targeting the mother and her motives. Only these comments also weave in the
lynch mob style fervor that can be triggered when we feel free to punish
those that have been accused of a doing something wrong/illegal.

Very few are mentioning the science behind coupling mothers and children
together: the importance of oxytocin to bonding, and the importance of
bonding in lowering child abuse rates, the health benefits of
breastfeeding, or that the women would only be eligible if a judge
determined that they were not violent, or that we have an over
incarceration problem and that incarceration rates follow race and class
lines.

Our request is to all lactation supporters and professionals is to help us
to counter balance the anti-mother rhetoric with the facts. You could do
this by posting to KQRE's facebook page, by sharing the story with your
social media followers-including a reframe of the issue, by writing letters
to the editor in support of similar legislation in your communities, by
contacting our legislators in NM and explaining that they are in the
national spotlight, etc. Without public support our legislators won't
likely have the courage to do what is not only just but fiscally
responsible.

Here is the letter the NM pediatric society drafted in support of the bill.

As physicians caring for New Mexico’s children, we write to ask that you
support SB 363 and vote to enact the Expectant and Postpartum Prisoners Act.

Women of reproductive age are the fastest growing subset of incarcerated
persons in the United States (1) with a ten-fold increase between 1980 and
2012. (2).  As of 2009, there were over 200,000 women in prison or jail in
the U.S.  (3).  Two-thirds of women held in state prisons or jails have
minor children (2).  The majority of these women are incarcerated for
nonviolent crimes, most are poor and non-white, and many have suffered from
abuse, mental illness, and substance abuse (4).  Their children suffer from
a disproportionate number of “adverse childhood events,” which have been
shown to increase their likelihood of experiencing a variety of adult
illnesses, including heart disease, cancer, diabetes, depression, suicide
attempts, and substance abuse (5).

We are just now beginning to understand the physiologic bases for these
adverse effects as disruption of brain circuitry and other organ systems
during sensitive periods of development which result in anatomic changes and
physiologic dysregulation that lead to impaired learning, behavior, and
poor health.  “Science tells us that interventions that strengthen the
capacities of families and communities to protect young children from the
disruptive effects of toxic stress are likely to promote healthier brain
development and enhanced physical and mental well being”  (6).

By allowing new mothers who are incarcerated or in the process of being
sentenced to either remain with their infants or, at a minimum, provide
them with their breast milk, SB 363 provides evidence-based interventions
that can reduce or ameliorate the toxic effects experienced by these
children (5-6).

Every medical society in the world recommends exclusive breastfeeding for
the first six months of a child’s life and then, along with supplemental
foods, for at least 1 or 2 years (7-11).  The benefits  include decreased
risk of infant death, hospitalizations for respiratory and diarrheal
illnesses, childhood cancer, diabetes, obesity, asthma, and other
autoimmune diseases.  Breastfed
infants have improved neurodevelopmental outcomes.  (8) Mothers who
breastfeed are less likely to be depressed, have lower rates of diabetes,
heart disease, and breast and ovarian cancer   (7-10).

Perhaps the singularly most important benefit of breastfeeding is
facilitation of mother-infant bonding via the release of oxytocin.   (12)
In
fact, breastfeeding has been shown to reduce the likelihood of a mother
neglecting or harming her child by almost 5 times.  (12)  If we can keep
mother and child together, we not only reduce that child’s exposure to
adverse childhood events by one, but increase the likelihood of a secure
attachment which increases that child’s resilience in the face of other
adverse events or stresses in his or her life.  (5-6)

Even in those mothers for whom remaining with their child is not an option,
expressing breast milk will result in the release of oxytocin (as it is the
hormone responsible for milk production) which decreases feelings of anxiety
and elevates mood (12).  This, in addition to the feeling of worth a mother
experiences when she knows she is providing for her child is likely to
promote stronger attachment between her and her child.  (1)  And, if she is
able to provide breast milk to her child during incarceration, a woman is
more likely to be able to breastfeed that child upon release.  Indeed,
successful breastfeeding during or after incarceration may motivate women
to remain drug free (1) and rates of recidivism are lower for women who
participated in prison nursery programs (13).

We know rates of substance abuse are high among women who are incarcerated.
The AAP, ACOG, and AFP 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.”  (8, 10, 14)

Moreover, breastfeeding has been shown to reduce the symptoms of neonates
experiencing neonatal abstinence syndrome as a result of in utero opioid
exposure.  (15)

As the AAP so aptly states in its most recent policy statement on
breastfeeding, “breastfeeding and the use of human milk confer unique
nutritional and non-nutritional benefits to the infant and the mother and,
in turn, optimize infant, child, and adult health as well as child growth
and development.  Infant feeding should not be considered as a lifestyle
choice but rather as a basic health issue.”  (8) (AAP)  As we provide
health care to incarcerated inmates, we should, “as a basic health issue,”
allow incarcerated women to breastfeed or provide breast milk to their
infants.

Not only will SB 363 help facilitate bonding between incarcerated mothers
and their children and improve the physical and mental well being of their
children throughout their lives, but it will potentially result in huge
savings to the State of New Mexico.  Studies show breastfeeding saves money
and lives worldwide, in the United States, and in New Mexico.  (16-19)
These projected savings do not include the potential savings that would
result by reducing the number of adverse childhood events experienced by
affected infants and increasing their resiliency in the face of other forms
of toxic stress.   Nor do they include the savings resulting from lower
numbers of women being incarcerated.

In sum, SB 363 will improve the lives of New Mexico children and save money.
We request that SB 363 be recognized as a critical statewide priority and
strongly urge the legislature to both support this bill and to allocate
appropriate funding to ensure these programs remain viable for as long as
pregnant and postpartum women are housed within the criminal justice
system.

*Resources*
(1) Huang, K., Atlas, R. and Parvez, F. (2012), The Significance of
Breastfeeding to Incarcerated Pregnant Women: An Exploratory Study. Birth,
39: 145–155.
(2) Women in the Justice System, the Sentencing Project, citing Carson,
E.A., Golinelli, D. (2013) *Prisoners in 2012*. Washington, D.C.: Bureau of
Justice Statistics,
http://www.sentencingproject.org/template/page.cfm?id=138 (accessed
2-6-15).
(3) Women’s Prison Association, Institute on Women & Criminal Justice,
http://www.wpaonline.org/wpaassets/2008_BJS_parents_Final.pdf (accessed
2-6-15).
(4) Sutherland, M.A., Incarceration During Pregnancy: Implications for
Women, Newborns, and Health Care Providers.  *Nurs Womens Health*.  2013
Jun-Jul;17(3): 225-30.
(5) Felitti, V.J., et al., Relationship of Childhood Abuse and Household
Dysfunction to Many of the Leading Causes of Death in Adults.  *American
Journal of Preventive Medicine*.  1998; 14(4): 245-258.
(6) Shonkoff, J.P., Garner, A.S., & The Committee on Psychosocial Aspects
of Child and Family Health, Committee on Early Childhood, Adoption, and
Dependent Care, and Section on Developmental and Behavioral Pediatrics, The
Lifelong Effects of Early Childhood Adversity and Toxic Stress.
*Pediatrics*.  2012;129;e232.
(7) WHO, Global Strategy on Infant and Young Child Feeding, 55th World
Health Assembly, Provisional Agenda Item 13.10, 16 April 2002.
http://apps.who.int/gb/archive/pdf_files/WHA55/ea5515.pdf?ua=1.  (accessed
2-6-15)
(8) AAP Section on Breastfeeding, Breastfeeding and the Use of Human Milk.
*Pediatrics*.  2012 Mar;129(3):e827-41.
(9) ACOG Committee Opinion No. 361: Breastfeeding: maternal and infant
aspects.  *Obstetrics and Gynecology*.  2007;109(2 Pt1).
(10)               AAFP Position Paper on Breastfeeding.  *Am Fam
Physician.* 2015 Jan 1;91(1):56-57.
(11)               CDC Healthy People 2020 Objectives for the Nation.
http://www.cdc.gov/breastfeeding/policy/hp2010.htm?topicId=26.  (accessed
2-6-15)
(12)               Strathearn, L., et al. Does Breastfeeding Protect
Against Substantiated Child Abuse and Neglect? A 15-Year Cohort Study.
*Pediatrics*.  2009 Feb;123(2):483-93.
(13)               Goshin, L. S. & Byrne, M. W. (2009). Converging streams
of opportunity for prison nursery programs in the United States. Journal of
Offender Rehabilitation, 48(4), 271-295. DOI:10.1080/10509670902848972
(14)               ACOG Committee Opinion No. 524: Opioid Abuse,
Dependence, and Addiction in Pregnancy.  *Obstetrics & Gynecology*.  2012
May 119(5):1070-1076.
(15)               Pritham, U. A. (2013), Breastfeeding Promotion for
Management of Neonatal Abstinence Syndrome. Journal of Obstetric,
Gynecologic, & Neonatal Nursing, 42: 517–526. doi: 10.1111/1552-6909.12242
(16)               UNICEF.  http
<http://www.unicef.org/programme/breastfeeding/challenge.htm>
://www.unicef.org/programme/breastfeeding/challenge.htm
<http://www.unicef.org/programme/breastfeeding/challenge.htm> (accessed
2-6-15).
(17)               Bartick, M, Reinhold, A, The Burden of Suboptimal
Breastfeeding in the United States: a Pediatric Cost Analysis.
*Pediatrics*.
2010 May;125(5):e1048-56.
(18)               Bartick, M.C., Cost Analysis of Maternal Disease
Associated with Suboptimal Breastfeeding.  *Obstetrics & Gynecology*.  2013
Jul;122(1):111-9.
(19)               Bureau of Business and Economic Research, University of
New Mexico, 'An Economic Analysis of Breastfeeding in New Mexico' (Working
Title), 2014
-----------
Lissa Knudsen, MPH | 505.218.5115 | Facebook:/lissaknudsen | Twitter:
@lissaknudsen | Pinterest: /lissaknudsen/

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