Elsewhere, my IBCLC colleagues also on the frontlines ask about what legal mandates exist, regarding lactation during COVID.
Lawyer here. Climbing onto soapbox.
There is no such thing as a “legal mandate” either to force, or prevent, lactation. Instead, there is the underlying and never-changed obligation to provide unbiased information and support, so the parent can make an informed decision on infant-feeding. Whether they wanna breastfeed/chestfeed (BFg/CFg), formula-feed, or mixed feed, they are gonna learn the risks-benefits, make a decision, and be supported to meet that goal in the hospital, and in community after discharge. This is the way we are ethically intended to have been doing this anyway, everywhere, and in all places, regardless of COVID-19.
So while there are no “laws,” there are a boatload of public health, health equity, and medical professional association **recommendations** and **guidelines** during the COVID pandemic to MAINTAIN LACTATION and KEEP THE PARENT AND BUB TOGETHER, isolated as a dyad, using respiratory and hand-washing protections during feeds and baby care. But YES do skin-to-skin. YES direct breastfeed. YES pump/hand express extra milk. YES let the parent meet their danged baby after delivery instead of being whisked away into isolation, as is occurring as a matter of course in some hospitals in the USA regardless of the birthing parent’s wishes and ability to care for the infant.
Over and over again we are hearing stories where the prevailing public health recommendations are NOT being offered. Birthing parents are being scared nearly to death by their healthcare providers — who are also, I will full-on recognize, scared nearly to death — into being separated, and *not* BFg/CFg. Into *not* protecting the milk supply. If you want a dose of legal precedent, I’d say: Folks being scared, even rightfully scared, is NOT a legitimate rationale to disregard the overwhelming global public health and medical recommendation to keep the parent-and-bub together and/or to promote and protect lactation.
Ethical and legal requirements do NOT change in a crisis, even in a pandemic. Standards of practice for one-to-one patient care may change daily in a crisis, a surge, a pandemic. Healthcare providers are re-using their same masks for *days* now, when that would have been unthinkable 2-3 months ago. Institutional-level implementation of surge-anticipated standards of care (“crisis standards of care,” as the literature frames it) may be initiated, where we are doing things like letting MDs/RNs practice across state lines without a license, or we create emergency hospital spaces in re-designated dorms, hotels, or fieldhouses.
But underlying legal and ethical authority and obligations DO NOT EVER CHANGE in a public health crisis or pandemic.
Indeed, there has *never* been a public health crisis ever in the history of humans archiving such things where the medical and public health experts looked back, after the fact, and concluded BFg/CFg was stupid. Instead, we are shown over and over again how support for lactation and safe infant feeding practices would have SAVED more people and allowed for better mental health outcomes.
If you are looking for legal “authority” there are also a boatload of public health, human rights, and legal doctrines that put well-informed decision-making by the parent, for their own and the child’s well-being, about infant feeding decisions, at the HEART of the basic CIVIL and HUMAN RIGHTS to which both parent and baby are entitled.
OK. I never bloviate like this unless I also offer resources. Here are three winners, of many that are out there, and current-to-date (18 April 2020).
(1) ILCA has a swiftly updated (and bless them, they date it each time) page with resources and links to the various public health pronouncements I allude to above. https://ilca.org/covid-19/
(2) U. S. Breastfeeding Committee has an excellent page about COVID resources described in the context of infant feeding in emergencies: http://www.usbreastfeeding.org/emergencies
(3) For advocacy information about more than lactation, see this page from the stupendous folks at Human Rights Watch: https://www.hrw.org/news/2020/03/19/human-rights-dimensions-covid-19-response#