Sex Characteristics Bill in California Legislation: Genital Autonomy for Intersex Babies



Full text of the California Legislation on SCR-110 Sex characteristics (2017-2018).

REVISED AUGUST 23, 2018
CORRECTED AUGUST 17, 2018
AMENDED IN ASSEMBLY AUGUST 16, 2018
AMENDED IN ASSEMBLY JUNE 27, 2018
AMENDED IN SENATE MAY 09, 2018
AMENDED IN SENATE APRIL 23, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Introduced by Senator Wiener (Coauthor: Senator Glazer)(Principal coauthor: Assembly Member Thurmond) (Coauthor: Assembly Member Limón)(Coauthors: Senators Glazer and Lara) (Coauthors: Assembly Members Gloria, Limón, Low, Aguiar-Curry, Arambula, Berman, Bloom, Bonta, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chiu, Chu, Cooper, Friedman, Gabriel, Cristina Garcia, Eduardo Garcia, Gipson, Gonzalez Fletcher, Gray, Holden, Jones-Sawyer, Kalra, Levine, McCarty, Medina, Mullin, Nazarian, O’Donnell, Quirk, Rendon, Reyes, Rivas, Rodriguez, Rubio, Santiago, Ting, Weber, and Wood) February 27, 2018

Relative to sex characteristics. 

LEGISLATIVE COUNSEL'S DIGEST 

SCR 110, as amended, Wiener. Sex characteristics. 

This measure would, among other things, call upon stakeholders in the health professions to foster the well-being of children born with variations of sex characteristics through the enactment of policies and procedures that ensure individualized, multidisciplinary care, as provided.

Fiscal Committee: no

BILL TEXT WHEREAS, Between 1 and 2 percent of individuals are Individuals born with variations in their physical sex characteristics, which may include may present with differences in genital anatomy, internal reproductive structures, chromosomes, or hormonal variations; and

WHEREAS, “Intersex” refers to the variety of different physical indicators that create these differences, which occur with about the same frequency as green eyes; differences; and

WHEREAS, The majority of babies born with these variations are healthy or do may not require medical intervention related to their physical sex characteristics until puberty, immediately, if at all; and

WHEREAS, Beginning in the 1950s, physicians in the United States began performing irreversible surgeries on intersex infants without medical justification in an attempt to surgically and hormonally force them to conform to what these physicians perceived as typical male and female bodies; and

WHEREAS, These surgeries, which include nonconsensual unnecessary infant vaginoplasties, clitoral reductions, reductions and recessions, and removal of gonadal tissues, continue to this day; and

WHEREAS, These surgeries are often performed before a child can even speak or stand, meaning the intersex individual is excluded from the decision whether to undergo these irreversible procedures; and

WHEREAS, There is evidence that these surgeries cause severe psychological and physiological harm when performed without the informed consent of the individual; and

WHEREAS, These harms may include scarring, chronic pain, urinary incontinence, loss of sexual sensation and function, depression, post-traumatic stress disorder, suicidality, and incorrect gender assignment; and

WHEREAS, Despite that being born intersex is not a flaw or shortcoming, intersex people and their families across California report difficulties accessing competent medical care that does not emphasize surgery, such as one mother, a resident of California interviewed by Human Rights Watch, who explained: “I just wish someone had said: ‘she’s OK, she’s perfectly healthy, there’s nothing wrong with her, surgery can happen later and here are some people who have been through your situation.’”; and

WHEREAS, The United Nations Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment explained in 2013, “Children who are born with atypical sex characteristics are often subject to irreversible sex assignment, involuntary sterilization, involuntary genital normalizing surgery, performed without their informed consent, or that of their parents, ‘in an attempt to fix their sex,’ leaving them with permanent, irreversible infertility and causing severe mental suffering.”; and

WHEREAS, The United Nations High Commissioner for Human Rights explained in 2015, “medically unnecessary surgeries and other invasive treatment of intersex babies and children… are rarely discussed and even more rarely investigated or prosecuted... . The result is impunity for the perpetrators; lack of remedy for victims; and a perpetuating cycle of ignorance and abuse... . We need to bridge the gap between legislation and the lived realities of intersex people.”; and

WHEREAS, The World Health Organization explained, also in 2015, that intersex children have been “subjected to medically unnecessary, often irreversible, interventions that may have lifelong consequences for their physical and mental health, including irreversible termination of all or some of their reproductive and sexual capacity… Human rights bodies and ethical and health professional organizations have recommended that free and informed consent should be ensured in medical interventions for people with intersex conditions, including full information, orally and in writing, on the suggested treatment, its justification and alternatives.”; and

WHEREAS, Physicians for Human Rights has “call[ed] for an end to all medically unnecessary surgical procedures on intersex children before they are able to give meaningful consent to such surgeries.”; and

WHEREAS, Human Rights Watch concluded that these surgeries are “often catastrophic, the supposed benefits are largely unproven, and there are generally no urgent health considerations at stake. Procedures that could be delayed until intersex children are old enough to decide whether they want them are instead performed on infants who then have to live with the consequences for a lifetime.”; and

WHEREAS, The Intersex and Genderqueer Recognition Project, the preeminent organization in the United States to address the rights of people to self-identify as nonbinary on government-issued documents, was founded by intersex individuals and “envisions a world that recognizes that sex, gender identity, and sexual orientation have endless variations, with all possibilities valued and respected,” and consequently calls for a delay of all medically unnecessary procedures on intersex children until the individual can participate in the decision; and

WHEREAS, The United States Department of State has commemorated Intersex Awareness Day in both 2016 and 2017 by recognizing the harm of these surgeries, stating “at a young age, intersex persons routinely face forced medical surgeries without free or informed consent. These interventions jeopardize their physical integrity and ability to live freely.”; and

WHEREAS, The largest intersex patient support group in the United States, the AIS-DSD Support Group, has called for a delay of all medically unnecessary procedures on intersex children until the individual can participate in the decision; and

WHEREAS, The largest advocacy organization in the United States dedicated exclusively to intersex advocacy, interACT: Advocates for Intersex Youth, was founded in Cotati, California and has called for a delay of all medically unnecessary procedures on intersex children until the individual can participate in the decision; and

WHEREAS, In light of ongoing advocacy by the intersex community, in 2005 the San Francisco Human Rights Commission performed an investigation into this topic and issued an indepth report, recommending that “‘normalizing’ interventions should not occur in infancy or childhood. Any procedures that are not medically necessary should not be performed unless the patient gives their legal consent.”; and

WHEREAS, Those subjected to medically unnecessary surgery at a young age express despair over the fact that they were unable to make these decisions for themselves, publishing about their experiences in major news outlets: “I know firsthand the devastating impact [these surgeries] can have, not just on our bodies but on our souls. We are erased before we can even tell our doctors who we are. Every human rights organization that has considered this practice has condemned it, some even to the point of recognizing it as akin to torture.”; and

WHEREAS, Physicians who have participated in these surgeries have also expressed remorse that their training did not properly prepare them to respect the bodily autonomy of intersex people, as a Stanford-educated urologist explains: “I know intersex women who have never experienced orgasm because clitoral surgery destroyed their sensation; men who underwent a dozen penile surgeries before they even hit puberty; people who had false vaginas created that scarred and led to a lifetime of pain during intercourse…the psychological damage caused by intervention is just as staggering, as evidenced by generations of intersex adults dealing with post-traumatic stress disorder, problems with intimacy and severe depression. Some were even surgically assigned a gender at birth, only to grow up identifying with the opposite gender.”; and

WHEREAS, Intersex young people who have been able to participate in these life-altering decisions are thriving, such as a young intersex San Francisco resident who was not forced to undergo surgery in infancy and instead participated in the decision at the age of 16, who told reporters that for them, surgery “was the right choice, but that’s very much an anomaly for intersex people... . The important thing was that I was old enough to make that decision for myself.”; and

WHEREAS, When the physical health of an infant with atypical sex characteristics is threatened and medical attention cannot be safely deferred, all therapeutic treatment options should remain available to children, families, and medical professionals to ensure that the imminent physical danger is addressed; and

WHEREAS, Medically unnecessary procedures, including all surgical procedures that seek to alter the gonads, genitals, or internal sex organs of children with atypical sex characteristics too young to participate in the decision, when those procedures carry both a meaningful risk of harm and can be safely deferred, are the sole subject of this resolution; and

WHEREAS, California should serve as a model of competent and ethical medical care and has a compelling interest in protecting the physical and psychological well-being of minors, including intersex youth; now, therefore, be it

Resolved by the Senate of the State of California, the Assembly thereof concurring, That the Legislature opposes all forms of prejudice, bias, or discrimination and affirms its commitment to the safety and security of all children, including those born with variations in their physical sex characteristics; and be it further

Resolved, That the Legislature considers intersex children a part of the fabric of our state’s diversity to be celebrated rather than an aberration to be corrected; and be it further

Resolved, That the Legislature recognizes that intersex children should be free to choose whether to undergo life-altering surgeries that irreversibly—and sometimes irreparably—cause harm; and be it further

Resolved, That the Legislature calls upon stakeholders in the health professions to foster the well-being of children born with variations of sex characteristics, and the adults they will become, through the enactment of policies and procedures that ensure individualized, multidisciplinary care that respects the rights of the patient to participate in decisions, defers medical or surgical intervention, as warranted, until the child is able to participate in decisionmaking, and provides support to promote patient and family well-being; and be it further

Resolved, That the Secretary of the Senate transmit copies of this resolution to the author for appropriate distribution.

___________________

All children deserve protection from forced genital cutting - girls, boys, and intersex.

Equal rights for ALL sexes.
Say no to forced genital cutting of minors, regardless of sex at birth.

Equality begins at birth.
For girls, boys, and intersex individuals.
Say no to forced genital cutting.

•••••••



The Myth of Foremilk / Hindmilk Imbalance

By Danelle Day © 2018


"If we had the power to eliminate just one misunderstood notion about breastfeeding, it would be the concept of foremilk and hindmilk!" write Cindy and Jana, Registered Nurses and International Board Certified Lactation Consultants (IBCLCs) who have assisted over 20,000 breastfeeding mothers.

Research clearly demonstrates that nursing mammals (human babies, too) receive milk near the end of most natural nursing sessions that is higher in fat content than milk at the beginning of that feeding. One biological reason for this is that early milk is the thirst quencher - baby can cue to nurse for just a few minutes to satisfy thirst, or comfort needs. Early milk is also power-packed in immunobodies and glyconutrients (the healthy sugars that kill cancer cells and feed the developing immune system) - super charging baby's immunity even when nursing briefly on-the-go. As breastfeeding continues, milk gradually becomes more and more dense in (healthy) fat content with each swallow baby takes. This beneficial fat feeds the cells of the rapidly developing brain and body. When baby is able to choose his/her time to breastfeed, because of this perfect set-up, s/he can get a quick snack for thirst and comfort and immunity, or s/he can get a full hearty meal that fills the tummy and feeds the brain.

This being said, there is no magic set amount of time from one mother to the next, one baby to the next, one nursing session to the next, or even one breast to the other, at which milk suddenly changes from 'foremilk' to 'hindmilk.' It is all just milk! Very gradually fat content increases. With each swallow baby takes, milk content shifts to meet baby's needs. When s/he is in control (and able to nurse effectively) baby is able to determine just the right amount of time to breastfeed to get just what s/he needs. This is why it is so vital to watch your baby, not the clock.

For one mother this may mean baby nurses on one breast for 30 minutes. For another mother baby may nurse each side for 20 minutes, or 15, or 10. Baby may nurse for 5 minutes, and come back 10 minutes later to nurse again. And again. Baby may nurse for longer periods of time at night than in the morning. One baby may nurse differently than his/her sibling did. Baby may nurse differently today than s/he did yesterday, and change week to week, due to his/her needs and also mom's hormone fluctuations. Milk content changes from one swallow to the next, from one baby to the next in the same mother, from one day to the next, and certainly from one mother to the next. In the midst of this beautiful dance of lactation and normal baby feeding, there is no 'foremilk / hindmilk imbalance' that occurs within any one individual mother's breasts.

When well meaning friends or ill-informed medical professionals tell nursing moms to "make sure your baby nurses long enough to get hindmilk" or "if your baby's poop is green, you have a foremilk/hindmilk imbalance" they are not dispersing information based in science, and this leads to mothers being troubled and thinking something is wrong. Many U.S. hospital postnatal rooms reinforce this myth by having mom record "how long baby breastfeeds on each side" on a chart that is reviewed by nursing staff. Breastfeeding moms wonder, "How long is 'long enough' for baby to get hindmilk?" "Should I only feed from one breast to try and help my baby gain?" Women want to do what they are being told by hospital staff, and begin to watch the clock instead of their baby -- the precise thing we should not be doing.

"A little knowledge can be a dangerous thing." writes Nancy Mohrbacher, author of the fantastic books, Breastfeeding Made Simple, and Working and Breastfeeding Made Simple, among others. "This has never been so true as in the ongoing debate about foremilk and hindmilk and their impact on breastfeeding. The misunderstandings around these concepts have caused anxiety, upset, and even led to breastfeeding problems and premature weaning."

Where did the foremilk / hindmilk imbalance myth arise from?

The foremilk / hindmilk imbalance idea was coined in a 1988 journal article * that reported the qualitative observations of a few mothers who breastfed by the clock, switching baby from one breast to the other after 10 minutes, even if baby was not finished nursing on that side. This is not something that is ever good to do as it does not allow baby to gradually control the amount of milk s/he takes in. The results from this one report have never been duplicated, and newer research calls its methods and conclusions into question. Many well versed in lactation science doubt there is even such a thing as a foremilk / hindmilk imbalance.


Myth-busting Lactation Facts: 

There are not two distinct kinds of milk. That's right - 'foremilk' and 'hindmilk' (as commonly as the terms are used) do not actually exist. There is no magic moment when foremilk becomes hindmilk. As noted above, the increase in fat content is gradual, with the milk becoming fattier and fattier over time as the breast drains more fully.

It is the total milk consumed daily by baby—not 'hindmilk' alone—that determines baby’s weight gain. Whether babies breastfeed often for shorter periods, or go for hours between feedings and nurse for longer times, the total daily fat consumption does not vary significantly.

Early milk is not always low-fat. The reason for this is that at the fat content of 'foremilk' varies greatly depending on the daily breastfeeding pattern. If baby breastfeeds again soon after the last nursing, the early-consumed milk at that feeding may be higher in fat than the late-consumed milk at other feeding. The longer a baby goes between feedings, the more varied milk will be from beginning to end when baby breastfeeds next. If baby is nursing more often than every 2-3 hours (frequent breastfeeding is normal and healthy for many babies at many points of development) than baby will be consuming fattier milk from the start.

If your baby is nursing more often, s/he is consuming more 'foremilk' that is higher in fat than babies who breastfeed less often. In the end, whether baby nurses for loooong stretches and goes 2-3 hours between, or breastfeeds more frequently, for less time, it all evens out at the end of the day, and watching baby and his/her cues is crucial (Kent 2007). Breastfeed on cue, around the clock, and safely sleep by your baby so that cue nursing and dream-feeding at night is easy too. See also: Your Baby's Signs of Hunger

Mohrbacher re-emphasizes: "What’s most important to a baby’s weight gain and growth is the total volume of milk consumed every 24 hours. On average, babies consume about 750 mL of milk per day (Kent et al., 2006). As far as growth is concerned, it doesn’t matter if a baby takes 30 mL every hour or 95 mL every three hours, as long as he receives enough milk overall (Mohrbacher, 2010). In fact, researchers have found that whether babies practice the frequent feedings of traditional cultures or the longer intervals common in the West, they take about the same amount of milk each day (Hartmann, 2007) and get about the same amount of milk fat. Let’s simplify breastfeeding for the mothers we help and once and for all cross foremilk and hindmilk off our 'worry lists.'"

Pumped breastmilk does not look like other forms of processed milk (cow, goat, etc.) that we are accustomed to seeing in the store. Cow milk is made perfectly for baby cows, not humans, as it is different in composition for the mammal it is designed to feed, and it also does not appear this way directly from a mother cow to her calf. Instead, natural human milk has a thin and watery appearance, with a creamy fat layer that may or may not develop when milk sits in the fridge. This is normal, and it will vary from one pumping to the next, and from one breast to the other.

If you are breastfeeding on cue, around the clock, babywearing in the day and safely cosleeping at night to keep baby close, and still find yourself concerned about baby's consumption, take note of how your baby nurses rather than watching any clock. Is your baby swallowing? Is s/he relaxed and content after nursing? Do her little hands open up into a tiny 5-point starfish when she is full? Is he gaining weight over the course of weeks passing? Baby's behavior matters far more than timing, and when we watch our babies and tune into their cues, we allow them to lead the way. In situations where baby is not gaining weight, an IBCLC can do a weighted nursing session (before/after breastfeeding), check for latch and suckle techniques by baby, and also note if a tongue or lip tie is preventing effective milk consumption. Reach out to an experienced lactation consultant in your area, and join local La Leche League and mom's milk cafe groups near you.


What about Green Poop?

Baby’s first bowel movements are the black and tarry meconium that was in the gut at birth. As breastfeeding commences, around Day 3 of life on the outside, baby’s poop changes to 'transitional stools,' which have a dark greenish color. Around Day 5, baby's poop color shifts again to yellow. Its consistency while exclusively breastfed (that is, while nothing but human milk is consumed) may look like mustard or split pea soup - liquid with seedy bits in it. Even when baby’s poop is all liquid with no seeds, and any variation of yellow-orange-green-brown, this is also normal.

In general lots of milk consumption in the early months, means lots of poops, no matter their color or how liquid or seedy they are. After 2 months of age, it is normal for many babies to poop only once every 3-4 days. There is very little waste in human milk, and this does not mean that baby is not receiving enough. Before 6-8 weeks of age, if baby is not pooping daily, a weight check is justified to ensure baby is receiving adequate amounts of milk.

Baby's poop color is not reason to worry if baby seems well and is gaining weight. In her book, Baby Poop: What Your Pediatrician May Not Tell You, Dr. Linda Palmer reminds readers that green is the most common color of baby stools seen, and should not cause alarm. "Beyond the newborn stage, the first matter of order when seeing green is to determine whether baby has eaten some especially green food, including kiwi, spirulina, or green veggies. It's said that grape-flavored Pedialyte [and other grape or chocolate or dark flavored/dyed items] can turn baby poop a bright green. If a child is being given iron supplements, these can turn his stools a dark evergreen." Palmer continues, "[I]f it's not a food pigment, then...green is the digestive juice bile; the same stuff that, when properly digested, imparts the normal yellow to brown colorations of poop. When bile comes out green, it is because the stool has been rushed through baby's digestive system, and not hung around long enough to break down. The question to ask is why."

Causes of Green Poop: 

1) Food dye, natural coloring, or flavoring in mom or baby's diet. This is the most common reason for green colorations of baby poop. In the majority of cases, something minor has shifted poop coloration for a few days.

2) A virus. When baby is ill, the body produces excess mucus that is swallowed by baby. This rushes poop through the digestive tract faster, and poop color may change for several weeks. Keep breastfeeding! It’s the best way to support baby's immune system in fighting the virus.

3) Antibiotics, which also cause stool to rush through baby's system.

4) Teething. When baby is teething large amounts of saliva are swallowed, entering and irritating the digestive tract, causing matter to rush through more quickly. Give baby plenty of teething options to make the process as painless as possible. See: Teething Solutions.

5) Abundant milk supply. If mom produces so much milk that baby receives mostly high-sugar/low-fat milk, it may overwhelm baby’s gut in the early weeks and cause watery or green stools. One way to change this is to simply pump for a few minutes before nursing, and use the pumped milk for your later freezer stash when milk supply regulates, and/or baby grows to be more effective at nursing, with a larger mouth and bigger stomach. We've also used this high-immunity pumped milk to turn into breastmilk popsicles for teething or toddler days. Doing this gets baby fattier milk from the start, and gradually decreases milk production when baby does not fully empty the breasts. Another form of reducing milk supply is block nursing (or block feeding).

6) Inability to breastfeed effectively. A health or anatomy issue (tongue tie, lip tie) may prevent baby from getting the milk s/he needs. See an IBCLC in person to determine if this is the case.

7) Sensitivity to a food or drug in mom's diet. There are certain foods (cow's milk, nuts, soy) that contain proteins that cannot be digested by newborn human babies, but pass easily through mom's milk when they are in her daily diet. This impacts all babies in their early life, but some much more than others. If you notice that your baby is agitated, "colicky," has gas or tummy pain, reflux, sometimes combined with frothy/green stools, it is very likely that your baby is responding more intensely to these items in your diet. Eliminating nuts and soy in the early months, and switching to vanilla rice milk (for example) instead of cow's milk, will help baby's digestion, discomfort, and pain in virtually all cases. For an easy-to-understand synthesis of the research on this, see Palmer's excellent book, Baby Matters: What Your Doctor May Not Tell You About Caring For Your Baby.

In conclusion, the foremilk/hindmilk myth is a misconception that is popular, but not based in lactation science. Breastfeed your baby on cue, around the clock, in a pattern that is baby-led (not clock-led). Find comfortable ways to babywear and sleep by your baby to make life easier for you, and to provide baby with round-the-clock access to the milk s/he needs. Provided s/he is gaining weight, wetting, and occasionally pooping (yellow, green, orange - lots of variations of normal), and is a happy and alert baby, all is well.


References:

Aksit, Sadik, Nese Ozkayin, and Suat Caglayan. "Effect of Sucking Characteristics on Breast Milk Creamatocrit.Paediatr Perinat Epidemiol Paediatric and Perinatal Epidemiology, 16.4 (2002): 355-60.

Hartmann, P.E. (2007). "Mammary gland: Past, present, and future." in eds. Hale, T.W. & Hartmann, P.E. Hale and Hartmann's Textbook of Human Lactation. Amarillo, TX: Hale Publishing, pp. 3-16.

Kent, J. C. (2007). "How breastfeeding works." Journal of Midwifery & Women's Health, 52(6), 564-570.

Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). "Volume and frequency of breastfeedings and fat content of breast milk throughout the day." Pediatrics, 117(3), e387-395.

Mohrbacher, N. Breastfeeding Answers Made Simple: A Guide for Helping Mothers. Amarillo, TX: Hale Publishing, 2010.

Mohrbacher, N. Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers.
New Harbinger Publications, 2nd Edition, 2010.

Palmer, L. Baby Poop: What Your Pediatrician May Not Tell You. Sunny Lane Press, 2015.

Palmer, L. Baby Matters: What Your Doctor May Not Tell You About Caring for Your Baby. Baby Reference, 3rd Edition, 2015.

* Woolridge MW and Fisher C. "Colic, 'overfeeding,' and symptoms of lactose malabsorption in the breast-fed baby: a possible artifact of feed management?" Lancet. 1988 Aug 13;2(8607):382-4.

Breastfeeding mothers are welcome to join the Breastfeeding Group on Facebook: FB.com/groups/Breastfed


About the Author

Danelle Day focused on human labor and lactation sciences as part of her graduate work in human development. After ten years teaching at the university level, Day left full time academia to raise babies of her own, and joined Peaceful Parenting in 2006 as a clinical advisory board member where she has served thousands of breastfeeding families since that time.

Historically, Breastfeeding Mothers Did NOT Cover Up



As World Breastfeeding Week kicks off (Aug 1-7 annually), Rene Johnson reminds readers on Facebook that, "When people say openly nursing in public without a cover is a new thing -- no, no it is not. In fact, it was not until the 20th century that breastfeeding started to be seen in a negative light."

Sara McCall previously expanded on these historical facts in her Breastfeeding USA article, "Nursing in Public: What U.S. Mothers Faced from Colonial Times Until Today." She writes:
Nursing in public seemed to be a non-issue in colonial America. Our foremothers were expected to maintain a busy household, which included feeding the baby, and breastfeeding in the market or other public areas was not a cause for uproar. At that time, breastfeeding was the only way to feed a baby, either by the natural mother or a wet-nurse. The Puritans believed breasts were created for the nourishment of children and strongly encouraged women to nurse their own babies. [1] Breastfeeding in public was commonplace for colonial women because they lived in a society that supported breastfeeding. 
What happened to change American society's views on nursing in public? Society’s outlook on breastfeeding began to change as the modern feeding bottle and nipple were invented, and commercially-created infant formulas became more accepted in the early 20th century. [...] 
Breastfeeding was dealt a double whammy in the early 20th century. As World War II raged on, women were needed to fill jobs left empty by men going off to war. Breast pumps were primitive in design, there were no laws that allowed women time to express milk while at work, and wet nursing went out of style. What was a mother to do? At this same time, large-scale manufacturing made infant formula easier for mothers to access. [2] Formula manufacturers cultivated relationships with physicians, which led to physicians promoting formula use as a safe and accepted way to feed baby. With so many factors suppressing breastfeeding, it isn't surprising that breastfeeding rates began to decline sharply after World War II. 
Johnson reflects on the reasons that today's mothers also do not want -- and do not need -- to cover while feeding their baby. She continues:
There are plenty of reasons a mom may not cover while breastfeeding. The baby could not allow it, and repeatedly remove the cover, or cry. It could be too hot, and a mother doesn't want her child to get too hot and sweaty. It is also really hard to cover while learning to nurse a new baby, and babies benifit from eye contact while breastfeeding. Believe it or not, covers actually draw more attention. Sometimes the mother simply doesn't wish to cover, and they legally don't have to. 
At the federal government level, Public Law 106-58, Section 647 protects breastfeeding mothers:
Notwithstanding any other provision of law, a woman may breastfeed her child at any location in a Federal building or on Federal property, if the woman and her child are otherwise authorized to be present at the location. [3]
While laws vary by state, as of 2018, all U.S. states have laws that additionally protect a breastfeeding mother and her baby in public locations.

So nurse on, Momma! You have a right to do so, your baby and his/her needs come first, and you join the ranks of millions of mothers before you, and many more to come.

Thank you for nursing in public cards to share and encourage breastfeeding mothers you see are available at Etsy:
PINK   •   GREEN with Laws   •   GREEN w/out Laws   •   SPANISH/English

References: 

1. Mays, D A (2004). Women in Early America: Struggle, Survival, and Freedom in a New World. Santa Barbara, CA: ABC-CLIO. 

2. Weimer, J.P. (2001). The Economic Benefits of Breastfeeding: A Review and Analysis. Washington, D.C.: U.S. Department of Agriculture. 


Related Reading: 


The Politics of Breastfeeding: When Breasts are Bad for Business: https://amzn.to/2KrHv2O

Breastfeeding in Public: A Christian Father Stands Up: http://www.DrMomma.org/2010/05/breastfeeding-in-public-christian.html




A historical look at breastfeeding mothers nursing in public
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"Maybe I'm 'old fashioned' but I don't like to feed my baby with a blanket on their head."

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