Policy

Once you have established a diverse group of stakeholders and local government has proclaimed the community Breastfeeding Family Friendly.

The community’s elected or appointed leadership has a written statement supporting breastfeeding that is routinely communicated to all. 

STEP 1 of 10
BREASTFEEDING FAMILY FRIENDLY COMMUNITY (BFFC) DESIGNATION 
Download the Global Criteria.

The written and signed policy must includes actions to support the Ten Steps. A copy of the Ten Steps designation and the local policy must be widely distributed at least annually, possibly during World Breastfeeding Week (In US, National Breastfeeding Month)

The BFFC Model Breastfeeding Support Policy

Updated July 2026. This model draws on policies we have researched from around the world, organized so your community can navigate it — and aligned with the National Academies’ 2024 report Breastfeeding in the United States and NACCHO’s Continuity of Care Blueprint. Replace every bracketed field and adapt each provision to where your community is today. Download the Word template. Email us if you would like to collaborate.

Preamble

The City and County of [Our Town] respect a family’s desire to breastfeed and appreciate the benefits of breastfeeding for the health of the child, the mother, the family, and the community, because breastfeeding provides the healthiest start for babies, providing ideal nutrition and a multitude of health benefits for both infants and families. In 2011, the Surgeon General’s Call to Action to Support Breastfeeding highlighted a need for a community-level, multifaceted approach to breastfeeding support. Through a breastfeeding family friendly community, the City and County of [Our Town] support a [Our Town] family’s decision to breastfeed. Most [Our Town] families initiate breastfeeding in the hospital; however, many stop breastfeeding within a few days or weeks. There are many barriers to increasing breastfeeding duration, in particular the need to return to work and be separated from their young babies, and also a lack of welcome in the community to breastfeed when and where the family needs. We, the [Our Town] leadership, must improve the overall tone and community atmosphere to promote [Our Town] public health interventions and breastfeeding support interventions aimed specifically at closing the gaps in the community support for breastfeeding families. A guiding priority and core value of the City and County of [Our Town] are supporting the creation of health equity. Our goal is that all [Our Town] people, regardless of skin color or social status, will have equal opportunity to engage in optimal breastfeeding and live longer, happier, and healthier lives. (1)

Universal access. [Our Town] provides all lactation and infant-feeding support services under a universal access and inclusive design model. Every service is available to every person and family. No service is denied to anyone on the basis of race, color, ethnicity, national origin, immigration status, religion or creed, age, sex, pregnancy or lactation status, sexual orientation, gender identity, family structure, primary language, ability or disability, veteran or military status, or socio-economic status. Outreach tailored to specific neighborhoods, languages, or communities is a strategy for expanding access to services that remain open to all.

Intention Statement

The purpose of this Policy is to ensure that all breastfeeding families have the support they need to continue breastfeeding and to engage in optimal breastfeeding whenever possible. The [Our Town] Government, with the help of the [Our Town] Communities, strives to make sure that all families are well-informed about the risks and benefits of infant feeding choices and are welcomed to breastfeed in the community.

Background

Improving rates of optimal breastfeeding is one of the most important ways [Our Town] can improve the health of our children and our families. The international definition of optimal breastfeeding is early and exclusive breastfeeding for up to 6 months, followed by appropriately-timed introduction of complementary foods starting at 6 months with continued breastfeeding for at least 1–2 years and for as long as mutually desired. Breastfeeding decreases the risk of maternal diabetes and cancers as well as a myriad of preventable pediatric conditions, including obesity, Type II diabetes, pneumonia, and Sudden Infant Death Syndrome. (2) [Our Town] is committed to the support of optimal breastfeeding for all, including all minoritized [Our Town] families, marginalized [Our Town] families, lower socio-economic families, younger mothers/families, and African-American families. Achieving health equity, eliminating disparities, and improving the health of all [Our Town] populations is one of the goals of the Breastfeeding Support Policy. By health equity, we mean everyone has the opportunity to attain their highest level of health, including optimal breastfeeding. (3)

Procedures and Practices

It is important for all of [Our Town] — including staff, volunteers, and families — to understand how to support families choosing to breastfeed. Different families need different things: some need more privacy, and some need more affirmation. It also is important to understand how to support breastfeeding staff and volunteers by providing them with adequate break time and space to express breast milk or breastfeed their babies while working their shifts. The common agreement is that all breastfeeding families (including [Our Town] government staff and volunteers) will NOT be discriminated against, treated disrespectfully, or asked to leave because they are breastfeeding.

1. A Written Commitment, Routinely Communicated

The [Our Town] community’s elected or appointed leadership has a written statement supporting breastfeeding that is routinely communicated to all. This written and signed Policy will be shared via all local media outlets, including the [Our Town] Government websites, government print materials, government podcasts/radio and streaming/television as well as social media, as available. A copy of the Breastfeeding Policy will be widely distributed at least annually, possibly during World Breastfeeding Week (in the US, National Breastfeeding Month).

2. A Welcoming Community Atmosphere

The [Our Town] community as a whole will provide a welcoming atmosphere for breastfeeding families, building upon US federal and state laws that dictate that breastfeeding may be carried out wherever a woman is lawfully allowed to be. Breastfeeding must not be relegated to places where adults would not consume food, such as toilet areas. [Our Town] government will display stickers, window clings, or signage in a visible location — and even on the [Our Town] website — indicating that breastfeeding families are welcome in all establishments in which they have the lawful right to be. “Breastfeeding welcome here” signage shall be posted next to the welcome signs to the city or in similar prominent positions (e.g., city-operated parks, swimming pools, senior centers, etc.), and a seal/logo shall be posted on city and county websites and/or social media, and/or flyers at the visitor’s bureau. North Carolina law is enforced; welcoming breastfeeding shall be supported by local law enforcement.

3. Breastfeeding in Emergencies

Breastfeeding shall be viewed as a safe and effective way to feed a child even in an emergency. Human milk is always clean; requires no fuel, water, or electricity; and is readily available when baby and nursing parents are kept close. During an emergency, emergency response teams (ERTs) will assist families to continue breastfeeding and/or to express milk at the same rate or more frequently during the emergency, and will be knowledgeable about the implications of reducing the frequency of expressing milk. Families shall be encouraged to keep their babies close to them and not to delay evacuating because of frozen milk. [Our Town] emergency planning shall incorporate infant and young child feeding in emergencies (IYCF-E), coordinated with breastfeeding support organizations, coalitions, and WIC, consistent with national emergency-preparedness recommendations. (4)

4. Health Leadership

Optimal breastfeeding is supported by health leadership. This Policy shall be disseminated at appropriate times, such as World Breastfeeding Week or National Breastfeeding Month, to all health entities. The definition of optimal breastfeeding, or that proposed by the World Health Organization, American Academy of Family Practitioners, or American Academy of Pediatricians, shall be disseminated and confirmed with healthcare and community leadership. The [Health Department] is encouraged to review local breastfeeding data annually and use it to direct support where it is needed most, consistent with national surveillance goals. (4)

5. Informing Families During Pregnancy

During pregnancy, all families shall be informed about the benefits of breastfeeding, as well as about the risks of unnecessary formula use, and where to access support as needed. The [Our Town] government is supportive of the International Code of Marketing of Breast-milk Substitutes, which calls for unbiased information in the hands of the public. Distribution shall include attention to equity — ensuring that those populations who are more vulnerable receive special inputs. Such distribution expands the reach of information and services that remain open to every family; it does not create or imply any eligibility criterion. [Our Town] encourages faith-based organizations and other organizations that are reflective of the [Our Town] population and culture to inform families about the benefits of breastfeeding through community-wide distribution, with materials from La Leche League (LLL), WIC, Breastfeed [Our Town], local breastfeeding support groups, or breastfeeding coalitions.

6. Breastfeeding-Friendly Health Care

[Our Town] encourages all health care in the community to be breastfeeding friendly. Research confirms that comprehensive breastfeeding support in prenatal, maternity, and postnatal care results in improved breastfeeding success. We encourage all maternity care centers to be designated Baby-Friendly (or fully qualified by their state maternity care breastfeeding designation). Healthcare personnel involved in the care of mothers and babies are trained in the skills necessary to support optimal breastfeeding. All [Our Town] health care providers and clinics are encouraged to apply for a breastfeeding-friendly and/or baby-friendly designation, OR offices provide documentation concerning the prenatal breastfeeding support they employ with all patients, regardless of race or ethnicity. A Designating Group should receive documentation from local healthcare organizations.

7. A Community Lactation Support Network — Continuity of Care

[Our Town] encourages all non-health-system breastfeeding support groups and services to be fully available in the community, including International Board Certified Lactation Consultants (IBCLCs), La Leche League (LLL), and other skilled breastfeeding support. Breastfeeding support must extend beyond the clinic; all clinics and hospitals should be called upon to provide active referral, and active collaboration between health care providers and community breastfeeding support entities is needed. The [Our Town] Government encourages the Health Department to: host at least one in-person yearly meeting with all breastfeeding support providers to confirm that services are actively being created with attention to meeting the needs of various racial/ethnic groups (all services confirmed under this provision are provided on a universal access basis and are open to all families); document annually a list of all non-health-system breastfeeding support groups and services; and provide at least one communication to the public on the mutual effort of breastfeeding support providers. Together, these provisions build the continuity of care between clinical and community settings described in NACCHO’s Continuity of Care in Breastfeeding Support: A Blueprint for Communities. (5)

8. Businesses and Social Organizations

The [Our Town] Government supports all [Our Town] businesses and social organizations in the community to become welcoming to breastfeeding families. We call on the Chamber of Commerce: at least 50% of the Chamber of Commerce member organizations, economic development organizations, and non-member organizations have signed a form (see Business Application) that they welcome breastfeeding in their place of business, and display welcome signs or the “Breastfeeding Welcome Here” logo. Local organizations (e.g., breastfeeding coalitions, La Leche League, Rotary) are encouraged to help distribute window clings/magnets and hanging units for breastfeeding materials.

9. Public Libraries

[Our Town] Public Libraries shall be welcoming. All [Our Town] libraries should have a written breastfeeding policy, culturally appropriate breastfeeding-friendly educational materials, and a list of community breastfeeding resources. All libraries shall provide staff training on optimal breastfeeding practices and benefits; appropriate introduction of solid foods with continued breastfeeding; and communication with families to support breastfeeding and lactation goals. All libraries shall provide interactive and developmentally appropriate learning opportunities that normalize breastfeeding for children in the program.

10. Swimming Pools, Parks, and Recreation

[Our Town] public swimming pools and public parks and recreation shall provide families with positive and encouraging messages about breastfeeding. In compliance with North Carolina law, a person may breastfeed a child at a recreation area, swimming pool, or pool deck area at their discretion. Support includes: “Breastfeeding Welcome Here” signs; explaining the law to staff; ensuring staff never ask someone who is breastfeeding to move, cover up, be more discreet, or stop for any reason; and preparing staff to respond to complaints as an opportunity to share information about the law, engaging the responsible manager when needed.

11. Food Pantries

All [Our Town] food pantries shall be encouraged to create a welcoming environment that feels friendly, accepting, and supportive of breastfeeding families. If the pantry accepts formula, we encourage storing it out of view of clients, distributing it thoughtfully with information about safe preparation and storage. We encourage each site to write breastfeeding-friendly guidelines or policies; provide information, education, and resources to breastfeeding families, staff, and volunteers; and connect families with local community breastfeeding resources such as WIC and hospital support groups. Consider language, imagery, nutritional restrictions, literacy levels, and family structure in all materials.

12. The International Code of Marketing of Breast-Milk Substitutes

Local businesses and healthcare clinics/offices are called on by [Our Town] to affirm the principles of the International Code of Marketing of Breast-Milk Substitutes, which strives to protect, promote, and support breastfeeding for the health and well-being of infants, especially during the vulnerable early months of life. [Our Town] asks that no locally controlled businesses advertise infant formula or related toddler formulas, by verification with such businesses.

13. Workplace Support for Lactating Employees

The WABA Maternity Care initiative or, in the U.S., The US Business Case for Breastfeeding is promulgated by the [Our Town] Government, and we ask the same of the Chamber of Commerce. Workplace accommodation for breastfeeding workers is included in the Affordable Care Act for hourly workers and is needed for breastfeeding to be successful following return to work. The current state of the laws concerning mandated business support for breastfeeding shall be made available to all Chamber of Commerce members, similar business groups, and other businesses at least annually.

14. Education Systems — Childcare Through University

The [Our Town] education systems, including childcare, K-12, colleges, and universities, are encouraged to include breastfeeding-friendly curricula at all levels. The [Our Town] School District and the Department of Education shall cooperate in review of all textbooks to ensure breastfeeding-friendly curricula are introduced at all levels of education. Education systems are encouraged to have a written policy for promoting and supporting breastfeeding; to support breastfeeding employees with appropriate breaks; and to provide a clean, comfortable, private place for employees to pump/express milk and/or nurse. Education systems shall contact and coordinate with community breastfeeding support resources and actively refer mothers and families.

Application, Communication, and Review

This policy applies to all [Our Town] employees and residents across all settings — outpatient and hospital care, home care, pediatrics, childcare, public spaces, workplaces, the Chamber of Commerce, and schools. Agencies are expected to write protocols for their setting consistent with these policies; contact Breastfeed [Our Town] for assistance. [Our Town] will correctly communicate the policy to all, with an effective date and review date set at adoption.

References

(1) Health Affairs, Overcoming Disparities in U.S. Health Care. (2) AHRQ Evidence Report No. 153 (2007), Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. (3) American Public Health Association, Health Equity. (4) National Academies of Sciences, Engineering, and Medicine (2024), Breastfeeding in the United States: Strategies to Support Families and Achieve National Goals. (5) NACCHO (2021), The Continuity of Care in Breastfeeding Support: A Blueprint for Communities.

Critical for Review

  1. Policy Statement: Breastfeeding and the Use of Human Milk Access the official policy statement by the American Academy of Pediatrics (AAP) on breastfeeding and the use of human milk at: https://publications.aap.org/pediatrics/article/150/1/e2022057988/188347/Policy-Statement-Breastfeeding-and-the-Use-of. This statement provides comprehensive guidelines and recommendations for healthcare providers, employers, and communities to support breastfeeding. It covers various aspects of breastfeeding, including initiation, duration, exclusivity, and supplementation, with a focus on the health and development benefits for infants.
  2. Technical Report: Breastfeeding and the Use of Human Milk For a detailed analysis of the scientific evidence and research behind breastfeeding recommendations, refer to the technical report on breastfeeding and the use of human milk by the American Academy of Pediatrics (AAP) at: https://publications.aap.org/pediatrics/article/150/1/e2022057989/188348/Technical-Report-Breastfeeding-and-the-Use-of?preview=true&utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=Pediatrics_TrendMD_0. This report delves into the benefits of breastfeeding for infants and mothers, explores the composition of human milk, and discusses the potential risks associated with not breastfeeding. It serves as a valuable resource for healthcare professionals, policymakers, and individuals seeking a comprehensive understanding of breastfeeding.
  3. The Surgeon General’s Call to Action to Support Breastfeeding Discover the Surgeon General’s Call to Action to Support Breastfeeding at: https://www.cdc.gov/breastfeeding/resources/calltoaction.htm. This initiative aims to promote and encourage breastfeeding nationwide, emphasizing the importance of societal support. The resource outlines evidence-based recommendations for healthcare professionals, employers, families, and communities to create breastfeeding-friendly environments. By visiting this link, you will gain insights into the benefits of breastfeeding and learn about actionable steps to support breastfeeding mothers.

ECONOMICS OF BREASTFEEDING

  • Eradicating Reliance on Free Artificial Milk-Srinivas, G. L., Swiler, K. B., Marsi, V. A., & Taylor, S. N. (2014). Eradicating Reliance on Free Artificial Milk. Journal of Human Lactation, 0890334414553246.
  • A Transition Strategy for Becoming a Baby-Friendly Hospital: Exploring the Costs, Benefits, and Challenges
  • DelliFraine, J., Langabeer, J., Delgado, R., Williams, J. F., & Gong, A. (2013). A transition strategy for becoming a Baby-Friendly hospital: Exploring the costs, benefits, and challenges. Breastfeeding Medicine, 8(2), 170-175.

TIMELY INITIATION

  • Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality-Edmond, K. M., Zandoh, C., Quigley, M. A., Amenga-Etego, S., Owusu-Agyei, S., & Kirkwood, B. R. (2006). Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics, 117(3), e380-e386.

BREASTFEEDING & DIABETES

  • Evidence on the long-term effects of breastfeeding: World Health Organization. Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of breastfeeding. Systematic reviews and meta-analyses. WHO Press, World Health Organization, Geneva, Switzerland, ISBN 978 92 4 159523 O, 2007. 52 pages. 
  • Insulin requirements of diabetic women who breast feed: Davies, H. A., Clark, J. D., Dalton, K. J., & Edwards, O. M. (1989). Insulin requirements of diabetic women who breast feed. BMJ: British Medical Journal,298(6684), 1357.
  • Duration of Lactation and Incidence of Type 2 Diabetes: Stuebe, A. M., Rich-Edwards, J. W., Willett, W. C., Manson, J. E., & Michels, K. B. (2005). Duration of lactation and incidence of type 2 diabetes. Jama,294(20), 2601-2610.

BREASTFEEDING & HYPOGLYCEMIA

  • Postnatal Glucose Homeostasis in Late-Preterm and Term Infants
  • Adamkin, D. H. (2011). Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics, 127(3), 575-579.

BREASTFEEDING & CHOLESTEROL

  • Evidence on the long-term effects of breastfeeding-World Health Organization. Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of breastfeeding. Systematic reviews and meta-analyses. WHO Press, World Health Organization, Geneva, Switzerland, ISBN 978 92 4 159523 O, 2007. 52 pages.

BREASTFEEDING & OBESITY

  • Effect of Infant Feeding on the Risk of Obesity Across the Life Course: A Quantitative Review of Published Evidence.
  • Owen, C. G., Martin, R. M., Whincup, P. H., Smith, G. D., & Cook, D. G. (2005). Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics, 115(5), 1367-1377.
  • Intergenerational impact of maternal obesity and postnatal feeding practices on pediatric obesity

ADOPTING A POLICY

  • Announce your plans for a breastfeeding family friendly policy to your community. 
  • Identify members in your organization who are currently breastfeeding or breastfed in the past to assist.
  • Inform public of the policy/guidelines and make educational materials on breastfeeding available. 
  • Plan a celebration to announce the new breastfeeding friendly policy and make information on breastfeeding available to all. 
  • Present copies of the policy/guidelines to public. 
  • Create a private place for staff to express their milk and to accommodate staff and other parents who may wish to nurse their infants in private while in the facilities, while welcoming breastfeeding in the public spaces.
  • Continue to provide education to public and resources to support breastfeeding.
  • Confirm the adopted policy states that all services operate on a universal access basis and that no service is denied to anyone on the basis of race, color, ethnicity, national origin, immigration status, religion or creed, age, sex, pregnancy or lactation status, sexual orientation, gender identity, family structure, primary language, ability or disability, veteran or military status, or socio-economic status.

Your Health Department might want to review the Breastfeeding Friendly Health Department Toolkit developed by Dr. Bonnie Brueshoff of the Dakota County Public Health Department. 

Recommended Laws for Review

The federal Fair Labor Standards Act (FLSA) offers protections for many breastfeeding parents, and a number of states have even better levels of support for lactation.  The cities listed here also offer lactation policies..

San Francisco, California

In 2018, San Francisco was the first U.S. city to implement a city-wide lactation law requiring all San Francisco employers to provide break time and a lactation space (other than a bathroom) to all breastfeeding employees. (FLSA only covers hourly employees). The law also sets minimum standards for lactation spaces, requiring that they space be clean, include a chair and a surface for a breast pump, and be located near a sink and a refrigerator where moms can store their milk. In addition, all San Francisco businesses must have a written lactation accommodation policy that outlines the process for requesting workplace support. (As a state, California is top-notch for breastfeeding mothers. Read more about California’s breastfeeding laws.)

Chicago, Illinois

Chicago passed a law in 2015 requiring all large airports in Chicago to have a lactation space (other than a restroom) beyond security in every terminal. Not only was Chicago a year ahead of their own state—Illinois passed a version of the same law in 2016— they were five years ahead of the FAA law that will require more than 60 national airports to have lactation spaces in every terminal. Read more about Illinois’s breastfeeding laws.

San Antonio, Texas

The city of San Antonio is the second largest city in Texas and home of the Alamo. It’s also a great city to work for if you’re a breastfeeding mom. Their workplace lactation policy mandates a private space (not a bathroom)  to pump for all public employees —from interns to full-time employees. The city employees almost 12,000 people! The best part? The city also provides hospital grade pumps to borrow in city lactations rooms and office spaces.

Madison, Wisconsin

Dane County, home to Madison, is the second largest county in Wisconsin.  In 2014 they passed a resolution requiring every county-owned building to provide a lactation space (other than a bathroom) that could be used by both the public employees who worked there and visitors to the spaces. While resolutions are not laws, per se, they matter because they express the clear will of the legislative body. And while every state has legislation to protect a mother’s right to breastfeed in public, the city of Madison takes it a step further with a breastfeeding ordinance that slaps a fine on anyone who tries to stop or interfere with a breastfeeding mama.

New York, New York

New York City law requires lactation spaces in departments that provide public services for families such as the Department of Health and Mental Hygiene, the Administration for Children’s Services, and the Department of Social Services. In 2018, The Big Apple’s City Council also passed ten new bills—called The Mother’s Day bills—to improve services and support for moms and families. One of these new laws (Int. 879-A)  requires employers with 15 or more employees to provide a dedicated lactation space (not a bathroom) for all employees (not just hourly). The other law (Int. 905-A) requires employers to provide breastfeeding employees with a written lactation accommodation policy to ensure moms know about their workplace rights. Both laws go into effect March 18, 2019. NYC’s local laws are in line with the rest of the state’s progressive legislation that ensures support for all nursing moms, including those in prison. Read more about New York’s breastfeeding laws.

Washington, D.C.

It’s fitting that our nation’s capital is a beacon of support for working breastfeeding women. Employers in D.C. are required to support breastfeeding employees by providing break time and a space (other than a bathroom) to pump at work. Plus, the Department of Health is charged with monitoring and reporting on D.C. breastfeeding rates.

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