The U.S. Senate completed its work for the year on December 22, when senators approved an omnibus bill to fund the federal government through the end of the current fiscal year on September 30, 2023.

The bill allocates $1.7 trillion in federal government spending ($858 billion for the military, and $772 billion in non-defense spending). The Washington Post broke down the funding by appropriations area.

The legislation also provides $44.9 billion more in aid to Ukraine, and $40.6 billion for disaster aid. It changes some Medicaid rules, which will preserve coverage for many new mothers and children. It also includes some policies not related to federal spending, such as reforms to the Electoral Count Act, workplace protections for pregnant or breastfeeding employees, and a ban on installing TikTok on government-owned devices.

Eighteen Republicans joined the whole Democratic caucus to pass the omnibus bill. Iowa’s Senators Chuck Grassley and Joni Ernst were among the 29 Republicans who opposed the bill on final passage (roll call). But they supported some amendments added to the bill on December 22, as well as several GOP proposals that failed to pass.

“The U.S. soybean industry’s worst fears are coming to pass today,” the Iowa Soybean Association said in a statement as the first round of tariffs between the U.S. and China went into effect on July 6.

An unfortunate incident at a public pool in Dubuque prompted that city to update its written policies this week to permit “breastfeeding in a public swimming pool or deck area at the mother’s discretion.” On Monday, KCRG’s Katie Wiedemann interviewed the woman whom lifeguards asked to retreat to a private place to nurse her baby. Thanks in part to advocacy by the non-profit Family Friendly Business Initiative, Dubuque officials quickly brought their policies into compliance with state law, Wiedemann reported today.

Whether or not other Iowa cities have similar written policies, breastfeeding mothers should know that they need no special permission to nurse their babies in public parks or recreation areas. Since 2000, Iowa Code 135.30A has stated, “Notwithstanding any other provision of law to the contrary, a woman may breast-feed the woman’s own child in any public place where the woman’s presence is otherwise authorized.” During my breastfeeding years, I nursed in public hundreds of times–including at least once in the rotunda at the Capitol–and was hardly ever hassled. My impression from acquaintances with babies and young toddlers is that it’s increasingly rare for employees in stores, restaurants, or other public places to ask nursing mothers to find an out-of-the-way spot.  

More than three-quarters of Iowa mothers are breastfeeding their newborns at the time of discharge from the hospital, according to the latest figures released by the Iowa Department of Public Health. A chart near the bottom of this page shows data compiled through the Iowa Newborn Metabolic Screening Profile Feeding Report since 2000. Statewide, about 63 percent of newborns were receiving some breast milk in the year 2000, but by 2013 the rate had risen to 77.7 percent. This chart shows the breastfeeding incidence for about two-thirds of Iowa counties between 2006 and 2013. (Counties with fewer than 20 recorded births per year were not included in the analysis.) Almost every county saw the breastfeeding rate increase during that period, but there was wide variation among counties. Howard County in northern Iowa started out above the statewide average in 2006 and had the highest breastfeeding rate in 2013 at 95.2 percent. Nearby Chickasaw County had the lowest rate at 54.5 percent and is one of the few Iowa counties where the newborn breastfeeding rate has declined in recent years.

Small changes in hospital policies can make a big difference in breastfeeding rates. This slide show created by Dr. Nils Bergman discusses how skin to skin contact in the first hours after birth promotes more breastfeeding. Toward the middle of the presentation, he discusses a study at one California hospital, where an hour of skin to skin time for babies in the first three hours of life dramatically increased the percentage of mothers who were breastfeeding at the time of hospital discharge.

The new Iowa statistics only reflect the percentage of babies receiving some breast milk in the hospital. For many women, the most difficult period for breastfeeding is the week or two after bringing baby home. (That was my experience.) In-person help from certified lactation consultants or accredited volunteer breastfeeding educators can be crucial. Sometimes a small change in how a woman holds her baby or her breast can make a huge difference in baby’s ability to transfer milk. Free breastfeeding support is available through Iowa chapters of La Leche League and Breastfeeding USA. After the jump I’ve posted information about other free breastfeeding resources for Iowa mothers.

Knowing what to expect during the early weeks of breastfeeding is critical. It’s typical for newborns to nurse every hour or two around the clock, or to go through a period of “cluster feeding” for a few hours each day. In our culture, many women wrongly interpret those and other normal behaviors as a sign that they are not making enough milk. Again, seeking advice in person or over the phone can be helpful. Good online sources for breastfeeding information, including trouble-shooting, include Kellymom, La Leche League, and Breastfeeding, Inc. Among the many good books that have been published about breastfeeding, the best short read in my opinion is Breastfeeding Made Simple by Nancy Mohrbacher and Kathleen Kendall-Tackett. The best book for trouble-shooting is The Ultimate Breastfeeding Book of Answers by Dr. Jack Newman and Teresa Pitman. The best overview of typical breastfeeding behavior is The Womanly Art of Breastfeeding, published by La Leche League International.  

What’s on your mind this weekend? In the spirit of past Mother’s Day diaries at this site, I’ve posted some mother-related links after the jump. I also added my thoughts on the latest TIME magazine cover, a sexualized depiction of a three-year-old breastfeeding next to a provocative “Are You Mom Enough?” tag line.

The Academy of Breastfeeding Medicine warns that recently updated “birth control guidelines released by the U.S. Centers for Disease Control and Prevention (CDC) could undermine mothers who want to breastfeed,” I learned from the ByMomsForMoms blog, sponsored by Lansinoh. From the Academy of Breastfeeding Medicine’s news release:

“The new guidelines ignore basic facts about how breastfeeding works,” says Dr. Gerald Calnen, President of the Academy of Breastfeeding Medicine (ABM). “Mothers start making milk due to the natural fall in progesterone after birth. An injection of artificial progesterone could completely derail this process.”

The CDC report, “U.S. Medical Eligibility Criteria for Contraceptive Use, 2010,” released in the May 28 issue of Morbidity & Mortality Weekly Report (MMWR), contains important changes in what constitutes acceptable contraceptive use by breastfeeding women. The criteria advise that by 1 month postpartum the benefits of progesterone contraception (in the form of progestin-only pills, depot medroxyprogesterone acetate (DPMA) injection, or implants), as well as the use of combined (progestin-estrogen) oral contraceptives outweigh the risk of reducing breastfeeding rates. Previously, progesterone birth control was not recommended for nursing mothers until at least 6 weeks after giving birth, and combined hormonal methods were not recommended before 6 months.

Based on clinical experience, breastfeeding support providers report a negative impact on breastfeeding when contraceptive methods are introduced too early. One preliminary study demonstrated dramatically lower breastfeeding rates at 6 months among mothers who underwent early insertion of progesterone-containing IUDs, compared with breastfeeding rates of mothers who underwent insertion at 6-8 weeks postpartum.

I have met women whose milk supply collapsed after they received a progesterone shot. One acquaintance had successfully nursed previous babies and was never informed by her health care provider that a birth control shot could impede her ability to produce enough milk for her infant.

It’s illogical for the CDC to give its blessing to early postpartum use of hormonal birth control when the federal government has supposedly been trying to promote breastfeeding for more than a decade. Earlier this year, the White House Task Force on Childhood Obesity set a goal of having half of U.S. babies breastfed for at least nine months by 2015, and recommended a number of specific policies to help reach that goal. But breastfeeding without a full milk supply is quite difficult no matter how educated the mother is or how supportive her environment. I hope the CDC will revise its guidelines and recommend non-hormonal forms of birth control for women in the early months of breastfeeding.  

Last Thursday, the Iowa Senate approved a bill that would improve the health and well-being of Iowa working mothers and their children. In addition, this bill would reduce many employers’ health care costs while lowering employee turnover and absenteeism. Unlike legislation that pits business interests against the needs of working families, this bill would be a win-win.

Nevertheless, almost the whole Republican caucus voted against Senate File 2270, which promotes workplace accommodations for employees who express breast milk.

Follow me after the jump for background on this bill and Republican opposition to it.

The coming week will be busy at the state capitol, because February 12 is the first “funnel” date. All bills excluding appropriations bills that have not been approved by at least one committee by February 12 will be dead for the 2010 session, unless something extraordinary happens.

Also, Iowa House Republicans are expected to try to suspend the rules this week to force consideration of a constitutional amendment to ban same-sex marriage. If last April’s events are any guide, they can expect help from two Iowa House Democrats: Geri Huser and Dolores Mertz. Meanwhile, Mertz is working with a group of Republicans on a constitutional amendment that would “recognize human eggs as persons worthy of legal protection.” Such an amendment would outlaw abortion and probably some forms of birth control as well.

With the compressed legislative calendar and severe budget restraints, there may be fewer bills passed in 2010 than in previous sessions. If you’re keeping your eye on any bill, let us know in this thread. I hope the Iowa Senate Labor and Business Relations Committee will pass Senate File 2112, introduced by Senator Pam Jochum, on “workplace accommodations for employees who express breast milk.” It’s already cleared the subcommittee. Last hear State Representative Ako Abdul-Samad introduced a similar measure in the Iowa House, and I think there’s a decent chance of getting this bill through the House Labor Committee. Employers also benefit from practices that make it easier for their employees to continue breastfeeding.

Jochum is an all-around outstanding legislator. If I lived in the first district, she would definitely have my vote for Congress whenever Bruce Braley decides to run for U.S. Senate.

This thread is for anything on your mind this weekend. Am I the only one out there who doesn’t care who wins the Superbowl?

After the jump I’ve posted details on other Iowa political events scheduled for this week.

This blog will always be primarily about politics, but I enjoy writing about other subjects from time to time. In fact, one of my new year’s resolutions for Bleeding Heartland is to write more about food and parenting in 2010.

After the jump I’ve compiled links to posts on those topics in 2009. Some of the diaries were political, others are personal. The link I’m most proud of combined the two: My case against Hanna Rosin’s case against breastfeeding.

Any thoughts or suggestions for future topics to cover are welcome in this thread.

I expected 2009 to be a relatively quiet year in Iowa politics, but was I ever wrong.

The governor’s race heated up, state revenues melted down, key bills lived and died during the legislative session, and the Iowa Supreme Court’s unanimous ruling in Varnum v Brien became one of this state’s major events of the decade.

After the jump I’ve posted links to Bleeding Heartland’s coverage of Iowa politics from January through June 2009. Any comments about the year that passed are welcome in this thread.

Although I wrote a lot of posts last year, there were many important stories I didn’t manage to cover. I recommend reading Iowa Independent’s compilation of “Iowa’s most overlooked and under reported stories of 2009,” as well as that blog’s review of “stories that will continue to impact Iowa in 2010.”

It took me a week longer than I anticipated, but I finally finished compiling links to Bleeding Heartland’s coverage from last year. This post and part 2, coming later today, include stories on national politics, mostly relating to Congress and Barack Obama’s administration. Diaries reviewing Iowa politics in 2009 will come soon.

One thing struck me while compiling this post: on all of the House bills I covered here during 2009, Democrats Leonard Boswell, Bruce Braley and Dave Loebsack voted the same way. That was a big change from 2007 and 2008, when Blue Dog Boswell voted with Republicans and against the majority of the Democratic caucus on many key bills.

No federal policy issue inspired more posts last year than health care reform. Rereading my earlier, guardedly hopeful pieces was depressing in light of the mess the health care reform bill has become. I was never optimistic about getting a strong public health insurance option through Congress, but I thought we had a chance to pass a very good bill. If I had anticipated the magnitude of the Democratic sellout on so many aspects of reform in addition to the public option, I wouldn’t have spent so many hours writing about this issue. I can’t say I wasn’t warned (and warned), though.

Links to stories from January through June 2009 are after the jump. Any thoughts about last year’s political events are welcome in this thread.

Breastfed babies can be long and lean, short and fat, or anywhere in between. But I never heard of an insurance company citing a breastfeeding infant’s “obesity” as a pre-existing condition before reading this story from the Denver Post:

By the numbers, [four-month-old] Alex [Lange] is in the 99th percentile for height and weight for babies his age. Insurers don’t take babies above the 95th percentile, no matter how healthy they are otherwise. […]

Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.

” ‘Your baby is too fat,’ she told me,” Bernie said.

Up until then, the Langes had been happy with Alex’s healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their “happy little chunky monkey.” […]

“I’m not going to withhold food to get him down below that number of 95,” Kelli Lange said. “I’m not going to have him screaming because he’s hungry.”

Good call, Mrs. Lange. There is “no evidence to support ‘dieting’ or substituting other foods or liquids for human milk to reduce weight gain.”

It’s outrageous for an insurance company to use Alex’s weight at four months of age as an excuse to deny coverage. Not that exclusions for other “pre-existing conditions” (such as a benign heart murmur that a child would grow out of without treatment) are any more defensible.

Also, the Lange family wouldn’t have been shopping around for new coverage if their previous carrier hadn’t raised their rates by 40 percent after Alex was born. I remember our insurance premiums went up quite a bit after our second child was born, but I don’t think it was by that much. Then again, they went up 10 percent last year even without any new babies or health problems in our family.

Share any relevant thoughts in this thread.

I haven’t written a breastfeeding diary here since I took on Hanna Rosin two months ago, but the Iowa blogger at Fat Single Mom Takes on the World informed me that  there was some kind of “online carnival” last week about nursing toddlers. (Here are some links.)

I figured now is as good a time as any to compile information about breastfeeding beyond a child’s first birthday.

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months, continued breastfeeding until a baby is at least 12 months old, and after that as long as it is mutually desirable for mother and baby to keep nursing.

The World Health Organization recommends nursing at least to age two, and beyond that age if mother and child wish to keep nursing.

This power point presentation by Dr. Jack Newman, author of the Ultimate Breastfeeding Book of Answers, contains lots of information about nursing toddlers. Dr. Newman also provides various views on what should be considered the “normal” age for weaning in humans.

Resources for women who are nursing beyond 12 months of age:

   *This page at KellyMom lists numerous advantages of extended nursing, for mothers as well as for children. (Links to references are provided.)

   *Mothering Your Nursing Toddler by Norma Jane Bumgarner is a must-read book.

   *The Attachment Parenting International site includes interactive forums for your own questions as well as these answers to frequently-asked questions about nursing toddlers.

   *La Leche League International provides lots of information, especially here.

Speaking of breastfeeding, at Mother Talkers prgrsvmama26 brings us the news that Representative Carolyn Maloney of New York will reintroduce the Breastfeeding Promotion Act in June. Click the link for more details about this bill and what you can do to support it.

Here is some information about the economic benefits (for employers as well as employees) of helping working mothers to breastfeed.

According to this page on the National Conference of State Legislatures site, 23 states have adopted laws related to breastfeeding in the workplace, but Iowa is not one of them. On the plus side, Iowa is among 43 states with laws allowing women to breastfeed in any public or private location. Iowa is also one of 12 states that exempt nursing mothers from jury duty. La Leche League has compiled more detailed information on breastfeeding and the law in the U.S. and around the world.

Happy Mother’s Day to all the mothers in the Bleeding Heartland community. The new thing I learned today is that Julia Ward Howe envisioned Mother’s Day as an anti-war day of action by women of all nations.

We are going to a picnic and nature walk instead.

Good resources for pregnant women or mothers:

Attachment Parenting International (includes discussion forums on lots of topics)

Mothering magazine’s site and Mothering.com discussion forums

International Cesarean Awareness Network (and more resources for women wanting to reduce their risk of surgical birth)

La Leche League

AskDrSears.com

Campaign for a Commercial-Free Childhood: Reclaiming Childhood from Corporate Marketers

Here are a few good reasons to wear your baby and some benefits of encouraging your children to play outdoors.

Good blogs for mothers: Mother Talkers (a community blog) and Momocrats

If Mother’s Day is painful for you, either because your mother didn’t provide the childhood you would have wanted, or because you are the parent of a child who has died, I recommend this diary Cronesense posted at Daily Kos two years ago: Mother’s Day – the other side of the coin. Frankenoid’s diary, Mother’s Day in the Land of the Bereaved, is also very moving.

Please use this thread to share any thoughts about this day or pay tribute to any inspiring mom in your life. Last year I wrote about my friend LaVon Griffieon.

UPDATE: Good post by DarkSyde at Daily Kos.

Warning: long diary ahead.

Hanna Rosin makes “The Case Against Breastfeeding” in the April issue of the Atlantic Monthly. The provocative title is misleading, because as Rosin explained in an interview on NBC’s Today show on March 16, she isn’t against breastfeeding. In fact, she kind of likes breastfeeding. Her problem is with the people who promote breastfeeding. Here’s the lead-in to her piece:

In certain overachieving circles, breast-feeding is no longer a choice-it’s a no-exceptions requirement, the ultimate badge of responsible parenting. Yet the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates. Is breast-feeding right for every family? Or is it this generation’s vacuum cleaner-an instrument of misery that mostly just keeps women down?

Rosin packs a lot into the article, but I would summarize her main points as:

1. American women face intense social pressure to breastfeed exclusively.

2. Advocates exaggerate the benefits of breastfeeding, which the scientific research does not support.

3. Advocates downplay the negatives about breastfeeding and fail to acknowledge that formula-feeding can be the right choice for some mothers. On a related note, Rosin depicts breastfeeding as extremely inconvenient for mothers who work outside the home.

4. Advocates have medicalized the conversation about breastfeeding, and American women are wrongly led to believe they are harming their babies if they give formula instead.

I address those points and more after the jump. Rosin’s conflicted feelings about breastfeeding are valid, but unfortunately, she draws too many broad conclusions based on her personal experiences.

For those who don’t care to read the rest of this post, be assured that as a feminist and pro-choice woman, I respect the right of women to decide what and how to feed their own babies. I am also aware that some women are unable to breastfeed for physical or medical reasons, and many more women are unable to breastfeed because they lacked the information and support they needed in the critical early weeks.

My intention is not to judge any mother for her choices or add to the pain of any mother who did not have the breastfeeding experience she sought.

Asthma has been on my mind lately, because a child in my extended family was recently diagnosed with it after going to the hospital for respiratory problems. The chronic disease is one of the leading causes of hospitalization in children.

In addition, at least 20 million American adults are estimated to have asthma.

Today is World Asthma Day, in connection with Asthma Awareness Month.

Join me after the jump to read about five policies our society should implement, as well as five steps individuals can take, to reduce the incidence and severity of asthma in our households and across the country.