Breastfeeding and Incarceration: An Analysis of California County Jails' Written Breast Milk Feeding Policies.

Between 1980 and 2019, the number of incarcerated women rose by more than 700%. Rising imprisonment of women corresponds with an increase in incarcerated lactating people. In 2018, California signed Assembly Bill (AB) 2507, requiring county jails to develop and implement a breast milk feeding policy for incarcerated women who wish to express their breast milk. We conducted a cross-sectional, descriptive study to determine if California's 58 counties created policies compliant with AB2507. Additionally, policies were analyzed for inclusion of evidence-based breastfeeding and lactation management practices and given a letter grade for their performance. Public records act requests were sent to all California counties, requesting their breast milk feeding policies. Of the 55 counties that responded, 51 had policies. Twenty-eight (51%) counties were in full compliance and 27 (49%) counties lacked compliance. No counties received letter grade A and 48 (87%) counties received letter grade C or below. Results reveal a discrepancy between legally compliant policies and evidence-based practices. The California county jail management needs increased surveillance to ensure policies are in full compliance and reflect best practices. Further research is required to investigate the actual implementation of compliant written breastfeeding policies.