Georgia Lactation Consultants Victorious Over Unconstitutional Licensing Law

Editor’s Note: Kindred congratulates our partner, Reaching Our Sisters Everywhere, ROSE, in its legal victory for babies and families in Georgia. Kindred has recognized ROSE and ROBE’s dedication and leadership in family wellness advocacy in our collaborative series and interviews (see below). Wesley Bugg, JD, director of ROBE, is an international editorial advisory board member of Kindred Media and an instructor for the Kindred Fellowship Program’s 2022 Summer Cohort.

Why Is This Legal Victory Important?

A 2017 Cochrane review reinforces the value of providing women with predictable, tailored, and multifaceted breastfeeding support offered by professional or lay/peer people or a combination of both.

This model is embodied in ROSE, a nonprofit organization dedicated to eliminating breastfeeding disparities and barriers experienced by mothers of color, including inadequate medical or family support, lack of shared decision-making, recognition of financial or psychological challenges, and historical antecedents. Many of these women’s ancestors were forced to wet-nurse slave masters’ children instead of breastfeeding their own children.

One of several national organizations solely dedicated to this issue, ROSE offers a variety of services and resources ranging from lactation counseling and peer support training programs to training for health professionals (for example, pediatricians, nurses) that serve communities of color. A companion arm (ROBE, Reaching Our Brothers Everywhere) aims to bring men into the fold through breastfeeding education and peer-to-peer connection. All of these services are provided in a judgment-free, culturally sensitive environment.

“We need to look not only into maternal health issues … but also offer support to people who are working in the birthing community,” cofounder Mary N. Jackson, a CLC, WIC lactation consultant, and former president of the Georgia Breastfeeding Coalition said in an interview.

Read the rest of this editorial here: Breastfeeding disparities further exacerbated by pending legislation

Listen to the podcast and read the transcript of the Kindred podcast interview with ROSE founder, Kimarie Bugg, PhD, here, “The Magic of Our Fears and Tears”

Listen to the Kindred series, Meet the Men of ROBE: Standing at the Intersection of Infant Mortality, Maternal Health, Breastfeeding, and Social Justice

Read about the Kindred Meet the Wayfinder Series, featuring the work of ROBE and ROSE for La Leche League International’s 65th Conference, here.

Listen to Joan C. Williams, director of the Center for WorkLife Law, talk about classism, racism and sexism as barriers to breastfeeding for families in Kindred’s podcast interview here.

“We took this on because of our passion and love for our community.” – Kimarie Bugg, PhD, ROSE Co-founder

State’s unique licensing law would have forced hundreds out of their jobs, reduced breastfeeding access

A law requiring that Georgians who want to teach women how to breastfeed obtain the equivalent of an advanced degree was ruled unconstitutional today by the Fulton County Superior Court. Georgia’s licensing requirement, enacted in 2016, made it the only state in the nation that licensed lactation consultants in this way, and would have forced hundreds out of work. That led Mary Jackson and Reaching Our Sisters Everywhere (ROSE), the nonprofit she helped found to educate families of color about breastfeeding, to challenge the law with representation from the Institute for Justice (IJ). Now, Georgia lactation consultants are free to teach new moms about breastfeeding without fear that their work will become illegal. 

Lactation consultants provide hands-on practical breastfeeding advice and support to new mothers. They had been working safely in Georgia for decades, without any state license, although many lactation consultants have chosen to become privately certified in their field. There are two predominant certifications: a Certified Lactation Counselor (CLC) and an International Board Certified Lactation Consultant (IBCLC). The Lactation Consultant Protection Act would have prohibited lactation consultants from working for pay unless they were IBCLCs or fit into a handful of arbitrary exemptions. 

To obtain an IBCLC credential, an individual must take roughly two years of college courses and complete at least 300 hours of supervised clinical work. The time and expense involved in obtaining certification would make it impossible for many people to obtain state licensure, especially people of modest means. In fact, a state report showed that families seeking breastfeeding help in minority and rural communities—the very communities who already lack access to lactation support—would suffer most from this law because IBCLCs are expensive and concentrated in urban areas. CLCs and other kinds of lactation care providers are more spread out throughout the state and are more affordable. Now, lactation consultants throughout the state can without fear help new moms as they always have. 

“The Court recognized that keeping perfectly competent lactation consultants from doing their jobs doesn’t protect the public, but instead reduces access to breastfeeding care and violates constitutional rights,” said IJ Attorney Renée Flaherty. “Now, IBCLCs will have to think twice before pushing for more laws like this in other states.” 

“We took this on because of our passion and love for our community,” ROSE CEO & Founder Kimarie Bugg said. “It feels so amazingly good. We cannot wait to celebrate with our community.” 

The week ROSE filed its lawsuit, they reached an agreement with the Georgia Secretary of State’s Office to not enforce the IBCLC requirement as litigation proceeded. In 2019, the Fulton County Superior Court dismissed the lawsuit, which ROSE then appealed to the Supreme Court of Georgia. The Supreme Court of Georgia unanimously declared that it has “long interpreted the Georgia Constitution as protecting a right to work in one’s chosen profession free from unreasonable government interference.”  

“Women have been helping other women learn to breastfed for millennia. This decision means that in Georgia, they can continue to do so,” IJ Attorney Jaimie Cavanaugh said. 

Georgia lawmakers created the lactation consultant license despite a government study — known as a “sunrise” review — recommending against regulating the occupation. An IJ report released last week, “Too Many Licenses?,” looked at more than 30 years of sunrise reviews across more than a dozen states. The report showed that an overwhelming majority of sunrise reviews recommended against the creation of new licenses and often recommend no new regulation at all. 

Now, Defendant Secretary of State Brad Raffensperger will have 30 days to appeal to the Supreme Court of Georgia. 


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