Court Ruling Supports Incarcerated Women's Right to Breastfeed

New Mexico AFP Joins AAP, ACOG Chapters to Celebrate Decision

July 18, 2017 01:03 pm Chris Crawford

On July 5, leaders from the New Mexico AFP, the New Mexico chapter of the American Academy of Pediatrics, and the American Congress of Obstetricians and Gynecologists New Mexico Section published a news release(313 KB PDF) applauding a Santa Fe, N.M., court's decision to support breastfeeding for incarcerated women.

[Woman with newborn infant lying on her]

The groups said in the release that they fully support the right of incarcerated women to breastfeed their infants during visitation and have access to electric breast pumps to maintain their milk supply while they are separated from their children.

The release came in response to a ruling by New Mexico First Judicial District Court Judge David Thomson, J.D., that a New Mexico Department of Corrections policy banning mothers incarcerated in New Mexico state prisons from breastfeeding their infants violated the state constitution.

The case concerned Monique Hidalgo, an inmate in the Western New Mexico Correctional Facility. Hidalgo was incarcerated on nonviolent drug charges and parole violations and was receiving medication-assisted therapy with methadone for opioid use disorder through the University of New Mexico Milagro Program's perinatal substance abuse outpatient clinic(hospitals.unm.edu) in Albuquerque.

Story highlights
  • On July 5, leaders from the New Mexico AFP, the New Mexico chapter of the American Academy of Pediatrics, and the American Congress of Obstetricians and Gynecologists New Mexico Section issued a news release applauding a court decision to support breastfeeding for incarcerated women.
  • The release came in response to a ruling by New Mexico First Judicial District Court Judge David Thomson, J.D., that a New Mexico Department of Corrections policy banning mothers incarcerated in the state's prisons from breastfeeding their infants violated the state constitution.
  • The case concerned Monique Hidalgo, an inmate in the Western New Mexico Correctional Facility.  

The Milagro Program offers patients who have substance abuse and addiction issues comprehensive maternity care. The program provides medication-assisted treatment with buprenorphine or methadone to women who are addicted to opiates or heroin. Additionally, the program offers outpatient counseling and case management support. The university's family medicine faculty, fellows and residents attend clients' deliveries and care for mother and baby postpartum.

According to an affidavit by AAFP member Lawrence Leeman, M.D., M.P.H.,(577 KB PDF) medical director of the Milagro Program, Hidalgo's daughter Isabella developed neonatal opioid withdrawal syndrome (NOWS) as a result of her mother's treatment. If left untreated, NOWS can lead to inability to feed, weight loss, tremors and seizures.

Leeman, who treated Hidalgo and supervised other physicians who treated Hidalgo and her daughter at the University of New Mexico Hospital, joined the hospital's medical staff in asserting that breastfeeding was an important part of the newborn's treatment plan because it has been shown to decrease the severity and length of NOWS.

Hidalgo was participating in a pilot program supporting breastfeeding for incarcerated women, but the Department of Corrections revoked her right to breastfeed because a drug screen was positive from medications she received during her hospitalization.

Members of Hidalgo's medical team testified to the court that the small amount of medication that was present in her breastmilk wasn't harmful for her infant and reiterated that breastfeeding was especially important for at-risk infants.

In his affidavit, Leeman told the court that breastfeeding would, among other benefits, help Hidalgo bond with her daughter, decrease the likelihood of postpartum depression and decrease postpartum bleeding.

"Ms. Hidalgo's infant, who is considered to be particularly vulnerable as a result of her ongoing recovery from NOWS, will also receive distinct and important benefits from live breastfeeding, in addition to those more general benefits from the ingestion of human milk," he said. "Continued, even if periodic, skin-to-skin contact and breastfeeding are likely to decrease the infant's neonatal need for pharmacological treatment, as well as to decrease her signs and symptoms of NOWS."

Leeman is also quoted in the press release, emphasizing that it has become an increasingly important and complex issue in New Mexico to figure out how to best treat incarcerated pregnant women with substance abuse disorders and, subsequently, their newborn infants. Not least among those concerns are the significant costs associated with NOWS treatment and the potential adverse effects for both mothers and their children.

"Breastfeeding is a critical part of the medical treatment for these high-risk infants, but it's not enough alone," he said. "We hope that a lactation policy for incarcerated women is a small part of a more comprehensive plan to address substance abuse for families statewide."

The press release further noted that physicians have cited a number of ways to support incarcerated women and their children, including

  • allowing buprenorphine maintenance therapy in correctional facilities,
  • increasing funding for substance abuse treatment and
  • alternative sentencing for drug-related offenses to allow nonviolent offenders to be with their infants.

Related AAFP News Coverage
AAFP Position Paper
FP Experts Offer Perspective on Incarceration and Health
(6/12/2017)

2016 Congress of Delegates
Family Physicians Focus on Tough Patient Care Issues
(9/22/2016)

Comprehensive Addiction and Recovery Act Sails Through Senate
(7/15/2016)