Calling breastfeeding one of the most 'highly effective steps a mother can take' to support the health of her baby and herself, this morning the U.S. Surgeon General Regina Benjamin released a significant policy document which I hope will have far reaching effects on the support for breastfeeding.
The Call to Action to Support Breastfeeding is a bold and far reaching document outlining the barriers to breastfeeding and steps to eliminate them.
Among the steps suppported by the administration, from the press release:
- Communities should expand and improve programs that provide mother-to-mother support and peer counseling.
Health care systems should ensure that maternity care practices provide education and counseling on breastfeeding. Hospitals should become more “baby-friendly,” by taking steps like those recommended by the UNICEF/WHO’s Baby-Friendly Hospital Initiative.
- Clinicians should ensure that they are trained to properly care for breastfeeding mothers and babies. They should promote breastfeeding to their pregnant patients and make sure that mothers receive the best advice on how to breastfeed.
- Employers should work toward establishing paid maternity leave and high-quality lactation support programs. Employers should expand the use of programs that allow nursing mothers to have their babies close by so they can feed them during the day. They should also provide women with break time and private space to express breast milk.
Families should give mothers the support and encouragement they need to breastfeed.
The press conference at which this report was released featured Tonya Lewis Lee (author, TV producer, activist, and wife of Spike Lee). The number of African American women on the panel was really impressive, especially given the persistent disparities between African American moms and other moms. A vice president of AOL also spoke about how successful their breastfeeding support program has been, both in terms of breastfeeding and return on investment. She said that they can pay for the entire program (which is huge) with the avoidance of one preterm delivery (which was 2.3% vs. over 12% nationally). One unexpected moment was when Dr. Benjamin mentioned compliance with the WHO Code and spontaneous applause broke out. Think the tide might be turning on this issue?
While there are some very important recommendations here to improve maternity care practices, I have to say that the section identifying barriers to breastfeeding is pretty heavy on the cultural barriers (embarassment, poor family and social support). These are of course very influential. But with so many mothers who want to breastfeed tripped up by hospital practices known to sabotage breastfeeding, I wonder if the identification of barriers at the maternity care level couldn't have been more pointed.
So, what does all this statement actually mean for you? Having worked in public policy, I can tell you that these kinds of documents (which, believe me, are not issued without a lot of review) form the framework for the administration's policy initiatives. In other words, if the document says that more hospitals should become Baby Friendly, you can expect to see pressure (or incentives) from federal agencies on hospitals to do so. This is already starting to happen, as the CDC has created a system of evaluating hospitals' breastfeeding practices, in the form of a score called the mPINC.