Promoting, Protecting and
Supporting Breastfeeding in North
Breastfeeding Work Group
Perinatal Health Committee
North Carolina Child Fatality Task Force
Breastfeeding Work Group
Sheryl Abrahams
Selena Barrier
Joe Holliday
Miriam Labbok
Alice Lenihan
Steve Shore
Catherine Sullivan
Mary Rose Tully
Sarah Verbiest
Tom Vitaglione
Our Charge…
 Study the link between breastfeeding and
the reduction of infant mortality, disease
and obesity
Experts Agree….
 American Academy of Pediatrics (AAP)
 American Academy of Family Physicians
 American College of Obstetrics and
Gynecology (ACOG)
 American Dietetic Association (ADA)
Breastfeeding is the
normal way to feed a
Breastfeeding is best for babies
 Exclusively breastfeeding for the first 6 months
of life
 Gradually add complementary solids after 6
months of age
 Continue breastfeeding for at least one year
 And as long as mutually desired for mom and baby
 WHO recommends breastfeeding for at least 2 years
Healthy People 2010 Goals
Breastfeeding goals for the United States:
 75% of babies breastfed at birth
 50% continue to breastfeed at 6 months
 25% are breastfeeding at 1 year
Additional goals from Midcourse Review:
 60% exclusively breastfeeding through 3
 25% exclusively breastfeeding through 6
Breastfeeding=Best Practice
Evidence Based Reports 2007
Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term
effects of breastfeeding: Sytematic Reviews and Meta-Analyses. World
Health Organization 2007
 World Health Organization (WHO) found
Lower mean blood pressure
Lower total cholesterol
Higher performance in intelligence tests
Reduced overweight/obesity
Reduced Type 2 Diabetes
Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries.
Evidence Report/Technology Assessment No. 153. AHRQ Publications No. 07E007. Rockville, MD: Agency for Healthcare Research and Quality. April 2007
 Infants/AHRQ found reduced
– Otitis media*
– Gastroenteritis*
– Severe lower respiratory tract infections*
– Atopic dermatitis
– Asthma* (infant and children <10 strongest impact)
– Obesity*
– Type 2 Diabetes*
– Necrotizing enterocolitis (*preterm infants)
*=strongest conclusions
American Institute for Cancer Research
 AICR’s Second Expert Report: Food, Nutrition,
Physical Activity, and the Prevention of Cancer:
a Global Perspective (2007).
– “It’s best for mothers to breastfeed exclusively
for six months and then add other liquids and
North Carolina mothers will be enabled to
begin their children’s lives by
breastfeeding - the best possible
foundation for infant and young child
Encourage the adoption of activities that create breastfeeding-friendly
Create a breastfeeding-friendly health care system.
Encourage the adoption of breastfeeding-friendly workplaces.
IV. Assist child care facilities in promoting, protecting and supporting
Advocate for insurance coverage by all third-party payers for
breastfeeding care, services, and equipment when necessary.
VI. Involve media and use social marketing and public education to promote
VII. Promote and enforce new and existing laws, policies and regulations that
support and protect breastfeeding.
VIII. Encourage research and evaluation on breastfeeding outcomes, trends,
quality of care, and best practices.
From Recommendations to Action
Health Care System
Child Care Facilities
Insurance Coverage
Media, Social Marketing, and Public Education
Laws, Policies, and Regulations
Research and Evaluation
Breastfeeding Work Group
 Statewide campaign should be
implemented to enhance public awareness
about the benefits of breastfeeding
– Foundation funding
– Legislative appropriations
* Other states with language/laws: California, Illinois, Missouri, Vermont
Healthcare System
 North Carolina Hospital Association
– Engage NCHA in championing the
implementation of a “Baby Friendly Hospital
Initiative” including policies and practices to
promote breastfeeding
* Other states with language/laws: Florida, California, Missouri
Breastfeeding Friendly Workplaces
 Employers (start with state agencies)
– Provide paid break time
– Provide private place for breastfeeding and/or
expressing milk
*Other states with language/laws: California, Connecticut, Georgia, Hawaii,
Illinois, Minnesota, Montana, New Mexico, New York, Oklahoma, Oregon,
Rhode Island, Tennessee, Texas, Washington, Wyoming
Assist Child Care Facilities
 Division of Child Development
 North Carolina Partnership with Children
– Help assure that breastfed infants and their mothers
will receive equal access and care in child care
* Other states with language/laws: Louisiana, Mississippi
Media, Social Marketing &
Public Education
 Department of Public Instruction
– Incorporate breastfeeding information into K12 school health curriculum
* K-12 curriculum: New York
Law, Policy and Regulations
 Seek legislation to create a jury exemption
for breastfeeding women
 Enhance access to support services
Creation of a registry for board certified lactation consultants
Define a scope of practice for registered lactation consultants
Insurance coverage for services post-discharge
Enhanced insurance coverage for the use of human milk in
*Other states with language/laws related to jury duty exemption: California, Idaho, Illinois,
Iowa, Kansas, Kentucky, Minnesota, Mississippi, Nebraska, Oklahoma, Oregon,
*Joint study for insurance coverage: Louisiana
*Regulation minimum guidelines for sale of milk, donor milk banks: Texas, California
Breastfeeding/Provision of Human
Breast Milk=Primary Prevention!

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