Surgeon General Calls the U.S. Into Action on Breastfeeding

This is shaping up to be another big year for breastfeeding. Coming off the heels of workplace support for breastfeeding moms mandated by 2010's Patient Protection and Affordable Care Act, U.S. Surgeon General Regina M. Benjamin issued the Call to Action to Support Breastfeeding on Jan. 20.

The Call to Action takes breastfeeding support recommendations to the next level, following the HHS Blueprint for Action on Breastfeeding. The HHS Blueprint was the first U.S. policy document on breastfeeding, released in 2000 by former Surgeon General David Satcher.

Dr. Benjamin's Call to Action expands on the 19 ideas listed in the HHS Blueprint, and presents 20 specific policies and activities that will effectively support, promote and protect breastfeeding. It outlines the many obstacles breastfeeding and pumping mothers face in the U.S. and identifies ways that families (especially fathers and grandmothers), employers, and health care professionals can support breastfeeding and pumping moms so they can meet the duration rates recommended by the World Health Organization and several other organizations.

In a press release, the Office of the Surgeon General highlighted the following as the key takeaways from the Call to Action:

  • 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 CDC reported in its 2010 Breastfeeding Report Card that 75 percent of babies in the U.S. start out breastfeeding, but the number drops precipitously after the first few weeks and months postpartum. Six months after birth, the rate of exclusive breastfeeding falls to just 13 percent. A 2010 study published in Pediatrics shows that an increase in breastfeeding duration rates that aligned with official recommendation of the World Health Organization could save the U.S. $13 billion and 911 infant lives each year. Dr. Benjamin's Call to Action recommends the specific actions that will drive breastfeeding rates higher, aiming to meet WHO recommendations and the goals for initiation and duration set by Healthy People 2020.

This document heralds a long-awaited change to breastfeeding-related policy. The Surgeon General now demands that this urgent public health issue gets the attention it deserves. In the two years it took to develop the Call to Action, citizens, community leaders, thought leaders, policy makers, and businesses such as Lansinoh were called upon to make recommendations for the actions that would support, protect, and promote breastfeeding. I made recommendations on behalf of Lansinoh at the CDC hearing in July 2009. In my testimony I stressed that while breastfeeding is the normal way to feed an infant it's not always easy, especially for working, pumping moms who get little support from their family, employers and coworkers.

In my testimony I made the point that while it's extremely important to educate families, employers, and health care workers about the benefits of breastfeeding and risks of not breastfeeding, we won't make much progress without policy that supports these women. And not just through the first days of their baby's life, but the entire first year postpartum.

The Call to Action lays the groundwork for this policy by recommending a number of realistic actions that communities can put to work now. Breastfeeding is about more than feeding -- it is a nurturing, nourishing act that improves not only the lives of moms and babies, but the health and well being of our nation. It's in all of our best interests to respond to this Call to Action.