Abstract
It is really a hard issue to get across, and it is a difficult issue to change because it involves behavioral changes. We have been working on all of these issues for a long time. It is time for us to see more action and more movement, and we have never had a better opportunity than now.
In just about every talk that I make about obesity, I also talk about the importance of breastfeeding, and that a breastfed child has less chance of being obese than a non-breastfed child—particularly if they are exclusively breastfed for the first 6 months.
Surgeons General throughout the last 25 years have been working to support breastfeeding. In 1994 Dr. Koop convened the first Surgeon General's workshop on breastfeeding. In 2000 Dr. Satcher had a Surgeon General's blueprint for action on breastfeeding. It was the first departmental policy on the practice that gave particular emphasis on reducing racial and ethnic disparities in breastfeeding. And I am sure all of you know that, this fall, we are going to be releasing the Surgeon General's Call to Action on Breastfeeding. I am looking forward to that coming out and being an opportunity to bring some more public attention to the issue.
Despite making improvements in the past few decades we still have a lot of disparities, and they persist in certain areas—along geographic, socioeconomic, racial, and ethnic lines. I was at the World Health Assembly a few weeks ago in Geneva, and many other countries have much more robust breastfeeding initiatives than we do. It is time for us to catch up and surpass them.
Going forward, we really need to approach this issue in a targeted fashion. We need to teach mothers and grandmothers about breastfeeding, because if we do not teach the grandmothers, there is no support there in the family. Also, we need to work with the men in their lives.
We really need to make sure that the medical community comes on board and understands. The Baby-Friendly Hospital Initiative is one that we need to push. Nurses really are the ones who do it, but the doctors—and not just the obstetricians—but the family doctors, the surgeons, the super specialists need to know about it, too, and be able to push that. When a young woman comes in and she is pregnant, they can ask, ”Are you going to breastfeed?” Or, if she is in with the baby, ask, “Why are you not breastfeeding?” Make it more of an everyday experience.
We really have to do some educating of our professionals, and so I think we need to engage the organized medicine and the specialty societies to do that. A particularly important part to look at is hospital follow-up—make sure that we follow up after mothers leave the hospital to make sure they are still breastfeeding because we are getting them to start. Now they kind of drop off as time goes on.
The other area is businesses and work sites. Throughout all my obesity talks, I talk about the need to make sure that we have safe and clean private areas for women who want to breastfeed, so that they can breastfeed in the work site.
We need to bring industry into this. We have blamed industry for a lot of the problems that we have, but we need to make them a part of the solutions. You do not get a whole lot done by calling somebody bad. Instead, you say, “Well, you've got expertise in a certain area, how can you help us?”
The other area is research—ongoing research and ongoing data gathering. We need to always be able to say with authority that the statements we make are based in science.
Finally, my whole goal in all of this is to start to move our healthcare system from a sick-care system to a system of wellness and prevention. And certainly that includes breastfeeding.