Surgeon General's Call to Action to Support Breastfeeding: Significant Actions in the First Year

Abstract

In January 2011, Surgeon General Regina Benjamin issued the Call to Action to Support Breastfeeding.¹ In this document, she outlined 20 Action Steps to be carried out to improve the ways that breastfeeding women can be supported. The Action Steps focused on mothers and their families, communities, health care, employment, research and surveillance, and public health infrastructure. In the year since the Call to Action was issued, numerous programs have been undertaken to respond to the Call. Examples of some of the most significant activities [as numbered by the Surgeon General] in support of breastfeeding that have occurred in the last year are listed below:

3. Strengthen programs that provide mother-to-mother support and peer counseling.

• The U.S. Department of Agriculture (USDA) peer counseling program significantly expanded.

• Loving Support Through Peer Counseling: A Journey Together for WIC Staff was released to train Supplemental Nutrition Program for Women, Infants and Children (WIC) managers and peer counselors.²

5. Create a national campaign to promote breastfeeding.

• USDA sponsored two scientific workshops on updating the social marketing campaign “Loving Support Makes Breastfeeding Work.”

• The U.S. Department of Health and Human Services (HHS) has contracted with Ogilvy to create a campaign on breastfeeding initiation among African American women.

• Text4Baby includes numerous messages on breastfeeding for pregnant and postpartum mothers.

7. Ensure that maternity care practices throughout the United States are fully supportive of breastfeeding.

• Baby-Friendly designation has accelerated, with 23 hospitals designated in 2011, more than in any prior year.

• The Centers for Disease Control and Prevention (CDC) and the National Initiative for Children's Healthcare Quality launched the “Best Fed Beginnings” project to develop hospital learning collaboratives with 90 hospitals.

• The Indian Health Service (IHS) committed to helping all 13 IHS hospitals that provide maternity services to become Baby-Friendly. In addition, IHS will encourage Tribal obstetrics facilities to make similar policy changes and achieve Baby-Friendly Hospital status.

• The Joint Commission launched a new Speak Up campaign on “What You Need to Know About Breastfeeding.”

• The Agency for Healthcare Research and Quality, CDC, and Maternal and Child Health Bureau funded the University of North Carolina Global Breastfeeding Institute to create an Interstate Collaborative for the Ten Steps to Successful Breastfeeding.

10. Include basic support for breastfeeding as a standard of care for midwives, obstetricians, family physicians, nurse practitioners, and pediatricians.

• HHS issued guidelines requiring health plans to cover women's health services at no cost to patients, including comprehensive lactation support and lactation equipment.

• The Centers for Medicare and Medicaid Services issued a brief on “Medicaid Coverage of Lactation Services,” outlining the ways that state Medicaid programs can cover lactation services for Medicaid beneficiaries.

13. Work toward establishing paid maternity leave for all employed mothers.

• The National Partnership for Women and Families and MomsRising are highlighting the need for paid maternity leave and calling for appropriations for the U.S. Department of Labor (DOL) State Paid Leave Fund.

• The National Center on Children in Poverty hosted a Paid Family Leave Forum to discuss state and national efforts to establish family leave insurance.

14. Ensure that employers establish and maintain comprehensive, high-quality lactation support programs for their employees.

• DOL trained field investigators about Section 4207, Reasonable Break Time for Nursing Mothers, of the Patient Protection and Affordable Care Act. They continue to provide compliance assistance to employers and employees.

• The Office on Women's Health (OWH) hosted Expert Panel meetings and a “National Business Case for Breastfeeding” Summit to raise awareness of the workplace accommodations law and target hospitals and schools.

• OWH contracted with Altarum and EveryMother to compile successful lactation accommodation programs in non–office-based settings.

16. Ensure that all childcare providers accommodate the needs of breastfeeding mothers and infants.

• First Lady Michelle Obama launched the Let's Move Child Care initiative to help early care and education facilities (centers and family homes) meet national standards and best practices for obesity prevention, including supporting breastfeeding mothers and accommodating breastmilk feeding.

18. Strengthen existing capacity and develop future capacity for conducting research on breastfeeding.

• The National Institutes for Health and OWH are developing plans to create a Breastfeeding Research Consortium.

• The Food and Drug Administration is leading a follow-up study of children who participated in the Infant Feeding Practices Study II in 2005–2007 as infants.

20. Improve national leadership on the promotion and support of breastfeeding.

• The Interagency Federal Breastfeeding Workgroup meets monthly, with representation from the Office of Personnel Management, DOL, USDA, and multiple agencies within HHS.

• The United States Breastfeeding Committee has expanded its core staff to three people using support from federal grants, fundraising programs, and a grant from the Kellogg Foundation.

• CDC's Community Transformation Grants support community-level prevention, including breastfeeding support in the workplace, childcare setting, and changing maternity care practices.

Disclosure Statement

No competing financial interests exist.

References

U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2011. www.surgeongeneral.gov/library/calls/breastfeeding/index.html. 2012 August 24.

Loving Support Through Peer Counseling: A Journey Together, Training Facilitator Guide, U.S. Department of Agriculture. www.nal.usda.gov/wicworks/Learning_Center/PC/TrainingFacilitatorGuide.pdf. 2012 August 24.