Five Years of Progress: A Road Map for the Future

Inspired by the enthusiasm and energy of the Surgeon General C. Everett Koop, MD, ScD, 30 years ago, we have orchestrated five Summits to carry out the original challenges to the nation to promote breastfeeding. Included in these gatherings were the government agencies in whose charge was maternal and infant health and nutrition. Also at the table were the healthcare reimbursement agencies and the healthcare experts who have estimated the monetary costs of failure to breastfeed. Many health professional organizations supportive of breastfeeding, including the United States Breastfeeding Committee, were also present. This year again advocates from diverse communities were present. An inspiring discussion of Reaching Our Sisters Everywhere (ROSE) demonstrated the need for peer leadership representing all women to affect change.

Much has happened between Summits as many individuals, agencies, organizations, and leaders have accepted the challenge and led the charge to conquer a need or provide a solution for a problem.

The recorded progress begins with the participation of the Centers for Disease Control and Prevention in documenting breastfeeding initiation and duration on a regular basis, and finally replacing the self-serving data reports from formula marketers.

The immediate past-Surgeon General, Regina Benjamin, MD, has picked up and expanded upon the points made at the first Surgeon General's workshop, publishing an extraordinary document: the Surgeon General's “Call to Action.” This has served as a blueprint for movement not only by government agencies but also by all soldiers in the crusade for breastfeeding.

The greatest impact has been created by the W.K. Kellogg Foundation. The Foundation not only funded each of the Summits but also has invested totally in the goal to make breastfeeding the normal, natural, and necessary infant feeding. The Foundation boldly committed its resources to breastfeeding and has funded well over 100 organizations that protect, promote, and support breastfeeding. It is committed totally, monetarily, ethically, morally, and practically to the cause.

Healthcare insurance providers are responding to the mandates to support breastfeeding for all neonates.

Progress among women of color is notable. Organizations involving mothers providing peer support for each other have changed the paradigm. ROSE, Mocha Moms, and Detroit's Black Mothers Breastfeeding Association have led the way.

The crusade is not over. Progress has been astounding, but there is need to:

• Improve and expand health insurance coverage

• Inspire neonatologists to support the value of human milk for sick and premature infants

• Support and expand the peer programs representing all women to help vulnerable populations adapt breastfeeding as the norm in all communities

• Develop a process that will make the human milk donor supply affordable, feasible, accepted, safe, and sustainable for needy infants and mothers nationally and internationally

This is not an exhaustive list, but it demonstrates how great the need to continue the work of the Summits really is.

A strong mechanism will be put in place to sustain the momentum that has increased breastfeeding initiation, fosters optimal duration, and guarantees support from the healthcare community, reimbursement organizations, the government at all levels, and the public at large.