Examining the Evidence,Seeking Solutions

This journal has reported on the four previous Annual Summits on Breastfeeding in the United States, ¹ and the Fifth Annual Summit on Breastfeeding is scheduled for June 2013.

In 2009, the First Summit focused on strategies to promote breastfeeding in diverse settings across the United States examining initiation, employment as a barrier, and disparities affecting breastfeeding. In 2010, the Second Summit reviewed accomplishments in initiating breastfeeding and reaching goals set by Healthy People 2010. The emphasis was to involve third-party payers and healthcare systems to influence duration of breastfeeding and persisting disparity in numbers among minorities. The Third Summit, in 2011, reviewed issues and efforts being addressed by the Surgeon General's new Call to Action, the White House Council on Women and Girls Report, the Office of Women's Health, the Centers for Disease Control and Prevention, and the Special Supplemental Nutrition Program for Women, Infants, and Children with input from across the United States. The Fourth Summit, in 2012, focused on issues and activities in the private and public sectors. The participants included leadership of organizations that support mothers of color and minority groups, insurance companies, and the National Prevention Council in an effort to assess and maintain progress in support of breastfeeding and maintain movement to positive action. ²

In this issue of the journal, as in most issues, one can find articles about breastfeeding that document progress in promoting and supporting breastfeeding and finding solutions to the barriers that remain. Psychosocial, emotional, and cognitive issues are raised in articles by Zhu et al. ³ in their examination of the effect of perinatal biopsychosocial stress on breastfeeding duration and the analysis by Díaz Meneses ⁴ of breastfeeding as an “emotional instinct.”

Several articles address the antioxidant capacity and properties of breastmilk, by examining various substances consumed by the breastfeeding mother. Codoñer-Franch et al. ⁵ looked at maternal diet supplementation with non-alcoholic beer, Kayiran et al. ⁶ investigated the effect of black tea consumption during pregnancy on the antioxidant status of breastmilk, and Nikniaz et al. ⁷ assessed the antioxidant capacity of breastmilk with symbiotic supplementation of the mother's diet. Each article contributes to our understanding of the antioxidant nature of breastmilk.

One “Baby-Friendly” initiative was examined by DelliFraine et al., ⁸ concerning the costs, benefits, and challenges of implementation, Macaluso et al. ⁹ reviewed data from Baby-Friendly communities in Italy, and Tsai et al. ¹⁰ measured the effect of a Baby-Friendly workplace on mother's intent to continue breastfeeding after returning to work. Lee et al. ¹¹ considered perspectives on promoting breastmilk feedings for premature infants during a quality improvement project.

This journal issue reflects part of the continued search for progress and effective solutions to barriers to breastfeeding, which the Fifth Summit on Breastfeeding will examine. The challenge for all of us and the Fifth Summit is to select and implement effective solutions that maintain the support for breastfeeding mothers within our communities through sustained actions by organizations, our government and healthcare systems, and the general populace.