Abstract
Introduction
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Founded in 2010 in conjunction with—but independent from—Let's Move!, PHA is a nonpartisan nonprofit that is led by some of the nation's most respected health and childhood obesity advocates. Supporting our effort is our Honorary Chair First Lady Michelle Obama, alongside our Honorary Vice-Chairmen The Honorable William H. Frist, MD, and U.S. Senator Cory A. Booker (D-NJ). Our Board of Directors also includes nationally recognized business leaders, advocates, health professionals, and thought leaders from a variety of backgrounds.
PHA works with the private sector to help solve the obesity crisis in three ways: (1) corporate commitments to make the healthy choice the easy choice, (2) signature marketing campaigns to promote healthy options, and (3) convening public and private stakeholders.
Breastfeeding Connection to PHA Work
Breastfeeding is a critical public health issue related to improving the health of children and their mothers and reducing health disparities. I do not need to speak to the myriad of breastfeeding benefits, as everyone in this room knows them well. Of interest to PHA, however, is the connection of breastfeeding to obesity prevention as part of a multipronged strategy to battle the obesity epidemic, especially in children.1,2 The Centers for Disease Control and Prevention say breastfeeding for 9 months reduces an infant's risk of being overweight by more than 30%. 3
Important nationally is action to protect, promote, and support breastfeeding. 4 Public policy plays a key role, and we have seen related initiatives from several Surgeons General's Calls to Action to the inclusion of relevant provisions in the Affordable Care Act legislation.
PHA's role focuses less on public policy and more on working with companies and organizations to change their own services, goods, and internal policies to promote healthier options. In other words, what role can the private sector play by committing to organizational policies that help make the healthy choice—breastfeeding—the easy choice? At PHA we believe the private sector can and does have an important role in solving the obesity crisis, and our work is devoted to this.
One of PHA's earliest commitments was made by Kaiser Permanente, the largest prepaid, integrated nonprofit health system in the United States, which promised to increase access to breastfeeding at its facilities. At the Sixth Annual Summit on Breastfeeding last year, Ray Baxter spoke of the just-completed 3-year commitment to PHA in which:
• All Kaiser Permanente hospitals that offer maternal services have been designated as “Baby Friendly” or publicly share performance using the Joint Commission's Breastfeeding measure. • Kaiser Permanente established a system-wide performance improvement program focusing on evidence-based hospital breastfeeding practices. • Kaiser Permanente developed and made publicly available a hospital breastfeeding practices guide that others may use. • Kaiser Permanente includes rates of exclusive breastfeeding at discharge as a core quality measure on the Kaiser Permanente Quality Dashboard.
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Additionally, in one of our signature initiatives, PHA's work has included provisions in childcare commitments that require accommodations for breastfeeding such as storage capabilities for breastmilk and accommodations for nursing mothers, or in PHA's initiative focusing on improving the health environment of college campuses, a guideline providing for breastfeeding accommodations for mothers is included.
Future Role PHA Can Play
PHA is interested in continuing this work. Some potential areas include:
Healthcare systems
Similar to the important work of Kaiser Permanente, healthcare systems might:
• Increase “Baby-Friendly” and similar designation • Work with obstetricians and pediatricians who serve mothers before and after the birth to increase education and support for mothers • Institute best practices to increase breastfeeding developed through various Centers for Disease Control and Prevention grants • Implement breastfeeding accommodation and other employer supportive policies for nurses, physicians, residents, etc., who work in the system • Add lactation support to various health system programs such as home visit programs, call line programs, and community clinics.
Employers
“Work gets in the way,” as stated by then-acting Surgeon General Rear Admiral Boris Lushniak.
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Employers could commit to policies that would help employed mothers with some of the greatest barriers to breastfeeding:
• Lactation accommodation (space, paid break time, flexibility, milk storage) • Paid maternity leave • Babies at work • On-site child care.
Community space owners
Moms and their babies would benefit greatly from shared resource/community space—places to breastfeed, meet with lactation specialists, and meet other moms. Possible private sectors that could commit to help include:
• Large chains that are adding health clinics to their services adding lactation specialists, lactation clinics, and other baby services • Malls—shared resource room for shoppers and employees of retail stores • Stadiums/airports • Coffee shops/restaurants.
Industries in the breastfeeding arena
Lactation equipment and supply manufacturers, as well as the health insurance industry, are examples of industries in the private sector that could be important players in support of national efforts such as:
• Education (translational information) for employers and workers, especially minority workers and training for professionals, is needed to promote and support moms and babies. • A major marketing campaign that helps change the cultural norms for breastfeeding.
Closing
PHA can work to help increase breastfeeding to improve the lives of babies, their moms, their families, and their communities. We remain interested in continuing this dialogue.
Footnotes
Disclosure Statement
No competing financial interests exist.