Advocacy

Lactation consultants make a difference every day in diverse settings and with a variety of people. You may think that you are too small to make a difference in the scheme of things. However, advocating a point of view is engaged in by almost all special interest groups in the United States. As individuals and/or groups, we have the right to lobby policy makers which insures that our interests and concerns are heard, as well as competing interests and views, so that legislators and policy makers have a broad base of information on which to base their decisions. Lobbying attempts to persuade an individual, agency, institution, or organization to support an idea, an issue, a certain course of action, etc. You lobby whenever you work to encourage someone to agree to your way of thinking or to embark on a new project or program. We call ourselves “advocates” because we speak for those whose voices are often silent – breastfeeding mothers and babies.

USLCA works to fulfill its vision and mission to see that IBCLCs are valued members of the health care team and that as an association it advocates for its members. However because USLCA is YOU, we are all needed to engage in advocacy activities. The power of “one” is strong and when one determined individual networks with others championing similar agendas, change happens. This website will serve as a central meeting place to share methods and ideas for advocating and lobbying for our common special interests of lactation support and services and breastfeeding reform.

Moms Rising has provided us with an opportunity to contact our Federal legislators regarding an important infant feeding issue. Breastfeeding suffers from a number of barriers, including the often unsubstantiated claims that formula manufacturers engage in to persuade vulnerable mothers to use their products. The Food and Drug Administration (FDA) regulates safety but not efficacy of formula additives (do the additives have any beneficial effect on the infant). In other words, formula manufacturers can put additives in their formula and make what the FDA calls a structure/function claim alluding to improved immune systems and better vision which the FDA does not regulate compared with a health claim (prevents or cures a disease) which the FDA does regulate. The problem is, mothers cannot tell the difference between the two and interpret any claim as a health claim. Read the Moms Rising advocacy opportunity and tell your legislators to protect all infants from hype that is bad for babies' health.

It simply isn't right to take advantage of new parents when they're vulnerable.

But baby formula companies are doing just that. And this is especially wrong because empty infant formula advertising claims undermine evidence-based messages like "breastfeeding is best for babies." This has got to be fixed, and we have a chance right now to change the way these infant formula companies and other food manufacturers do business so that parents get the facts, and not just empty hype on labels.

Tell your Senator that the Child Nutrition Act should include independent scientific reviews of formula and other foods so parents can make the best choices for their infants.

http://action.momsrising.org/go/WIC/282?akid=2222.64027.ybLx_3&t=4

"All parents want what's best for their babies, and we want them to feel empowered to make an informed feeding decision at one of the most vulnerable and precious times of their lives-the birth of a new baby," explains Megan Renner, Executive Director of the United States Breastfeeding Committee (USBC). "The marketing of infant formula has been shown to undermine breastfeeding intention and success. Independent review of 'functional ingredients' will go a long way towards providing parents with the information they have a right to receive."

What's happening right now?

Congress is debating the renewal of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) through the Child Nutrition Act. As the re-authorization of the Child Nutrition Act moves through the Senate, we're urging Senators to also include a review of the "functional ingredients" in baby formula and other foods WIC offers. Functional ingredients are things like prebiotics, nucleotides, and others ingredients that are marketed as improving a baby's health. Companies add these "functional ingredients" as a way to command higher prices and make catchy health claims. Initial independent studies have shown very mixed results as to whether so-called "functional ingredients" actually do anything for the health of our kids.[1]

Our federal government carries enormous weight in this formula fiasco because half of all U.S. infants participate in the WIC program.[2] WIC's mission is to provide healthy foods, breastfeeding support and nutrition counseling to low-income pregnant women, infants, and young kids. To that end, WIC gives vouchers for specific foods that qualifying families can use in their local grocery stores.

The government has estimated that these "functional ingredients" cost WIC $91 million annually.[3] Meanwhile, front-line WIC providers, who work hard to promote and support breastfeeding, are very concerned that moms are increasingly asking WIC for the formula "that's just like breastmilk."[4] And that's why it's so important for USDA to get expert advice based on an independent, systematic review of the research, which will be published for all consumers to see. An independent review of "functional ingredients" could save the taxpayers and the average new parent a lot of money.

Making baby formula labels crystal clear is critical because new parents need to be able to read baby formula labels and make the best selection for their children. Yet the current system isn't working. Here's how MomsRising member Roberta describes her moment of new-parent-formula-selection-paralysis:

"The few times I had to buy formula for my son, I was paralyzed by the wall of options in the grocery store. Each brand made a different claim about what their formula would do for my son's health, and the more claims there were, the more expensive the can. Even my son's pediatrician couldn't recommend a choice."

It's no wonder Roberta and her pediatrician couldn't figure out which infant formula was best for her son. If companies want to say their formula makes your baby smarter, stronger, and cuter, no one in our government makes sure their claim is true.[5]

Unfortunately, we're up against the formula companies in this fight, and as you can imagine they're pretty powerful. That's why as parents we need to be even louder!

*Don't forget to send a note to your Senator today:

http://action.momsrising.org/go/WIC/282?akid=2222.64027.ybLx_3&t=6

Please let your friends and family know about this campaign too by forwarding this email right now. Together we can stand up for all the sleep-deprived moms and for the health of our children!

Together we're a powerful voice for women and families,

--Sarah, Kristin, Donna, Joan, Mary and the whole MomsRising.org team

A letter signed by 90 organizations was sent to Congress today, thanks to Dr. Melissa Bartick of American Public Health Association.

USLCA is one of many professional or health related organizations and associations that have signed on to a letter that will be sent to the Senate and House Congressional Appropriations Committees as well as the Secretary and Assistant Secretary of Health regarding the formation of a federal interagency workgroup on breastfeeding. The letter in part calls upon Congress ". . . to dedicate new sustainable line item funding to breastfeeding in order to raise our nation’s rates to approach the levels recommended by major national and international health organizations. Funding is required for strong central federal government leadership to strategically coordinate, develop and implement plans to accomplish the following:

We urge that this $15 million be directed to the office of the Secretary of Health and Human Services. The Inter agency Work Group on Breastfeeding, would then serve as the coordinating body that makes recommendations to the Secretary and departmental and agency leaders as to how to allocate these funds for research, education, and services in order to accomplish breastfeeding goals. At least one third of the funds should be used to improve maternity care practices such as through building hospital collaborative's and training programs."
USLCA is hopeful that better coordination of breastfeeding funding and strategy at the Federal level will help remove some of the barriers to breastfeeding encountered by so many mothers in this county.

The National WIC Association's Kiran Saluja, Deputy Director of Public Health Foundation Enterprises WIC, testified about WIC and breastfeeding issues before the House Committee on Education and Labor, chaired by WIC Champion George Miller (D-Concord) on Tuesday, March 2, 2010. The Committee listened to testimony on federal child nutrition programs - WIC, child care food, and school meals - that are up for reauthorization.

Among other points, she noted that an important place to start to help WIC succeed in its breastfeeding support and promotion efforts would be to fix the “breastfeeding - broken hospitals.”

"While I recognize this may be beyond the purview of this Committee, I am compelled to ask you to work collaboratively with your colleagues on the Energy and Commerce Committee and Ways and Means Committee to pass legislation that requires that all hospitals that receive Medicaid funds adhere, at a minimum, to a set of model policies that do not sabotage breastfeeding, and at best initiate steps to become a Baby Friendly Hospital.... another important way to help WIC promote and support breastfeeding would be for the Committee in collaboration with your partners in Congress to make a determined effort to eliminate or sharply curb the blatant direct marketing of infant formula, which violates the WHO code and targets vulnerable low income women of color."

Breastfeeding advocates are encouraged to write a letter to members of the Committee in support of the points in bold contained in Kiran’s testimony. Keeping breastfeeding prominent in the eyes of Congress will help secure better funding and increase opportunities for advancing breastfeeding as a public health issue.

A sample letter can be viewed here. Feel free to adapt the letter to your situation.

The Breastfeeding Promotion Act (H.R. 2819, S. 1244) includes five provisions:

Amends the Civil Rights Act of 1964 to

H.R. 2819 has been referred to the Committee on Ways and Means, the Committees on Energy and Commerce, and the Education and Labor Committee and has 17 co-sponsors. S 1244 was referred to the Senate Finance Committee and has 5 co-sponsors. You can track the progress of both bills at http://thomas.loc.gov/.

What can you do?

It is very important that both bills acquire many more co-sponsors. A House bill needs at least 200 co-sponsors to draw attention to it. Communicating with your congressional representatives is easy and takes only a little time. You can do this electronically by going to the US Breastfeeding Committee's advocacy site at http://org2.democracyinaction.org/o/5162/t/6359/campaign.jsp?campaign_KEY=1697.
Feel free to modify the sample letter, including personal experiences and the need for such a law. The letter will be automatically sent to your 2 senators and representative.

Passage of this bill into law will have a direct effect on IBCLCs. Your services will be tax deductible, businesses will have more motivation to engage your services in order to obtain tax credits, and it defines your services as "medical care."

During October and November the Department of Health and Human Services (DHHS) will conduct public meetings in Kansas City (Kansas), Philadelphia (Pennsylvania), and Seattle (Washington) on draft objectives for Healthy People 2020. The public will have an opportunity to comment on the draft objectives at the public meetings, and on the public comment Web site. The comments received will then be used to revise the objectives appropriately. We hope that you will consider attending if you live near one of these sites. We will coordinate work on this with the US Breastfeeding Committee. This presents a wonderful opportunity to have our voices heard on national policy-making relative to breastfeeding. The IBCLC is directly affected by these ultimate objectives so it is important that federal agencies hear our input.

If you plan to attend any of the public meetings, please check the dates and fill in USBC's online Attendance Tracker:Click Here

After DHHS releases the draft objectives at the end of the month, USLCA will be preparing and sharing talking points for those attending the public meetings. USBC will hold a conference call prior to each public meeting for breastfeeding advocates planning to attend-we encourage attendees to participate in USBC's pre-meeting calls to coordinate breastfeeding messages among those attending each meeting.

You must also register for the regional meeting with HHS. Please be sure to register for the meeting you will attend by clicking here

Thank you all for your continued work on behalf of IBCLCs and the families we serve.

Please let us know if you attend one of the regional meetings and submit a short summary of your experience to ScottSherwood@uslcaonline.org.

On November 7, I (Marsha Walker) had the privilege of testifying on behalf of USLCA in Philadelphia at one of the 3 regional meetings being held around the country for public input into the development of the Healthy People 2020 objectives. The objectives for the next 10 years represent a means to meet a broad range of health needs which tend to be the ones that receive state, federal, and foundation funding to accomplish. The objectives hope to provide benchmarks to track and monitor progress over time in order to help motivate, guide and focus health care activities. Each person who presented oral testimony had 3 minutes. The 567 draft objectives have been put forth for public comment during Phase II of the development process. The HP2020 website is now open for comments on the draft objectives and it is very important that all USLCA members consider providing input into the direction that breastfeeding will take. The comment period closes December 31, 2009. This represents an upstream effort to improve health care quality and have our voice heard at the highest levels.

The American Academy of Pediatrics (AAP) has recently endorsed the WHO/UNICEF 10 Steps to Successful Breastfeeding, a significant step forward in the promotion and support of breastfeeding. The AAP has integrated the 10 Steps into its breastfeeding residency curriculum and sample hospital breastfeeding policy for newborns. This endorsement moves the 10 Steps into a category of a community standard, providing the impetus for all birthing hospitals to embrace the 10 Steps as their model for lactation care and services. USLCA believes that it is the IBCLC who will be instrumental in assisting to attain these goals

IBCLCs may wish to bring this to the attention of their hospital administrators and perinatal practice committees as a means of implementing best breastfeeding practices. Hospitals who implement the 10 Steps will reap higher scores on the mPINC survey conducted by the Centers for Disease Control and will find that they will be better able to meet the Joint Commission's core measure for exclusive breastmilk feeding upon discharge.

Click here to read the AAP letter announcing their decision to endorse the 10 Steps to Successful Breastfeeding.

In late 2007, The Joint Commission’s Board of Commissioners recommended retiring and replacing the Pregnancy and Related Conditions (PR) measure set with an expanded set of evidenced-based measures. A technical advisory panel (TAP) comprising experts in the perinatal care field was convened in February 2009 to select the replacement set of measures from among those endorsed for national use by the National Quality Forum. This expanded measure set, now referred to as Perinatal Care (PC) comprises the following measures.

The Joint Commission's core measures serve as a national, standardized performance measurement system providing assessments of care delivered in given focus areas. One factor causing varying compliance with core measures may be a lack of awareness of the evidence connecting processes of care to improved outcomes. Even though they are collecting data, many hospitals continue to struggle with how to make that data useful. Core Measures should be used to achieve noticeable performance improvements at your facility. The data gathered should be applied, rather than letting your efforts go to waste once the data are reported. Clinicians should plan a course of action to turn those results into actionable changes and implement those changes to create quality improvements. Hospitals across the country are measured and compared by The Joint Commission against all other accredited institutions on their performance in these Core Measures. This way, consumers can compare their hospital against national data.

The Joint Commission has just posted the Perinatal Core Measure specifications that includes exclusive breastmilk feeding upon discharge. You can see it at http://manual.jointcommission.org/releases/TJC2010A/PerinatalCare.html. You may wish to inform your hospital that this measure set and specifications are available and urge that the hospital choose it as a core measure to be addressed. The Joint Commission requires hospitals to choose a minimum of 4 out of the 11 core measure sets, thus hospitals are not required to choose the perinatal core measure that includes exclusive breastmilk feeding upon discharge. It may be a wise idea to check and see if your hospital will be addressing this measure. If you have an opportunity to influence the choice, now is the time.