By Emily Lindsey, BSPsy, CLE

The meeting went well. We had 3 minutes (yes, I typed right) to get our comment in and we could put in written as well. I had my written leave behind document and my speech typed up to give out. I came from a different stand since there were so many who just got up and spoke on why their issues were important. I did not say who I was or where I was from until the end. I began with in 12 years and what we could have prevented and percentages from studies such as breast cancer, ovarian cancer, SIDS, asthma, etc. It worked, I got their attention and they listened intently.

 Gretchen Andrews and her daughter Jeanne joined us from Inland Empire Breastfeeding Coalition and spoke on breastfeeding and obesity and the environment and formula company impact. Sue Wirth also came from Bay Area Lactation Coalition and spoke generally on the major impact breastfeeding could have. Therese Doan also came from the San Fran Coalition and spoke on post partum assistance and how that could help.

Many others stood and breastfeeding was part of their speech such as birth advocates and CWA also said a quick word before they were cut off at the podium about increasing breastfeeding goals.

It is clear that they want to steer HP2020 away from disease specifics to prevention and equality. Many had comments about that and also timeframes. We should be told by Jan 2009 what objectives will be had. Emphasizing breastfeeding everywhere must be key as currently there are almost 500 objectives and this is being cut to 150(yikes!).

I have attached what I took and my speech did vary slightly as I had to think on my feet and emphasize certain areas, add in a couple words to keep them on track with goals, and include dental health as they outnumbered breastfeeding advocates; so showing we go hand in hand helped.

The website will continue to have updates and we should check it. For now, our voice was heard and well listened to. Jeanne Andrews even received applause after her speech which was impressive as she was the only one who spoke that got that (out of 40 or so speakers).

They did have what they think will be their leading indicators listed in the packet and breastfeeding was not listed. So I emphasized why that was important, specific numbers, etc. Thank you everyone for your input and we can only cross our fingers and make sure other meetings are attended in the numbers that we showed in.

Emily Lindsey, BSPsy, CLE
Chair Person
Merced County Breastfeeding Coalition
California Breastfeeding Coalition Worksite and Awareness Coordinator

Emily’s Public Comment:

Ladies and Gentleman Good Morning/Afternoon.

In 12 years the United States could be a much better place with small changes that would affect our physical, mental, and global health. Would we not be a better society if we could look at our nation and say that we suffer from:

28% less breast cancer

21% less ovarian cancer

12% less Type 2 maternal diabetes and 39% less childhood type 2 diabetes

Over 87,000 tons of waste spared from our landfills

15% less acute myelogenous leukemia

19% less acute lymphocytic leukemia

27-40% less asthma under age 10

24% less obesity

72% less hospitalizations from lower respiratory tract infections

64% less non specific gastroenteritis

42% less atopic dermatitis

50% less ear infections

4-82% reduction of relative risk of necrotizing entercolitis

And

36% less infant deaths from Sudden Infant Death Syndrome

Ladies and Gentleman, this can be our future. Breastfeeding is now known and seen as the optimal feeding method for human children. While infant formula does save lives in times of need, it is not free of risk. Our society sees breastfeeding as the superior choice yet does not stay with this decision. The California Breastfeeding Coalition urges the Healthy People 2020 committee to agree with other organizations such as the American Public Health Association and the World Health Organization and make breastfeeding a public goal by including it as a leading health indicator with goals that will both allow and pave the path for exclusively breastfed children for time frames that are recommended and proven to make a difference in our worlds health. Breastfeeding is the normal way of feeding therefore any deviation in any amount increases risks to our children, mothers, families, and nation.

Therefore we recommend:

• Make Breastfeeding a Leading Health Indicator and
• Increase breastfeeding initiation to 85%
• Increase exclusively breastfeeding at 3 months to 75%
• Increase exclusively breastfeeding at 6 months to 50%
• Increase any breastfeeding at one year to 75%
• Increase Baby Friendly Hospitals to 50%
• Recommend federal legislation that protects mothers breastfeeding in public and within the workplace; with breastfeeding care and supplies being paid for by health insurance companies and making available worksite lactation programs
• Increasing to 100% hospitals who have donor human milk available for medical supplementation at birth and immediately following

These goals ladies and gentleman will create change. People will rise to expectations and these must be set to transform our nation into a much better place in 12 years time.

Emily’s Written Comment

California Breastfeeding Coalition

Working Together for a Healthier California

April 1, 2008

Re: Healthy People 2020 Regional Meeting San Francisco

The California Breastfeeding Coalition and supporting organizations would like to highlight the following for Healthy People 2020.

• Breastfeeding helps with approximately 10% of the leading health indicators of Healthy People 2010; obesity, mental health, injury and violence, environmental quality, immunizations, among other individual parts within each area 1, 2, 3.

          *       For each month a child is breastfed their obesity risk is reduced by            4%. 

*       Not breastfeeding or a short duration increases your risk for postpartum depression

*       Kangaroo care (skin to skin) has been shown to increase     breastfeeding rates as well as a mother’s perception of her newborn making her feel less depressed, and also made mothers more sensitive, warm, and resourceful during a child’s first 6 months.

*       Breastfeeding is environmentally friendly as it uses no energy on our environment to produce such a widely recognized beneficial nutrition. Every year approximately 87,230 tons of tin and paper are put into our landfills from formula containers. Also women who breastfeed space children naturally and do not menstruate therefore saving 3,000 tons of paper each year that would have been used for sanitary products.

*       Breastfeeding is regarded as an infant’s first immunization as it has been shown to reduce ear infections, atopic dermatitis, gastrointestinal infections, lower respiratory tract diseases, asthma, diabetes, childhood leukemia, SIDS, and Necrotizing Enterocolitis.

*       Mothers also have been shown to have a decreased risk of Type 2 Diabetes, osteoporosis, breast cancer, and ovarian cancer; as well as the benefit to their bodies in naturally spacing children.

Breastfeeding has been recognized as leading health measure by the American Public Health Association (APHA). The APHA recognizes breastmilk as the sole source of infant nutrition for 6 months exclusively with added solids for 1-2 years. They recommend further funding for breastfeeding so that mothers may succeed to breastfeed their children and also with protection while breastfeeding in public, paid maternity leave, and worksite lactation programs 4.

CDC and many other organizations recognize that maternity care practices impact breastfeeding rates. Such items are written breastfeeding policies, staff education, early initiation through skin to skin, restricting supplements and pacifiers, and post discharge follow up 5. Recent studies have proven that implementing even five of the ten best practices can increase duration 6. Mothers in the United States have been increasing the amounts of initiation yet duration still lacks as well as exclusivity 1.

Baby Friendly or Model Hospital Policies already exist and have been shown to increase breastfeeding regardless of population being served 5.

Current education must start during prenatal time and while in the hospital. Hospitals serve as a resource for communities and should therefore market health and nothing else such as certain brands of formula through gifts to mothers and families that promote such items and reduce exclusive breastfeeding by as little time as 10 weeks post partum. 8

Cost benefits of breastfeeding have been shown to be millions yet the US still lacks behind other countries 9 and spends millions of dollars in purchasing formula each year through government organizations.

The California Breastfeeding Coalition recognizes that the Healthy People 2020 goals are neither law nor regulation. However they are a guiding force with research and policy and therefore have a great influence over future health events. Current recommendations need to be updated to include increased exclusivity of breastfeeding and duration as well as model hospital policies such as achieving Baby Friendly Status; well recognized as an intervention tool that increases breastfeeding rates in a very short duration of time. Funding will also then be geared towards resources that will enable organizations such as hospitals and health care centers as well as personal physicians and governmental agencies to meet the new Healthy People Goals. In order to meet even the current Healthy People 2010 goals we advise the following action be taken.

• Increase breastfeeding initiation to 85%
• Increase exclusively breastfed 3 month goal to 75%
• Increase exclusively breastfed 6 month goal to 50%
• Increase any breastfeeding for one year to 75% (this is breastmilk with solids and other fluids such as water or infant formula)
• Increase Baby Friendly Hospitals to at least 50% of our USA hospitals
• Recommend federal legislation to protect mothers breastfeeding in public and at the worksite

          *       Breastfeeding care and supplies such as pumps should be paid for           by health insurance companies or employers

          *       All worksite programs should have lactation assistance available

• Increase to 100% hospitals that have donor human milk from a milk bank available for medical supplementation reasons at birth and shortly thereafter
• Provider education must be a priority

Bibliography

• Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Evidence Report/Technology Assessment No. 153 (Prepared by Tufts-New England Medical Center Evidence-based Practice Center, under Contract No. 290-02-0022). AHQR Publication No. 07-E007. Rockville, MD: Agency for Healthcare Research and Quality. April 2007.
• Feldman, R, Eidelman, A, Sirota, L, Weller, A (2002). Comparison of Skin to Skin (Kangaroo) and Traditional Care: Parenting Outcomes and Preterm Infant Development. Pediatrics, 110, 16-26.
• Radford, Andrew The Ecological Impact of Bottle Feeding. Reducepackaging.com, Retrieved March 27, 2008 from http://www.reducepackaging.com/article.html
• American Public Health Association (2007). APHA Adopts New Policies on Food Safety, Global Climate Change, Multidrug-Resistant Organisms, Breastfeeding and Feminine Hygiene [Press Release]. Washington D.C.
• Centers for Disease Control and Prevention (2007). The CDC Guide to Breastfeeding Interventions. Atlanta, GA.
• Murray, EK, Ricketts, S, Dellaport, J. (2007). Hospital practices that increase breastfeeding duration: results from a population-based study. Birth, 34, 202-211.
• Centers for Disease Control (2007). Breastfeeding Practices: Results from the National Immunization Survey. Atlanta, GA.
• Rosenberg, K, Eastham, C, Kasehagen, L, Sandoval, A (2008). Infant formula marketing through hospitals: the impact of commercial hospital discharge packs on breastfeeding. American Journal of Public Health, 10/2105.
• Ball, T, Wright, A. (1999). Health care costs of formula-feeding in the first year of life. Pediatrics, 103, 870-876.