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Breastfeeding promotion programs

Health Factors: Diet & Exercise
Decision Makers: Employers & Businesses Local Government State Government Federal Government Healthcare Professionals & Advocates Nonprofit Leaders Public Health Professionals & Advocates
Evidence Rating: Scientifically Supported
Population Reach: 1-9% of WI's population
Impact on Disparities: Likely to decrease disparities

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Description

Breastfeeding promotion programs aim to increase breastfeeding initiation, exclusive breastfeeding, and duration of breastfeeding.

Expected Beneficial Outcomes

Increased breastfeeding rates
Improved health outcomes

Evidence of Effectiveness

There is strong evidence that breastfeeding promotion programs increase initiation, duration and exclusivity of breastfeeding (Cochrane-Renfrew 2012, Cochrane-Lewin 2010, Dyson 2010, USPSTF-Chung 2008, Cochrane-Dyson 2005, CDC-Breastfeeding 2013). Breastfeeding has also been shown to provide health benefits to mother and child, including reduced rates of breast and ovarian cancer for women; fewer ear infections, lower respiratory tract infections, and gastrointestinal infections for children; and lower likelihood of childhood obesity, type 2 diabetes, and asthma (USPSTF-Breastfeeding 2008).    

Education interventions increase breastfeeding initiation rates (Dyson 2010), particularly in low income women (Cochrane-Dyson 2005). Face to face support (Cochrane-Renfrew 2012) and tailored education (Cochrane-Renfrew 2012, Cochrane-Dyson 2005) increase the effectiveness of support efforts. Combining pre- and post-natal interventions increases initiation and duration more than pre- or post-natal efforts alone (USPSTF-Chung 2008, USPSTF-Breastfeeding 2008).

Support from health professionals (Cochrane-Renfrew 2012, CDC-Breastfeeding 2013, USPSTF-Breastfeeding 2008), lay health workers (Cochrane-Renfrew 2012Cochrane-Lewin 2010, USPSTF-Chung 2008, CDC-Breastfeeding 2013), and peers (Chapman 2010, Dyson 2010, CDC-Breastfeeding 2013, USPSTF-Breastfeeding 2008) have demonstrated positive effects, including increasing initiation, duration, and exclusivity.

Implementing components of the Baby Friendly Hospitals Initiative, as a whole or individually, has been shown to increase breastfeeding rates (Dyson 2010, CDC-Breastfeeding 2013). This includes practices in maternal care such as rooming in, staff training to support breastfeeding, and maternal education (CDC-Breastfeeding 2013).

For employed mothers, supportive work environments increase the duration of breastfeeding (CDC-Breastfeeding 2013).

Implementation

United States

The Affordable Care Act (ACA) includes provisions to encourage breastfeeding, such as requiring insurance coverage of supplies and support, and requiring employers to provide unpaid time and private space for nursing mothers to pump breast milk at work (AMCHP-Breastfeeding 2012). Forty-six states and Washington DC have laws that allow women to breastfeed in any public or private location (NCSL-Breastfeeding), and 25 states and Washington DC have workplace breastfeeding legislation (NPHL-Breastfeeding).  

As of 2014, approximately 8% of live births occur at Baby-Friendly facilities (CDC-Breastfeeding RC 2014). CDC’s 2013 Prevention Status Reports assess breastfeeding support at birth facilities; 5 states score over 80% on this measure, 19 score between 70-79.9%, and 27 score under 70% (CDC-NPAO PSR 2013).

Wisconsin

Under Wisconsin law, 2009 Assembly Bill 57, women are allowed to breastfeed in any public or private location where the mother and child are otherwise authorized to be (NCSL-Breastfeeding).

Implementation Resources

CDC-Breastfeeding 2013 - Centers for Disease Control and Prevention (CDC). The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: US Department of Health & Human Services (US DHHS); 2013. Accessed on March 1, 2017
CDC-DNPAO data - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Nutrition, physical activity and obesity: Data, trends and maps online tool. Accessed on June 16, 2017

Citations - Evidence

CDC-Breastfeeding 2013 - Centers for Disease Control and Prevention (CDC). The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: US Department of Health & Human Services (US DHHS); 2013. Accessed on March 1, 2017
Chapman 2010 - Chapman DJ, Morel K, Anderson AK, Damio G, Perez-Escamilla R. Breastfeeding peer counseling: From efficacy through scale-up. Journal of Human Lactation. 2010;26(3):314-26. Accessed on December 10, 2015
Cochrane-Dyson 2005 - Dyson L, McCormick FM, Renfrew MJ. Interventions for promoting the initiation of breastfeeding. Cochrane Database of Systematic Reviews. 2005;(2):CD001688. Accessed on December 14, 2015
Cochrane-Lewin 2010* - Lewin S, Munabi-Babigumira S, Glenton C, et al. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases. Cochrane Database of Systematic Reviews. 2010;(3):CD004015. Accessed on November 30, 2015
Cochrane-Renfrew 2012 - Renfrew MJ, McCormick FM, Wade A, Quinn B, Dowswell T. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews. 2012;(5):CD001141. Accessed on December 10, 2015
Dyson 2010 - Dyson L, Renfrew MJ, McFadden A, et al. Policy and public health recommendations to promote the initiation and duration of breast-feeding in developed country settings. Public Health Nutrition. 2010;13(1):137-44. Accessed on December 22, 2015
USPSTF-Breastfeeding 2008 - US Preventive Services Task Force (USPSTF). Primary care interventions to promote breastfeeding: US Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2008;149(8):560-4. Accessed on February 10, 2017
USPSTF-Chung 2008* - Chung M, Raman G, Trikalinos T, Lau J, Ip S. Interventions in primary care to promote breastfeeding: An evidence review for the US Preventive Services Task Force. Annals of Internal Medicine. 2008;149(8):565-82. Accessed on February 10, 2017

Citations - Implementation

AMCHP-Breastfeeding 2012 - Association of Maternal & Child Health Programs (AMCHP). Health reform: What is in it to promote breastfeeding? Washington, DC: Association of Maternal & Child Health Programs (AMCHP); 2012. Accessed on November 24, 2015
CDC-Breastfeeding RC 2014 - Centers for Disease Control and Prevention (CDC). Breastfeeding Report Card. Atlanta: US Department of Health & Human Services (US DHHS); 2014. Accessed on March 1, 2017
CDC-NPAO PSR 2013 - Centers for Disease Control and Prevention (CDC). Nutrition, physical activity, and obesity: Prevention status reports (PSR). 2013. Accessed on February 16, 2016
NCSL-Breastfeeding - National Conference of State Legislatures (NCSL). Breastfeeding laws. Accessed on March 2, 2016
NPHL-Breastfeeding - The Network for Public Health Law (NPHL). Maternal and child health issue brief: Breastfeeding in the workplace. Accessed on December 8, 2015

Page Last Updated

December 10, 2015

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