FOLLOWUP REPORT: THE SURGEON GENERAL'S WORKSHOP ON BREASTFEEDING & HUMAN LACTATION Presented by the US. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Heatth Service Health Resources and Services Administration Bureau of Health Care Delivery and Assistance Division of Maternal and Child Health DHHS Publication No. HRS-D-MC 85-2 “This report was prepared with the. assistance of the National Center for Educa- tion in Maternal and Child Health, 38th & R Streets, N.W., Washington; D.C. 20057. The National Center is a resource center that responds to. public . and professional inquiries in maternal and child health, including. human . genetics. Established in 1982, the National Center for Education in Maternal and Child Health provides services‘ under a grant from the Division of Mater- nal and Child Health, Department of Health and Human Services. U.S. NATIONAL - LIBRARY OF MEDICINE The original drawing on the cover was done: by Bob Conge of Rochester, N.Y. PREFACE Since the Surgeon General’s Workshop on Breastfeeding and Human Lactation last year, there has been a notable renewal of interest and a resurgence of activity in promotion of breastfeeding. This may be attributed to the philosophy of “shared responsibility” which guided the planning com- mittee in organizing the workshop. The workshop participants, represent- ing many professional and voluntary organizations, were actively involved in the workshop process of assessing the current status of breastfeeding pro- motion in the United States and of developing recommendations and strategies to facilitate progress toward achieving the 1990 breastfeeding ob- jective for the nation. The workshop recommendations have become a na- tional agenda, with participant organizations providing leadership in disseminating the recommendations and encouraging their implementation. The Report of the Surgeon General’s Workshop on Breastfeeding and Human Lactation, published in September 1984; has become a valuable reference on the science and art of breastfeeding and a useful planning guide for breastfeeding promotion efforts. The original printing of 35,000 copies was quickly distributed by participant organizations, and a second printing has been done. . This Followup Report has been prepared to document efforts emanating from the workshop and to continue to disseminate information related to breastfeeding promotion activies and accomplishments. At the workshop four successful models to promote breastfeeding were presented. In the past year many additional approaches have come to our attention. The purpose of this Followup Report: Surgeon General's Workshop on Breastfeeding and Human Lactation is to recognize other useful ap- proaches, describe these approaches, and identify where they are being im- plemented. It is hoped that policymakers, administrators, educators, health care providers, professional and voluntary organizations, Federal agencies, employers, and others who read this Followup Report will gain new ideas that will inspire them to further action. Information included in this report was submitted in response to requests made to the participants in the workshop; State Directors of Maternal and Child Health; members of the Healthy Mothers, Healthy Babies Coalition; and Department of Health and Human Services Regional Health Administrators. The responses were im- pressive and included descriptions of a variety of efforts such as legislation, policies, resolutions, guidelines, meetings, publications, media campaigns, service delivery models, support systems, and research, all of which are in- cluded in this report. ii We are interested in your response to our ongoing efforts to disseminate information and stimulate action to reduce barriers to breastfeeding. Will you please take a few minutes to complete the question- naire on the back cover of this publication? We recognize and appreciate the new, renewed, and continuing work that is being done in support of improved. health and nutrition for our na- tion’s mothers and babies. Progress has been made, but many challenges re- main in our efforts to promote informed decisions by more women to breastfeed their babies. UpucDige C. Everett Koop, M.D., Sc.D. Surgeon General iii CONTENTS INTRODUCTION 2.2... 0... cc cece teen e nee e eee eenee 1 ACTIVITIES RELATED TO RECOMMENDATIONS OF THE SURGEON GENERAL’S WORKSHOP ON BREASTFEEDING AND HUMAN LACTATION ........... 0.0: ccc cee eee ene ees 3 PROFESSIONAL EDUCATION Task Forces/Work Groups/Committees .......... 0.000000 ee eee 3 Policies/Standards/Protocols/Curricula ................000005 4 Continuing Education ............ 0... cece cece ener ene eeee 5 Professional Consultation/Technical Assistance ................ 6 Manuals/Guides/Educational Materials .............. 0.000000 7 PUBLIC EDUCATION Media ......... 0. 0c ccc ccc cece cece eect ne neceueenneaecs 8 Hard-To-Reach Groups ..........0 00.0. ccc cece cece ence ceuaees 10 Promotion/Public Education Campaigns ...................... 11 Education Systems ..........0.. 0.0 ccc ccc ccc e eee c eee eeeaeees 12 Coordination/Sharing of Educational Materials ................ 12 Data Collection ...... 00.0 c eee ene c nee neeueas 12 HEALTH CARE SYSTEM Policies/Standards/Protocols .................. 0... c cen eeeee 14 Laws/Regulations ......... 0... cece cece ete cect eee evenes 15 Model/Demonstration Programs ...............0cccceceeceees 16 Staff/Client Education ...........0 00. cc cece cece cece cence 17 Task Forces/Guides/Materials ........... 0.0.00 ccc cece eee cece 18 SUPPORT SERVICES Telephone Calling Systems ............... 00.00 cece eee een 19 Peer Support Groups .......... 0.0. c cece eee cece nee e ee eeeee 20 Breastfeeding Counselors ............ 0.0 cece cence cee eeeaues 20 Nurse Followup/Referral .......0.0... 0.0: cc eee c eee e nsec eens 21 Clinmics/Classes 2.0.0... ccc ccc cc eee cece teen eee aeens 21 Institutional Practices ....... 0.0... cece ec c eee eeeee 22 Human Milk Banks ........... 2.0... cece cee cece ee een ees 23 iv WORLD OF WORK Data Base .....-. sce reece tert e eens rere rere sree ese Information/Education ........-.++ssreseerrerrtre erst Institutional Policies ......----+-+++50+e: Sec e eee cen e ences Breast Pump Loan Programs ......-----srercrsrrrr rrr Model/Demonstration Programs .....---++++sserrrrtr erst RESEARCH Trend Data ......-..cce cece eee e entree renee e eee Determinants/Behaviors/ Practices/Attitudes ......--.--++eeee: Physiology/Nutrition/Other ASPeCtS 0.2.2 cece eee eee ete Interventions/Strategies .....--... sence cece eerrr esters NATIONAL AWARENESS ......----e2srrrrrcrctsr CONTRIBUTORS ........-22c seer eer e etter treet APPENDIX A— Task Force on Professional Training in Lactation .. APPENDIX B-— Research on Human Lactation and Breastfeeding Supported by the National Institutes of Health, Department of Health and Human Services .....-- APPENDIX C—Research on Human Lactation and Breastfeeding Supported by the U.S. Department of Agriculture . . QUESTIONNAIRE .....---0-esecese restr