It seems that the “secret formula” for the perfect public health initiative or campaign is sometimes all too mysterious in our field of work. Even the most theory-based, well-funded, and culturally popular topics can fall flat sometimes because of competing initiatives, consumer attention, political sensitivities, and more. However, at other times initiatives seem almost to grow feet on their own and progress with little nudging—regardless of how well built they may be. So this week we’re taking a look at the topic of breastfeeding to showcase just one successful recipe—built on a structure of specific observance days, network-based calls to actions, and future-focused policy strategies—for bringing light to public health issues in a meaningful way.
The Cause for Action
Breastfeeding is a topic with a rich cultural history across time, throughout the world, and across disciplines. It inspires passion and controversy. But for women making the decision about whether or not to breastfeed, any debate or precedence is replaced by one central question: What is best for my baby and me?
Years of public health research has concluded that for most mothers and babies, breast milk is the best option. It is important to point out here that the decision to breastfeed is very personal and depends on the mother, her baby, her family, and her circumstances.
Most mothers in the United States start out breastfeeding their babies. According to the Breastfeeding Report Card 2013, published by CDC’s Division of Nutrition, Physical Activity, and Obesity, 77 percent of U.S. infants begin their lives breastfeeding. Of these infants, only 49 percent were still breastfeeding at 6 months.
Why do women quit breastfeeding? And what can help encourage these women to continue breastfeeding for at least the first 6 months of their babies’ lives? For many, a peer counselor and/or family support can make all the difference.
Building Awareness with Observance Days and Networks
In an effort to build awareness around breastfeeding, the World Alliance for Breastfeeding Action established World Breastfeeding Week, which began in 1992 as an official observance day and has evolved into a full week of commemoration and celebration. This year’s World Breastfeeding Week, scheduled August 1–7, tapped into the valuable tactic of social and environmental support, and focused on the importance of peer counseling for women who want to breastfeed their babies. Women who have support are more likely to breastfeed their babies longer. This year’s theme, “Breastfeeding Support: Close to Mothers” celebrates peer counseling and support.
Most health organizations, including the American Academy of Pediatrics and the American Public Health Association, recommend that babies breastfeed exclusively for the first 6 months of life and continue to breastfeed (while parents introduce cereal and other solid foods to their diets) for at least 12 months. Many women start out breastfeeding, but do not continue for a full 6 months because they lack support, have difficulty breastfeeding once they return to work, experience pain, feel they are producing too little milk, and so forth.
World Breastfeeding Week’s call-to-action is network-based and focuses not only on mothers, but also their entire support system for greatest impact. Lactation consultants and peer counselors truly serve as health educators for breastfeeding women. They help women who want to breastfeed by providing practical and scientific information and giving them the moral support they need to follow through on their decision to breastfeed. Family members, partners, friends, clinicians, childcare providers, and employers also can help women who are breastfeeding.
Leveraging Other Influencers
Designing a successful public health initiative often can be affected by the amount of support given by trusted organizations, and bolstered by policies and programs that make it more future-ready. The World Breastfeeding Week, for example, is supported by many organizations, including UNICEF, the World Health Organization (WHO), and the Food and Agriculture Organization.
Breastfeeding, as a general topic, also is a focus of policy and program initiatives, including the Healthy People objectives. By 2020, Healthy People aims to increase the proportion of infants ever breastfed from 74 percent to 81.9 percent, and the proportion of infants breastfed through 6 months from 43.5 percent to 60.6 percent with collaboration, empowered consumers, and community and partner resources.
Similarly, in her 2011 Call to Action to Support Breastfeeding, Surgeon General Regina M. Benjamin suggested the following ways to improve breastfeeding rates and increase support for breastfeeding:
- Communities should expand and improve programs that provide mother-to-mother support and peer counseling.
- Healthcare systems should ensure that maternity care practices provide education and counseling on breastfeeding. Hospitals should become more “baby-friendly,” by taking steps like those recommended by the UNICEF/WHO’s Baby-Friendly Hospital Initiative.
- Clinicians should ensure that they are trained to properly care for breastfeeding mothers and babies. They should promote breastfeeding to their pregnant patients and make sure that mothers receive the best advice on how to breastfeed.
- Employers should work toward establishing paid maternity leave and high-quality lactation support programs. Employers should expand the use of programs that allow nursing mothers to have their babies close by so they can feed them during the day. They also should provide women with break time and private space to express breast milk.
- Families should give mothers the support and encouragement they need to breastfeed.
As the 2013 World Breastfeeding Week comes to a close, we all can pitch in as consumers and help women who want to breastfeed their babies—all while respecting their decisions—during the next year. Additionally, as health communications and public health professionals, we can take a note from the work being done in this field and strive to create cross-sector, culturally sensitive, and structured interventions that will have the greatest impact to shape healthy futures.
To learn more about World Breastfeeding Week and the organization that sponsors the week, the World Alliance for Breastfeeding, visit http://worldbreastfeedingweek.org/. You can find a list of events planned for World Breastfeeding Week at http://worldbreastfeedingweek.org/pledges.shtml.