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The Context of Lactation and Breastfeeding

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION I © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORThe SALE OR ContextDISTRIBUTION of LactationNOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,and LLC Breastfeeding© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1 Influence of the Biospecificity of Human Milk Chapter 2 ©Influen Jonesce of & the Bartlett Maternal Anatomy Learning, and Physiology LLC on Lactation © Jones & Bartlett Learning, LLC Chapter 3 NOTInfluen FORce of the SALE Infant’s OR Anatomy DISTRIBUTION and Physiology NOT FOR SALE OR DISTRIBUTION Chapter 4 Influence of Peripartum Factors, Birthing Practices, and Early Caretaking Behaviors PreLude: InfLuenCe of The PoliticaL and SociaL LandscaPe on BreastfeedIng © JonesBreastfeeding & Bartlett and the Learning,provision of human LLC milk provide the foundation© of Jonesa person’s &health. Bartlett Increasing Learning, the rate LLC of breastfeeding in the United States has been a public health priority for more than a century. For three decades, NOT theFOR U.S. SALEDepartment OR of DISTRIBUTIONHealth and Human Services (HHS) has promulgatedNOT breastfeeding FOR SALE goals OR for the DISTRIBUTION nation through the Healthy People initiative, which provides science-based, 10-year national objectives for improving the health of all Americans. The breastfeeding objectives for 2020 include improving the breastfeeding initiation and duration rates, raising the exclusive breastfeeding rates, increasing the number of employers who have worksite lactation support programs, reducing the proportion of newborns who receive formula supplementation in the © Jones & Bartletthospital, Learning, and increasing LLC the number of infants born in© hospitals Jones that & provideBartlett optimal Learning, lactation care LLC (HHS, 2010). NOT FOR SALE OR DISTRIBUTIONCurrently, 74.6% of mothers in the United StatesNOT initiate FOR breastfeeding, SALE OR with DISTRIBUTION 35% exclusively breastfeed- ing at 3 months (CDC, 2011). A great deal of progress has been made in the political and social environment surrounding breastfeeding (Box I-1). Contributing to the progress seen in breastfeeding support over the last 25 years has been the increase in employers who provide time and space to express milk at work, the increase in state legislation mandating worksite support for breastfeeding employees and laws protecting the right to breastfeed in© public, Jones the expansion & Bartlett in breastfeeding Learning, education LLC and training opportunities for© healthcare Jones provid-& Bartlett Learning, LLC ers, the increaseNOT in the FOR interest SALE and number OR ofDISTRIBUTION hospitals obtaining the Baby Friendly designation,NOT the FOR availability SALE OR DISTRIBUTION of advanced lactation support and services from international board-certified lactation consultants (IBCLCs), and increased research on breastfeeding and human lactation. While steady progress has been made, there remain many challenges and gaps in care that prevent mothers from meeting their breastfeeding goals. The Surgeon General’s Call to Action to Support Breastfeeding outlines © Jones20 steps & thatBartlett can be taken Learning, to remove someLLC of the obstacles faced by women© Jones who wish & to Bartlettbreastfeed their Learning, infants LLC NOT (HHS,FOR 2011) SALE (Box ORI-2). EachDISTRIBUTION step includes implementation strategies andNOT places FOR responsibility SALE for OR breastfeeding DISTRIBUTION improvement on all stakeholders. © Jones & Bartlett Learning,1ST LLC. NOTPAGES FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE9781449694654_CH01_0001.indd OR DISTRIBUTION 1 NOT FOR SALE OR DISTRIBUTION 2/20/13 2:27 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 2 Part I: The Context of Lactation and Breastfeeding Box I-1© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC TimelineNOT of 15 FORYears ofSALE Breastfeeding OR DISTRIBUTION Progress, 1996–2012 NOT FOR SALE OR DISTRIBUTION 1996 The Loving Support campaign from Food and Nutrition Service is formed to increase the number of breastfeeding mothers in the WIC program. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR 1997SALE ORThe DISTRIBUTIONAmerican Academy of Pediatrics releases its first NOTpolicy statement FOR SALEon breastfeeding. OR DISTRIBUTION 1998 The United States Breastfeeding Committee is formed. 1999 The Right to Breastfeed Act (H.R. 1848) by Representative Carolyn Maloney (D-NY) is passed, ensuring a woman’s right to breastfeed on all federal property. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION2000 The Healthy People 2010 guidelines NOTfor the nation FOR are SALE released with OR breastfeeding DISTRIBUTION objectives. 2003 The National Breastfeeding Awareness Campaign is conducted, aimed at increasing breastfeeding among first-time parents. Of note, it used a risk-based format and was significantly watered down by interference from the infant formula industry. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 2005 ■ The Healthy People 2010 mid-course review adds exclusive breastfeeding targets. NOT■ FORHHS SALEissues Bluep ORrint DISTRIBUTION for Action on Breastfeeding, which positions breastfeedingNOT FOR as SALE OR DISTRIBUTION a public health issue, not just an individual choice. 2007 The CDC conducts the first Maternity Practices in Infant Nutrition and Care (mPINC) survey, which highlights hospital practices related to breastfeeding. The results dem- © Jones & Bartlettonstrated Learning, how poorly LLC many hospitals were supporting© breastfeeding Jones & and Bartlett has led many Learning, LLC NOT FOR SALE ORhospitals DISTRIBUTION to improve their practices. NOT FOR SALE OR DISTRIBUTION 2008 With the creation of the Business Case for Breastfeeding program, the Maternal and Child Health Bureau and Health Resources and Services Administration involve employers in supporting breastfeeding mothers by providing a package of information © Jones & Bartlett Learning, LLCon how best to provide lactation accommodations© Jones & inBartlett the worksite. Learning, LLC NOT FOR SALE OR DISTRIBUTION2010 ■ The Joint Commission establishesNOT the FOR Perinatal SALE Core MeasureOR DISTRIBUTION Set, which measures among other things the number of infants exclusively fed breastmilk upon dis- charge from the hospital. ■ The Patient Protection and Affordable Care Act of 2010 (P.L.111-148, Sec. 4207 [2010]) introduces specific worksite protections for breastfeeding employees on a © Jonesnational & Bartlett level. Learning, LLC © Jones & Bartlett Learning, LLC NOT■ FORA presidential SALE memorandumOR DISTRIBUTION orders the creation of appropriate workplaceNOT accom- FOR SALE OR DISTRIBUTION modations for nursing mothers who are federal civilian employees. ■ The Healthy People 2020 goals add three more breastfeeding objectives, (1) increase the proportion of employers that have worksite lactation support programs, (2) reduce the proportion of breastfed newborns who receive formula supplementa- © Jones & Bartlett Learning,tion within the LLCfirst 2 days of life, and (3) increase ©the Jonesproportion & of Bartlettbirths that occur Learning, LLC NOT FOR SALE OR inDISTRIBUTION facilities that provide recommended care for lactatingNOT mothers FOR andSALE their babies.OR DISTRIBUTION © Jones & Bartlett Learning,1ST LLC. NOTPAGES FOR SALE OR DISTRIBUTION. 1ST PAGES © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE9781449694654_CH01_0001.indd OR DISTRIBUTION 2 NOT FOR SALE OR DISTRIBUTION 2/20/13 2:27 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Prelude: Influence of the Political and Social Landscape on Breastfeeding 3 Box I-1© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC TimelineNOT of 15 FORYears ofSALE Breastfeeding OR DISTRIBUTION Progress, 1996–2012 (continued) NOT FOR SALE OR DISTRIBUTION 2011 ■ The Surgeon General issuesThe Call to Action to Support Breastfeeding. ■ The Internal Revenue Service allows breastfeeding equipment to be reimbursed © Jones & Bartlett Learning,from flexible healthLLC spending accounts. © Jones & Bartlett Learning, LLC NOT FOR SALE OR■ The DISTRIBUTION Affordable Care Act states that health insurersNOT will FOR be required SALE to ORpay for DISTRIBUTION a range of preventive care services specifically aimed at women, including “compre- hensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.” © Jones & Bartlett Learning,2012 LLC■ The Joint Commission mandates© Jones that all& birthingBartlett hospitals Learning, with more LLC than 1,100 deliveries per year must participate in its Perinatal Care Core Measure Set in NOT FOR SALE OR DISTRIBUTIONorder to remain accredited. NOT FOR SALE OR DISTRIBUTION ■ Rhode Island and Massachusetts are the first and second states to achieve the elimination of formula discharge bag distribution in all of their birthing hospitals. ■ CDC grant to the National
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