USBC Suggested Key Messages

Key Message:  Make breastfeeding a leading health indicator. Improved breastfeeding would contribute to achieving approximately 10% of the Healthy People 2010 Objectives.

Suggested Objectives

Breastfeeding Initiation/Duration

• Increase to 85% the proportion of infants who initiate breastfeeding or receive human milk after birth. Data Source: National Immunization Survey
• Increase to 55% the proportion of infants who breastfeed or receive human milk at 6 months. Data Source: National Immunization Survey
• Increase to 35% the proportion of infants who breastfeed or receive human milk at 1 year. Data Source: National Immunization Survey
• Increase to 75% the proportion of preterm and special care infants that receive human milk (either from their own mother or from a HMBANA-certified milk bank) as their first feed. (Proposed Data source: HMBANA; some Children’s Hospitals keep this data)
• Increase to 50% the proportion of mothers who have access to professional lactation support following discharge from the hospital. Data Source: CDC Breastfeeding Report Card i
• Increase to 50% the proportion of mothers who have access to peer or mother-to-mother support following discharge from the hospital. Data Source: CDC Breastfeeding Report Card

Exclusive Breastfeeding

• Of the babies who initiate breastfeeding, 90% are exclusively breastfed during their entire hospital stay as measured at hospital discharge. Data Source: National Birth Certificate Data
• Increase to 75% the proportion of preterm babies who are breastfed or fed human milk exclusively during the hospital stay.
• Increase to 40% the proportion of babies who are exclusively breastfed at 3 months. Data Source: National Immunization Survey
• Increase to 20% the proportion of babies who are exclusively breastfed at 6 months. Data Source: National Immunization Survey

Hospital Practices         

• Increase to 10% the proportion of hospitals that are designated as Baby-Friendly™ Hospitals. Data Source: Baby Friendly USA
• Increase to 50% the proportion of maternity care facilities that make donor human milk from HMBANA-certified Banks available. Data Source: HMBANA
• Increase to 90% the proportion of infants who experience skin-to-skin contact with their mothers immediately after birth. Data Source: Infant Feeding Practices Survey; Maternity Care Practices Survey
• Increase to 75% the proportion of infants who initiate breastfeeding within the first hour after birth. Data Source: Maternity Care Practices Survey
• Increase to 50% the proportion of hospitals that require all professional (clinical) maternity staff to complete at least 18 hours of breastfeeding training. Data Source: Maternity Care Practices Survey; Infant Feeding Practices Survey.
• Increase to 50% the number of hospitals with 1FTE lactation consultant (IBCLC) per 783 breastfeeding couplets, 1FTE lactation consultant (IBCLC) per 235 infant admits into the NICU, and 1 FTE lactation consultant (IBCLC) per 1292 mother/baby outpatient couplets.ii Data Source: Maternity Care Practices Survey; Breastfeeding Report Card. References: “Achieving Breastfeeding in the United States: Findings and Recommendations. USBC (Labbok and Taylor), February 2008; Mannel R, Mannel RS. Staffing for hospital lactation programs: recommendations from a tertiary care teaching hospital. J Hum Lact 2006; 22:409-417.

Increasing Equity (eliminating disparities)

• Increase to 75% the proportion of African-American babies (or other minority populations with low breastfeeding rates) who initiate breastfeeding or receive human milk after birth. Data Source: National Immunization Survey; National Birth Certificate Data
• Increase to 45% the proportion of African-American babies who breastfeed or receive human milk at 6 months. Data Source: National Immunization Survey
• Increase to 30% the proportion of African-American babies who breastfeed or receive human milk at 1 year. Data Source: National Immunization Survey

Workplace Support

• Increase to 50% the proportion of employed breastfeeding mothers who have access to family medical leave or other forms of leave that allow them to exclusively breastfeed for 6 months. Data Source: Infant Feeding Practices Survey
• Increase by 50% the number of employers with workplace lactation programs. Data Source: Infant Feeding Practices Survey
• Increase by 50% the number of insurers offering rebates to employers whose corporate rates of breastfeeding mirror the HP2020 goals.

Professional Support

• Increase to 60% the proportion of medical, nursing and dietetic/nutrition schools and education programs that require a pre-service competency based course in lactation management and breastfeeding counseling. Proposed data source: survey of professional schools or the associations they belong to.

i Baseline: As of 2008, in the Americas, 1745 IBCLCs work in community settings, which is 16% of total IBCLCs

ii Baseline: As of 2008, n the Americas, 7094 IBCLCs work in hospitals or birth centers (67% of IBCLCs); 8671 IBCLCs are also licensed nurses (RN, LPN, RNC, NP, CNM) (78%), and 716 are medical doctors (6.5%.)