US plans breast-feeding education initiative 
Anne Barnard / Boston Globe 31oct00

	Woman Breast Feeding a Newborn 1991  Paris France Annemiek Franken-Determann nurses her newborn son, Tunui.

In a move that women's health advocates hailed as a major victory, the surgeon general yesterday announced a new national health priority: increasing the number of women who breast-feed their babies, particularly among African-Americans, the group most likely to use infant formula.

At a ceremony honoring Rhode Island's South County Hospital for its breast-feeding policies, Dr. David Satcher threw the weight of the US government behind an idea many health professionals have endorsed for years - that breast-feeding is the ideal way of feeding and nurturing an infant, with dramatic health benefits for both mothers and children.

''It's a giant leap for womankind,'' said Gail Prachniak, a nurse at Women's and Infants' Hospital in Providence and chairwoman of the Rhode Island Breastfeeding Coalition.

The Department of Health and Human Services' Blueprint for Action on Breast-Feeding, which Satcher released yesterday, is the first broad statement of national policy on the subject, said Wanda Jones, director of the department's Office on Women's Health.

''It seems like it's a no-brainer,'' Jones said. ''And yet many workplaces and insurers and others ... look and don't see any firm policy from the government.''

That changed partly because the Clinton administration placed a priority on women's health, elevating Jones's position to the level of deputy assistant secretary and bringing together numerous federal agencies to coordinate breast-feeding policy, said spokeswoman Carol Krause.

The blueprint has no legal force, but calls on federal, state and local agencies, communities, medical professionals, scientists, insurers, and others to educate women about breast-feeding and to make it easier for them to do.

There is a long way to go. The blueprint sets a goal for 2010 of persuading 75 percent of women to breast-feed in the early postpartum period. The plan's authors would also like to see 50 percent still breast-feeding six months after birth, and 25 percent on their child's first birthday.

In 1998, 68 percent of white women breast-fed their babies in the early postpartum period, followed by 66 percent of Hispanic women and 45 percent of black women. When the children reached six months, just 29 percent of white women, 28 percent of Hispanic, and 19 percent of black women were still breast-feeding.

According to the American Academy of Pediatrics, breast milk offers infants the most complete nutrition possible, as well as an infusion of antibodies that make them less likely to have ear infections, diarrhea, and other maladies. It can save a family hundreds of dollars in the infant's first year, even with the added cost of breast pumps that allow working mothers to draw milk throughout the day. And it saves money for insurers and employers by cutting down on doctor visits and sick days.

Breast-feeding has been shown to protect women from ovarian and breast cancer, and, contrary to the folk wisdom that it's bad for the figure, helps them return more quickly to their pre-pregnancy weight.

Yet, in spite of the benefits, many women get the opposite message. Friends, relatives, and partners may believe formula is better or be embarrassed by breast-feeding. Formula companies, while stating that breast milk is best, offer free formula and diaper bags to mothers in the hospital. Few workplaces offer on-site day care or facilities for breast pumping. Even hospitals inadvertently discourage breast-feeding, officials say.

''To this day we still battle societal factors and the medical community,'' said Jan Kallio, assistant director for nutrition services at the Massachusetts Women, Infants and Children program (WIC), which teaches women about breast-feeding. ''As soon as the woman has problems, they switch them to formula.''

Many hospitals are trying to change that, reeducating their staff and hiring lactation consultants and peer counselors to promote breast-feeding in culturally appropriate ways.

Yesterday, South County Hospital became the first in Rhode Island to meet the World Health Organization's breast-feeding standards. The only Massachusetts hospital so designated is Boston Medical Center, where doctors and nurses led by pediatrician Barbara L. Philipp fought to eliminate free formula and reconfigure the delivery floor so that babies were kept with their mothers to allow for breast-feeding on demand.