Proposal: to Increase Breastfeeding Rates in New York

Public Budgeting Professor Lynch Spring 2009 Proposal to: Increase Breastfeeding Rates in New York Introduction In a time when overwhelming research shows that human milk is superior to any sort of manufactured human milk substitute, with great economic benefits for breastfeeding families, the health care system, and society in general, breastfeeding is no longer seen as just an individual choice, but as a public health challenge that deserves more publicity to create supportive systems and environments for mothers to breastfeed. Human milk is more than food, it’s a living substance like blood that have active germs fighting and health ingredients to help protect babies against all kinds of common or un-common infections. Human milk have all the necessary nutrients and a low protein content a baby will need and any period of breastfeeding a women can give either short or long would be of benefit. The national goals set by Health People 2010 are for 75% of women to initiate breastfeeding, for 50% to still be breastfeeding at 6 months and 25 % by 12 months. Billions of healthcare dollars would be saved if more infants were exclusively breastfed and for a longer time. The United States Breastfeeding Committee (USBC) Page 2 estimates that $2 billion per year are spent by families on infant formula and that $3. 6 – 7 billion dollars could be saved each year in preventable conditions if breastfeeding rates were increased to the recommended levels. Breastfeeding is one of the most important aspects of infant health. When babies are fed with formula rather than breast milk they are more likely to be sick more often and more seriously. The health problems that infants encounter for not breastfeeding are gastrointestinal, respiratory, and ear infections. There are negative health consequences to not breastfeeding for the mother also. The mothers experience more postpartum bleeding and delayed uterine involution, return or no return to pre-pregnancy weight and increase risk of ovarian cancer. Additionally, formula feeding is not good for the environment since it burdens our landfills and required more fuels for its manufacturer and preparation. It also creates pollution from required products during the manufacturing of plastic bottles and containers for the storage and delivery of infant formula Despite evidence that in New York State there has being a decrease in the number of women who initiates breastfeeding, minority and low income women are still being reluctant to promote breastfeeding. According to the New York State Department of Health is goal is to provide the physical and emotional well-being of childbearing mothers and their infants by increasing the rate and duration of breastfeeding in the State. Page 3 The overall percentage of New York women breastfeeding is 76. 3% higher than that of the entire United States. However, the overall rate of women New York exclusively breastfeeding for the first 6 months is only 8. 4%, 3 months exclusively 25. 5% and 12 months 24. 6 %. Existing Law Several laws have been enacted in New York to protect a woman’s right to breastfeed. In August of 2007 Governor Eliot Spitzer sing into legislation protecting rights of nursing mother in the workplace, that requires employers to provide uncompensated time and private space to express milk or nurse their children for a period of time. A bill was introduced to amend the public health law in relation to breastfeeding mother’s bill of rights. The public health law was amended by adapting a new section 2505 which specifies that a patient bill of rights for breastfeeding should be posted in a public place in each maternal health care facility. The Breastfeeding Bill of Rights was re-introduced for breastfeeding practice and the New York State Rules and Regulations for more to be done to protect mother’s right to breastfeed her child, but also empower and supports new mothers as they seek to breastfeed their children. Page 4 Proposal To address this issue I am proposing breastfeeding legislation that would: 1)Change a hospital stay policy that does not provide adequate time for mother’s milk to come in or for appropriate education and support. )Recommend that all licensed nurses working within a maternity unit of a hospital receive a minimum of 18 hours of training on basic lactation management and demonstrate a specified level of competencies; and 3)Recommend teaching all licensed doctors in Obstetrics and Child Health to diagnose and treat the medical problems that comes between baby and mothers whom are breastfeeding; and 4) To recognize the importance of breastfeeding in maternal child health Women experie nce many barriers to successful breastfeeding, the proposed legislation would address three of the many problems that occurs during the most vulnerable time. The early postpartum period is critical to the successful establishment of lactation making what occurs during this short time extremely important. A breastfeeding woman can always switch to formula feeding very easily; the decision to bottle feed is very hard to reverse after only a few days. Page 5 Rationale for restricting formula marketing: Women need to feel confident in their ability to adequately nourish their babies. Exposure to formula marketing and free samples of formula has been shown to undermine a woman’s confidence, especially if she is encountering difficulties to establish lactation. The use of supplements has the negative effect of decreasing a woman’s milk supply and further interfering with adequate and early weaning from the breast. Restricting formula marketing during the early postpartum period allows women to make a more informed decision about feeding, based on personal preference and available resources. Marketing formula to women during the vulnerable postpartum period is unethical from a public health standpoint. Some healthcare professionals are collaborating with the industry by accepting materials, incentives and financial assistance (discharge packs, free supplies, lunches, sponsorship of in-services and conferences, upgrade and construction of maternity facilities, etc. ) from formula companies. Instead of formula samples and messages, health care institutions should provide women with medically accurate breastfeeding support and information, such as the direct cost of buying artificial milk, including the cost of consumers advertising. Besides perfect nutrition of human milk, there are many other benefits in breastfeeding for babies, mothers as well as society, such as easily digested, higher IQ, protects infant guts, prevents hemorrhaging after delivery, no worry of which brand of milk Page 6 s best, the milk is never been recalled due to manufacturing problem, no issues of contamination, etc. Major Obstacles/Implementation Challenges Breastfeeding may not be for all women, therefore the decision to breastfeed or formula feed is based on their comfort level, lifestyle and medical conditions that they might have, as well as, class and racial implication of breastfeeding, such as economic and cultural constraints could make it difficult for a woman to nurse. Women need and should have the right to receive medically accurate, evidence-based information about lactation from health care providers before delivery that provides nutritional, medical and psychological benefits of breastfeeding and after delivery for adequate assistance and support during the critical postpartum period from nurses/doctors who possess accurate, up to date information and skills in basic lactation managements is essential to helping women breastfeed. During the early postpartum period, nurses are often the most influential and trusted sources of information about infant feeding. But, many do not possess the knowledge or skills to adequately provide the support needed to help women to initiate lactation. Nurses who have not been trained in breastfeeding management cannot be expected to give mothers effective guidance and provide skilled counseling. Page 7 Lactation management is often omitted from curricula in basic training of nurses and is currently not a required part of on the job training. Opponents of this training may argue that the resource for this is beyond the scope of the New York State government’s duties or that it may cost too much. Upon examining the program, however, one will note that some of the burden could be assume by the federal government to improve the quality of care mothers’ receive after post-partum on breastfeeding. Looking at the cost on implementing these trainings and certifications no one institution should cover the cost. Given the rapid growth of new mothers, there would be no better time to implement these trainings, although the decision to breastfeed is a personal one. Breastfeeding do come with some challenges for both women and babies such as plenty of patience and persistence, personal comfort, time and frequency feedings, etc. U. S. Department of Health and Human Services. HHS Blueprint for Action on Breastfeeding, Washington, D. C. U. S. Department of Health and Human Services. HHC People 2010; Conference Edition – Volumes I and II. United States Department of Agriculture, â€Å"The Economic Benefits of Breastfeeding† A Review and Analysis. Food assistance and Nutrition Research Report No. 13 (20001) American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk (RE9729). Pediatrics 1997; 100(6) 1035-1039 D. A. Frank et al, â€Å" Commercial discharge Packs and Breastfeeding Counseling: Effects on Infant-Feeding Practices in a Randomized Trial. Pediatrics 80 (1987): 845-854. www. Baby center. com â€Å"Breastfeeding† www. Kids Health. com â€Å"Benefits of Breast Feeding† New York State Department of Health: â€Å"Breastfeeding Mothers Bill of Rights† See generally the websites for the Center for Disease Control: [http://www. cdc. gov/breastfeeding] and the National Women’s Health Information Centers’ Resources on Breastfeeding: [http://www. 4woman. gov/breastfeeding]. 6 S e e American Academy of Pediatrics home page at [http://www. aap. org/advocacy/bf/brhist. htm]. http:/www. state. ny. us/governor/press/0822072