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DNPAO Breastfeeding Strategies. Nutrition, Physical Activity, and Obesity Program  Annual Training Meeting March 17-19, 2010 Laurence M. Grummer-Strawn, PhD Chief, Nutrition Branch. Model for Data-Driven Action.

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dnpao breastfeeding strategies

DNPAO Breastfeeding Strategies

Nutrition, Physical Activity, and Obesity Program Annual Training MeetingMarch 17-19, 2010

Laurence M. Grummer-Strawn, PhDChief, Nutrition Branch


Figure 2. Percent of infants completely emptying the milk in the bottle/cup in late infancy by intensity of bottle use in early infancy (95% Confidence interval were indicated by the line on each bar)

>2/3 of milk by bottle

% Completely emptying the milks in late infancy

1/3 to 2/3 of milk by bottle

<1/3 of milk by bottle

Either formula or expressed milk (N=1531)

Formula Only (N=1545)

Expressed Milk Only (N=1531)

Intensity of bottle use in early infancy








Insufficient data

Figure 1. Difference in percent ever breastfeeding between non-Hispanic whites and Hispanics, and between non-Hispanic whites and non-Hispanic blacks, National Immunization Survey for children born in 2003–2006.

Non-Hispanic white vs. Hispanic

Non-Hispanic white vs. non-Hispanic black




Among women who initiated breastfeeding and intended to breastfeed for2 months,

percentage who stopped breastfeeding before 6 weeks according to the number of

Baby-Friendly Hospital Initiative practices they experienced.

national breastfeeding trends
National Breastfeeding Trends

Healthy People 2010 Goals

Exclusive at 3 mo

Data Source: Pre-1999 – Ross Mothers’ Survey

1999-present – CDC National Immunization Survey

breastfeeding rates by race ethnicity
Breastfeeding rates by Race/Ethnicity

Source: National Immunization Survey, 2007-2009 (2006 births)

percentage of infants ever breastfed by county
Percentage of infants ever breastfed* by county

* Among infants born during the reporting period.

2008 GA PedNSS Table 7B

public attitudes regarding breastfeeding
Public attitudes regarding breastfeeding

* 2003 data ** 2005 data

Source: Healthstyles, 1999-2007

federal policies on breastfeeding
Federal Policies on Breastfeeding


SG Call to Action


HHS Blueprint for Action on Breastfeeding


Healthy People 2020


Surgeon General’s Workshop on BF


USDA sets 1st WIC BF standards


USBC Strategic Plan on Breastfeeding


Nat’l BF Policy Conference


Healthy People 2000 BF Goals established

surgeon general s call to action on breastfeeding
Surgeon General’s Call to Action on Breastfeeding

Public input

Public comment April 1-May 31, 2009

Expert panel meeting April 28–29, 2009

Stakeholder hearing July 30, 2009

Stakeholder hearing August 13, 2009

Federal steering committee

CDC (scientific editor)

HHS/OWH (managing editor)





healthy people 2020
Healthy People 2020
  • Increase the proportion of infants who are breastfeed (NIS)
    • At birth
    • At 6 months
    • At 12 months
    • Exclusively at 3 months
    • Exclusively at 6 months
  • Increase the proportion of employers who have worksite lactation programs (SHRM)
  • Decrease the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life (NIS)
  • Increase the proportion of births that occur in hospitals and birth centers that provide all the recommended elements of care for lactating mothers and their babies (BFHI)
state funding projects
State funding projects
  • Nutrition, Physical Activity and Obesity cooperative agreements
    • Previous funding (2003-2007): 35 breastfeeding interventions reported
    • Current funding (2008-2012): 11 states reported 17 breastfeeding interventions
  • Communities Putting Prevention to Work (nutrition, physical activity and tobacco)
    • 8 states planning Maternity Care interventions
    • 3 states planning Work Place interventions
    • 1 state planning Childcare intervention
    • 4 states planning general interventions
cdc guide to breastfeeding interventions
CDC Guide to Breastfeeding Interventions
  • Evidence-base interventions
    • Maternity Care Practices
    • Workplace Support
    • Peer Support
    • Educating Mothers
    • Professional Support
    • Media and Social Marketing
  • Interventions Whose Effectiveness Has Not Been Established
    • Countermarketing and the WHO International Code
    • Professional education
    • Public acceptance
    • Hotlines and other information resources