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• in the early postpartum period to 75%
• at six months to 50%
• at 12 months to 25%

Healthy People 2010 objectives also aim to increase the proportion of mothers who are exclusively breastfeeding through three months of age to 40%,and to 17% at six months age.⁷

The California Department of Public Health is dedicated to promoting, protecting, and supporting breastfeeding among all Californians.⁸ The California Department of Public Health views breastfeeding promotion as an important public health initiative, likely to reduce, offset, and prevent disease, and to reduce health disparities among ethnic and minority groups. The California strategic initiative to promote breastfeeding was launched in November 1996 with the release of the first Breastfeeding Promotion Committee Report: Breastfeeding: Investing in California’s Future and extended with the publication of the second Committee Report in January 2007.⁷

To achieve these goals, professional organizations and the U.S. Preventive Services Taskforce recommend that pregnant women receive breastfeeding education, counseling, and support beginning early in pregnancy, continuing throughout prenatal care, during hospitalization around the time of birth, and throughout infancy.^5,9

Formal education for mothers and families, direct support during breastfeeding, training for healthcare staff on how to support breastfeeding, and peer support for new mothers are strategies that in combination, increase rates of breastfeeding initiation and its duration.⁹

References

1. American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. Breastfeeding Handbook for Physicians. 2006.
2. Rabet, L.M., Vos, AP, Boehm, and Garssen, J. Breast-Feeding and Its Role in Early Development of the Immune System in Infants: Consequences for Health Later in Life.  J of Nutr 2008;138:1782S-1790S.
3. American Dietetic Association.  Position of the American Dietetic Association: Promoting and Supporting Breastfeeding. J Am Diet Assoc 2005;105:810-818.
4. Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries.  Evidence Report/Technology Assessment No.153 (Prepared by Tufts-New England Medical Center Evidence-based Practice Center, under Contract No.290-02-0022). AHRQ Publication No. 07-E007. Rockville, MD: Agency for Healthcare Research and Quality. April 2007.
5. Association of Women’s Health, Obstetric and Neonatal nurses. Evidence-based clinical practical guideline. Breastfeeding Support: Prenatal Care Through the First Year. 2nd Edition.  AWHONN Washington DC.
6. Galson, Steven K, US Surgeon General. Mothers and Children Benefit from Breastfeeding. J Am Diet Assoc 2008;108:1106
7. Breastfeeding Promotion Committee Report to the California Department of Health Services, Primary Care, and Family Health Division. 2007. Available here.
8. California Department of Health Services Maternal and Child Health Breastfeeding Program. DHS Breastfeeding Promotion Policy. Accessed on June 15, 2007. Available here.
9. U.S. Preventive Services Taskforce. Primary Care Interventions to Promote Breastfeeding. October 2008  http://www.ahrq.gov/clinic/uspstf/uspsbrfd.htm

Academy of Breastfeeding Medicine Protocol Committee.  ABM Clinical Protocol #14: Breastfeeding-friendly physician’s office, part 1: optimizing care for infants and children. Breastfeed Med 2006; Summer; 1(2):115-9.
This document primarily focuses on policies and procedures for supporting breastfeeding following birth; Recommendation #4 addresses content to discuss during prenatal care.

Academy of Breastfeeding Medicine-Clinical Protocol Number #19: Breastfeeding Promotion in the Prenatal Setting. 2009 Developed by the Academy of Breastfeeding Medicine Protocol Committee, this document outlines topics for discussion at the initial prenatal visit, and ongoing education during the first, second and third trimesters of prenatal care.

Prenatal Breastfeeding Assessment: Commonly used prenatal forms such as ACOG, and U.S. General Services Administration have space to record “Breast or Bottle”.  POPRAS and the California Comprehensive Perinatal Services Program forms add information about prior pregnancy and planned duration of breastfeeding.

Providers may benefit from having a form that provides additional “prompts” or questions to assess knowledge of breastfeeding benefits, attitudes and beliefs about breastfeeding, past experience, potential contraindications and intention, as presented in current guidelines.⁵  Supplemental forms need to be supplied to providers to assist in completing a comprehensive breastfeeding assessment.

Breastfeeding Friendly Workplace Policy (2007):
This Breastfeeding Friendly Workplace Policy brochure demonstrates the rationale, benefits, and importance of developing a workplace policy that supports lactation at the workplace; a sample policy is included.

The brochure is also available in Spanish.

The Business Case for Breastfeeding (2008) -U.S. Department of Health and Human Services provides a series of materials including a toolkit with reproducible resources designed to create a breastfeeding friendly work environment.

Provider & Family Breastfeeding Education

Resources