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Health Campaign: Breastfeeding

Kona Necklen

HCS 535

September 16, 2013

Instructor: Qiana Amos

Health Campaign: Breastfeeding

Breastfeeding, a topic not so popular twenty years ago, is becoming the subject of today’s healthy lifestyle. According to the Centers for Disease Control and Prevention (2013), 69.2% of adults over the age of 20 are overweight including obesity from 2009 to 2010. Eighteen percent of children ages six to 19 years are obese as well and has become a major health concern (Centers for Disease Control and Prevention, 2013). Chronic diseases are also an issue with one in two adults having at least one chronic health condition (Centers for Disease Control and Prevention, 2013). To reduce the obesity rates and chronic diseases for the future generation, promoting a healthy lifestyle from childhood years is highly recommended. This report reviews the importance of breastfeeding, Minnesota’s health themes for 2020, the different agencies and surveillance systems involved in addressing these issues, and the type of data used. Health Issue: Breastfeeding
Healthy Minnesota 2020 The health assessment for Minnesota recognizes a healthy start early in life. The themes for Healthy Minnesota 2020 to promote health are: * “Capitalize on the opportunity to influence health in early childhood” (MDH, 2012, p.11) * “Assure that the opportunity to be healthy is available everywhere and for everyone” (MDH, 2012, p. 11) * “Strengthen communities to create their own healthy futures” (MDH, 2012, p. 11)
The focus of this report will be on indicator 1.2 which states “By 2020, more Minnesota children are exclusively breastfed for six months” (MDH, 2012, p. 13). Statistics indicates that four out of five Minnesota infants are breastfed from the beginning but then more than half of the infants stop breastfeeding by the age of six months. In addition, infants were not exclusively breastfeeding during that time. The rate of children being breastfed exclusively through three months was 45% and those going through six months of age dropped significantly to 15% (MDH, 2012). The good news is Minnesota’s breastfeeding rates are higher than the US overall. For example, Minnesota’s rate for children ever breastfed was 82.5% compared to children in the US at 74.6% (MDH, 2012). One of the objectives for Healthy People 2020 is also to “…improve the health and well-being of women, infants, children, and families” through the promotion of a healthy start such as breastfeeding (Healthy People 2020, 2013).

Breastfeeding Benefits Infant health: The benefits of breastfeeding are greater than the benefits of using infant formula. The components of breast milk provide resistance to infectious diseases, enhances the infant’s immune system, reduces the risk for chronic diseases, and provides developmental benefits. Because the human milk contains secretory antibodies, leukocytes, and carbohydrates that fight against viruses, bacteria, and parasites, infections such as diarrhea, respiratory tract infections, ear infections, pneumonia, urinary infections, necrotizing enterocolitis, and invasive bacterial infections are limited in breastfed infants (Benefits of Breastfeeding, 2003). The anti-inflammatory factors in human milk enhance immune response to immunizations such as the polio, tetanus, diphtheria, and Haemophilus, in addition to respiratory syncytial virus infection (RSV) that is popular in infants (Benefits of Breastfeeding, 2003). As mentioned above, obesity and chronic diseases are health concerns for Minnesota as well as the United States as a whole. Human breast milk reduces the risk of diabetes type one and type two, celiac disease, inflammatory bowel disease, childhood cancer, and allergic disorders or asthma (Benefits of Breastfeeding, 2003). Maternal health: Breastfeeding benefits mother as much as the infant. There is reduced risk of ovarian cancer and premenopausal breast cancer for moms who breastfeed (Queenan, 2003). In addition, the increase level of oxytocin reduces postpartum bleeding and returns the uterus back to normal size quickly. Socioeconomic benefits: Families benefit from breastfeeding too because it is not as costly as formula feeding. Breast milk is readily available and in quantities to satisfy the infant. Both infant and mother have fewer sick days; thus, benefiting employers by reducing employee absenteeism (Benefits of Breastfeeding, 2003).

Agencies Addressing this Issue The three levels of government, federal, state, and local agencies, is tasked with addressing the breastfeeding issue. From the federal level, the United States Department of Health and Human Services manages Healthy People initiatives (Healthy People 2020, 2013). Healthy People establish benchmarks and monitors progress to encourage collaboration, guide individuals to make healthy decisions, and measure prevention activities (Healthy People 2020, 2013). The breastfeeding objective for 2020 is under Maternal, Infant, and Child Health (MICH) topic area (Healthy People 2020, 2013). At the state level, the Minnesota Department of Health (MDH) is responsible for Healthy Minnesota 2020 objectives. Established in 1858 for controlling communicable diseases, MDH provides public health to keep Minnesotans healthy through health promotions (Minnesota Department of Health, 2012). Other statewide initiatives include the Prenatal-to-Three State Plan which leads to address the needs of young children from the prenatal period to age three (Minnesota Department of Health, 2012). In collaboration with the Healthy Minnesota 2020 objectives, local health care agencies partnered with MDH. Listed are just a few who may have an impact on the breastfeeding objective: Boynton Health Services, Chicano Latino Affairs Council, and Council on Asian-Pacific Minnesotans, Hennepin County Medical Center (HCMC), Local Public Health Association, Minnesota Association of Community Health Centers, Minnesota Council of Health Plans, and the University Of Minnesota School Of Public Health (Minnesota Department of Health, 2012). Hospitals, such as HCMC, are becoming a Baby Friendly hospital promoting only breastfeeding. This initiative, originated from the World Health Organization (WHO), requires that hospitals follow ten steps before earning the title of Baby Friendly hospital (Baby-Friendly Hospital, 2009).

Models, Systems and Epidemiologic Surveillance Systems In order to recognize healthcare disparities, collecting data from vital statistics, disease registries or other sources of data are crucial. According to the Healthy People 2020 report, data source used for the breastfeeding objective was from the National Immunization Survey (NIS), CDC National Center for Health Statistics (CDC/NCHS) and the CDC National Center for Immunization and Respiratory Diseases (CDC/NCIRD) (Healthy People 2020, 2013). The CDC is a major federal source of data used in public health and within the CDC is the National Center for Health Statistics (NCHS) that provides numerous statistical data collection for research (Novick, Morrow & Mays, 2006). The NCHS is a major source of national-vital statistics that includes information on maternal education and prenatal care (Novick, Morrow & Mays, 2006). The NIS “…is a list-assisted random-digit-dialing telephone survey followed by a mailed survey…” monitoring childhood immunization coverage (Centers for Disease Control and Prevention, 2013, p. 1). Breastfeeding Report Cards measure and provide current data on reaching the breastfeeding goals in each state (Centers for Disease Control and Prevention, 2010).

The Targeted Population Increase breastfeeding is a national goal; however, for the purpose of this analysis, the community will be the state of Minnesota and the population will be prenatal women and infant ages 0-12 months. Healthy Minnesota 2020 Indicators 1.1 and 1.2 focus on the importance of prenatal care especially during the first trimester, and creating a healthy relationship through maternal-infant bonding by breastfeeding (Minnesota Department of Health, 2012). Women of child-bearing age, 15-44 years, are recommended to seek prenatal care right away in their first trimester. However, statistics indicate there are disparities. Data from Minnesota Department of Health indicates inadequate prenatal care for low income women on assistance (Minnesota Department of Health, 2004). Rates of inadequate or no prenatal care are three to four times higher in colored women than white women in Minnesota (Minnesota Department of Health, 2004). Neonates are vulnerable to infections when mothers do not receive proper prenatal care. Infections and diseases during pregnancy include Hepatitis B, Group B streptococcal (GBS) disease which leads to neonatal infection and death, and perinatal transmission of HIV (Minnesota Department of Health, 2004). About 67% of infant mortality occurs in the first month of life, the neonatal period and the rest occurs from one month to the first year of life (Minnesota Department of Health, 2009). The four top leading cause of infant mortality in Minnesota is congenital anomalies, or birth defects followed by prematurity, sudden infant death syndrome (SIDS), obstetric conditions such as multiple gestations and premature rupture of membranes (Minnesota Department of Health, 2009). Epidemiologic Tools in other areas needed to address this issue Epidemiologic tools used to address breastfeeding in other areas may include colleges such as Harvard University—National Scientific Council on the Developing Child (MDH, 2012). Health professionals such as International Board Certified Lactation Consultants (IBCLC) have the highest level of knowledge in breastfeeding and can support mothers to breastfeed successfully. Breastfeeding counselors and doulas are also health professionals providing education and support for breastfeeding mothers (Office on Women’s Health, 2010). The Women, Infants, and Children (WIC) program under the Special Supplemental Nutrition Program for Women, Infants, and Children, provides educational materials, counseling support, food, and even breast pumps to support breastfeeding (Office on Women’s Health, 2010).

Conclusion The health of the future starts with the health of our kids. Healthy Minnesota 2020 identified breastfeeding to provide benefits to the health of infants and mothers. The breastfeeding campaign involves agencies from federal, state, and local levels to target infants and perinatal women. Epidemiologic surveillance systems provide data and keep track of its progress. Without the support of epidemiologic surveillance systems and supporting agencies, the goals to increase breastfeeding cannot be met.

References
Baby-Friendly Hospitals. (2009, May 10). The Santa Fe New Mexican. Retrieved from http://search.proquest.com/docview/331650147?accountid=458
Centers for Disease Control and Prevention. (2010). Breastfeeding report card—United States, 2010. Retrieved from http://www.cdc.gov/breastfeeding/pdf/BreastfeedingReportCard2010.pdf
Centers for Disease Control and Prevention. (2013). National immunization survey. Retrieved from http://www.cdc.gov/nchs/nis.htm
Centers for Disease Control and Prevention. (2013). Obesity and overweight. Retrieved from http://www.cdc.gov/nchs/fastats/overwt.htm
Healthy People 2020. (2013). Maternal, Infant, and Child Health. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=26
Minnesota Department of Health (MDH). (2004). Minnesota Title V MCH needs assessment fact sheets: Pregnant women, mothers and infants. Retrieved from http://www.health.state.mn.us/divs/cfh/na/factsheets/prenatalcare.html
Minnesota Department of Health (MDH). (January 2009). Disparities in infant mortality. Retrieved from http://www.health.state.mn.us/divs/chs/infantmortality/infantmortality09.pdf
Minnesota Department of Health (MDH). (December 2012). Healthy Minnesota 2020: Statewide health improvement framework. Retrieved from http://www.health.state.mn.us/healthymnpartnership/hm2020/
Novick, L. F., Morrow, C. B., & Mays, G. P. (Eds.). (2008). Public health administration: Principles for population-based management (2nd ed.). Sudbury, MA: Jones and Bartlett Pub
Queenan, J.T., (2003, July). Breastfeeding: It’s an important gift. Obstetrics & Gynecology. 102(1), 3-4. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.apollolibrary.com/

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