In retrospect, nutrition has been a public health concern. As such, breastfeeding, a physical process, is considered as an essential element of infants’, as well as mothers’ wellbeing. Childhood nutrition underpins successful human development throughout the lifespan. In this context, breast milk, the primary infant’s source of nutrients plays essential roles in the child’s growth (Cadwell & Turner-Maffei, 2013). This explains the reason why the current healthcare policy reforms have shifted from focusing on adult nutrition to childhood nutrition. Over the decades, new evidence has been emerging regarding the benefits of breastfeeding. Overall, evidence indicates that breastfeeding plays significant roles in growth, development and survival of a child. It also promotes the wellbeing of the mother. This implies that breastfeeding exhibits a dual-benefit. Based on systematic literature reviews, breastfeeding has long-term benefits; it goes a long way in sustaining growth, development, defense against diseases, and wellbeing of an individual (Horta & Victora, 2013). On the one side, breastfeeding a child exclusively for six months has been found to influence the health of the child. It lowers the incidence of some childhood conditions such as obesity, childhood leukemia, diabetes mellitus, and inflammatory bowel disease. Similarly, exclusive breastfeeding reduces infant mortalities caused by otitis media, respiratory tract infections and diarrhea (Buontempo, Busuttil & Gauci, 2015). Additionally, breastfeeding has been found to have profound effects on mental development and chronic illnesses in later life. On the other side, breastfeeding has been found to have immediate, short-term, as well as long-term maternal benefits to mothers. Immediate effects are attributable to the stimulation of oxytocin which reduces the risk of postpartum hemorrhage. It also enhances the mother’s psychological health through reducing postpartum depression (Hamdan & Tamim, 2012). In this context, this paper focuses on providing a comprehensive analysis on breastfeeding healthcare policy through discussing the policymakers concern over the issue, competing policy options and organizational influence.
Introduction
In retrospect, nutrition has been a public health concern. As such, breastfeeding, a physical process, is considered as an essential element of infants’, as well as mothers’ wellbeing. Childhood nutrition underpins successful human development throughout the lifespan. In this context, breast milk, the primary infant’s source of nutrients plays essential roles in the child’s growth (Cadwell & Turner-Maffei, 2013). This explains the reason why the current healthcare policy reforms have shifted from focusing on adult nutrition to childhood nutrition. Over the decades, new evidence has been emerging regarding the benefits of breastfeeding. Overall, evidence indicates that breastfeeding plays significant roles in growth, development and survival of a child. It also promotes the wellbeing of the mother. This implies that breastfeeding exhibits a dual-benefit. Based on systematic literature reviews, breastfeeding has long-term benefits; it goes a long way in sustaining growth, development, defense against diseases, and wellbeing of an individual (Horta & Victora, 2013). On the one side, breastfeeding a child exclusively for six months has been found to influence the health of the child. It lowers the incidence of some childhood conditions such as obesity, childhood leukemia, diabetes mellitus, and inflammatory bowel disease. Similarly, exclusive breastfeeding reduces infant mortalities caused by otitis media, respiratory tract infections and diarrhea (Buontempo, Busuttil & Gauci, 2015). Additionally, breastfeeding has been found to have profound effects on mental development and chronic illnesses in later life. On the other side, breastfeeding has been found to have immediate, short-term, as well as long-term maternal benefits to mothers. Immediate effects are attributable to the stimulation of oxytocin which reduces the risk of postpartum hemorrhage. It also enhances the mother’s psychological health through reducing postpartum depression (Hamdan & Tamim, 2012). In this context, this paper focuses on providing a comprehensive analysis on breastfeeding healthcare policy through discussing the policymakers concern over the issue, competing policy options and organizational influence.
Policymakers’ Breastfeeding Policy Concern
Over the decades, breastfeeding has been attracting divergent perspectives. Of concern is the policy aspect which has solicited intense political attention. Despite the benefits of exclusive breastfeeding, breastfeeding rates have been relatively low in the US, as well as, other regions around the globe. This is attributable to the barriers to breastfeeding. On the one side, cultural factors such as sexuality, formula feeding and media influence have been found to hinder breastfeeding. On the other side, national factors such as the lack of supportive environments at the workplace, competency of healthcare professionals in relation to breastfeeding and lack of breastfeeding education amongst the population. These barriers, as well as the consequences of inadequate breastfeeding and formula feeding of infants have attracted the concern of policymakers; thus prompting the need for a national policy that guarantees exclusive breastfeeding for the wellbeing of the US population. Additionally, the changing epidemiological trends of chronic diseases, most of which can be prevented through breastfeeding during infancy, amongst the US population have raised the attention of policymakers who are making extensive efforts to address the burden of chronic illnesses through healthcare policy regulations. Finally, the risk associated with breastmilk substitutes including contamination and nutritional deficiencies has prompted policymakers to consider policy approaches for reducing these risks.
Background Information
The breastfeeding healthcare policy has its roots in global policies and declarations on breastfeeding. Apparently, the issue of breastfeeding has been the concern of various stakeholders, primarily health organizations and policymakers around the globe. For instance, the World Health Organization (WHO), World Health Assembly (WHA) and UNICEF have developed various guidelines on breastfeeding. These health policy guidelines have been developed to promote breastfeeding and reduce health consequences associated with formula feeding including contamination and nutritional imbalance. Initially, the introduction of breastmilk substitutes marked the beginning of a public health issue, replacing physical breastfeeding with artificial infant feeding. Consequently, breastmilk substitutes become a threat to breastfeeding; thus prompting the WHA to adopt the International Code of Marketing of Breastmilk Substitutes in 1981. This regulation aimed at protecting breastfeeding by requiring manufacturers and distributors of breastmilk substitutes to adhere to the Code’s provisions. Later in 1989, a Joint WHO/UNICEF Statement that aimed at enhancing and protecting breastfeeding was released. This statement provided recommendations on successful breastfeeding (Department of Health, 2015). Consequently, the Innocenti Declaration of 1990 advanced approaches towards promoting breastfeeding. This paved the way for the US breastfeeding policies in which CDC developed a comprehensive guide to Breastfeeding Intervention 11. Through this guide, CDC called for regulatory measures that will improve breastfeeding rates leading to the adoption of the Baby-Friendly Hospital Initiative. As a result, the US Health and Human Services department has developed the HHS Blueprint for Action on Breastfeeding. Therefore, the breastfeeding healthcare policy is based on the World Health Assembly Resolution 65.6 which was endorsed in 2012 with the aim of increasing the rates of exclusive breastfeeding within the first six months by at least 50% by 2025 (WHO, 2012).
Policy Analysis
Despite the emerging evidence on the benefits of breastfeeding, US breastfeeding policies seem to be experiencing some barriers including cultural factors, political factors, as well as health education factors. These have led to the emergence of competing policy options.
Policy Options
The first policy option requires state laws to be enacted to create ‘Break time Provisions’ in order to support breastfeeding at the workplace. In this context, lactating mothers especially those who are paid by the hour are expected to benefit from break time provisions. Similarly, break time provisions allow salaried mothers to take breaks express milk or breastfeed their children. Such statutory provisions have been adopted in Indiana where employers are required to compensate public employees for breastfeeding breaks.
On the contrary, the second option seeks to introduce statutory laws that require employers to designate infant and mother-friendly workplace environments. This approach aims at promoting workplace breastfeeding through various strategies. For instance, employers are expected to adopt employment policies that grant lactating mothers flexible work schedules. They also focus on designing locations for breastfeeding at the workplace. Over the years, the lack of location and facility provisions at the workplace has been considered as one of the main barriers to breastfeeding amongst working mothers. Mothers have been reported to express milk in bathrooms or toilet stalls; thus raising health concerns. Therefore, the provision of designated facilities and locations will enhance safety. In addition, providing locations and facilities for breastfeeding that conceal privacy will address cultural barriers to breastfeeding. Ideally, culture portrays human breasts as elements of sexuality, but not sources of nutrition for infants. As such, mothers fear exposing their breasts in public while breastfeeding and this hinders continued breastfeeding. Finally, this option calls for workplace designations that allow access to breastmilk storage in a hygienic environment. At present, several federal states, including Texas, Washington and North Dakota have adopted this policy option to promote breastfeeding (Murtagh & Moulton, 2012).
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- Patrick Kimuyu (Author), 2017, Breastfeeding Healthcare Policy in Australia, Munich, GRIN Verlag, https://www.grin.com/document/381302