DOCTORS’ LOUNGE
DOCTORS’ LOUNGE
and 14 percent, respectively. This compares to 59 percent and eight percent, respectively in 2007. There was not much progress in our state in those seven years. We will need to take a bold and innovative approach in the next four years to achieve the goals set by the Healthy People 2020 campaign.
In a state as poor and as diseased as ours we should have a keen interest in achieving these goals. Infants who are breastfed have fewer ear infections, respiratory illnesses and gastrointestinal infections, and a decreased risk for asthma, allergies and death from Sudden Infant Death Syndrome. Recent studies also suggest that breastfeeding may decrease the risk of obesity later in life and improve cognitive ability. The cost of illness in infants goes well beyond the personal and family cost of suffering and the costs of medication and hospitalization. Illness in infants has a significant economic price as working parents stay home to care for their sick infants.
There is also benefit to the mothers who breastfeed. Studies have shown a decrease in postmenopausal osteoporosis and breast cancer. Collectively and indiviudally, the cost of not breastfeeding infants is significant in socioeconomic terms.
With all these benefits and cost considerations, why aren’ t we doing better? I think it is because we still make it hard for women to breastfeed. Since the Industrial Revolution we in the United States have increasingly valued the woman’ s time in the workplace more than we valued her time at home. Yes, we have enacted laws that require employers to provide maternity leave and the Affordable Care Act now requires the employer to provide a space for a woman to express her breast milk. But, women are encouraged and have a financial incentive to return to work as quickly as possible. This works against sustaining breastfeeding and achieving the goal of exclusive breastfeeding at six months.
Obviously women play a role in this. They must have a say about their careers and in matters that involve their bodies. But I ask where do our financial incentives lie? What are our social attitudes about breastfeeding and do we as a society appropriately value breastfeeding? The burden of breastfeeding should not be on the backs( or other parts) of women alone.
What can we do as physicians of the Greater Louisville Medical Society to support women and breastfeeding and to help our state achieve the Healthy 2020 goals?
1. Keep abreast of the facts and speak clearly. First, exclusive breastfeeding to 6 months has significant public health and economic benefits. Our state could save millions of dollars in health care costs each year by promoting exclusive breastfeeding to six months of age, and we would have a healthier and more productive workforce. Next, women who choose to breastfeed exclusively to six months should not be economically penalized for doing so. And, employers and health insurers should be incentivized to make breastfeeding to six months successful.
2. Make your offices and hospitals breastfeeding friendly. Independent practitioners, your office environment is within your control. Employed physicians, know what your employer’ s attitudes and practices are and advocate for the pregnant and breastfeeding employees and pregnant and breastfeeding patients and visitors. Assure that informational material is available and visible in all of our offices and hospitals. All physicians must walk the fine line of supporting breastfeeding and yet not make those who choose not to breastfeed feel guilty.
3. Educate the public about the benefits of breastfeeding infants. Many of today’ s women lack the educational, social, psychological and emotional support to initiate and sustain breastfeeding. Historically, this education has fallen to nurses and to the family physicians, pediatricians and obstetricians. But I submit that all physicians can play a role. Everyone who knows a pregnant woman has the opportunity to encourage breastfeeding. Whenever your patient talks about having a new baby, grandbaby, niece or nephew bring up the topic of breastfeeding. We must make the benefits of breastfeeding a topic of social discourse.
4. Advocate for better laws, tax breaks for employers and economic incentives for women that promote breastfeeding through six months of age. Our area hospitals are increasing the percent of mothers who are breastfeeding their infants after delivery. Most have employed lactation consultants to assist new mothers who have no prior experience with breastfeeding and who may lack appropriate support and role models in their families. We now need to optimize the post-hospital environment to assure breastfeeding is sustained through six months of the infant’ s age.
Above all else remember: breast milk is better than any udder milk. During this month, let’ s make breastfeeding the talk of the town. Who knows, with our help perhaps someday someone will read about our own Mayor Greg Fischer de Louis Villiers.
Dr. Roberts is a neonatologist with the University of Louisville Physicians and the Vice Dean for Graduate Medical Education and Continuing Medical Education at the University of Louisville School of Medicine.
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