A Decision Tree for Donor Human Milk: An Example Tool to Protect, Promote, and Support Breastfeeding

Despite decades of breastfeeding promotion, exclusive breastfeeding rates for the first 6 months of life remain low: around 40% globally. Infants that are admitted to a neonatal ward are even less likely to be exclusively breastfed. Lactogenesis is frequently delayed in mothers that deliver early, with the added burden of separation of the unstable newborn and mother. For such vulnerable infants, donor human milk is recommended by the World Health Organization, UNICEF, and professional organizations as the next best alternative when mother's own milk is unavailable and can serve as a bridge to full feeding with mother's own milk. Hospital support of optimal breastfeeding practices is essential with thoughtful integration of donor human milk policies for those infants that need it most. We propose a decision tree for neonatal wards that are considering the use of donor human milk to ensure donor human milk is used to replace formula, not to replace mothers' own milk. By first evaluating barriers to full feeding with mother's own milk, healthcare workers are encouraged to systematically consider the appropriateness of donor human milk. This tool also seeks to prevent overuse of donor human milk, which has the potential to undermine successful lactation development. In settings where donor human milk supplies are limited, prioritization of infants by medical status is also needed. Readily available and easy-to-use tools are needed to support healthcare staff and mothers in order to improve lactation development and neonatal nutrition

Analysis of media coverage on breastfeeding policy in Washington State

Thesis (Master's)--University of Washington, 2016-06Background: Framing of messages about breastfeeding policy in the media can foster or hinder interpretations of policy’s potential benefits and may ultimately influence important policy decisions in institutions and legislative bodies. Objectives: To evaluate how breastfeeding policies were framed in print and web-based newspapers in Washington State; to identify sources of frames; to examine the balance of media coverage in support or against breastfeeding policy adoption. Methods: Print and web-based newspaper articles published from January 2000 through June 2014 specifically discussing breastfeeding policy were analyzed and coded (n= 131). A sub-sample (n= 46) was double coded. Inter-coder agreement was acceptable (Krippendorff α coefficient 0.83). Results: The number of articles about breastfeeding policy grew overall between 2000 and 2014 and peaked during periods of specific policy development. Seventy-four articles had a neutral tone, 49 supported breastfeeding policy and four were in opposition. Nine distinct supporting frames were identified and six distinct opposing frames. The most frequent supporting frames were health benefits of breastfeeding and challenges of breastfeeding in public. The most common opposing frame was indecency of breastfeeding in public. Many framed messages did not reference a source of information. Conclusions: There is limited but growing media coverage of breastfeeding policies. For the most part, coverage is supportive of the need for policies. Breastfeeding advocates can apply information about using message framing to craft effective policy development strategies