CDC publishes 2010 Breastfeeding Report Card: US isn't making the grade

The Centers for Disease Control and Prevention (CDC) has released the 2010 Breastfeeding Report Card, the first update on U.S. breastfeeding rates since 2006. The Report Card provides breastfeeding rates immediately after birth (referred to as initiation), at six months, at 12 months, as well as rates of exclusive breastfeeding (feeding only breastmilk) at three months and six months. The data shows rates for the U.S as a whole and is also broken down by state.

Here's the bottom line: While there is one piece of good news coming out of this report, it also reveals that we still have a lot of work to do.

The only category in this report card where the U.S. gets an A is initiation. Three out of every four new mothers in the United States tries breastfeeding. This statistic meets the Healthy People 2010 national objective for breastfeeding initiation.

Otherwise, we haven't made much progress. The chart below illustrates how we've performed against the objectives and goals of Healthy People 2010 and what's changed since the 2006 report card. Green means we met our goal, red means we missed the mark.

It's disheartening that so little progress has been made in four years. While I'm glad that initiation rates have reached 75 percent, that means very little when duration rates are still so far from where they should be. Rates of breastfeeding at six and 12 months, in addition to rates of exclusive breastfeeding at three and six months, remain stagnant and low.

The CDC's highlighting of exclusivity rates is important. The American Academy of Pediatrics and other major medical organizations around the world recommend exclusive breastfeeding for the first six months of life and breastfeeding for a minimum of 12 months.

Currently, 43 percent make it to the six month marker, with 22.4 percent making it a full year. Exclusive breastfeeding rates haven't budged either, with 33 percent of moms breastfeeding exclusively at three months, and only 13.3 percent at six months.

There are a few states performing well above the national average. Alaska, Colorado, Montana, Oregon, and Vermont have particularly impressive rates of exclusive breastfeeding at six months. The average among those states is 22.9 percent, compared to a national average of 13.3 percent.

What these numbers mean to me is that we need to continue promoting how important it is to support breastfeeding moms. The Breastfeeding Report Card indicates, and I agree, that there should be a focus in the following areas:

• Birth facility support. Birth facility policies and practices significantly impact whether a woman chooses to start breastfeeding and how long she continues.

• Professional support. A strong statewide group of professional breastfeeding experts (IBCLCs) is needed to assist the mother-infant pair, create and administer lactation programs, and educate other health professionals about breastfeeding.

• Legislation. Most states now have some form of laws protecting the basic human right to breastfeed. The laws requiring support for breastfeeding mothers in the workplace are a step in the right direction.

• Infrastructure. It's important to increase the number of state health department FTEs responsible for breastfeeding. According to the CDC's report, "health departments now dedicate nearly 97 full-time equivalents (FTEs) to supporting breastfeeding mothers and babies in their states. However, this still represents less than 2 FTEs per state dedicated to a health issue that is clearly recognized as a national priority." The report also suggests growing statewide breastfeeding coalitions with public websites for educational purposes.

• Support in child care settings. Child care facilities play an important role in breastfeeding promotion. States that lack regulations that support breastfeeding at child care facilities are encouraged to meet best-practice national standards.

Read the report in its entirety to get all the details. Does any of this data surprise you? Is your state's breastfeeding rates above the national average? I'd love to hear what you think has made the difference for you and/or for other women in your state or hometown. And for those whose state's duration rates are far from ideal, what do you think needs to change?