Reaching the goals of "Healthy People 2000" regarding breastfeeding

The Healthy People 2000 objectives for breastfeeding were to move the breastfeeding initiation rate to 75% from 54% and the breastfeeding continuation rate to 50% at age 6 months from the 1988 baseline of 21%. The 1996 data indicated that the goal will not be met either for initiation or duration in spite of governmental strategic planning and coalition building, the acknowledgement of the benefits of breastfeeding by professional associations, the implementation of the Baby-Friendly Hospital Initiative, or the efforts of individual health professionals. Clearly, there is still work to be done. The Baby-Friendly Hospital Initiative was organized within Baby-Friendly USA too late in the decade to have had any impact on the 1996 data. It may take an additional decade before sufficient hospitals and birthing centers are engaged in the process to make a measurable difference in duration. Work protection legislation was not introduced until 1998. A national breastfeeding committee was not formed until 1998. National breastfeeding promotion programs were still either in the planning stage or in early stages of implementation in 1996. There is no paid maternity leave guaranteed by legislation for women in the United States. The International Code on Marketing has not been addressed, except to propose ways of examining the issue. The blueprints developed by the Surgeon General's Workshop on Breastfeeding and the Call for Action workshop enumerated strategies that will be carried over to the 2010 objectives. New blueprints will be developed to meet the 2010 goals, but it is not enough to strategize and plan. The substantive advantages of breastfeeding make accomplishment of the goals imperative if we are to achieve "health for all."