Policy Development for the Use of Human Milk and Breastfeeding in the United States

Selection to the inaugural cohort of the American Academy of Nursing’s Jonas Health Policy Scholar Program (2014-2016) provided the opportunity to learn from and collaborate with nurse leaders from across the globe responsible for the transformation of nursing, health and health care. This presentation will share the experiences of mentorship in policy scholarship, organizational leadership, and advocacy through work with the Expert Panel on Breastfeeding. This group serves the Academy as a key catalyst for innovations in research, education and policy regarding the use of human milk and breastfeeding.

The implementation of the Affordable Care Act in 2010, followed by the Call to Action to Support Breastfeeding by the U.S. Surgeon General provided a political framework upon which the Expert Panel focused efforts transform lactation practices within hospitals, workplaces and communities. The Expert Panel on Breastfeeding crafted policy briefs, calls to action, and expert testimony to leverage global evidence-based knowledge to improve lactation practices in all settings across the U.S. These policy efforts addressed the changing role of women in society, including: the increased proportion of women in the military; alternative family and community structures; and variations in culture and beliefs – all of which challenge the long-standing Victorian views on breastfeeding practices.

The experience as a Jonas Policy Scholar accelerated personal development as an emerging leader and resulted in numerous scholarly opportunities from publication to national advocacy and advancement of a trajectory of research focused on human lactation. Three areas of interest emerged from a publication produced with Expert Panel that proposed breastfeeding as a behavior to mitigate the harmful effects of toxic stress. Discussion of each project will highlight how policy may be used to bridge the gap in health care experienced after hospital discharge. The first project identifies the need for improved implementation of institutional breastfeeding policy in workplace settings, the second attempts to identify characteristics necessary for policy to support breastfeeding women and newborns living in homeless shelters and the final project addresses policy development to achieve better outcomes for infants born to women who are incarcerated.

An important lesson learned from working with the Expert Panel on breastfeeding has been the understanding that policies to redesign the health care system are insufficient to improve the national health of women and newborns. Rather, the investment in the development of future leaders through programs like the Jonas Scholar Program may spur innovation of solutions, cross-collaboration and advocacy efforts dedicated to providing better care and improved, cost-effective breastfeeding outcomes.