BOX 4-1

Areas Where Breastfeeding Research Is Needed

  • Protection

    • Artificially inverted economic pressures related to formula use

    • States’ dependency on formula rebates

  • Promotion

    • New WIC food package for women who breastfeed exclusively: content, presentation, promotion, and implementation

    • Timing and location of contact

    • Continuity of care

  • Support

    • Messaging and how WIC is understood by clients

    • Peer counselors (versus lactation consultants versus other): training, time available, skills for support, and cost-effectiveness

    • Lactation consultants: sufficiency of numbers and availability

  • Impact of formula feeding on health


Presenter: Karen Bonuck

Lessons from Previous Research

Bonuck began by highlighting lessons for WIC that she had gleaned from a 2008 review by the U.S. Preventive Services Task Force (USPSTF, 2008) of the effects of breastfeeding interventions on initiation, duration, and exclusivity of breastfeeding. Those lessons include:

  1. Study quality matters.

  2. The continuity of care (breastfeeding interventions) over the prenatal and postnatal periods matters.

  3. The focus should be on exclusive breastfeeding rather than any breastfeeding.

  4. The effects of professional and lay support need to be compared.

Based on preliminary evidence from an ongoing study by her group, Bonuck identified a number of key elements of successful interventions to support breastfeeding:

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