The first clear evidence that the federal government was increasing its attention to breastfeeding appeared in the report Promoting Health/Preventing Disease: Objectives for the Nation (DHHS, 1980). That publication included an explicit objective to increase the proportion of breastfed infants. The target breastfeeding rates were 75% at hospital discharge and 35% at 6 months post partum. At that time, the Maternal and Child Health Program of the U.S. Department of Health and Human Services (DHHS) was charged with the responsibility of developing national policy related to lactation and breastfeeding and of convening a national group periodically to advise them on specific issues.

Lactation research received increased attention in 1982, when the National Institute of Child Health and Human Development (NICHD) sponsored a conference that dealt primarily with techniques for collection, analysis, and storage of human milk—prerequisites for meaningful studies as well as for milk banking. This was followed by other lactation research conferences (see, for example, FASEB [1984] and Jensen and Neville [1985]).

In 1984, before it was recognized that national rates of breastfeeding had begun to decline (see Chapter 3), Surgeon General C. Everett Koop convened a workshop on Breastfeeding and Human Lactation (DHHS, 1984) and said, ''We must … identify and reduce those barriers which keep women from initiating or continuing to breastfeed their infants" (DHHS, 1984, p. 6). The following six recommendations were made at that workshop to facilitate progress toward the previously mentioned 1990 breastfeeding objective:

  • Improve professional education in human lactation and breastfeeding

  • Develop public education and promotional efforts

  • Strengthen the support for breastfeeding in the health care system

  • Develop a broad range of support services in the community

  • Initiate a national breastfeeding promotion effort directed to women in the world of work

  • Expand research on human lactation and breastfeeding (DHHS, 1985, p. 1).

The publication Followup Report: The Surgeon General's Workshop on Breastfeeding & Human Lactation (DHHS, 1985) summarizes many of the activities that emanated from the recommendations made at the 1984 workshop. Attention to nutrition during lactation fell primarily under the research recommendation.

Between 1985 and 1989, NICHD sponsored three additional lactation-related workshops: the first one on the effects of maternal and environmental factors on human milk (Hamosh and Goldman, 1986), the next one on the effects of milk on the recipient infant (Goldman et al., 1987), and the third one on future needs for human milk research. Statements issued from these workshops and through other forums (e.g., Goldman and Garza, 1987) have clearly indicated that there is a need for additional study of nutrition during lactation and how it may influence the health of both the mother and her infant.

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